Building an informatics training program for pathology.
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Electronic Data Processing↗
Biomedical subjects
E Schubert
Publications and source records attributed to E Schubert.
A pathologist-designed imaging system for anatomic pathology signout, teaching, and research.
Pathology images are derived from gross surgical specimens, light microscopy, immunofluorescence, electron microscopy, molecular diagnostic gels, flow cytometry, image analysis data, and clinical laboratory data in graphic form. We have implemented a network of desktop personal computers (PCs) that allow us to easily capture, store, and retrieve gross and microscopic, anatomic, and research pathology images. System architecture involves multiple image acquisition and retrieval sites and a central file server for storage. The digitized images are conveyed via a local area network to and from image capture or display stations. Acquisition sites consist of a high-resolution camera connected to a frame grabber card in a 486-type personal computer, equipped with 16 MB (Table 1) RAM, a 1.05-gigabyte hard drive, and a 32-bit ethernet card for access to our anatomic pathology reporting system. We have designed a push-button workstation for acquiring and indexing images that does not significantly interfere with surgical pathology sign-out. Advantages of the system include the following: (1) Improving patient care: the availability of gross images at time of microscopic sign-out, verification of recurrence of malignancy from archived images, monitoring of bone marrow engraftment and immunosuppressive intervention after bone marrow/solid organ transplantation on repeat biopsies, and ability to seek instantaneous consultation with any pathologist on the network; (2) enhancing the teaching environment: building a digital surgical pathology atlas, improving the availability of images for conference support, and sharing cases across the network; (3) enhancing research: case study compilation, metastudy analysis, and availability of digitized images for quantitative analysis and permanent/reusable image records for archival study; and (4) other practical and economic considerations: storing case requisition images and hand-drawn diagrams deters the spread of gross room contaminants and results in considerable cost savings in photographic media for conferences, improved quality assurance by porting control stains across the network, and a multiplicity of other advantages that enhance image and information management in pathology.
Computer Systems↗
Computer-assisted instruction in pathology residency training: design and implementation of integrated productivity and education workstations.
Computer-assisted instruction (CAI) has been significantly advanced by the development of inexpensive multimedia personal computers (PCs). As a part of efforts to integrate PC workstations as the primary interface to the anatomic pathology information system, we undertook an evaluation and implementation of image-based resident workstations drawing on technology and software now available. The goal was to develop an integrated diagnostic and research data center using PC workstations. After considerable analysis we implemented a Resident's Resource Center (RRC) to augment the training environment of the resident pathologist by providing productivity tools for the writing, research, and presentation needs of the trainee. We also provided video- and text-based education applications specifically tailored to the training pathologist. This led to the creation of two types of Windows-based workstations. The Productivity Workstation consists of a flatbed scanner, laser printer, and photorecorder connected to a 486-type PC. The Education Workstation consists of a high-resolution monitor and video disc player with bar code scanner connected to a 486-type PC. We briefly review the literature concerning CAI in pathology; outline the hardware, software, personnel and cost concerns that we faced in setting up our RRC; provide a partial list of vendors and programs currently on the market; review the software we have installed; and discuss the results of our efforts.
Computer Systems↗
Spatial and temporal informations from the cardiac electric field.
Cardiac excitation generates an electric field which projects onto the body surface. This allows the information about the heart to be obtained noninvasively as a physical process. Thus the analysis of the cardioelectric field requires spatial, spatio-temporal and temporal approaches. The spatial approach resolves the distribution of the field in the body in relation to the configuration of the source by means of constructing a field map for one instant. This reflects the anatomical background. The spatio-temporal analysis includes the events of activation and repolarization, provides a series of maps or compressed presentations and comprises the dynamics of the cardiac excitatory cycle. The temporal access investigates the generation of the cardiac rhythm. It utilizes the analysis of sinus arrhythmia and the frequency analysis of heart rate variability. The results reflect efferent mechanism of chronotropic control as well as afferent and central management of informations relevant for cardiac control.
Computer Simulation↗
Muscle elasticity: effect of muscle length and temperature.
