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PubMed1986

Image analysis combined with quantitative cytochemistry. Results and instrumental developments for cancer diagnosis.

This paper describes the application of image analysis combined with a quantitative staining method for the analysis of cervical specimens. The image analysis is carried out with the Leyden Television Analysis System, LEYTAS, of which two versions are described. LEYTAS-1 as well as LEYTAS-2 have both been designed with a high degree of flexibility and interaction facilities. A much wider range of image analysis programs is however, possible with LEYTAS-2, enabling many applications. LEYTAS-1, the earlier version, consists of a Leitz microscope with automated functions, a TV camera, the Texture Analysis System (TAS, Leitz), a four-bit grey value memory and a minicomputer (PDP 11/23). Using this instrumentation 1,500 cervical smears prepared from cell suspensions and stained with acriflavin-Feulgen-Sits have been analysed in a completely automated procedure. Image transformations working in parallel on entire fields, have been used for cell selection and artefact rejection. Resulting alarms, consisting of selected single cells and non-rejected artefacts are stored in the grey value memory, which is displayed on a TV monitor. This option allows visual interaction after the machine diagnosis has been made. The machine diagnosis was correct in 320 out 321 specimens with a severe dysplasia or more serious lesion. The false positive rate in 561 morphologically negative specimens (normal and inflammation) was 16% (machine diagnosis). Visual interaction by subtracting the visually recognized false alarms from the total number of alarms reduces the false positive rate to 11%.(ABSTRACT TRUNCATED AT 250 WORDS)

4-Acetamido-4'-isothiocyanatostilbene-2,2'-disulfo↗
PubMed1981

Combined staining procedures for cytophotometry of protein and DNA Feulgen-Naphthol Yellow S and dinitrofluorobenzene-Feulgen.

A comparison has been made between dinitrofluorobenzene (DNFB) and Naphthol Yellow S (NYS) as protein stains in combination with the pararosaniline-SO2 Feulgen procedure. Chicken erythrocytes were used as test cells. Cytophotometric measurements were made using a Zeiss scanning stage cytophotometer coupled to a PDP 11/10 minicomputer using the BICOSCAN program to obtain values for protein per cell, protein per "nuclear area' and DNA per nucleus. With 5N HCl as the Feulgen hydrolysis agent, DNFB staining, applied before the Feulgen procedure, was found to be unaffected by hydrolysis conditions required to give optimum Feulgen staining and showed only small losses after longer hydrolysis times. On the other hand measurements of NYS staining, of necessity applied after the Feulgen procedure, seem to be susceptible to the duration of Feulgen hydrolysis. This susceptibility is probably due to the interaction of the DNA phosphates with the basic amino acid residues, potential binding sites for NYS. Since the degree of this interaction may be variable, it is argued that NYS binding will measure the available basicity of proteins at the time of staining but no specific protein fraction. DNFB binding is unaffected by DNA-protein interactions and therefore can give a more reliable measure of "nuclear' protein, particularly in conjunction with Feulgen-DNA measurements.

Animals↗
PubMed1991

Sex difference in the pattern of lower limb movement during treadmill walking.

To evaluate the characteristics of stereo-typed movement of the lower limb during treadmill walking, the step length and duration of 200 steps were monitored consecutively and calculated by means of a computerized system, consisting of a position sensor, shoes with foot switches and a minicomputer. Eleven male and 10 female subjects walked at various constant speeds ranging from 60-130 m.min-1. Mean, standard deviation (SD) and coefficient of variation (CV) of the time-distance component at each speed were utilized for the assessment of stereotyped movement. When compared with males, females had a tendency to increase their speed by increasing their cadence. The difference of the walking pattern was specifically related to their height. The SD and CV of the time-distance component at a given speed were significantly greater in females than in males. Regression analyses revealed that in the relationship between the walking speeds and the SDs or CVs of the time-distance component, the significant quadratic equations could be fitted. The speed, at which the SD of step length was minimum, was estimated to be about 90 m.min-1 in both males and females. This was regarded as the free walking speed or as the walking speed resulting from a mechanically efficient step length which suited the subject's body size.

