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Biomedical subjects

P C Tang

Publications and source records attributed to P C Tang.

At least 19 recordsLinked to original sources
PubMed1997

Matrix metalloproteinase inhibitors reduce phorbol ester-induced cutaneous inflammation and hyperplasia.

Matrix metalloproteinases (MMPs) are a family of zinc-dependent proteases which play key roles in extracellular matrix remodeling, connective tissue damage, inflammation and cell proliferation in a variety of tissues. Since MMP inhibitors have been recently shown to decrease proliferation of vascular smooth-muscle cells, and to prevent neutrophil infiltration in response to alkali burns, we sought to determine whether MMPs play a role in the pathogenesis of inflammatory or hyperproliferative skin disorders. The effects of a specific MMP inhibitor and its analogues on phorbol dibutyrate (PdiBu)-induced inflammation and epidermal hyperplasia in murine skin were assessed. Topical GM 6001, a hydroxamic acid analog with potent inhibitory activity against several MMPs, markedly inhibited PdiBu-induced increases in both ear thickness and ear punch-biopsy weight in a dose-dependent manner 30 h after topical application of PdiBu. Maximal inhibition (75%) was obtained at a dose of 100 micrograms/cm2 (P < 0.01). Moreover, histologic analysis revealed that GM 6001 decreased both the inflammatory cellular infiltrates and epidermal hyperplasia induced by PdiBu. Whereas similar results were found for GM 1489, an analog of GM 6001, acetohydroxamic acid, containing the critical metal ligand group but without the amino acid side chains necessary for binding to the MMPs, did not alter the response to PdiBu inflammation/hyperplasia. These results show that the MMP inhibitors, GM 6001 and GM 1489, are effective in reducing both the inflammatory and hyperproliferative responses that occur following topical phorbol ester application, suggesting a potential role for MMPs in cutaneous inflammatory dermatoses. Moreover, the delivery of this class of inhibitors across intact stratum corneum implies that MMP inhibition could provide an approach to the topical treatment of inflammatory dermatoses.

Animals↗
PubMed1997

Meeting the information needs of patients: results from a patient focus group.

Changing roles in health care call for patients to share increased responsibility for managing their health. Patients may need additional health-related information to participate more fully in health care decisions. We examined patients' information needs from the perspective of clinicians, educational software vendors, and patients. The most instructive information came directly from patients in focus groups. The participants in our focus groups clearly sought more information about their health than they had received during visits with their physicians. Patients' needs were specific to their individual clinical situation, and timing was critical. Although physicians spend a significant amount of time on patient education during an encounter, patients typically formulate their questions after the encounter. We used the results of focus groups to develop desired characteristics of patient education material that addresses patients' information needs. Providers who understand and address these needs will be in a better position to effectively engage patients' active participation in their health care.

Adult↗
PubMed1996

Clinician information activities in diverse ambulatory care practices.

Ambulatory care is assuming an increasing role in health-care delivery. Yet, most health-care information systems were developed for the acute-care setting. To address the needs of ambulatory care, developers need a comprehensive understanding of the information-related activities of clinicians in heterogeneous outpatient practices. We studied the information activities of clinicians in seven diverse (primary-care, specialty-care, faculty, and independent private practices) ambulatory care sites. The results of our study allow us to characterize clinicians' information-related activities, their perceived information needs, and their satisfaction with computer resources. Developers of health-care information systems can use the results to design applications for clinicians in ambulatory care.

Ambulatory Care↗
PubMed1995

Immunocytochemical localization of ribonuclease in yolk granules of adult Rana catesbeiana oocytes.

To determine the localization of the pyrimidine-guanine sequence-specific ribonuclease in Rana catesbeiana (bullfrog) oocytes, the RNase was first isolated and used to prepare a specific rabbit antiserum. Only one protein of similar molecular size to the RNase was immunoprecipitated from ovary homogenate by the antiserum, but two bands were observed by Western blotting analysis. These two proteins were shown by further purification of antibody and Western blotting analysis to have similar antigenicity. Immunoprecipitation and Western blotting of tissue homogenates showed that the RNase was found predominantly in the ovary, but not in other tissues. The specific localization of the RNase was determined by immuno-electron microscopy of oocyte sections incubated with the specific antiserum; the yolk granules, but not other organelles, were found to contain the RNase. Most of the RNase was evenly distributed in the lateral amorphous area of the yolk granule but not in the central yolk crystal area which contains stored vitellogenin proteins. Our results indicate that the RNase is compartmentalized in the yolk granules of oocytes, which might prevent damage to cellular RNAs.

Amphibian Proteins↗
PubMed1995

Methods for assessing information needs of clinicians in ambulatory care.

Clinical information systems that provide physicians with relevant information at the time and place where decisions are being made can positively affect the quality and cost of health care. We have developed an assessment methodology to study clinicians' information needs in the context of the work flow and operational constraints of the ambulatory care practice environment. We employed a combination of methods, including observational studies, process flowcharting, semi-structured interviews, and surveys to comprehensively define clinicians' needs. Results from our study point to functional requirements not commonly found in hospital-based systems, such as access to problem lists and medications, computer-based support for health-care team communications, and patient-specific instructions and education.

Ambulatory Care Information Systems↗
PubMed1994

Major issues in user interface design for health professional workstations: summary and recommendations.

