[Archives of radiology and the loan service of these archives].
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Archival cervical smears: a versatile resource for molecular investigations Archival cervical smears represent a huge resource of pathological specimens. This, together with long clinical follow-up data, makes archival smears the most valuable resource for cervical cancer research. Despite this huge potential, only a few molecular investigations have been carried out based on archival smears. It has been shown that archival smears can be used for amplification of genomic sequences by polymerase chain reaction (PCR). However, it is unknown whether PCR can be applied to minute dyskaryotic cells microdissected from archival cervical smears and whether these archival materials are suitable for reverse transcription PCR (RT-PCR). To address these issues, we prepared DNA and RNA samples from dyskaryotic cells microdissected from archival cervical smears with a storage time of 11 years and systematically tested the extent that these materials can be used for PCR-based molecular investigations at both DNA and RNA levels. Our results showed that a crude DNA preparation simply by proteinase K digestion was suitable for PCR amplification of genomic sequences. By targeting the amplified genomic sequence to 250 bp or less, most if not all archival smears could be used for PCR and are therefore suitable for screening gene mutations and loss of heterozygosity, human papillomavirus typing, etc. Purified DNA samples from microdissected dyskaryotic cells were adequate for restriction enzyme digestion and could be used for a PCR-based clonality analysis of the androgen receptor gene. Finally, RNA samples extracted from dyskaryotic cells microdissected from archival smears were adequate for RT-PCR as long as a gene-specific primer was used for the RT reaction and the target sequence was restricted to 150 bp or less. In summary, our results demonstrated that archival cervical smears are suitable for a range of molecular investigations at both DNA and RNA levels. The potential gain of knowledge on cervical cancer by the molecular study of archival smears is immense.
EHR system is a system for recording, retrieving, and manipulating information in electronic health care records. Archive is an organisation that intends to preserve health records for access and use for an identified group of consumers. There exist many combinations of EHR-systems and archives. EHR-system can be a single on-line system with integrated archiving functions or archive and EHR-system are co-operative or federated systems. This paper describes both common security requirements for EHR-systems and archives and security requirement specific for archives. Requirements are derived from ethical and legal principles. From principles a set of security requirements are derived. Safeguards for implementing security are discussed. In practise EHR-system and archive share many security services. This document is proposing that inside a security domain both the archive and EHR-system have a common security policy. In addition to this the archiving organisation needs a documented policy for information preserving and a policy for access and distribution of information between other archives.
This article describes how the Craniofacial Imaging Laboratory at the Cleft Palate and Craniofacial Deformities Institute, St. Louis Children's Hospital, Washington University Medical Center, has developed an electronic archive for the storage of computed tomography image digital data that is independent of scanner hardware and independent of units of storage media (i.e., floppy disks and optical disks). The archive represents one of the largest repositories of high-quality computed tomography data of children with craniofacial deformities in the world. Archiving reconstructed image data is essential for comparative imaging, surgical simulation, quantitative analysis, and use with solid model fabrication (e.g., stereolithography). One tertiary craniofacial center's experience in the establishment and maintenance of such an archive through three generations of storage technology is reported. The current archive is housed on an external 35-GB hard drive attached to a Windows-based desktop server. Data in the archive were categorized by specific demographics into groups of patients, number of scans, and diagnoses. The Craniofacial Imaging Laboratory archive currently contains computed tomography image digital data for 1827 individual scans. The earliest scan was done in 1980; the most recently stored scan for the purposes of this report occurred in May of 2000. The average number of scans archived per complete year was 94, with a range of 59 to 138. Of the 1827 total scans, 74 percent could be classified into specific diagnostic categories. The majority of the archive (55 percent) is composed of the following five diagnoses: sagittal synostosis (17 percent), unilateral coronal synostosis (11 percent), hemifacial microsomia (10 percent), plagiocephaly without synostosis (10 percent), and metopic synostosis (7 percent). Storage of computed tomography image data in a digital archive currently allows for continuous upgrading of image display and analysis and facilitates longitudinal and cross-sectional studies, both intramural and extramural. Internet access for clinical and research purposes is feasible, but contingent on protection of patient confidentiality. The future of digital imaging regarding craniofacial computed tomography scan storage and processing is also discussed.
After over 80 years of exclusive archiving of radiologic films, at present, in Radiology, digital archiving is increasingly gaining ground. Digital archiving allows a considerable reduction in costs and space saving, but most importantly, immediate or remote consultation of all examinations and reports in the hospital clinical wards, is feasible. The RIS system, in this case, is the starting point of the process of electronic archiving which however is the task of PACS. The latter can be used as radiologic archive in accordance with the law provided that it is in conformance with some specifications as the use of optical long-term storage media or with electronic track of change. PACS archives, in a hierarchical system, all digital images produced by each diagnostic imaging modality. Images and patient data can be retrieved and used for consultation or remote consultation by the reporting radiologist who requires images and reports of previous radiologic examinations or by the referring physician of the ward. Modern PACS owing to the WEB server allow remote access to extremely simplified images and data however ensuring the due regulations and access protections. Since the PACS enables a simpler data communication within the hospital, security and patient privacy should be protected. A secure and reliable PACS should be able to minimize the risk of accidental data destruction, and should prevent non authorized access to the archive with adequate security measures in relation to the acquired knowledge and based on the technological advances. Archiving of data produced by modern digital imaging is a problem now present also in small Radiology services. The technology is able to readily solve problems which were extremely complex up to some years ago as the connection between equipment and archiving system owing also to the universalization of the DICOM 3.0 standard. The evolution of communication networks and the use of standard protocols as TCP/IP can minimize problems of data and image remote transmission within the healthcare enterprise as well as over the territory. However, new problems are appearing as that of digital data security profiles and of the different systems which should ensure it. Among these, algorithms of electronic signature should be mentioned. In Italy they are validated by law and therefore can be used in digital archives in accordance with the law.