Adult↗
PubMed1991

A very large PC LAN as the basis for a hospital information system.

Brigham and Women's Hospital is converting its financial, administrative and clinical information systems from a mini-computer environment to a platform based on MUMPS and a network of several thousand personal computers. This article describes the project rationale and status and provides an overview of the architecture of the new system. The initial results of the project indicate that the personal computer network can provide large amounts of processor power and storage at costs per unit of power and storage that are several times less expensive than the minicomputer environment. The performance of the converted Accounts Payable system indicates that the architecture can deliver acceptable performance.

Hospital Information Systems↗
PubMed1983

A comprehensive patient care system for the family practice.

Family and Community Health Associates (FACHA) has incorporated an in-house, on-line computerized medical information system into a two-office, three-physician family practice medicine group. A Basic Four System 610 minicomputer is utilized to store all the medical, pharmaceutical, financial, and scheduling records. A SOAP-formated encounter form is used to collect the data. Five medical reports are printed prior to each patient encounter. Evaluations of the use and the benefits of this system are presented. A cost study, which calculated the cost of maintaining a computer-stored patient record, showed that a patient record could be updated and maintained for $1.32. A quality of care evaluation revealed that the preaudit of the computer-generated medical reports increased patient compliance to health maintenance suggestions. Another quality of care evaluation revealed that computer-generated flow charts did not significantly improve the diastolic blood pressure value of chronic hypertensive patients.

Comprehensive Health Care↗
PubMed1983

The Johns Hopkins Oncology Clinical Information System.

The Johns Hopkins Oncology Center has developed and maintains a clinical information system to support patient care, education, research, and administrative functions. It operates on a dedicated minicomputer (PDP-11) programmed in MUMPS. Clinical information collected includes patient medical status and laboratory values. Data are used daily in patient care and also in support of retrospective and prospective research. The use of the system to manage a large blood pheresis program and to study and treat infectious disease is described. Administrative functions include patient and personnel scheduling, program evaluation, and projects directed toward control of costs.

Blood Transfusion↗
PubMed1983

Developments and implementations of microcomputer MUMPS systems.

The accelerating pace of improvement and innovation in today's microprocessors offers a real challenge to the software industry. MUMPS, a language well suited to take advantage of this technology, has already been introduced on 8-bit microcomputers, and 16-bit versions are under development. The long-term results of the availability of MUMPS on new generations of microprocessors will have an impact on the visibility of the language, its evolution, and its use on existing minicomputers. These implications are discussed in depth in this paper.

Computers↗
PubMed1977

The use of mini- and micro-computers in eye clinical practice.

In an ophthalmological department there are many sectors in which the use of computers can give useful support. We have singled out three major areas of interest: 1. the rationalization of the flow of patients; 2. the management of clinical records; 3. the automatization of ophthalmological devices. Instead of using different dedicated computational systems we preferred to focus our attention on a unique system based on a minicomputer driving several parallel micro-processors. Preliminary results are given.

Computers↗
PubMed1986

Implementation of an advanced clinical and administrative hospital information system.

Over the last six years since University Hospital opened, the University Hospital Information System (UHIS) has continued to evolve to what is today an advanced administrative and clinical information system. At University Hospital UHIS is the way of conducting business. A wide range of patient care applications are operational including Patient Registration, ADT for Inpatient/Outpatient/Emergency Room visits, Advanced Order Entry/Result Reporting, Medical Records, Lab Automated Data Acquisition/Quality Control, Pharmacy, Radiology, Dietary, Respiratory Therapy, ECG, EEG, Cardiology, Physical/Occupational Therapy and Nursing. These systems and numerous financial systems have been installed in a highly tuned, efficient computer system. All applications are real-time, on-line, and data base oriented. Each system is provided with multiple data security levels, forward file recovery, and dynamic transaction backout of in-flight tasks. Sensitive medical information is safeguarded by job function passwords, identification codes, need-to-know master screens and terminal keylocks. University Hospital has an IBM 3083 CPU with five 3380 disk drives, four dual density tape drives, and a 3705 network controller. The network of 300 terminals and 100 printers is connected to the computer center by an RF broadband cable. The software is configured around the IBM/MVS operating system using CICS as the telecommunication monitor, IMS as the data base management system and PCS/ADS as the application enabling tool. The most extensive clinical system added to UHIS is the Physiological Monitoring/Patient Data Management System with serves 92 critical care beds. In keeping with the Hospital's philosophy of integrated computing, the PMS/PDMS with its network of minicomputers was linked to the UHIS system. In a pilot program, remote access to UHIS through the IBM personal computer has been implemented in several physician offices in the local community, further extending the communications horizons of University Hospital's Information System. The implications of remote access to PDMS through the IBM PC emulating a Siemens Model 420 Patient Data Management Terminal are being examined.

