WO1993017614A1 - Appareil electronique servant a localiser des lesions dans le systeme nerveux peripherique - Google Patents

Appareil electronique servant a localiser des lesions dans le systeme nerveux peripherique Download PDF

Info

Publication number
WO1993017614A1
WO1993017614A1 PCT/EP1993/000539 EP9300539W WO9317614A1 WO 1993017614 A1 WO1993017614 A1 WO 1993017614A1 EP 9300539 W EP9300539 W EP 9300539W WO 9317614 A1 WO9317614 A1 WO 9317614A1
Authority
WO
WIPO (PCT)
Prior art keywords
muscles
test
electronic apparatus
test muscles
display means
Prior art date
Application number
PCT/EP1993/000539
Other languages
English (en)
Inventor
Paolo Fardin
Original Assignee
Paolo Fardin
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Paolo Fardin filed Critical Paolo Fardin
Priority to AU36319/93A priority Critical patent/AU3631993A/en
Publication of WO1993017614A1 publication Critical patent/WO1993017614A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/45—For evaluating or diagnosing the musculoskeletal system or teeth
    • A61B5/4519—Muscles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons

Definitions

  • the object of this invention is an electronic apparatus which, in function of motion deficits ascertained by a physician (or anyway by a qualified operator) in suitably chosen muscles (in the following referred to as "test muscles"), permits to make rapidly a first diagnosis, localizing with good success chances the probable sites of lesions of the peripheral nervous system which constitutes the brachial plexus or the lumbosacral plexus respectively.
  • test muscles one means therefore muscles of the upper or lower limb respectively, whose efficiency can be considered as an indication of the functionality of the nervous branch (of the peripheral nervous system which constitutes the brachial plexus and the lumbosacral plexus respectively), by which they are innervated.
  • the physician shall evaluate each time the opportunity of confirming by means of more accurate electromyografical examinations the first diagnosis made by means of the apparatus object of this invention.
  • the electronic apparatus object of this invention is suitable for displaying at least two anatomic diagrams which show (in the various steps starting from the motor roots up to the twigs) the peripheral nervous system which constitutes the brachial plexus and the lumbosacral plexus respectively: for each step (corresponding to a branching point of the relevant diagram), the anatomic diagram comprises a case containing the initials that identify the test muscles (of the upper limb and the lower limb respectively), innervated by the corresponding portion of the peripheral nervous system.
  • a number of keys permits to select and mark test muscles that show a motion deficit; the site of the lesion is localized in the case where all test muscles are marked whose motion deficit is considered as significant because of the particular lesion level.
  • the electronic apparatus will be described in detail with reference to an embodiment consisting of an electronic ruler equipped with a commercial-type display without graphic capabilities: anyway, without overstepping the field of this invention, a second embodiment of said apparatus is possible, said second embodiment consisting of an electronic ruler equipped with a display (for instance a liquid crystal colour display) having graphic capabilities, such as to permit to display, among other things, pictures utilized for the so-called "sensorial analysis".
  • a display for instance a liquid crystal colour display
  • Any physician, general practitioner or specialist has often to examine patients showing motion deficits of muscles or muscle bundles which are most probably due or anyhow associated to lesions of the peripheral nervous system.
  • diagnostic techniques based on the clinical examination of the patient and/or the results of even very complex electromyographical examinations
  • Many diagnostic techniques are known and widely used in medicine, which allow to evaluate the functionality of the peripheral nervous system which constitutes the brachial plexus and the lumbosacral plexus respectively: such diagnostic techniques can be utilized to localize the site of a possible nervous lesion causing the motion deficit ascertained in the patient's muscles.
  • the peripheral nervous system has a very complex structure, branched and intricate (suffices to consider as a mere example the fact that muscles of a same body region may be innervated by fibres coming from several nervous roots): in fact, to reach the muscles of the limbs, the axons follow a path which is not only long but also complicated by their redistribution in the plexus mingling, especially that of the brachial plexus.
  • a muscle motion deficit may be due to a lesion localized in very different sites of the peripheral nervous system, and a lesion may cause motion deficits of different muscles. depending on the nervous trunk involved.
  • Knowing the level and the exact localization of a lesion is therefore essential for an accurate diagnosis, an adequate therapy and a realistic prognosis.
  • a possible approach to the problem could be to identify the deficient muscles and the normal ones, and starting from this combination try to localize the site of the lesion, remembering the path and the minglings of the axons that innervate the alterated muscles: such an approach requires to be familiar with such pathology and a certain mnemonic effort, unless one can resort to diagrams representing the peripheral nervous system; referring to such diagrams - if they are complete - is generally a complex and difficult operation.
