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PubMedDate not supplied

Automatic quantitation of cell growth and determination of mitotic index using DAPI nuclear staining.

The growth rate of primary tumors and derived cell lines is an important identifying trademark to researchers studying the growth and differentiation of pediatric neoplasms. For the in vivo tumor specimen, the mitotic index is utilized to assess growth potential while, in vitro, the determination of the growth curve and doubling time of the cells is employed. Because of the importance of these parameters this laboratory has developed a technique for the simultaneous determination of cell number and mitotic index for adherent cultured cells, as well as solid tumors, using the polycationic dye DAPI (4',6-diamino-2-phenylindole). DAPI, when bound to nuclear DNA, fluoresces, and this property has been utilized to develop an image analysis based technique to determine cell number automatically based on gray scale discrimination. In addition, DAPI staining clearly delineates mitotic figures and this has allowed the simultaneous manual determination of mitotic index for each automatic cell count. This technique was first tested using four different human cell lines and was shown to determine cell growth and mitotic index simultaneously. Lastly, employing an atypical mesoblastic nephroma, it was shown that the mitotic index of the primary tumor could easily be obtained and compared to both the mitotic index of tumor heterotransplant in nude mice and the mitotic index of the tumor-derived cell culture. This technique should be useful in studies assessing the effects of various factors on the growth of adherent cultured cells as well as the accurate determination of the mitotic index in solid tumors.

Cell Count↗
PubMed2002

[Transition zone index in predicting therapeutic efficacy of benign prostatic hyperplasia].

PURPOSE: We studied how transition zone index (TZ index) influenced the therapeutic efficacy of benign prostatic hyperplasia (BPH). In addition, we retrospectively investigated the availability of TZ index in selection of the more effective therapeutic method for BPH. METHOD: One hundred twenty-five patients with symptomatic BPH whose prostate volume (PV) was more than 15 ml by transrectal ultrasonography were investigated. Sixty-nine men underwent transurethral resection of the prostate (TURP) whereas 56 were treated with alpha 1-blocker. Tamsulosin hydrochloride. These patients were evaluated based on TZ index as well as ordinary parameters of BPH; international prostatic symptom score, QOL score, peak flow rate and PV. RESULTS: The patients with TZ index > or = 0.5 showed good therapeutic results in the TURP group. On the other hand, the patients with TZ index < 0.5 showed favorable response in alpha 1-blocker group. Multivariate analysis revealed that TZ index affected the therapeutic efficacy more strongly than the other parameters. CONCLUSION: TZ index had strong influence on therapeutic efficacy of TURP or alpha 1-blocker and seemed to be a useful tool for the selection of BPH therapy.

Adrenergic alpha-Antagonists↗
PubMed1998

Development of a classification and index of dental treatment experience for adults.

OBJECTIVE: To develop and evaluate a classification and index of dental treatment experience for adults. DESIGN: Twenty-four general dental practitioners recorded treatment experience at baseline on 4,211 regularly attending adults of whom 3,878 were re-examined after one year and 3,698 patients completed a questionnaire on factors related to treatment. SETTING: Health authorities of Manchester and Salford. METHOD: Set theory was used to divide the baseline clinical data set into 7 mutually exclusive classes of dental treatment experience. Seven dental specialists used the nominal group technique to weight tooth status to form an index of dental treatment experience (DTE). The ability of the DTE classification and index to discriminate between groups of patients' responses to the questionnaire was compared with the THI and DMFT index. RESULTS: Ninety-nine per cent of the patients fell into 5 hierarchical classes ranging from fillings only to wearing a denture in addition to a crown and/or bridge. When calculated on the baseline data, the classification discriminated between 16 of the 20 variables investigated in the questionnaire. Fifteen significant differences were found between mean scores for groups of patients on the DTE index, 14 on the THI and 8 on the DMFT index. Fifty-five (1%) patients moved their class as a consequence of the treatment carried out during the year. All three indices found significant differences for the same four variables of the 20 tested. CONCLUSION: A classification of dental treatment experience together with an index to measure the severity of that experience has been successfully developed and tested. It appears to have advantages over the traditional DMFT index and is at least as discriminating as the THI.