Artificial Intelligence↗
PubMed1989

Clinical percutaneous imaging of coronary anatomy using an over-the-wire ultrasound catheter system.

This manuscript describes initial applications of a unique new intravascular ultrasound imaging catheter. This 5.5F catheter uses an over-the-wire design and incorporates a phased array transducer at its tip. There are no moving parts. A 360 degree image is produced perpendicular to the catheter axis using a 20 MHz center frequency. A dedicated minicomputer is used for initial image processing, as well as enhancement and analysis. Initial studies using phantoms demonstrated excellent accuracy for linear dimensions (r = 0.99, range 3.0 to 7.6 mm, image = 1.0 phantom + 0.1). Serial imaging of the same arterial segment in vitro showed good reproducibility (coefficients of variance 2.5-5.2%). Likewise, intra- and inter-observer variability in image analysis was minimal (r = 0.92-0.99). Initial in vivo studies were performed in dogs. The catheter was easily passed over a wire into mesenteric, cerebral and coronary vessels without evidence of significant vessel trauma. Subsequently, 20 patients had percutaneous coronary imaging performed during cardiac catheterization. Cardiac motion was rarely a problem and acceptable images were obtained in all but two patients. Areas of calcification, mild stenoses, branching vessels and graft atherosclerosis could be identified. We conclude that intracoronary ultrasound imaging will be useful for assessing vascular pathology, for studying both rapid change in vessel size as well as chronic progression or regression of atherosclerosis, and for assisting with new therapeutic interventions.

Angioplasty, Balloon↗
PubMed1984

General method for the derivation and numerical solution of epithelial transport models.

A general method is presented for the formulation and numerical evaluation of mathematical models describing epithelial transport. The method is based on the principles of conservation of mass, and maintenance of electroneutrality within the cells and bathing solutions. It is therefore independent of the specific membrane transport mechanisms, and can be used to evaluate different models describing arbitrary transport processes (including passive, active and cotransport processes). Detailed numerical methods are presented that allow computation of steady-state and transient responses under open-circuit, current-clamp and voltage-clamp conditions, using a general-purpose laboratory minicomputer. To evaluate the utility of this approach, a specific model is presented that is consistent with the Koefoed-Johnson and Ussing hypothesis of sodium transport in tight epithelia (Acta Physiol. Scand. 42:298-308, 1958). This model considers passive transport of an arbitrary number of permeant solutes, active transport of sodium and potassium, and osmotically induced water transport across the apical and basolateral membranes. Results of the model are compared to published experimental measurements in rabbit urinary bladder epithelium.

Animals↗
PubMed1986

Modifications of the slit lamp for digital image processing of the anterior segment of the eye.

The Zeiss slit lamp has been modified in order to extend its use to measurements of lens transparency. Two major modifications have been introduced: (1) a support for a high-sensitivity TV camera that is connected to an image processing system; (2) two potentiometers for recording electrical signals proportional to the rotation angle of the slit-supporting arm with respect to the visual axis and the slit tilting angle. As a result, the slit lamp output consists of three signals; one TV signal for the images and two analog signals for measurement of the angles. With the aid of an image-processing system connected to a minicomputer, software has been developed to enable the operator to acquire reliable digital images of the anterior segment of the eye in real time. The software provides the user with an easy-to-follow menu.

Anterior Eye Segment↗
PubMed1984

Creation of personnel at the medical/computer science interface: should it be a specialty?