  • the electronic apparatus object of this invention allows to obviate such drawbacks and to make in a simple and rapid way a first diagnosis (having good chances of being correct) based on the motion deficits ascertained on the patient's muscles, sparing the physician the hard and boring comparison, integration and synthesis work as described above: in a particular embodiment, the apparatus according to this invention allows to localize the probable site of possible nervous lesions also through the analysis of the sensorial disturbances complained by the patient.
  • the invention consists in an electronic apparatus for localizing, at least in function of motion deficits ascertained in test muscles of the upper limb and the lower limb respectively, the site of lesions of the peripheral nervous system which constitutes the brachial plexus and the lumbosacral plexus respectively.
  • Such electronic apparatus comprises means suitable for displaying at least:
  • each case contains the initials of the test muscles that are innervated by a portion of the peripheral nervous system, whose motion deficit is (or may be) associated to a lesion of said portion of the peripheral nervous system;
  • Fig. 1 is a diagram of the ruler according to this invention.
  • - Fig. 2 is a perspective view of the ruler of Fig. 1, showing its book-like shape;
  • Fig. 3 is a logic diagram, suitable to better illustrate the working of the ruler according to this invention.
  • - Fig. 4 and 5 are examples of some of the explanatory pictures included in the instruction handbook supplied with the ruler;
  • - Fig. 6 and 7 are examples of some of pictures utilized for the so-called "sensitive analysis”.
  • Fig. 1 is the diagram of an electronic ruler realized according to this invention and constituted by two valves folding like a book, as illustrated more clearly on Fig. 2.
  • Fig. 1 on the internal surface of the first valve 1, which constitutes the ruler's lid, a list (extrapolated from an instruction handbook not illustrated in the pictures for simplicity) of the test muscles that innervate the upper limb and the lower limb respectively is given; near each test muscle the initial is specified which identifies said test muscle in the two anatomic diagrams of the second valve 2 which comprises, in order,
  • a first area 3 comprising the initials of the upper limb test muscles; some of said initials have been grouped, especially for mnemonic convenience, according to the three main nervous trunks (median, ulnar and radial nerve) by which said test muscles are innervated;
  • first anatomic diagram 4 representing the peripheral nervous system which constitutes the brachial plexus, with the indication of the motor roots and of the various nervous trunks formed in succession up to the twigs: at each branching point and in correspondence of each twig, the first anatomic diagram 4 shows a case containing the initials of the test muscles of the upper limb whose motion deficits evidence the existence of a lesion localized in the branching point or in the twig respectively;
  • a second area 5 containing the initials of the lower limb test muscles some of said initials have been grouped, especially for mnemonic convenience, according to the two main nervous trunks (internal and external popliteal hischiatic nerve) by which said test muscles are innnervated;
  • a second anatomic diagram 6 representing the peripheral nervous system which constitutes the lumbosacral plexus, with the indication of the motor roots and of the various nervous trunks formed in succession up to the twigs: at each branching point and in correspondence of each twig, the second anatomic diagram shows a case containing the initials of the test muscles of the lower limb whose motion deficits evidence the existence of a localized lesion in the branching point or in the twig respectively;
  • the first, second and third areas (3, 5 and 7) and the first and second anatomic diagrams (4, 6) are shown by means of a display 9 (or any other equivalent display means) which can be found on the market and has no graphic capabilities; according to an embodiment that will be described later on, the ruler is equipped with a display provided with advanced graphic capabilities, and the physician can recall on the display of the ruler one of the anatomic diagrams (4, 6), either individually or together with the relevant lists of test muscles (3, 5); the evaluation of the possible motion deficit of each test muscle can be displayed on the display either by a panel analogous to the third ruler area (7) or by means of the colour of the muscle initial in all the cases of the anatomic diagram in which such muscle shows up.
  • the lesion site is displayed by permanently switching on the case in which all and only the test muscles are marked whose motion deficit is considered to be significant for the particular lesion type;
  • the highlighted case comprises, besides all the marked test muscles, also other (unmarked) test muscles whose possible motion deficit may not be significant for the particular lesion type.
  • the following tables are an example of combinations of normal (unmarked) muscles, alterated ("A"-marked) muscles, and indifferent ("X"-marked) muscles, which are relevant for the various sites of possible lesions; in both tables, the initials of test muscles are indicated on the abscissa axis, and the corresponding motor roots and/or nervous trunks are indicated on the ordinate axis.
  • Fig. 2 is a perspective view showing the book-like structure of a ruler realized according to this invention.
