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PubMedDate not supplied

A client/server system for Internet access to biomedical text/image databanks.

Internet access to mixed text/image databanks is finding application in the medical world. An example is a database of medical X-rays and associated data consisting of demographic, socioeconomic, physician's exam, medical laboratory and other information collected as part of a nationwide health survey conducted by the government. Another example is a collection of digitized cryosection images, CT and MR taken of cadavers as part of the National Library of Medicine's Visible Human Project. In both cases, the challenge is to provide access to both the image and the associated text for a wide end user community to create atlases, conduct epidemiological studies, to develop image-specific algorithms for compression, enhancement and other types of image processing, among many other applications. The databanks mentioned above are being created in prototype form. This paper describes the prototype system developed for the archiving of the data and the client software to enable a broad range of end users to access the archive, retrieve text and image data, display the data and manipulate the images. System design considerations include; data organization in a relational database management system with object-oriented extensions; a hierarchical organization of the image data by different resolution levels for different user classes; client design based on common hardware and software platforms incorporating SQL search capability, X Window, Motif and TAE (a development environment supporting rapid prototyping and management of graphic-oriented user interfaces); potential to include ultra high resolution display monitors as a user option; intuitive user interface paradigm for building complex queries; and contrast enhancement, magnification and mensuration tools for better viewing by the user.

Anatomy, Cross-Sectional↗
PubMed1989

A confocal laser microscope scanner for digital recording of optical serial sections.

A confocal laser microscope scanner developed at our institute is described. Since an ordinary microscope is used, it is easy to view the specimen prior to scanning. Confocal imaging is obtained by laser spot illuminatin, and by focusing the reflected or fluorescent light from the specimen onto a pinhole aperture in front of the detector (a photomultiplier tube). Two rotating mirrors are used to scan the laser beam in a raster pattern. The scanner is controlled by a microprocessor which coordinated scanning, data display, and data transfer to a host computer equipped with an array processor. Digital images with up to 1024x1024 pixels and 256 grey levels can be recorded. The optical sectioning property of confocal scanning is used to record thin (about 1 microm) sections of a specimen without the need for mechanical sectioning. By using computer-control to adjust the focus of the microscope, a stack of consecutive sections can be automatically recorded. A computer is then used to display the 3-D structure of the specimen. It is also possible to obtain quantitative information, both geometric and photometric. In addition to confocal laser scanning, it is easy to perform non-confocal laser scanning, or to use conventional microscopic illumination techniques for (non-confocal) scanning. The design has proved reliable and stable, requiring very few adjustments and realignments. Results obtained with this scanner are reported, and some limitations of the technique are discussed.

Animals↗
PubMed1982

A double-blind clinical trial of nomifensine vs. amitriptyline in depressed patients.

This article describes a controlled clinical trial comparing nomifensine and amitriptyline in endogenously depressed inpatients. It is also the first trial of the ICPP-BLIPS, a computer based clinical trial data documentation system. Using strict methodological criteria, careful quality control and comprehensive and systematic data display and data analysis, we have been able to show clearcut efficacy differences between nomifensine and amitriptyline (favouring the later) and clearcut differences in the profile of side effects between these drugs. Future studies utilizing this methodology are recommended were definitive and documented results of clinical trials are desired.

Adult↗
PubMed2006

Developments in CORG: a gene-centric comparative genomics resource.

The CORG resource (Comparative Regulatory Genomics, http://corg.eb.tuebingen.mpg.de) provides extensive cross-species comparisons of promoter regions in particular and whole gene loci in general. Pairwise as well as multiple alignments of 10 vertebrate species form the key component of CORG. We implemented a rapid alignment approach based on weight matrix motif anchors to ensure efficient computation and biologically informative alignments. All CORG workbench components have been enhanced towards more flexibility and interactivity. Reference sequence based data presentation and analysis was put into the well-known and modular Generic Genome Browser framework. Herein, various plugins facilitate online data analysis and integration with static conservation data. Main emphasis was put on the design of a new JAVA WebStart application for comparative data display. Flexible data import and export options for standard formats complete the provided services.