Lack of good user interfaces has been a major impediment to the acceptance and routine use of health-care professional workstations. Health-care providers, and the environment in which they practice, place strenuous demands on the interface. User interfaces must be designed with greater consideration of the requirements, cognitive capabilities, and limitations of the end-user. The challenge of gaining better acceptance and achieving widespread use of clinical information systems will be accentuated as the variety and complexity of multi-media presentation increases. Better understanding of issues related to cognitive processes involved in human-computer interactions is needed in order to design interfaces that are more intuitive and more acceptable to health-care professionals. Critical areas which deserve immediate attention include: improvement of pen-based technology, development of knowledge-based techniques that support contextual presentation, and development of new strategies and metrics to evaluate user interfaces. Only with deliberate attention to the user interface, can we improve the ways in which information technology contributes to the efficiency and effectiveness of health-care providers.

Cognition↗
PubMed1994

Semantic integration of information in a physician's workstation.

Patient care is an information-intensive activity, yet physicians have few tools to effectively access and manage patient data. We studied physicians' information needs in an outpatient clinic, and developed a prototype physician's workstation (PWS) to address those needs. The PWS provides integrated access to patient information and uses embedded domain knowledge to enhance the presentation of clinical information to the physician. All the applications in the PWS share a common patient context, defined by the state of the internal patient model--semantic integration. Relevant data are presented together and higher-order alerts are generated by combining notable events with relevant data from the patient context. Semantic integration allows us to present and to operate on all patient data in a given patient's context, significantly enhancing the effectiveness with which information is presented to the physician.

Computer Communication Networks↗
PubMed1994

Traditional medical records as a source of clinical data in the outpatient setting.

We conducted an observational study at a university hospital clinic to determine the success with which physicians find patient information using traditional hospital records as the source of data. We recorded 168 consecutive patient cases presented to attending physicians by internal medicine residents, and analyzed the transcripts to identify questions indicating that the physicians could not find patient information in the medical record. In 81 percent of the cases, physicians could not find all the patient information that they desired during a patient's visit. We performed thematic analysis to generate a set of 15 prototypical questions asked by physicians regarding patient information. The multiauthored medical record system we studied did not provide effective access to patient information for physicians making clinical decisions in an outpatient setting. Improved methods for addressing prototypical questions arising in routine practice are needed.

Decision Making↗
PubMed1994

Implementing a Physician's Workstation using client/server technology and the distributed computing environment.

PWS is a physician's workstation research prototype developed to explore the use of information management tools by physicians in the context of patient care. The original prototype was implemented in a client/server architecture using a broadcast message server. As we expanded the scope of the prototyping activities, we identified the limitations of the broadcast message server in the areas of scalability, security, and interoperability. To address these issues, we reimplemented PWS using the Open Software Foundation's Distributed Computing Environment (DCE). We describe the rationale for using DCE, the migration process, and the benefits achieved. Future work and recommendations are discussed.

Ambulatory Care Information Systems↗
PubMed1993

Automated identification of relevant patient information in a physician's workstation.

The introduction of computer-based patient records offers an opportunity to improve the ability of physicians to browse the medical record and to monitor patient events. We describe a methodology to identify relevant information in the patient record. This methodology combines a patient-specific physiological model with functions to determine relevance of patient information. The model consists of a qualitative representation of physiological parameters and influences, custom-tailored to a particular patient's problems, medications, and test results. We describe two applications of this model in the context of an integrated physician's workstation: automatic linking of relevant patient information for configuration of user-interface displays, and monitoring of patient events to prevent oversight of noteworthy information.

Computer Systems↗
PubMed1991

Heterogenous database integration in a physician workstation.

We discuss the integration of a variety of data and information sources in a Physician Workstation (PWS), focusing on the integration of data from DHCP, the Veteran Administration's Distributed Hospital Computer Program. We designed a logically centralized, object-oriented data-schema, used by end users and applications to explore the data accessible through an object-oriented database using a declarative query language. We emphasize the use of procedural abstraction to transparently integrate a variety of information sources into the data schema.

Computer Communication Networks↗
PubMed1991

An open systems architecture for development of a physician's workstation.

We are developing a physician's workstation consisting of highly integrated information management tools for use by physicians in patient care. We have designed and implemented an open systems, client/server architecture as a development platform which allows new applications to be easily added to the system. Applications cooperate by exchanging messages via a broadcast message server.

Ambulatory Care Information Systems↗
PubMed1991

Physicians' workstations: integrated information management for clinicians.

This paper describes a project to specify, design, develop, and evaluate a physician's workstation for use in patient care. We conducted an ethnographic study of physicians' information needs in an outpatient setting, from which we derived a set of functional specifications for a physician's workstation. We have implemented an experimental prototype using an open systems, client/server architecture, and are exploring research issues in heterogeneous database integration, object-oriented database technology, model-based reasoning, and semantic integration. We plan to evaluate our workstation prototype in a clinical setting to assess its impact on quality of care and health care costs.

Artificial Intelligence↗
PubMed1991

Knowledge-based support for a physician's workstation.

We describe knowledge-based support for a Physician's Workstation prototype. Our knowledge base uses a qualitative simulation model of patient physiology. We present the motivation behind our design, discuss the components of the knowledge base, and show how the knowledge base supports a physician's workstation in the patient management process. We describe a graphical knowledge base editor used by the domain expert for knowledge acquisition, and a graphical knowledge base presenter which monitors the qualitative simulation during patient event processing.

Artificial Intelligence↗
PubMed1991

Modelling work practices: input to the design of a physician's workstation.

To ensure tight coupling between users' work practices and the system's model of these practices, designers need methods to generate accurate descriptions of what users actually do. This paper illustrates how we model physicians' information needs and translate knowledge about these needs into design specifications.

Artificial Intelligence↗