  • Fig. 2 shows the two valves 1, 2 connected to one another, the function keys 8 and the display 9, while the instruction handbook (containing, among other things, the list of test muscles and the relevant initials shown on Fig. 1, and a set of pictures, such as the ones shown as examples on Fig. 4 and 5, which indicate how the physician should examine the individual test muscles to make a correct evaluation of the possible motion deficit) placed inside the instruction handbook (containing, among other things, the list of test muscles and the relevant initials shown on Fig. 1, and a set of pictures, such as the ones shown as examples on Fig. 4 and 5, which indicate how the physician should examine the individual test muscles to make a correct evaluation of the possible motion deficit) placed inside the instruction handbook (containing, among other things, the list of test muscles and the relevant initials shown on Fig. 1, and a set of pictures, such as the ones shown as examples on Fig. 4 and 5, which indicate how the physician should examine the individual test muscles to make a correct evaluation of the possible motion deficit) placed inside the instruction handbook (containing, among other things
  • first valve 1 and the diagrams (first area 3, first anatomic diagram 4, second area 5, second anatomic diagram 6 and third area 7), realized on display 9, have been omitted for simplicity of the graphic representation.
  • the anatomic diagram to be utilized is chosen and the initial of the first test muscle is highlighted (for instance, GD muscle for the upper limb; the three heads of the trapezius muscle, TRS, TRM and TRT have not ben indicated explicitly, as they do not make part of the anatomic diagram of the brachial plexus) in the corresponding case of the test muscles (first area 3 or second area 5).
  • the initial of the selected test muscle flashes in all the cases in which it is contained, pointing out therefore its path: if the test muscle is normal, the relevant initial switches off when one goes on to the next (or the preceding) test muscle by means of the special key > (or ⁇ ).
  • the ruler object of this invention takes into account, in its analysis, some special conditions.
  • test muscles (BB, ABP, RA and TA) are comprised in two different cases for the same radicular level, while on the other hand, if a complex lesion occurs, the contemporaneous involvement of all the test muscles of several cases (for instance C5-C6-C7 and TPS and TPM) may occur; the normal/alterated condition of the GD test muscle causes one to decide for either of the level.
  • the normal/alterated evaluation of a test muscle and the severity of the observed motion deficits can be modified at any moment, as the system stores the evaluation of each individual test muscle, and therefore any error can be always corrected.
  • the ruler switches off automatically, after a preset time from the last key pushing, holding the data previously set: therefore, by switching on the ruler, one can resume the examination procedure from where it had been interrupted.
  • Fig. 3 The logic diagram of Fig. 3 is a "translation" in a graphic form of the ruler working according to the above described invention.
  • step 1 When the ruler is switched on (key ON, step 1), the last anatomic diagram used (concerning either the upper limb or the lower limb) is displayed again (step 2, US), as it appeared at the moment it had been switched off (we remind that on switching off the ruler, all the data previously set are stored): this allows the physician to resume the examination procedure (step 10, CM) from where it had been interrupted (for any reason whatever).
  • step 4 the physician starts up a new examination procedure, initializing the ruler (step 4, INIT), i.e. resetting the storage and the logic circuit which scans muscles cyclically and setting the evaluation of the motion deficit equal to 5 (normal muscle).
  • a function key for instance key ON; step 3, TP
  • the anatomic diagram of the upper limb (area 4, fig, 1) is displayed (step 5, VIS): if the physician should wish to examine the peripheral nervous systems that innervates the lower limb (area 6, Fig. 1), he pushes (step 6, AI) a function key (for instance the key ⁇ ) to display (step 7, SV) the relevant anatomic diagram.
  • the initial of the first scanned muscle highlights (step 8, ESM) in the list of the test muscles of said limb (area 3 or 5. Fig. 1) and flashes (step 9. LSM) in all the cases of the anatomic diagram that contain it; if the muscle is judged to be "normal”, one goes on (step 10, CM) to the following muscle (or to the preceding one), pushing the key ⁇ or the key >: the initials of the just examined muscle switch off, those concerning the new muscle to be examined flash up (step 11, NM), while the initials of possible muscles already found to be deficient remain permanently switched on (step 12, SA) and the system goes back to step 10.
  • step 13 VL if such evaluation is correct for the tested muscle, the physician confirms it by pushing the key ENT (step 14, CV), the system associates it (step 15, VC) to the muscle under examination and switches on permanently the relevant initial in the anatomic diagram before going back to step 10; if the "current" evaluation is wrong, the physician modifies it by pushing the key ⁇ or the key > (any new pushing of either key causes the new evaluation to flash; step 16, VM) until the exact value is reached, which is confirmed by means of the key ENT (step 14, CB).
  • the "current" evaluation of the motion deficit keeps to the initial value (no deficit) as long as normal muscles are examined, whose scanning is therefore particularly rapid.
  • step 10 The physician selects (step 10, CM) another muscle and the above process is repeated until (at the end of the examination or whenever he deems it suitable) he pushes the key D to activate the function of evaluation of the lesion level.
  • the nervous trunks that may be the sites of lesions are displayed (step 17, VT), which correspond to cases that contain the initials of alterated test muscles (evaluation ⁇ 5), taking into account the possible multiple lesions, as per the preceding Tables I and II; if this diagnosis level is deemed sufficient (step 18, FE), the examination ends, otherwise the physician (step 19, CE)