Because data archives contain patient-based rather than study-based data, they can address meta-analytic questions on uncommon outcomes and on predefined patient subsets, questions that are difficult to address using the traditional meta-analytic approach based on grouped data. We report the tasks involved in establishing the first data archive of rheumatoid arthritis trials. In general, problems stem from the heterogeneity of trials in the archive and we suggest some solutions. In the initial phases, difficulties include recruitment and incomplete participation of trial investigators, whereas later on, other issues arise, such as quality control, coping with different dataset designs, and incomplete documentation. Other issues include heterogeneous measures, missing variables, and comparing data across different visit intervals and trial lengths. Suggested solutions include requesting trial data in predefined archive-wide structures and asking for all possible documentation for each dataset. Data cleaning is necessary, as is rescaling of variables or developing unit-free outcomes, and estimating data for missing variables. Archive design should allow for referencing a patient's data among various datasets. Although one goal is to reduce the quantity of data in the archive while retaining information content, data from early stages of archive building must be accessible for developing new analysis datasets. Documentation of archive building and software choices are discussed. Our experience suggests data archiving for meta-analysis is time consuming and expensive, yet it provides a useful method for analyzing data from multiple trials.
OBJECTIVE: In this article, we describe the implementation of a digital archive center for a radiology department in a 700-bed teaching hospital. MATERIALS AND METHODS: The archive center consists of two identical archive systems, each comprising five components: an archive server, a data-base server, an optical disk library, a stand-alone optical disk drive, and a communication network. An image management system controls the image traffic from acquisition devices to display stations. A fault-tolerant mechanism was built into the archive center to achieve a 100% uptime. RESULTS: The center has been in operation for over 6 months. We have not experienced a single total system failure during this period. It currently archives all digital images from three MR units and four CT scanners and selected images from three computed radiographic systems and two laser film digitizers. The center archives between 1.5 and 2.0 gigabytes of images per workday. CONCLUSION: With its built-in fault-tolerant mechanism, we believe that the implemented archive center is very reliable and is suitable for a radiology department to archive its digital images.
PURPOSE: To investigate the use of radiological technology and archive utilization in two sampled international radiological journals and radiology clinics in Turkey, and to explore the impact of these findings on radiological publications. MATERIALS AND METHODS: Randomly selected 22 issues of AJR and Radiology, 1037 articles in total, were reviewed. The type of article, radiological technique, country of origin, use of advanced technology and archiving were defined for each article. Additionally, a questionnaire, investigating implementation of various radiological devices, archiving and their technical features, was posted to the chairmen of the radiology departments in Turkey. RESULTS: Most of the articles (61.4%) originated in US. Studies from Turkey constituted 0.9% of the articles. This ratio was 2% for France, which has almost the same population as Turkey. Magnetic resonance imaging was used in 27.4% of cases. Based on our definition criteria, advanced technology and archiving were used in 19% and 32%, respectively. Data returns of the questionnaire were obtained from 17 of 45 (38%) radiology clinics. Responding clinics had conventional radiography, B mode ultrasound and conventional computed tomography. Archiving of all radiological examinations, excluding plain radiography, was performed in one center while only interesting radiological images and variations were stored in 8 departments. Implementation of archiving was reported sufficient in three clinics, partly sufficient in ten clinics and insufficient in four clinics. Archiving was performed by medical doctors in most of the cases (53%). The leading problems of archiving were technical and economical insufficiencies (82%). CONCLUSION: Archiving is more commonly required than utilization of advanced technology for international radiological publications. The rate of articles originating from Turkey was lower compared to some countries having the same population as Turkey. The lack of sufficient technical infrastructure and shortage of staff may be important reasons for such differences.
PURPOSE: Increasing percentages of digital modalities in radiology, in particular of digital image acquisition in conventional radiography, call for digital reporting, communication, and archiving techniques. These techniques are prerequisites for the "filmless" hospital. The first 2 have been covered extensively in the literature and by vendors. However, as regards online digital image archives there are still no satisfactory concepts available in the medical field. The present paper puts forward some suggestions as to how this situation could be improved. MATERIAL AND METHODS: Analyses of radiology operations consider the prevailing PACS (picture archiving and communication system) archive concepts that use optical discs to be too small, too slow and too cumbersome to manage and therefore unable to function as comprehensive image archives for filmless hospitals. We suggest borrowing and adapting the well tested archive technologies from space research and the oil and broadcasting industries which have much higher capacities and speeds and better software interfacing possibilities. With such technologies the needs of filmless hospital operations can be met. RESULTS: A feasible concept for a transition strategy from conventional analog to digital archives is presented. Model calculations of the necessary investments and potential savings, including generous placement of viewing stations in the entire hospital, indicate amortization periods of 3.8-4.8 years. CONCLUSION: Alternative technologies for digital image archives already today make full-scale PACS for filmless hospitals technologically and conceptually feasible and financially mandatory.