The development of minicomputers and microprocessors allows the paper and pencil records to be replaced by electronic records. Data from medical practice stored in paper form disappear in the jaws of office files and hospital record rooms. Only a fraction are retrieved for retrospective studies. Records kept in electronic form are immediately available and over time give the doctor a data base from which he can construct a computerized textbook describing his own practice in terms of diagnosis, treatment and outcomes. Data from the practice can even be available as a basis for clinical trials of drugs and procedures. The doctor now has a potential data base for biostatistical and epidemiologic studies relating to his practice on an ongoing basis.

Computers↗
PubMed1978

Distributed processing techniques: interface design for interactive information sharing.

The Information Systems Division of the University of Iowa Hospitals and Clinics has successfully designed and implemented a set of generalized interface data-handling routines that control message traffic between a satellite minicomputer in a clinical laboratory and a large main-frame computer. A special queue status inquiry transaction has also been developed that displays the current message-processing backlog and other system performance information. The design and operation of these programs are discussed in detail, with special emphasis on the message-queuing and verification techniques required in a distributed processing environment.

Computers↗
PubMed1978

An input-output model for resources planning in a medical care system.

As medical care delivery systems grow in complexity, the understanding of interaction between entities within the system becomes a key aspect in resource planning. The model presented in this paper is geared to aiding resource planning both at the community or regional level and at the medical facility level. At the regional level the problem is related to the elimination of duplication and the sharing of services. At the medical facility level the concern is the balancing of the supply and demand of services among the departments. The framework of the model is a directed graph with nodes representing the service entities and branches representing the interrelationships. At the regional level, entities are hospitals, clinics, and centralized supportive units, such as the data center or the central laboratory. At the medical center level, entities are generally departments within the facility. An iterative procedure is used to simulate the propagation effect of a change on all entities. The model at the medical center level, as implemented in a minicomputer system was applied to a real problem. The results strongly correlated with another, independent study.

California↗
PubMed1980

A distributed computer system for hierarchical control of a clinical vestibular laboratory.

A vestibular testing laboratory with five test stations was implemented as a clinical research and testing facility, automating and adapting tests for patients with inner-ear balance disorders. These were designed to quantitate postural control, and eye movement response to rotational, caloric, and visual (optokinetic) stimuli. Microprocessors were used as satellite processors in a star network under hierarchical control of a host minicomputer. All disk storage was controlled by the host, with data transfer from satellites via parallel interfaces. Network software was designed and implemented to be under control of the host in a foreground-background structure. The practical operation of this laboratory required that technicians at each satellite test station initiate, perform, and complete an individual test in dependently of other tests. Examples from two test stations are presented. A 2-year data base of test results provides important multitest correlations for use in diagnostic evaluations.

Computers↗
PubMed1977

Missouri Automated Radiology System: a dynamic, interactive diagnostic and management system for radiant images.

Missouri Automated Radiology System has functioned in full support of the Department of Radiology for more than 7 years. For the past 5 years, MARS has functioned as a minicomputer system on a DEC (Digital Equipment Corporation) PDP-15 computer. While continuing to effectively support the department, in daily use by 20 staff and 15 resident physicians, MARS has continued to function in a research and development mode. With the continuous development of new applications, MARS is now essential to the function of the department and has again proven the point that physicians and computers can function symbiotically in the medical environment.

Diagnosis, Computer-Assisted↗
PubMed1977

A modular computer system for the nuclear medicine/ultrasound laboratory: a multidisciplinary proposal.

In many nuclear Medicine studies computer-controlled graphic displays are an absolute necessity for obtaining meaningful results. Design criteria developed by an interdisciplinary scientific panel are presented to achieve a display system based on television technology; an instrument interface employing list mode using bubble-memory storage technology, thus having a low information-loss rate; and flexible modular software easily tailored to the specific needs of both clinicians and technicians. The panel considers a minicomputer system with broad, flexible applications to be a valuable tool, particularly in doing those function studies that only can be done via nuclear medicine techniques. The final specifications ultimately allow the selection of a vendor and hospital installation, even though all criteria are not currently achievable.

Computers↗