Animals↗
PubMed1981

Technical aspects and clinical applications of CT/X, a dynamic CT scanner.

CT/X is an X-ray computed tomographic scanner system designed for research in the clinical applications of rapid sequence scanning. The minimum scan time is 1.5 sec, and up to 18 images of the same cross section can be derived from scans taken over a 30 sec time interval. With this high image rate, the transit of a bolus of iodinated contrast medium can be followed through any cross section of the body. Rapid sequence scanning through a series of contiguous levels can also be performed, and 12 levels can be scanned in less than 50 sec. The short aggregate scan period minimizes the likelihood of interslice patient motion resulting in high quality multiplanar images. To fully exploit this capability, an imaging facility capable of reformatting axial transverse display data into a plane of arbitrary orientation has been incorporated into the system. A computer-electrocardiographic interface is also provided for use in retrospective cardiac gating. The capabilities of the scanner are illustrated with selective clinical studies.

Angiography↗
PubMed2003

RNAi microarray analysis in cultured mammalian cells.

RNA interference (RNAi) mediated by small interfering RNAs (siRNAs) is a powerful new tool for analyzing gene knockdown phenotypes in living mammalian cells. To facilitate large-scale, high-throughput functional genomics studies using RNAi, we have developed a microarray-based technology for highly parallel analysis. Specifically, siRNAs in a transfection matrix were first arrayed on glass slides, overlaid with a monolayer of adherent cells, incubated to allow reverse transfection, and assessed for the effects of gene silencing by digital image analysis at a single cell level. Validation experiments with HeLa cells stably expressing GFP showed spatially confined, sequence-specific, time- and dose-dependent inhibition of green fluorescence for those cells growing directly on microspots containing siRNA targeting the GFP sequence. Microarray-based siRNA transfections analyzed with a custom-made quantitative image analysis system produced results that were identical to those from traditional well-based transfection, quantified by flow cytometry. Finally, to integrate experimental details, image analysis, data display, and data archiving, we developed a prototype information management system for high-throughput cell-based analyses. In summary, this RNAi microarray platform, together with ongoing efforts to develop large-scale human siRNA libraries, should facilitate genomic-scale cell-based analyses of gene function.

Cell Line, Tumor↗
PubMed1990

The oxygen status algorithm: a computer program for calculating and displaying pH and blood gas data.

Input parameters for the program are the arterial pH, pCO2, and pO2 (measured by a blood gas analyzer), oxygen saturation, carboxy-, met-, and total hemoglobin (measured by a multi-wavelength spectrometer), supplemented by patient age, sex, temperature, inspired oxygen fraction, fraction of fetal hemoglobin, and ambient pressure. Output parameters are the inspired and alveolar oxygen partial pressures, pH,pCO2 and pO2 referring to the actual patient temperature, estimated shunt fraction, half-saturation tension, estimated 2,3-diphosphoglycerate concentration, oxygen content and oxygen capacity, extracellular base excess, and plasma bicarbonate concentration. Three parameters related to the blood oxygen availability are calculated: the oxygen extraction tension, concentration of extractable oxygen, and oxygen compensation factor. Calculations of the 'reverse' type may also be performed so that the effect of therapeutic measures on the oxygen status or the acid-base status can be predicted. The user may choose among several different units of measurement and two different conventions for symbols. The results are presented in a data display screen comprising all quantities together with age, sex, and temperature adjusted reference values. The program generates a 'laboratory diagnosis' of the oxygen status and the acid-base status and three graphs illustrating the oxygen status and the acid-base status of the patient: the oxygen graph, the acid-base chart and the blood gas map. A printed summary in one A4 page including a graphical display can be produced with an Epson or HP Laser compatible printer. The program is primarily intended for routine laboratories with a blood gas analyzer combined with a multi-wavelength spectrometer. Calculating the derived quantities may enhance the usefulness of the analyzers and improve patient care. The program may also be used as a teaching aid in acid-base and respiratory physiology. The program requires an IBM PC, XT, AT or similar compatible computer running under DOS version 2.11 or later. A VGA color monitor is preferred, but the program also supports EGA, CGA, and Hercules monitors. The program will be freely available at the cost of a discette and mailing expenses by courtesy of Radiometer Medical A/S, Emdrupvej 72, DK-2400 Copenhagen NV, Denmark (valid through 1991). A simplified algorithm for a programmable pocket calculator avoiding iterative calculations is given as an Appendix.

