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[Key-stone mammaplasty. Architectural considerations].

A breast usually has a conical or pyramidal shape. The best way to reduce such a structure is to resect the base. This reduction can be mathematically defined following the principles of the architecture of pyramids. Once the volume is decreased, a conical shape and a stable position has to be recreated. Using the principle of cathedral architecture, a key-stone, is created to stabilise the mammary arch. The architectural study is presented as well as its adaptation to the breast.

Breast↗

Incorporating client-server database architecture and graphical user interface into outpatient medical records.

Computerized medical record systems require structured database architectures for information processing. However, the data must be able to be transferred across heterogeneous platform and software systems. Client-Server architecture allows for distributive processing of information among networked computers and provides the flexibility needed to link diverse systems together effectively. We have incorporated this client-server model with a graphical user interface into an outpatient medical record system, known as SuperChart, for the Department of Family Medicine at SUNY Health Science Center at Syracuse. SuperChart was developed using SuperCard and Oracle SuperCard uses modern object-oriented programming to support a hypermedia environment. Oracle is a powerful relational database management system that incorporates a client-server architecture. This provides both a distributed database and distributed processing which improves performance.

Ambulatory Care Information Systems↗

Actin architecture of cultured human thyroid cancer cells: predictor of differentiation?

The actin cytoskeleton is important for cell structure and motility. A disordered actin architecture has been correlated with a high metastatic potential in melanoma, fibrosarcoma, and colon cancer models. Thyrotropin is known to induce growth and differentiation in cultured thyroid cells, whereas the carcinogenic phorbol ester 12-O-tetradecanoylphorbol 13-acetate (TPA) causes dedifferentiation and malignant transformation in many cell lines. We therefore assessed the effect of thyrotropin and TPA on the actin architecture of FTC-133 human follicular thyroid cancer cells in continuous culture. Staining of filamentous actin with rhodamine phalloidin showed that 1 mU/ml or 30 mU/ml thyrotropin-induced actin polymerization was detectable at 1 hour but more notable at 24 hours. Similarly TPA (0.008 to 10 mumol/L) caused rapid actin fiber disruption and redistribution to the cell periphery. Secondary antibody staining for alpha-actinin, a protein that binds and crosslinks actin, was more prominent after treatment with thyrotropin but decreased after TPA. These findings indicate that the actin cytoskeleton has a dynamic response to trophic factors. Thyrotropin promoted actin polymerization, but TPA caused depolymerization. These effects may correlate with cellular alpha-actinin levels. Actin architecture may therefore reflect the state of differentiation of thyroid tumor cells.

Actin Cytoskeleton↗

Serious unintentional injuries associated with architectural glass.

Injuries associated with architectural glass have become a matter of considerable concern in recent years. Despite this concern there has been no attempt to document either the extent of the problem in New Zealand or the circumstances under which these events occur. In this study, national injury mortality data for the period 1977-86 were examined and cases selected if the cause of death was attributable to an event involving architectural glass. A total of nine deaths were identified. All discharges from New Zealand public hospitals during 1986 were examined to identify victims who had been treated for injuries associated with architectural glass. Descriptive information contained on each patient record was coded to provide more specific information on the circumstances of injury. A total of 501 first admissions to hospital were identified, giving an incidence rate of 15 per 100,000 persons per year. The highest rate of 60 per 100,000 per year, was found for males in the age group 15-24 years. Seventy-eight percent of the events involved males, 62% occurred at home, 64% involved windows, and 32% involved doors. Ninety-three percent of the injuries were open wounds. Seventy-nine percent of the injuries were to the upper limbs, 13% were to lower limbs and 5% were to the head. The mean length of stay in hospital was 3.3 days. Opportunities for injury prevention are discussed including visual and physical barriers, mandatory glazing standards and public education. Specific areas requiring further research are identified.

Accident Prevention↗

[Delaire's architectural and structural cranio-facial analysis in cephalometric evaluation].