  • step 20 NV
  • step 21, VTN VTN
  • step 21, VTN VTN
  • Fig. 4 and 5 show respectively the set of explanatory pictures which shows the physician how the individual test muscle of the upper limb and the lower limb respectively should be examined to make a correct evaluation of the possible motion deficit: under each explanatory picture the muscle tested each time is indicated by the corresponding initial listed on Fig. 1, taken, in its turn, from the instruction handbook.
  • the ruler above described with reference to the attached drawings may be equipped with a display having advanced graphic capabilities (for instance, a liquid crystal colour display or any other equivalent display means), suitable to display (on request by the physician) anatomic diagrams, test muscles lists, explanatory pictures as the ones illustrated as mere examples on Fig. 4 and 5, pictures (as those of Fig. 5 and 6) utilized for the so-called "sensitive analysis” (which will be disclosed later on) and other possible information which can be displayed in graphic form: this makes unnecessary the printed information handbook which can be omitted.
  • a display having advanced graphic capabilities for instance, a liquid crystal colour display or any other equivalent display means
  • the first test muscle list at least part of the test muscles of the upper limb (and the corresponding identification initials) are grouped according the three main nervous trunks (median, ulnar and radial nerve), by which the above test muscles are innervated; in the same way, in the second test muscle list at least part of the test muscles of the lower limb (and the corresponding identification initials) are grouped according to the two main nervous trunks (internal and external popliteal hischiatic nerve) by which the above test muscles are innervated.
  • the diagnosis procedures are not different from the ones above described with reference to Fig. 2 and 3; however, in making the diagnosis, the physician is helped by the fact that, by displaying the anatomic diagram of the limb to be examined (either individually or associated to the relevant test muscle list), he can refer (if and when he should deem it necessary and/or helpful) to the relevant explanatory pictures (Fig. 4 and 5) recalled on the display from the ruler memory and go back after the reference to the anatomic diagram of the tested limb.
  • condition and possible motion deficit of such test muscle may be either highlighted by means of a panel analogous to the third area 7 of the ruler of Fig. 1, or (preferably) visually indicated by means of the colour of the initial of said test muscle in all of the cases of the anatomic diagram in which such muscle appears: this allows the physician to evaluate at first sight the whole picture, to timely notice any possible inconsistency (by repeating, if necessary, the evaluations, if any, that do not appear to be consistent with the whole picture) and/or to make a first provisional diagnosis, to be confirmed by activating the function "EVALUATION OF THE LESION LEVEL" as described above.
  • the ruler having advanced graphic capabilities also permits to perform at any moment, either during the above described diagnosis procedures or independently from them, the so-called “sensitive analysis” (more exactly: “analysis of the topography of the sensory disorder”).
  • the physician recalls from the ruler memory and displays a set of pictures (as those illustrated as mere examples on Fig. 5 and 6) each of which schematically shows the cutaneous region innervated by the nerve indicated under the same picture, and compares such regions with those concerned by the possible sensory disorder complained by the patient to localize the presumably impaired nerve.
  • Sensitive analysis permits to preliminarily orientate the diagnosis procedures based on motion deficits and/or to confirm the diagnosis obtained by means of said procedures, but it is particularly advantageous whenever no motion deficits are found, as in such case it allows the physician to detect a damage which cannot be localized by means of the above described diagnosis procedures limited to the sensitive nervous fibres only.
  • the use of a computer allows to store, process, compare among one another (also to research and/or statistical purposes) and anyway to manage at will the data however acquired by means of the above diagnosis procedures and to integrate such diagnostic data (pre-processed, if necessary) with further data (first name, name, age, anamnesis, etc.) concerning the patient, in order to set up and/or update a computer clinical record of the patient, realized by means of one of the programmes for the management of medical consulting rooms that are available on the market; such management programmes and the computer graphic programmes for displaying the pictures on the monitor are not described herein, being well known to any technician of the sector.
  • a technician can change the structure and/or the working of the electronic apparatus subject of this invention to adapt it to the individual needs, as well as introduce any further change or improvement suggested by the normal experience and the natural evolution of the art.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Physics & Mathematics (AREA)
  • Public Health (AREA)
  • Biophysics (AREA)
  • Pathology (AREA)
  • Engineering & Computer Science (AREA)
  • General Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Surgery (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Dentistry (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Rheumatology (AREA)
  • Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)