2,3-Diphosphoglycerate↗
PubMed1988

Circadian and ultradian rhythms in blood glucose and plasma insulin of healthy adults.

The circadian and ultradian variations of blood glucose and plasma insulin have been characterized individually and as a group phenomenon in five healthy young adults studied while adhering as closely as possible to their usual routine of sleep, activity, meal content and timing. Three complementary methods were used to analyze the data: displaying raw data as a function of time; cosinor method according to Nelson and Halberg; and time series analyses as proposed by De Prins and Malbecq. The subjects were studied in the laboratory and their life routine were controlled, but very close to that of their habitual routine. They had mainly ultradian rhythms of blood glucose (mainly about 6 hr) and circadian rhythms of immunoreactive insulin (I.R.I.). Blood glucose ultradian rhythms seem to be mainly but not exclusively mealtime dependent, while I.R.I. circadian rhythms appear to be primarily endogenous in origin. Therefore, the role played by insulin in the control of blood glucose levels seems to be programmed on a circadian basis rather than by a time independent feedback phenomenon as postulated by the conventional homeostatic hypothesis. The advantage of this chronophysiologic approach is to consider circadian rhythms of both I.R.I. and insulin effectiveness as an adaptive phenomenon able to maintain blood sugar changes in the ultradian domain of rhythms.

Activity Cycles↗
PubMedDate not supplied

Good measurement for good improvement work.

PURPOSE: To provide guidance on using measurement to support the conduct of local quality improvement projects that will strengthen the evaluation of results and increase their potential for publication. TARGET GROUP: Individuals leading quality improvement efforts who wish to enhance their use of measurement. PROCEDURES TO PROMOTE GOOD MEASUREMENT: Eleven procedures are offered to promote intelligent measurement in quality improvement research that may become publishable: 1. Start with an important topic 2. Develop a clear aim statement 3. Turn the aim statement into key questions 4. Develop a theory about causes and effects, process changes and predictable sources of variation 5. Construct a research design and accompanying dummy data displays to answer your primary research questions 6. Develop and use operational definitions for each variable needed to make your dummy data displays 7. Design a data collection plan to gather information on each variable that will enable you to generate reliable, valid, and sensitive measures related to each research question 8. Pilot test the data collection plan, construct preliminary data displays, and revise your methods based on what you learn 9. Stay close to the data collection process as the data plan goes from idea to execution 10. Perform data analysis and display results in a way that answers your key questions. 11. Review and document the strengths and limitations of your measurement work and use this knowledge to guide intelligent interpretation of the observed results.

Health Facilities↗
PubMed1994

Autoregressive spectral array for graphical display of EEG data.

A graphical display of the frequency content of background electroencephalogram (EEG) activity is obtained by calculating the spectral estimates using autocorrelation autoregressive method and the classical Fourier transform method. Display of spectral content of consecutive data segments is made using hidden-line suppression technique so as to get a spectral array. The autoregressive spectral array (ASA) is found to be sensitive to baseline drift. Following baseline correction the autoregressive technique is found to be superior to the Fourier method of compressed spectral array (CSA) in detecting the transitions in the frequencies of the signal. The smoothed ASA gives a better picture of transitions and changes in the background activity. The ASA can be made to adapt to specific changes of dominant frequencies while eliminating unnecessary peaks in the spectrum. The utility of the ASA for background EEG analysis is discussed.

Computer Graphics↗
PubMed1986

A data acquisition, display and plotting program for the IBM PC.

A program, AQ, has been developed to perform analog-to-digital (A/D) conversions on IBM PC products using the Data Translation DT2801-A or DT2801 boards. This program provides support for all of the triggered and continuous A/D modes of these boards. Additional subroutines for management of data files and display of acquired data have also been developed. These programs have been written so that a minimum number of keystrokes are required for their operation. Parameter files are used to simplify reconfiguration of this program for various data acquisition tasks.