The present study describes a new method which allows the determination of muscle elasticity by applying quick releases at one end of a muscle and measuring the resulting tension drops at both ends, and simultaneously the propagation time of the mechanical impulse. The elasticity determined by both methods was examined on resting as well as on tetanized frog muscles (Rana esculenta, M. flexor hallucis brevis) in relation to muscle length and at two different temperatures 1 degree C and 20 degrees C. The average propagation velocity of the mechanical impulse of resting muscle was 55.7 +/- 4.7 m/s and of the contracting muscle 104.8 +/- 24.7 m/s at 1 degree C (L0, n = 6), which corresponds to elasticities of 3.3 +/- 0.5 N/mm2 and 14.4 +/- 6.2 N/mm2, respectively. The elasticity modulus calculated from the tension drop was for the resting muscle 2.3 +/- 0.5 N/mm2 and for the contracting muscle 11.1 +/- 2.1 N/mm2 (L0, 1 degree C, n = 6). When the muscle length is varied, the elasticity modulus corresponds to the length-tension relation of the resting and the isometrically contracting muscle. There is a strong correlation between the elasticity moduli which was determined by both methods for measurement of resting (r = 0.99, n = 19, p less than 0.05) and contracting muscle (r = 0.97, n = 19, p less than 0.05). This relation between elasticity and tetanic tension, i.e. filament overlap at constant temperature, can be interpreted in accordance with the sliding filament theory. But if the temperature is increased from 1 degree C to 20 degrees C, an increase of the tetanic tension (Q10 = 1.56) and a decrease of the elasticity measured by both methods (Q10 of 0.86 and 0.84) were obtained. This suggests that the increased tetanic force is generated by a smaller number of attached cross-bridges, but with a higher amount of force generated by each cross-bridge.
Animals↗
[Epidemiological research on primary hyperparathyroidism. A prospective multicenter study].
Serum calcium determination of 11,588 hospitalized patients during a twelve-month period revealed hypercalcaemia in 74 (0.64%). Further clinical and biochemical investigation established primary hyperparathyroidism in 20 of them (27%), and in 15 (20%) a malignant tumour (with bone metastases in six) as the cause of the hypercalcaemia. Rarer causes were found in 11 patients (15%): diuretic medication (5), lithium treatment (3), immobilization (2) or hyperthyroidism (1). In the remaining 28 patients (38%) no cause of the hypercalcaemia could be established with certainty. In at least six patients, however, there were clinical pointers towards hyperparathyroidism in the absence of unequivocal biochemical findings. Leaving out of account borderline cases, one must reckon on a prevalence of hyperparathyroidism in 0.17% of an unselected group of hospitalized patients. Parathyroid hyperfunction must always be considered in the differential diagnosis because of its manifold clinical presentation.
Austria↗
[A study using the computer-controlled perimeter Perimat 206 on the effect of Circo-Maren on visual field defects].
In 1987 an open study was conducted in an ophthalmological practice to test Circo-Maren tablets. Examinations using a computerized perimeter revealed that therapy with Circo-Maren can lead to a reduction in visual field defects in patients with senile macular edema and retinal angiosclerosis. In cases with severe defects, favorable results were achieved which were statistically significant (duration of treatment: 4-12 weeks). Considerable fluctuations in the number and intensity of the defects were seen in the various intermediate examinations.
Aged↗
More exercise for the hyperlipidaemic patients?
Epidemiological studies have left no doubt that moderate to vigorous physical training (PT) of endurance type decreases atherogenic lipoprotein fractions and increases vasoprotective lipoproteins. Depending on the underlying metabolic abnormality in various dyslipoproteinaemias a different response to endurance training was observed. PT is particularly effective in most forms of primary hypertriglyceridaemias. PT acts on both excessive VLDL production and fractional catabolic rate of TG--rich lipoproteins. However, improved removal seems to be of dominating importance. In primary hypercholesterolaemia LDL--cholesterol levels did not change during a 4 weeks exercise regimen with standardized isocaloric lipid lowering diet. In observational studies with hyperlipidaemic patients with stable body weight and under lipid lowering diet, during the first 4-6 weeks no significant effect on HDL was seen, whereas longterm studies clearly demonstrate an increase in HDL--cholesterol. Further beneficial effects of PT in hyperlipidaemic patients are improved glucose tolerance, down--regulation of hyperinsulinaemia, lowering of blood pressure and correction of hypercoagulability of the blood.
Arteriosclerosis↗
[Secretory performance of eccrine sweat glands from the nephrologic viewpoint].
The question is of nephrological interest, whether the secretory product of eccrine sudoriferous glands apart from the well known function for thermoregulation is useful as excretory product for the therapy of renal insufficiency. In 17 healthy subjects and 39 patients with renal insufficiency thermal sweat was obtained by exposition in the sauna and four-tub bath. Control of the trainability of sweating in 23 patients during six weeks in the Kneipp cure sanatory. For the daily fluid balance remarkable quantities of sweat could be achieved. The sweat performance is trainable. The content of soluta in the sweat of patients with renal insufficiency surmounts that of healthy test persons. The excretion of nitrogen metabolites, electrolytes and acidity is quantitatively different and is analysed individually. Apart from the reliable methods of the conservative and invasive therapy of the uraemia the thermically stimulated sweating can be recommended as an adjuvant therapeutic regime.