Adult↗
PubMed2002

[Thoracic scoliosis: exothoracic and endothoracic deformations and the spinal penetration index].

PURPOSE OF THE STUDY: We reviewed retrospectively our patients with thoracic lordoscoliosis and conducted a conceptual analysis of the patients with airway compression and atelectasia due to anterior protrusion of the vertebral bodies in order to describe the pathological conditions involved and the management methods used. Our goal was to develop a new concept for quantifying thoracic deformation. The individual cases discussed here have been reported earlier, but this is the first series analysis to date. MATERIAL AND METHODS: Eighteen patients, aged 7.3 to 18 years, with thoracic lordoscoliosis due to a variety of causes, mostly neuromuscular disorders (12 cases), are described. Most patients were treated by anterior subtotal periosteal resection of the vertebral body followed by posterior instrumentation and arthrodesis. RESULTS: Atelectasia disappeared with a normalization of blood gases but the effect was variable on vital capacity. The analysis of the CT studies led to the concept of spinal deformity as an endothoracic deformation resulting from protrusion of the vertebral body into the thorax, the endothoracic vertebral hump. This concept was developed and quantified leading to the definition of a new index: the spinal penetration index. The spinal penetration index was obtained by tracing a line tangent to the posterior curve of the concave and convex ribs on each CT slice to determine a relationship between the real thoracic surface and theoretical thoracic surface measured with this tangent and the circumference of the thoracic cage. The index was expressed as a percent of the endothoracic surface occupied by the protruding veterbral body and the associated ribs. Calculated for each successive CT slice for the entire height of the thorax yielded a spinal penetration index quantifying the thoracic volume occupied by the spine. For the control population, we used CT series of the thorax obtained to search for pulmonary metastases in patients with malignant tumors. This gave a theoretical volume of 8 to 10% occupied by the spine in normal subjects. In our patients with lordoscoliotic deformations we obtained real volumes of 15, 20 and even 50%. DISCUSSION: The spinal penetration index is an important morphological index of thoracic anatomy that measures the real volume of the functional thoracic cavities and which must be differentiated from vital capacity which measures both volume and function. This index can be used for pre- post-operative comparisons and constitutes a first step in 3-D assessment of thoracic spine deformations. It can also be used to classify spinal deformations and to make general recommendations concerning the management of both endothoracic humps and exothoracic rib humps.

Adolescent↗
PubMed1992

Correlations of body mass index of adult adoptees and their biological and adoptive relatives.

Adult family members resemble each other in body mass index (weight/height2). Our aim was to assess the extent to which the genetic relationship can account for the resemblance in natural families. We estimated the correlations in body mass index between adult adoptees, their adoptive parents, and their biological parents and siblings and compared the correlations to those between the biological relatives. Height, current weight, and greatest ever weight were obtained for 3651 adoptees. Groups representing thin, medium weight, overweight and obese subjects were selected by current body mass index (n = 540) and similarly selected by maximum body mass index (n = 524). The heights and weights of their biological and adoptive family members were assessed. The correlation in current body mass index between the adoptees and biological mothers, fathers, and full siblings were 0.15, 0.11, and 0.23, respectively (all P less than 0.001). These correlations were compatible with those found among the biological relatives living together. The correlations exhibited no consistent gender-related pattern. There was no correlation in body mass index between the adoptees and their adoptive parents. Similar results were obtained for maximum body mass index. Moreover, the correlations between the adoptees and their biological relatives are very similar to those found in large population studies of natural families. This study suggests that the genetic relationship fully accounts for the familial resemblance in body mass index among adults.

Adoption↗
PubMed1991

Measuring outcomes of hospital care using multiple risk-adjusted indexes.