In this study, the main rules of architectural and Structural cranio-facial analysis developed by Delaire is explained. This architectural and structural cranio-facial analysis of the lateral cephalometric radiograph clarifies the mutual balance of the various bony structures of the cranium and face, individualizes certain of the structures, and specifies their normal of pathologic relationships. Five cephalometric, films were evaluated according to Delaire's architectural and structural analysis and according to classic cephalometric analysis. The results we obtained are presented.

Cephalometry↗

Mosaic architecture of the somatic sensory-recipient sector of the cat's striatum.

The striatum is known to have a compartmental organization in which histochemically defined zones called striosomes form branched 3-dimensional labyrinths embedded within the surrounding matrix. We explored how fiber projections from cortical somatic sensory areas representing cutaneous and deep-receptor inputs are organized in relation to this striatal architecture. Areas SI and 3a were mapped electrophysiologically, and distinguishable anterograde tracers (wheat germ agglutinin-HRP and 35S-methionine) were injected into physiologically identified loci. Primary somatic sensory corticostriatal projections were confined to a small, well-defined sector in the dorsolateral corner of the ipsilateral striatum. The somatic sensory afferents were arranged according to a coherent global body map in which rostral body parts were represented more laterally than caudal body parts. Single cortical loci innervated branched and clustered striatal zones that were reminiscent of the striosomes in their range of sizes and shapes yet lay strictly within the extrastriosomal matrix. In contrast to the global orderliness of the striatal body map, there were clear examples of locally complex patterns in which functionally distinct inputs interdigitated with each other. These patterns were often, but not always, produced when corticostriatal afferents carrying different submodality types were labeled. These findings demonstrate the existence of striosome-like striatal compartments within the seemingly uniform extrastriosomal matrix. The principle of mosaic organization thus holds throughout the tissue of the somatic sensory striatum. The striatal architecture delineated here could provide the anatomical substrate for computations requiring cross-modality comparisons within the framework of an overall somatotopy. If a similar multicompartmental architecture also characterizes other striatal regions, as seems likely, it may set general constraints on the nature of associative processing within the striatum as a whole.

Afferent Pathways↗

[Results of pathologico-anatomic findings on the synthetic architecture of the human brain].

The synthetic architecture of the brain reflects the dynamics of life, which require harmony. In man, the goal of the energy recognizable in this architecture differs from that in animals. Individual reactions are the results of the different spatial architecture. Special enzyme properties have been pointed out. These are responsible for differences in structure and relationships. Such differences are necessary for the various biologic demands. They also explain many clinical findings.

Age Factors↗

[Microvascular architecture of human gastrointestinal and breast cancer xenografts in nude mice, and its relation to chemosensitivity].

As a tumor factor possibly responsible for chemosensitivity of human cancer xenografts in nude mice, the vascular architecture of tumors growing in mice was investigated in 15 kinds of cancer lines. These consisted of 7 gastric, 3 colorectal, 3 breast and 2 pancreatic cancers. Whole body angiograms of tumor-bearing mice were obtained by perfusing a radiopaque silicone rubber compound (Microfil) through the left ventricle of each mouse. Each cancer retained a characteristic vascular architecture comparable to its histopathological finding. According to the vascularity of the viable part of the tumor, the 15 lines of cancer were classified into 5 groups. Compared with colorectal cancers, stomach cancers had a tendency to decline to a more hypervascular group. There was no apparent relation between vascularity and growth rate, or histological differentiation of the tumors. Among 14 anticancer agents studied, statistically significant correlation between chemosensitivity and vascularity of the 15 cancer lines was observed in 2 drugs, 5'-DFUR and adriamycin. The vascular architecture of the tumors would have some influence in their chemosensitivity through drug accessibility to cancer cells.

Adenocarcinoma↗

Changes in the cell surface architecture in normal and polyoma virus transformed hamster cells after infection with influenza virus.

