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D Densow

Publications and source records attributed to D Densow.

9 recordsLinked to original sources
PubMed1999

Internet-based physician's workbench as user interface for a central medical case repository.

Two World Health Organization Radiation Medical Emergency Preparedness and Assistance Network centers have constructed a standardized central repository of acute radiation syndrome case histories. The case histories are stored on a database server. Radiation protection centers can remotely access the database by user-friendly client software over the Internet. Physicians can use the medical information system to retrieve similar case histories for decision support, to improve their medical knowledge by inspecting real case histories, and for research on the acute radiation syndrome. The system architecture is presented and it is shown in detail how the information system can be employed to deliver medical decision support. Dialogue-response times over narrow-bandwidth Internet connections are better than when using conventional World-Wide-Web technology. However, the latter does not require the installation of client software other than a browser. A Java applet as client could combine the advantages of the two approaches.

Acute Disease↗
PubMed1998

A pragmatic implementation of medical temporal reasoning for clinical medicine.

In most development tools for knowledge-based systems object-property-value-triples are the basic ontological representation. We have extended this approach for temporal reasoning by replacing the values with time-objects. A time-object is a combination of a value with a time-point or a time-interval. By preserving the object-property-value-triples basic artificial intelligence techniques can be applied without modifications in the temporal case. The greater complexity of temporal inferences is compensated by a blackboard control architecture enabling small knowledge-sources. The control of the strategic reasoning is in accordance with the select and test model. A prototype of a knowledge-based advisor for the acute radiation syndrome has been implemented and partially evaluated. Due to the affected proliferative tissues it is a strongly time-oriented medical domain.

Acute Disease↗
PubMed1998

Providing dermatological photographs using the multimedia extension of the international computer database for radiation accident case histories.

The World Health Organisation (WHO) Radiation Emergency Medical Preparedness (REMPAN) centres have built up the International Computer Database for Radiation Accident Case Histories (ICDREC) to document the medical treatment of acute radiation syndrome (ARS) patients. Images play an increasing role as complementary information beside text and numerical data in medicine. In particular, retrieval and display of digitised skin photographs serve to improve patient care, medical education and scientific analysis concerning the cutaneous radiation syndrome (CRS). The ICDREC has been built up as a client/server system. Particular focus has been set on using commercial off-the-shelf software components. All the medical data including the multimedia data are stored in a relational database system. The database can be accessed by inexpensive personal computers in the physician's workplace. Retrieval of one photograph via local area network (LAN) requires approximately 3 s. Authorised institutions can access the database via the Internet. The current state of the ICDREC multimedia component is illustrated with the skin lesion treatment of a Chernobyl patient. An example is given on how the workflow in a dermatology department is supported by the ICDREC.

Databases, Factual↗
PubMed1998

A multimedia database for dermatology.

The World Health Organisation (WHO) Radiation Emergency Medical Preparedness (REMPAN) centres have built up the International Computer Database for Radiation Accident Case Histories (ICDREC) to document the treatment of acute radiation syndrome (ARS) patients. Radiation induced skin lesions may cause severe late effects in radiation accident patients. Dermatological multimedia documentation is included into the ICDREC. In particular, retrieval and display of digitised skin photographs and medical reports serves to improve patient care, medical education, and scientific analysis concerning the cutaneous radiation syndrome (CRS). The database has been built up as a client/server system. A particular focus has been set on using commercial off-the-shelf software components. The medical data including the multimedia data are stored in a relational database system. The database can be accessed by inexpensive personal computers in the dermatologist's workplace. Authorised institutions can access the database via the Internet. Retrieval of one skin photograph via local area network (LAN) requires approximately 3 seconds. The current state of the application is illustrated with the skin lesion treatment of a Chernobyl patient. An example is given on how to access the ICDREC from a dermatologist's desktop personal computer. The discussion focuses on the advantages of storing the textual and pictorial data in one central database to be accessed from different care centres and how the results can be generalised for medical multimedia information systems.

Dermatology↗
PubMed1997

Criteria for the selection of radiation accident victims for stem cell transplantation.

The management of acute radiation syndrome in persons inadvertently exposed to total-body irradiation greatly benefits from the experience gained in previous clinical management situations. Within the framework of exposure to high doses, one of the most critical issues is the question of whether hematopoietic stem cell transplantation is indicated. A valid answer can be given with appropriate accuracy based on a thorough analysis and evaluation of all accessible case histories. Based on the clinical evaluation of patients severely affected with acute radiation syndrome, the following recommendations may be issued. There is limited indication for stem cell transplantation when there is accompanying severe radiation damage to organ systems other than the hematopoietic system. The optimum duration of pancytopenia can be estimated using the biomathematical model introduced in this article.

Acute Disease↗
PubMed1997

Internet access to a medical case repository for teaching and analysis.

The acute radiation syndrome is a rare disease. Teaching its treatment and the achievement of scientific progress require a sufficient number of accessible case histories. An information system for standardized recording of acute radiation syndrome case histories has been established in the framework of the World Health Organization Radiation Medical Emergency Preparedness and Assistance Network Centers. The information system has been realized in client/server architecture. The centers are able to access the database by easy to use graphical user interfaces via the Internet. Focusing on optimization of network traffic and flexible information retrieval the hypertext transfer protocol has not been applied. At the moment the system is tested on the campus of the University of Ulm before it will be installed at the other centers.

Acute Disease↗
PubMed1995

Are there 'common denominators' in different radiation exposure scenarios as a target for predictive assessment?

The first panel discussion of the International Searle-Foundation Workshop on Biological Indicators of Exposure to Ionizing Radiation was directed at identifying 'common denominators' for the development of somatic late effects. The presented accidents were analyzed in terms of occurrence of total body or partial body irradiation, external or internal contamination, onset of early signs or symptoms of acute radiation syndrome, reduction of life expectancy, and occurrence of neoplastic or non-neoplastic disorders. Evidence of radiation effects was sought in the victims' cell systems and in any cellular or molecular response to ionizing radiation, and whether other complicating factors could be established. From the results presented during the meeting, as well as from a review of the relevant literature, it is, however, rather unlikely that a single parameter will emerge by which the late effects of ionizing radiation in man can be determined easily. Instead, a couple of acute and chronic effects of exposure to ionizing radiation could be identified which are more or less common to any given exposure scenario.

Cataract↗
PubMed1995

Necessity of extensive comprehensive databases for the improvement and test of diagnostic guidelines.

Diagnostic guidelines seem to be promising for improving medical care. One aspect of a diagnostic guideline for the acute radiation syndrome has been tested against an extensive case history database. Subsequently, the guideline has been optimized for a small set of case histories. The improved performance has then been proven by a test against the rest of the case history database.

Diagnosis, Computer-Assisted↗