Abstract

L'invention se rapporte à un appareil électronique qui, en fonction de déficiciences motrices détectés dans des muscles testés, permet de localiser les sites de lésions dans le plexus brachial et le plexus lombosacré du système nerveux central. L'appareil électronique convient à l'affichage d'au moins deux diagrammes anatomiques (4, 6) représentant les deux plexus: à chaque point d'embranchement desdites figures on place un compartiment correspondant aux branches significatives contenant les muscles testés (du membre supérieur et inférieur respectivement), innervés par la partie correspondante du système nerveux. Des touches de fonction (8) permettent à l'utilisateur de choisisr et de marquer les muscles testés présentant une déficience motrice; le compartiment contenant tous les muscles testés dont la déficience motrice est considérée comme étant significative pour une lésion spécifique, est identifié comme le site de la lésion. Selon un mode de réalisation particulier, l'appareil permet de localiser le site probable des lésions possibles du système nerveux par l'analyse des plaintes sensorielles du patient.
PCT/EP1993/000539 1992-03-12 1993-03-10 Appareil electronique servant a localiser des lesions dans le systeme nerveux peripherique WO1993017614A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU36319/93A AU3631993A (en) 1992-03-12 1993-03-10 Electronic apparatus for localizing lesions of peripheral nervous system

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
ITMI92A000574 1992-03-12
ITMI920574A IT1254265B (it) 1992-03-12 1992-03-12 Regolo elettronico tascabile atto ad individuare la sede di lesioni del sistema nervoso periferico

Publications (1)

Publication Number Publication Date
WO1993017614A1 true WO1993017614A1 (fr) 1993-09-16

Family

ID=11362395

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP1993/000539 WO1993017614A1 (fr) 1992-03-12 1993-03-10 Appareil electronique servant a localiser des lesions dans le systeme nerveux peripherique

Country Status (2)

Country Link
IT (1) IT1254265B (fr)
WO (1) WO1993017614A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1609425A1 (fr) * 2003-03-10 2005-12-28 Hisaki Kamo Systeme permettant de realiser un diagnostic topique des nerfs et une etude neuroanatomique

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0303930A2 (fr) * 1987-08-13 1989-02-22 Synthes Ag Chur Système expert
GB2218546A (en) * 1988-05-12 1989-11-15 John Percival Reid Medical diagnosis aid
WO1991008702A1 (fr) * 1989-12-20 1991-06-27 Paolo Fardin Tableau de poche permettant de localiser les lesions du systeme nerveux peripherique
EP0470837A2 (fr) * 1990-08-10 1992-02-12 Gregory Allen Appareil autonome d'aide à l'examen et de stockage d'information

