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Software design for an inexpensive, practical, microcomputer-based DNA cytometry system.

Recent advances in digital electronics have made it possible to put together videophotometry systems capable of practical DNA ploidy measurements at a relatively modest cost. Such a system, based upon the IBM PC microcomputer and other "off-the-shelf" components, is now operational in our laboratory. This paper discusses the design considerations that went into the development of the software for this system. It examines the choices, constraints and tradeoffs involved in such a software engineering project and considers the practical implementation of image processing algorithms and a user-friendly interface. An overview is given of the modular, menu-driven software through which the system is controlled, along with a description of normal operational flow.

Cell Nucleus↗

Description of a novel microcomputer program to analyze left ventricular segmental wall motion during normal sinus rhythm and sinus tachycardia.

The authors have written a program to describe left ventricular (LV) regional wall motion (RWM) for a Tektronix 4051 graphic system and an MC68000, 32-bit word based microcomputer utilizing interactive graphics methods. Proper wall motion of 16 defined regions of the LV endocardial perimeter (RAO angiographic views) were computed from the magnitudes of fixed vectors fixed to analogous positions along the LV perimeter from end-diastole to end-systole (Figure 1). It was assumed that (1) LV contraction, tangential to the perimeter, produced RWM at large angles to the direction of contraction, and (2) LV contraction occurred uniformly along the anterolateral and posteromedial perimeters. All motion vectors were computed following digitization of the LV perimeters from projected images of 35-mm cineangiographic frames corrected for linear and nonlinear distortion. Digitization input was accurate to less than 0.3 mm and area computation demonstrated errors of less than 1.5%. A normal group (NG) without coronary artery (CA) disease (N = 31) defined a set of Gaussian distributed referent values for mean WM (magnitude of motion vectors) for all segments. WM amplitudes for the CA disease group (N = 125) demonstrated significant diviation in the areas supplied by occluded or stenosed coronary arteries. Qualitative and quantitative evaluation of the adequacy of coronary circulation and/or collateral vessel development could be made by inspection of WM amplitude computer plots. Proper WM was found to be highly specific for numbers and distribution of coronary arteries diseased.

Cineangiography↗

An analysis program MULTI(ELS) based on extended nonlinear least squares method for microcomputers.

An analysis program MULTI(ELS) was developed for population pharmacokinetics on a microcomputer. The program based on the extended least squares (ELS) is written in the Microsoft minimum BASIC command alone. ELS simultaneously estimates not only the population pharmacokinetic parameters but also the variances of inter-individual variabilities around the population parameters and of intra-individual variabilities for the plural time courses, whereas the ordinary least squares estimates the pharmacokinetic parameters of each time course. Two least squares algorithms (i.e. quasi-Newton and simplex methods) are provided in MULTI(ELS). MULTI(ELS) was compared with NONMEM (Version I, Level 3) developed by Sheiner and Beal for several time course data. It was shown that MULTI(ELS) gave the same results as NONMEM. MULTI(ELS) calculates the Akaike's information criterion (AIC) for the extended least squares. It was also shown that the AIC is effective in comparing the population characteristics of time courses in a group with those in another group and in verifying the model structures of population means, inter-individual variations and intra-individual variations.

Computers↗

Epidemiologic programs for computers and calculators. Decision-tree analysis using a microcomputer.

Decision analysis using decision trees enables the medical decision maker to simplify and solve complex problems. The technique, however, becomes cumbersome when the decision maker attempts to perform sensitivity analysis on the problem. This paper describes a computer program, written in PASCAL, to construct, modify, and perform deterministic and stochastic simulations and risk analysis on a hypothetical, decision-analysis problem. The deterministic version can be run on microcomputers with CP/M, PC-DOS, or MS-DOS operating systems, and the deterministic/stochastic version requires a PC-DOS or MS-DOS operating system.

Computers↗

A microcomputer program for critical evaluation of diagnostic tests.

We developed a microcomputer program that provides a Bayesian model of diagnostic performance and a simple decision tree model of clinical utility. We have used this program to review diagnostic performance and clinical utility for proposed new services at our 360-bed university hospital. We believe that significant benefits can be achieved if medical journals report complete data on test performance. First, this allows physicians to perform their own evaluations of diagnostic performance. Second, this allows physicians to evaluate clinical utility using either standard decision trees or decision trees that reflect specific clinical problems.