Using existing data sources, we developed three risk-adjusted measures of hospital quality: the risk-adjusted mortality index (RAMI), the risk-adjusted readmissions index (RARI), and the risk-adjusted complication index (RACI). We describe the construction and validation of each of these indexes. After these measures were developed, we tested the relationships among the three indexes using a sample of 300 hospitals. Actual numbers of adverse events were observed for each hospital and compared to the number predicted by the RAMI, RARI, and RACI models. Then each hospital was ranked on each index. Our results showed that no relationship existed between a hospital's ranking on any one of these indexes and its ranking on the other two indexes. This result provides some evidence that no measure of quality should be used by itself to represent different aspects of the quality of hospital care. Adequate overall measures of hospital quality will need to include multiple measures in order to be credible and to reflect the complexity of hospital care. The findings suggest that consumers, payers, and policymakers cannot simply choose one hospitalwide measure, such as the mortality rate, to validly represent a hospital's performance: those hospitals with high rankings on their mortality rates do not necessarily rank high on their readmission rates or complication rates.

Abstracting and Indexing↗
PubMed1985

Regional hospital pharmacy information index.

An index system was developed that provides participating hospitals with an up-to-date list of regionally available written materials used in hospital pharmacy practice. Eight acute-care hospitals agreed to participate in developing the index to avoid duplication of effort in producing original materials. A regional drug information center agreed to maintain the index and serve as the central repository for the materials. Newsletters and bulletins were given high priority for coverage by the system, followed by drug monographs and directed studies and residency projects. A three-year back-index period was set for most categories to ensure that the index was current. Only active entries were listed for investigational drug lists, i.v. drug administration monographs, and extemporaneously compounded drug products. Other categories were drug administration policies, unusual drug information requests, and patient-oriented drug information. The representatives provided the relevant materials from their institutions, and it was categorized and indexed. The index was entered on a word processor, which permits efficient updating. The index has been useful to the participating hospital pharmacy departments. As the system is tested through use, it will be evaluated formally and refined.

Abstracting and Indexing↗
PubMed1979

Indexes of severity: conceptual development.

A discussion of severity index development is presented in relation to conceptual issues in index definition, analytic issues in index formulation and validation issues in index application. The CHOP index is discussed along with six severity indexes described in an earlier paper dealing with underlying concepts to illustrate the material presented. Replies are provided to specific questions raised in an accompanying paper discussing the Injury Severity Score. This conceptual material is presented to provide a foundation for severity index development, to suggest criteria to be used in their formulation and testing, and to identify analyses that can lead to the successful selection and application of an index for a defined purpose.

Abstracting and Indexing↗
PubMed1995

Correlation of American Urological Association symptom index with obstructive and nonobstructive prostatism.

The precise role of the American Urological Association (AUA) symptom index in the management of benign prostatic hyperplasia (BPH) is not well established. The AUA symptom index has been recommended only for quantifying the symptoms of BPH but not for its diagnosis. However, to our knowledge the ability to discriminate obstructive from nonobstructive BPH using the AUA symptom index has never been investigated. To establish the relationship between the AUA symptom index and prostatic obstruction 125 men (mean age 67.7 +/- 8.4 years) with voiding dysfunction presumably related to BPH were analyzed. Patients were given the AUA symptom questionnaire, following which video urodynamic studies were done, including micturitional urethral pressure profilometry for specifically diagnosing outlet obstruction. The patients were divided into 2 groups: group 1-78 with primary BPH dysfunction and group 2-47 with prostatism of ambiguous etiology. The mean AUA symptom index in group 1 (15.5 +/- 7.1) was not statistically different from that in group 2 (14.8 +/- 7.9). In both groups the mean AUA symptom index in the patients with obstruction (15.3 +/- 7.2 for group 1 and 13.9 +/- 7.9 for group 2) was not statistically different from that in the nonobstructed group (17.0 +/- 5.4 and 16.1 +/- 7.9, respectively). Of the severely symptomatic patients 22% did not have obstruction whereas all mildly symptomatic patients did. No significant correlations were found between the severity of obstruction and the AUA symptom index in either group. These observations indicate that the AUA symptom index cannot discriminate obstructed from nonobstructed BPH cases, not all severely symptomatic BPH patients will have outlet obstruction, a significant proportion of mildly symptomatic BPH patients can have outlet obstruction and voiding dysfunctions in elderly men, regardless of the etiology, produce similar symptoms.