Test of Con A induced cell agglutination, method of binding cells to Con A coated nylon fibres and modified procedure of cell-to-cell binding were used in the investigation of architectural surface changes in normal and polyoma virus transformed hamster cells infected with influenza virus. In both cell types influenza virus infection caused 1) increase in fixation resistant Con A agglutination, 2) decrease in the level of surface membrane fluidity and cell plasticity. It has postulated that influenza virus infection results in stabilization of the cell surface architecture. These changes are amplified by polyoma virus transformation. Con A acts in this system, as an indicator rather than as a modifier of architectural changes.

Agglutination↗

A determinant of bone architecture. The minimum effective strain.

Minimum effective strain (MES), a hypothesis since 1964, has achieved experimental support. The range is about 0.0008-0.002 unit bone surface strain. Strains below the MES apparently do not evoke adaptive architectural bone modeling, but those above it do. As a key property of living lamellar bone and its intermediary organization, MES offers the potential to predict exactly when and where mechanical loads will cause bone architectural adaptations. MES represents a step toward the goal of constructing a specific, predictive, and quantitative theory of the mechanical determinants of skeletal architecture.

Animals↗

Dusart syndrome: a new concept of the relationship between fibrin clot architecture and fibrin clot degradability: hypofibrinolysis related to an abnormal clot structure.

Fibrinogen Dusart is a congenital dysfibrinogenemia (A-alpha 554 Arginine-->Cysteine) associated with severe thrombotic disorder, high incidence of thrombotic embolism, and abnormal fibrin polymerization. This thrombotic disorder was attributed to an abnormal clot thrombolysis with reduced plasminogen binding to fibrin and defective plasminogen activation by tissue plasminogen activator. The purpose of this work was to assess whether clot architecture could be involved in the thromboresistance of the fibrin Dusart and the high incidence of embolism. An important change in Dusart fibrin clot structure was identified with dramatic decrease of gel porosity (Ks), fiber diameters (d), and fiber mass-length ratios (mu) derived from permeation analysis. In addition, rigidity of the Dusart clot was found to be greatly increased compared with normal fibrin. We provide evidence that both thrombolysis resistance and abnormal rigidity of the fibrin Dusart are related to this abnormal architecture, which impairs the access of fibrinolytic enzymes to the fibrin and which is responsible for a brittle clot that breaks easily, resulting in a high incidence of embolism. Indeed, when restoring a normal clot structure by adding dextran 40 (30 mg/mL) before coagulation, clot thrombolysis and clot rigidity recovered normal values. This effect was found to be dose-dependent. We conclude that clot architecture is crucial for the propensity of blood clot to be degraded and that abnormal clot structure can be highly thrombogenic in vivo. The alpha-C domains of fibrinogen are determinant in fibrin clot structure.

Dextrans↗

A physician-based architecture for the construction and use of statistical models.

Physicians need specially tailored computer tools to take advantage of published research results. We present a knowledge-based computer framework--the physician-based (PB) architecture--for constructing such tools, and we use the problem of physicians' interpretation of two-arm parallel randomized clinical trials (TAPRCT) as a working example. Statistical models are represented by influence diagrams. The interpretation of influence-diagram elements are mapped into users' language in a domain-specific, physician-based user interface, called a patient-flow diagram. Statistical-model transformations that maintain the semantic relationships of the model and that embody clinical-epidemiological knowledge are encoded in a mediating structure called the cohort-state diagram. The algorithm that coordinates the interactions among the knowledge representations uses modular actions called construction steps. This architecture has been implemented in a Bayesian system, called THOMAS, that supports physician decision making in light of TAPRCT data. This support entails assessing clinical significance, prior beliefs, and methodological concerns. We suggest that the PB architecture applies to a wide range of statistical tools and users.

Algorithms↗

Architectural pattern of the normal and cancerous breast under the influence of parity.