Bayes Theorem↗

[PorkCHOP: an economic microcomputer replacement model for sows].

A computer model called PorkCHOP, was developed in an electronic spreadsheet on the microcomputer to help farmers, veterinarians and other livestock specialists reach economically sound culling decisions in swine breeding herds. It quantifies the benefits of a longer herd life and a shorter farrowing interval, calculates an economic index (Retention Pay-Off) to be used as a culling guide for individual sows within a herd and determines the maximum number of permissible services when sows fail to conceive following the first service. PorkCHOP runs with 'default' settings for the major factors affecting replacement economics, but the user can modify all variables to represent a specific herd more precisely.

Animal Husbandry↗

Anatomy of a microcomputer.

The author discusses how to buy a microcomputer for the optometric office. What kinds of features should a neophyte look for in computer hardware? What kinds of software products are available and how should you select the right ones for your office?

Computers↗

Surgical pathology accessioning and management on a multiuser hard disk microcomputer system.

We have developed an inexpensive, microcomputer-based, multiuser hard disk system for surgical pathology that uses a commercially available word processor and data base manager, linked together by several BASIC programs written by us. System functions include keyboard input of patient demographic data and specimen information, word processing with the generation of preliminary and final surgical reports, on-line access to the surgical pathology data base, generation of daily secretarial and histology log sheets, and computer-assisted SNOMED coding. Successful implementation of this system has produced greater efficiency and productivity in the surgical pathology department at a reasonable cost.

Computers↗

The trauma registry: a method for providing regional system audit using the microcomputer.

Medical accountability is an essential component of a system for trauma care. The microcomputerized regional trauma registry provides a simple method of providing accountability by integrating medical and system information to evaluate quality of care, adequacy of system criteria, and system compliance. The regional trauma registry is developed by identifying all patients who are suspected or known to have sustained a serious injury, whether or not they received trauma system care, and documenting their course from initial contact through final disposition. The microcomputer provides an inexpensive and readily available method for storing and evaluating the database. Information derived from the regional trauma registry is useful for profiling the nature and extent of trauma and for monitoring and modifying the system to improve patient access and medical care.

California↗

Glaucoma assessment by microcomputer.

An automated system for comprehensively monitoring glaucoma patients is described. This economic and practical microcomputer data system has been designed to be thoroughly 'clinician oriented' through the collaborative efforts of ophthalmological and computer specialists. It incorporates novel and efficient methods for transferring both automated and manually recorded perimetry data into analysable digital form. The system is inexpensive, simple to use, maintains safe records, allows thorough analysis of patient data, and can considerably reduce the administrative load on ophthalmological clinics.

Computers↗

Management of postcardiotomy hypertension by microcomputer-controlled administration of sodium nitroprusside.

Manual administration of sodium nitroprusside in patients who have undergone cardiac operations can be associated with wide swings in mean systemic arterial pressure. Moreover, it is necessary for constant attention to be paid in order to minimize these potentially catastrophic arterial pressure changes. A microcomputer-based controller was constructed in the belief that it might improve the accuracy of systemic arterial pressure control as well as relieve the clinical staff of a time-consuming task. Comparison was made of the effectiveness of manual control versus computer control of sodium nitroprusside infusion in two groups of patients with similar clinical characteristics. In the manual control group the mean systemic arterial pressure could be maintained within 5 mm Hg of the target pressure only half (52%) of the time. In the computer-controlled group the mean systemic arterial pressure was maintained within 5 mm Hg of the target pressure 94% of the time (p less than 0.005). Thus, computerized control of sodium nitroprusside infusion eliminated the need for an intensive care unit nurse to be "locked into" the task of making frequent adjustments of infusion rate. Of even greater importance, control of mean systemic arterial pressure was more precise.

Cardiac Surgical Procedures↗

Microcomputers and neurobiology: a short review.