Acid-Base Equilibrium↗
[Cross-over comparison of fava bean protein and HLP diet in patients with hypercholesterolemia (HC)].
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Adult↗
[The effect of selected disintegrants on the properties of three hydrochlorothiazide tablet formulations].
The admixture of disintegrants was investigated in three different hydrochlorothiazide formulations with respect to tablet properties. Sodiumcarboxymethyl starchs, Na-CMS (Explotab, Primojel, Na-CMS AB-G.D.R.), cross-linked polyvinylpyrrolidone, CL PVP (Polyplasdone) and potato starch were applied. The investigations were especially aimed at the alteration of tablet properties in dependence on compressive force. Considering the values of decomposition and compressive strength Polyplasdone XL has been proved to be the most effective disintegrant for the hydrochlorothiazide formulations investigated. Potato starch shows the worst results. There are only slight differences between the three Na-CMS.
Drug Compounding↗
Ventilatory and cardiovascular responses to hyperoxia and hypoxia.
The influence of different oxygen content in the inhaled air was examined in 21 healthy male volunteers using noninvasive methods. Tidal volume, breathing frequency, minute ventilation, heart period duration, stroke volume factor, cardiac output factor, arterial blood pressure, and total peripheral resistance factor were measured. It is shown that the reactions of the cardiovascular parameters to a decrease of oxygen content in inhaled air were more sensitive than those of ventilatory parameters.
Adult↗
[Pigmented spindle cell tumor].
Pigmented spindle cell tumor is a benign lesion and can be differentiated from benign juvenile melanoma and malignant melanoma by its uniform cytologic pattern as well as its pattern of growth.
Diagnosis, Differential↗
Comparative analysis of phospholamban phosphorylation in crude membranes of vertebrate hearts.
Phospholamban, a sarcoplasmic reticulum phosphoprotein, is present in the hearts of mammalian, avian, amphibian, and fish species. Phylogenetic changes are indicated by marked differences among species in cardiac phospholamban content and by the absence of Ca2+/calmodulin-dependent phospholamban phosphorylation at an early developmental stage.
Animals↗
[Bifonazole for the topical treatment of surface mycoses--progress!].
69 patients with superficial mycosis were treated with 1% Bifonazol cream once a day. 48 of them who suffered from tinea pedis interdigitalis received Bifonazol for 3 weeks, the remaining 21 patients who had superficial candidiasis applied it over a period of 4 weeks. The local tolerance of the cream has been very good. Control examinations 3 and 14 days after treatment proved 59 (89%) of all patients to be cured, i.e. 40 of those who had suffered from tinea pedis and 19 of the group with candidiasis.
Administration, Topical↗
Concurrent use of quinidine and disopyramide: evaluation of serum concentrations and electrocardiographic effects.
The effects of concurrent disopyramide phosphate and quinidine sulfate therapy were studied in 16 normal healthy adults. No adverse effects serious enough to warrant discontinuation of therapy were observed. There was a small but significant increase in disopyramide serum concentration when concurrent quinidine therapy was given and a small decrease in quinidine serum concentration when disopyramide was added. No significant change in elimination half-life was seen for either drug. Both drugs produced prolongation of the corrected QT interval. This QT prolongation was greater for quinidine than for disopyramide.
Adult↗
[Cross-reactivity of 3M KCl-extracts of fetal tissue from various species in the macrophage electrophoresis mobility test. II. Tissue extracts from lower vertebrates in various phases of development].
Cellular sensitization was detected by the MEM-test using 3M KCl-extracts of fetuses from man and mouse and of different metamorphic stages of the water frog (tadpoles) and the carp (yolk sack-bearing stage). The sensitization demonstrated was independent on the type of tumor tested. The occurrence of active components in the extracts was correlated with certain stages of individual development of water frog and carp. The evidence of these components in species of several classes of vertebrates confirms the assumption of phylogenetically conserved structures.
Animals↗
[Coincidence of chronic pancreatitis and liver cirrhosis in alcohol abuse. A x-ray and histomorphological study].
We conducted a retrospective study in 112 chronic alcoholics in order to evaluate the incidence of simultaneous damage of both pancreas and liver. In all patients, an endoscopic retrograde pancreaticography (ERP) and a liver biopsy were performed. 65 patients had alterations of the pancreatic ducts compatible with the diagnosis of chronic pancreatitis. 30,7% (20/65) suffered from an additional alcoholic liver cirrhosis. This is a much more frequent association than presumed by H. Sarles et al. and Ammann et al. When the diagnosis was established, the average age of the group with chronic pancreatitis and liver cirrhosis was the same as in patients with chronic pancreatitis without cirrhosis (43,3 versus 42,4 years). Routine laboratory findings were of little value in comparison to the morphological findings.
Adult↗