Analog-Digital Conversion↗
PubMed1988

The development of a third generation system for entering microbiology data into a clinical laboratory information system.

Increased demands on technologists' time and the desire to have electronic storage of patient information have led to numerous computer-based efforts to manage microbiology data. Our approach to the design of a new microbiology subsystem has been to maximize the functionality without requiring unusual input devices. DEC VT100-compatible terminals are used for data entry and display. Data are displayed taking advantage of such features of these terminals as reverse video, highlighting, and scroll windowing. Numerous single-key instructions for invoking functions and changing cursor positions have been implemented to minimize keystrokes and to anticipate the entry sequences of the technologists. A program that allows the quick location and display of specimens and results is also included in the package.

Clinical Laboratory Information Systems↗
PubMed1989

Statistical analysis and graphical display of multivariate data on the Macintosh.

Two Macintosh programs written for multivariate data analysis and multivariate data graphical display are presented. MacMul includes principal component analysis (PCA), correspondence analysis (CA) and multiple correspondence analysis (MCA), with a complete, original and unified set of numerical aids to interpretation. GraphMu is designed for drawing collections of elementary graphics (curves, maps, graphical models) thus allowing comparisons between variables, individuals, and principal axes planes of multivariate methods. Both programs are self-documented applications and make full use of the user-oriented graphical interface of the Macintosh to simplify the process of analysing data sets. An example is described to show the results obtained on a small ecological data set.

Algorithms↗
PubMed2005

Common strategies in clinical data collection displayed by experienced clinician-teachers in internal medicine.

The role model displayed by clinician-teachers influences learning experiences but learners may face various reasoning styles. Our goal was to describe common strategies in clinical data collection displayed by experienced clinician-teachers in internal medicine. We studied six internists heavily involved in teaching while they were working up the same seven cases portrayed by a standardized patient. Each encounter was audio-recorded and replayed to allow the subjects commenting on the purpose and diagnostic hypotheses considered for each piece of information collected. Information and hypotheses elicited by all physicians were considered key items. Although the subjects reached the same final diagnoses, they differed on several characteristics of their data collection process. They also displayed common behaviours, such as: early acquisition of key data (half of them acquired within the first 19 questions asked) through clarification of the patients' complaints and focused data collection; early generation of the final diagnosis (within the first 10 questions asked) and use of diagnostic hypotheses to frame data collection; and summarization of the information at hand during the encounter (at least twice). Whether making teachers explicitly conscious about their own reasoning processes may help them better model and explain their diagnostic approach to specific cases should be assessed in follow-up studies.

Adolescent↗
PubMed1994

Integrated clinical workstations for image and text data capture, display, and teleconsultation.

The Department of Veterans Affairs (VA) DHCP Imaging System digitally records clinically significant diagnostic images selected by medical specialists in a variety of hospital departments, including radiology, cardiology, gastroenterology, pathology, dermatology, hematology, surgery, podiatry, dental clinic, and emergency room. These images, which include true color and gray scale images, scanned documents, and electrocardiogram waveforms, are stored on network file servers and displayed on workstations located throughout a medical center. All images are managed by the VA's hospital information system (HIS), allowing integrated displays of text and image data from all medical specialties. Two VA medical centers currently have DHCP Imaging Systems installed, and other installations are underway.

Diagnostic Imaging↗
PubMedDate not supplied

Displaying clinical data for decision making.

Computers are being used in increasing numbers to support health care facilities. Consequently, there is a need to examine how this technology can be effectively used to assist in the process of patient care. At the present time, most computer applications are directed toward (1) the management of large and amounts of data during a short period of time (e.g., ECG analysis and physiological monitoring) or (2) the transfer of information within a facility (e.g., Hospital Information System (HIS) order entry/results reporting). Some systems use the data for the purposes of surveillance or patient management. Other systems are concerned with the organization and presentation of the clinical data as part of the decision making process. This paper considers the ways in which systems can effectively display information. It draws upon experience with the Johns Hopkins Oncology Clinical Information System (OCIS).

Cancer Care Facilities↗