A brief history of the application of computing techniques emphasizes the two-part development with expensive minicomputers available in a few laboratories being added to by inexpensive microcomputers ubiquitously available. Computers are used for microscope control and plotting, serial section reconstruction, morphometric measurement, stereology, video image analysis, photometry and fluorescence microscopy. Basic principles are exemplified by considering nerve cell reconstruction. General principles of computerized electrical measurement including filtering, averaging and stimulus generation are discussed. Computerized waveform selection as used for spike discrimination, when considered along with computer control of electrode position and the growing availability of multichannel recording arrays, suggests a possible advance in automatic analyses. With the ability to process more complex waveforms successfully, electrophysiological data such as compound extracellular potentials may usefully replace the cleaner, but more limited intracellular data. Success with multichannel feedback controlled stimulators making paraplegics stand and walk point to a developing application with much potential.

Microcomputers↗

Accessing remote data bases using microcomputers.

General practitioners' access to remote data bases using microcomputers is increasing, making even the most obscure information readily available. Some of the systems available to general practitioners in the UK are described and the methods of access are outlined. General practitioners should be aware of the advances in technology; data bases are increasing in size, the cost of access is falling and their use is becoming easier.

Computers↗

[Irradiation of lymphogranulomatosis patients with large fields of complex configuration, calculating absorbed doses by microcomputer].

The authors demonstrated advantages of irradiating lymphogranulomatosis patients with large fields of complex configuration. The use of computer eliminates the difficulties of dosage calculation. Application for these purposes of the 15 VUMS-28 unit based on the microcomputer "Elektronika-60" is suggested. Algorithm of the dosage calculation program is presented. The program is drawn up according to the GOST so that it can be used by other institutions concerned.

Cobalt Radioisotopes↗

Analysis by microcomputer of the effect of capsaicin on pulmonary mechanics in the rat and guinea-pig.

Analysis of airways resistance and lung compliance in anaesthetized rats and guinea-pigs was accomplished on-line by microcomputer. In spontaneously respiring guinea-pigs capsaicin (0.5-2.5 microgram/kg i.v.) increased both resistance by 0.33 +/- 0.13 cmH20/ml/sec and the end-expiratory lung volume and it decreased compliance by 0.24 +/- 0.09 ml/cmH2O. These effects of capsaicin were resistant to vagotomy. In the rat, doses of capsaicin (40-80 micrograms/kg i.v. and i.a.) which produced respiratory apnoea had no effect on resistance or compliance in artificially ventilated animals but it did cause a decrease of end-expiratory volume, an effect which was abolished by vagotomy. The results confirm that reduction in tidal volume seen in spontaneously respiring rats following capsaicin (Mitchell et al., 1984) appears to be due to an action other than one on the bronchial calibre.

Airway Resistance↗

The use of a microcomputer for inpatient audit in an orthopaedic department.

A microcomputer has been used to assist in the inpatient audit of an orthopaedic unit in a district general hospital. The aims were to provide a more detailed, accurate audit, more rapidly than previous manual methods had allowed. The clinical details of 609 patients treated over a 9-month period were fed into the computer and various statistical analyses performed. The results of the audit are presented. The extent to which our aims have been achieved is discussed together with the specific problems encountered with computer hardware, software and organisation of the system.

Computers↗

Storing summary patient data as a microcomputer file.

The time taken to summarize 1000 patient records and store this data as a hard disc file on a microcomputer was evaluated in a health centre with about 7300 patients. On average it took 25 minutes to prepare or update summary sheets for each patient and between three to five minutes to input the data to the computer. About one in 10 of the records were long and complicated and took considerably more time to summarize. An error rate of 9% over six months was determined for the age-sex register, mostly owing to patients who had left the practice. In about 5% of cases important information was missing from the A4 folders and was only obtainable from the health visitor records.

Computers↗

Microcomputer-based communication augmentation systems for two nonspeaking, physically handicapped persons with severe visual impairment.

Two different microcomputer-based communication systems were developed for nonspeaking physically handicapped individuals with severe visual impairment. One subject was 24 years old and had an inoperative optic glioma which impaired motor function as well as vision. The second subject was cortically blind with severe motor limitation secondary to an automobile accident which occurred at 17 years of age. Both communication systems employed speech synthesis as a control feature to compensate for visual impairment. Both subjects have learned to use their communication systems. The second subject has not achieved extended, independent system use due to reduced vigilance and attention span.

Adolescent↗