Epidemiological and clinical observations indicate that breast cancer incidence is greater in nulliparous women, whereas early parity confers protection. Since the initiation of breast cancer is related to the degree of development of the organ, this study was designed with the purpose of determining what basic differences exist between the parous and the nulliparous women's breast, and whether these differences correlated with the presence or absence of malignancies. For this purpose, the architecture of the mammary gland of parous and nulliparous women with breast cancer was compared with that of women free of mammary pathology. The women ranged in an age from 20 to 63 years. Normal whole breasts obtained at autopsy or cancer-bearing breasts surgically removed by modified radical mastectomy were studied in whole mount preparations in which the number and relative proportion of normal structures, i.e., lobules type 1, 2, and 3 (Lob 1, 2, and 3), were determined. In the breast of nulliparous women, the predominant structure present was the Lob 1; the presence of cancer did not modify the basic architectural pattern of the breast, which contained a higher proportion of Lob 1, as well. In parous women free of cancer, the breast contained a greater percentage of Lob 3 and a moderately increased number of Lob 2, with a concomitant reduction in Lob 1. Parous women with breast cancer, on the other hand, exhibited a different architecture in the mammary gland, which had a greater percentage of Lob 1 and a lower of Lob 3 than the noncancerous group, approaching the percentages found in nulliparous women.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

A new architecture for integration of heterogeneous software components.

An architecture is described that integrates existing applications in a network-wide system. The architecture follows the new open software paradigm, and defines kernel and application services that collaboratively solve the tasks of end-users and provide them with an intuitive user-interface. This paper describes the message language and the kernel mechanism for addressing application services. The architecture has been developed as much as possible to conform with current standards.

Computer Communication Networks↗

A server architecture for ambulatory patient record systems.

Baylor College of Medicine is developing the Collaborative Social and Medical Services System (CSMSS) to provide a computerized patient record (CPR) system for the Teen Health Clinics (THC) [1]. The THCs consist of five geographically distributed clinics providing health care and social services to teenagers in the Harris County Hospital District. The CSMSS is the first application built upon the Ambulatory Systems Architecture (ASA) [2]. The ASA is aimed at providing an architecture and application framework for the development and deployment of CPR systems in ambulatory care settings. This paper describes the ASA server architecture.

Ambulatory Care↗

A portable communicative architecture for electronic healthcare records: the Good European Healthcare Record project (Aim project A2014).

The European Union is supporting research into medical informatics via its Advanced Informatics in Medicine (AIM) program. One of the current AIM projects is the Good European Healthcare Record (GEHR) project. Its objective is to devise an architecture for electronic healthcare records that will enable them to be comprehensive, communicative, and portable to different systems. The work was funded from January 1992 to December 1994. The project team consisted of over 50 personnel representing clinicians, computer scientists, and computer programmers in eight European countries. The partner organizations are Health Data Management Partners (Belgium), Croix Rouge Francaise (France), France Telecom, Association des Medecins et Medicins Dentistes (Luxembourg), Instituto Clinica Geral Zona Norte (Portugal), Medical College of St Bartholomew's Hospital (UK), and SmithKline Beecham (UK). The work of the project has been carried out by three subgroups covering clinical, architecture, and systems aspects. One of the strengths of the project has been that most of the work has been done as collaborations between members of different groups. This has meant that there has been very close contact between clinicians and computer experts. The GEHR project is providing important input into the standardization process in Europe via, for example, PT011 of Working Group 1 of CEN TC/251 (the developing standards for the architecture of healthcare records).

Computer Communication Networks↗

Moving a hospital information system towards a client server architecture.

This paper is intended to give you an overview about the migration process of the Hospital Information System (HIS) at the University Hospital of Giessen towards an open client server based architecture. It describes the software architecture of the existing mainframe applications and the network interfaces involved in opening the centralized software architecture to a wide variety of remote applications.

Computer Communication Networks↗

An intelligent information systems architecture for clinical decision support on the Internet.

This paper presents a prototype of an agent-based intelligent information systems architecture that can provide clinical decision support in a distributed, heterogeneous environment such as the Internet. After presenting the architecture, a specific transaction sequence is detailed and implemented to test the architecture. A transaction sequence is a detailed analysis of all actions by all entities to accomplish the system goal. In this case, the goal is to give decision support information access to a provider in the context of a computerized patient record. Based on the results of the prototype implementation, we argue that the system is scaleable and discuss other transactions, standards, and needed development.

Computer Communication Networks↗