Aged↗
PubMed1993

Proposal for a composite index of alcohol problems.

This study proposes constructing a composite index to measure the severity of alcohol problems in Canada. Composite summary indicators are used in many areas, particularly in economics where the Consumer Price Index is well known. The composite indexes developed for this analysis were constructed using the index number method. The indexes were based on the statistical series for alcohol consumption, alcohol morbidity, alcohol mortality and alcohol-related traffic offences in the ten provinces and cover the years 1975, 1980, 1985 and 1990. The selected statistical series were compared using both Spearman and the Pearson correlations. In addition, Kendall's coefficient of concordance was used to determine the degree of association among all the statistical series together. The initial results indicated that there were different provincial rankings for each of the four statistical series, demonstrating that in comparing provinces the ranking of the "alcohol problem" depends on the statistical series selected. The construction of a composite index can be an effective strategy for resolving these differences in the rankings. Provincial rankings for the composite indexes on the severity of alcohol problems were fairly consistent for each time period. In terms of general trends among the provinces, Prince Edward Island, Alberta, British Columbia and Saskatchewan had the highest composite indexes; Manitoba, Nova Scotia and Ontario the mid-range; and New Brunswick, Newfoundland and Quebec the lowest.

Accidents, Traffic↗
PubMed1994

[Cardiac surgery: predictive mortality index, severity and care of illness. 243 cases].

OBJECTIVES: Medical teams are keenly aware of the need to evaluate health care quality and the cost/benefit ratio. We prospectively applied three proposed indexes, designed for predicting mortality, for evaluating disease gravity, and for evaluating health care in intensive care patients, in two populations of patients undergoing heart surgery. METHODS: From January to June 1991, 243 patients (mean age 58.1; 55 females, 188 males) underwent coronary bypass surgery (n = 116; mean number of bypasses = 2.94 per patient) or valve replacement (n = 127). The patients were divided into 3 groups of increasing gravity on the basis of the preoperative presentation (Groups 1, 2 and 3 for Parsonnet's index, a specific index for predicting mortality in patients with acquired cardiopathies undergoing heart surgery = 0-9, 10-19 and > 20 respectively). A comparison was then performed for each population (bypass surgery and valve replacement) between the predicted mortality and the APACHE II index of disease gravity and the OMEGA index of intensive care. RESULTS: Overall mortality was 3.7% (2.85% in the bypass population and 4.72% in the valve population). The specific Parsonnet index (PI) for cardiac surgery gave a good indication of mortality risk (observed deaths 0.7% for PI = Group 1; 2.6% for PI = Group 2; 13.1% for PI = Group 3) and of postoperative morbidity since inotropic support was required in 18, 45 and 59% for PI Groups 1, 2 and 3 respectively. For patients in the PI Group 3, postoperative care in the intensive care unit lasted > 3 days and required ventilatory support for > 24 hours. APACHE II and OMEGA did not contribute to evaluating the Parsonnet index. CONCLUSION: A high risk population undergoing cardiac surgery can be defined among patients with a Parsonnet index above 20. Under this threshold, the risk of mortality falls to 1.4%.

Adolescent↗
PubMed1994

An INTERSALT study investigation: relationship between body mass index and blood pressure in the combined populations of three local centres in Japan.