Ophthalmological image archiving and distribution can be automated using a picture archiving and communication system (PACS). A fundus PACS has been in clinical use since February 2000 at the ophthalmology clinic of Tampere University Hospital. It consists of a digital fundus camera, an imaging workstation, from which new patients can be added to the archive, 10 viewing stations and an image archive server. In glaucoma imaging, the fundus images taken from a patient are transferred from the imaging workstation to the image archive server and are then immediately available from the physician's viewing workstation; the transfer time of an average image, of 350 kbit, is 0.0035 s, even though the archive is located 5 km away. After 18 months of operation there were over 16,000 images archived; these took 5.3 GByte of a total storage capacity of 41.9 GByte. The network and archive server achieved 99% reliability in use. Digital imaging makes it possible to shift ophthalmology clinics towards more patient-oriented treatment procedures.
In July 2001, the National Institute of Mental Health sponsored a workshop titled "Data Archiving for Animal Cognition Research." Participants included scientists as well as experts in archiving, publishing, policy, and law. As is described in this report, the workshop resulted in a set of conclusions and recommendations concerning (A) the impact of data archiving on research, (B) how to incorporate data archiving into research practice, (C) contents of data archives, (D) technical and archival standards, and (E) organizational, financing, and policy issues. The animal cognition research community is encouraged to begin now to establish archives, deposit data and related materials, and make use of archived materials in new scientific projects.
HYPOTHESIS: Contamination of archival human temporal bones with extraneous deoxyribonucleic acid may represent a potentially significant problem in the analysis of nucleic acids isolated from archival specimens. BACKGROUND: During the past decade, there has been growing interest in the development of molecular biologic techniques that can be applied to the investigation of pathologic changes in archival human temporal bones. The impetus for the development of these techniques is in part related to the fact that the temporal bone collections represent a repository of archival material compiled over decades, which is not available from living patients. METHODS: An archival human temporal bone specimen from a male patient with the Mohr-Tranebjaerg syndrome (formerly called DFN-1) and a well-characterized mutation was analyzed for the presence of the mutation by a standard method for extraction, isolation, amplification, and sequencing of deoxyribonucleic acid. The experiment was repeated four times. RESULTS: The deoxyribonucleic acid sequence from three of four extractions was normal. The known mutation was easily and repeatedly demonstrated in a blood sample from the same individual. Because Mohr-Tranebjaerg syndrome is X-linked, there is only one allele, and therefore there is no potential endogenous source to account for the normal sequence that was amplified. Contamination of the tissue sections by extraneous deoxyribonucleic acid presumably occurred during acquisition and processing of the temporal bone. CONCLUSIONS: Contamination of archival temporal bones with exogenous deoxyribonucleic acid is a significant potential problem that must be considered in the interpretation of the results of deoxyribonucleic acid retrieved from archival sections. The authors recommend collecting blood samples from temporal bone donors in the future to ensure the availability of a reliable source of deoxyribonucleic acid.
Scholars are increasingly citing electronic "web references" which are not preserved in libraries or full text archives. WebCite is a new standard for citing web references. To "webcite" a document involves archiving the cited Web page through www.webcitation.org and citing the WebCite permalink instead of (or in addition to) the unstable live Web page. This journal has amended its "instructions for authors" accordingly, asking authors to archive cited Web pages before submitting a manuscript. Almost 200 other journals are already using the system. We discuss the rationale for WebCite, its technology, and how scholars, editors, and publishers can benefit from the service. Citing scholars initiate an archiving process of all cited Web references, ideally before they submit a manuscript. Authors of online documents and websites which are expected to be cited by others can ensure that their work is permanently available by creating an archived copy using WebCite and providing the citation information including the WebCite link on their Web document(s). Editors should ask their authors to cache all cited Web addresses (Uniform Resource Locators, or URLs) "prospectively" before submitting their manuscripts to their journal. Editors and publishers should also instruct their copyeditors to cache cited Web material if the author has not done so already. Finally, WebCite can process publisher submitted "citing articles" (submitted for example as eXtensible Markup Language [XML] documents) to automatically archive all cited Web pages shortly before or on publication. Finally, WebCite can act as a focussed crawler, caching retrospectively references of already published articles. Copyright issues are addressed by honouring respective Internet standards (robot exclusion files, no-cache and no-archive tags). Long-term preservation is ensured by agreements with libraries and digital preservation organizations. The resulting WebCite Index may also have applications for research assessment exercises, being able to measure the impact of Web services and published Web documents through access and Web citation metrics.