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0303930A2 (fr) * 1987-08-13 1989-02-22 Synthes Ag Chur Système expert
GB2218546A (en) * 1988-05-12 1989-11-15 John Percival Reid Medical diagnosis aid
WO1991008702A1 (fr) * 1989-12-20 1991-06-27 Paolo Fardin Tableau de poche permettant de localiser les lesions du systeme nerveux peripherique
EP0470837A2 (fr) * 1990-08-10 1992-02-12 Gregory Allen Appareil autonome d'aide à l'examen et de stockage d'information

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1609425A1 (fr) * 2003-03-10 2005-12-28 Hisaki Kamo Systeme permettant de realiser un diagnostic topique des nerfs et une etude neuroanatomique
US7510525B2 (en) * 2003-03-10 2009-03-31 Hisaki Kamo System for topical nerve diagnosis and neuroanatomical study
EP1609425A4 (fr) * 2003-03-10 2009-05-27 Hisaki Kamo Systeme permettant de realiser un diagnostic topique des nerfs et une etude neuroanatomique

Also Published As

Publication number Publication date
IT1254265B (it) 1995-09-14
ITMI920574A0 (it) 1992-03-12
ITMI920574A1 (it) 1993-09-12

Similar Documents

Publication Publication Date Title
US7966062B2 (en) Multi-color overlay system for processing and displaying electrocardiac signals
US4634243A (en) Glaucoma detection utilizing pattern discrimination test
Timberlake et al. Reading with a macular scotoma. II. Retinal locus for scanning text.
US5916163A (en) Graphical user interface for use with multiple electrode catheters
US7751874B2 (en) Display for ECG diagnostics
US3883234A (en) Computer controlled apparatus for automatic visual field examination
US4731725A (en) Data processing system which suggests a pattern of medical tests to reduce the number of tests necessary to confirm or deny a diagnosis
CN103649961B (zh) 对图像数据中的发现的解剖学标记的方法
US6049732A (en) Electrophysiological interface system for use with multiple electrode catheters
WO1996010368A3 (fr) Appareil et procede pour des interventions neurochirurgicales stereotactiques
JPH04500168A (ja) 特に神経外科手術を誘導するための方法及び装置
US3705003A (en) Computer controlled method for automatic visual field examination
US20040138574A1 (en) Methods and apparatus for enhancing diagnosis of myocardial infarctions
WO1993017614A1 (fr) Appareil electronique servant a localiser des lesions dans le systeme nerveux peripherique
US20040022424A1 (en) Method, device and software for separating the individual subjects of an anatomical structure segmented from 3d datasets of medical examination procedures
Brunelli et al. Preoperative assessment of the adult plexus patient
Valk Randomized controlled trials are not appropriate for imaging technology evaluation
CN115886999A (zh) 一种基于仿真虚拟技术的手术引导方法、装置和控制系统
MacLeod et al. ECG measurement and analysis
US6643539B2 (en) Electrocardiogram system for synthesizing leads and providing an accuracy measure
JP2003111733A (ja) 標本検査システム
Parker et al. Effect of low-intensity hippocampal stimulation on spatial versus working memory in rats.
JP2000148895A5 (ja) 電子カルテシステム及び電子カルテ表示方法
BG1Y1 (bg) Диагностично помагало за локализиране пораженията на периферната нервна система
Smith Colposcopy

Legal Events

Date Code Title Description
AK Designated states

Kind code of ref document: A1

Designated state(s): AU BB BG BR CA CZ FI HU JP KP KR LK MG MN MW NO NZ PL RO RU SD SK UA US

AL Designated countries for regional patents

Kind code of ref document: A1

Designated state(s): AT BE CH DE DK ES FR GB GR IE IT LU MC NL PT SE BF BJ CF CG CI CM GA GN ML MR SN TD TG

DFPE Request for preliminary examination filed prior to expiration of 19th month from priority date (pct application filed before 20040101)
EX32 Extension under rule 32 effected after completion of technical preparation for international publication

Ref country code: BY

LE32 Later election for international application filed prior to expiration of 19th month from priority date or according to rule 32.2 (b)

Ref country code: BY

122 Ep: pct application non-entry in european phase
NENP Non-entry into the national phase

Ref country code: CA