Body mass index was positively and strongly correlated with BP in the INTERSALT study. Because the average body mass index in Japan, although low relative to other developed countries, has been increasing recently it would be useful, particularly from the public health viewpoint, to investigate the impact of body mass index on BP in Japanese populations. In this study, the relationship between body mass index and BP was investigated taking into account age, alcohol intake and sodium and potassium excretion in 24h urine. Data were obtained from 274 men and 284 women, aged 20-59 years, who were not taking antihypertensive medication. Random selection of participants took place at three local centres as outlined in the 1985 INTERSALT study in Japan. It was found that body mass index was positively and significantly correlated with BP in men and women, respectively, but was independent of age, alcohol intake and urinary sodium/potassium ratio. Both SBP and DBP were significantly higher by > or = 5 mmHg in participants whose body mass index (kg/m2) was in the highest quartile compared with participants in the lowest or the next lowest quartile category in men and women. In this study, it was suggested that the body mass index in Japanese men and women was directly correlated with BP independent of other confounding factors. Accordingly, the maintenance of a moderate body mass index may be important in achieving and maintaining a desirable BP level.

Adult↗
PubMed1995

Feasibility of Broka's index for the nutritional status of adults.

The utility and feasibility of Broka's index for assessing the nutritional status of adults was studied in comparison with the efficacy of weight for height (%) and body mass index (BMI). The coefficients of correlation, sensitivity, specificity and efficiency and Kappa statistic for agreement were determined and tested for significance. The data pertaining to urban adults of Hyderabad belonging to better socio-economic class were utilised. Broka's index was well correlated with weight for height (%) (r = 0.97) and BMI (r = 0.99). Broka's index, BMI and weight for height (%) were least correlated with stature indicating that these indices were of use for classifications of nutritional status irrespective of variations in stature. There was a good agreement between classifications of nutritional status based on Broka's index, weight for height (%) and BMI. The values of sensitivity, specificity and efficiency were in the range of 90-100 per cent. The Kappa statistic of agreement between Broka's index, BMI and weight for height (%) for all forms of nutritional status was 0.839 (P < 0.0001). The mean values of Broka's index, BMI and weight for height (%) were higher in the better socio-economic group as compared to the poor ones. Broka's index which is simple and easy to calculate is useful for the assessment of the grades of body built and nutritional status in adults.

Adult↗
PubMed1998

American Urological Association symptom index in the assessment of urethroplasty outcomes.

PURPOSE: In men undergoing urethroplasty we used the American Urological Association (AUA) symptom index to assess the magnitude of symptoms and determine the validity of this index as an outcome assessment tool. MATERIALS AND METHODS: The AUA symptom index was completed by individual interview of 50 men a mean of 41 years old who underwent urethral reconstruction. Symptom scores were then correlated with radiographic retrograde urethrograms and urinary flow rates to determine whether changes in the score were consistent with these other clinical indicators of success or failure. RESULTS: Mean preoperative AUA symptom index score in all evaluable patients was 26.9 (maximum 35), indicating severely bothersome voiding symptoms. In patients with radiographic evidence of successful urethral reconstruction the average postoperative score was 5.1 (p <0.0001). In those with recurrent stricture after urethroplasty scores were essentially unchanged but after successful repeat urethroplasty the mean symptom index score decreased to 3.4 (p <0.0001). A statistically significant inverse correlation (r = -0.712, p <0.0001) was found between AUA symptom index scores and maximum urinary flow rates. CONCLUSIONS: Patients with urethral strictures who are selected for formal urethroplasty have severe obstructive and irritative voiding symptoms. Results of the AUA symptom index correlate closely with conventional measures of urethroplasty outcome, such as radiographic retrograde urethrography and urinary flow studies. The AUA symptom index appears to have clinical validity as an adjunctive outcome assessment tool after urethroplasty.

Adolescent↗
PubMed1998

Relationship between the care index and mean dmft/DMFT.

OBJECTIVE: To assess the relationship between the care index and the mean dmft/DMFT in different populations of 5-, 12- and 14-year old children. DESIGN: Information from recent studies of 5-, 12- and 14-year old children, co-ordinated by the British Association for the Study of Community Dentistry (BASCD) was used. The correlation between the mean dmft/DMFT and the care index for each health district was calculated for each age group, along with the linear regression equation of the care index in terms of dmft/DMFT. RESULTS: All the correlation coefficients were negative indicating that the care index would be expected to increase as the disease levels decrease. For the 5-year-old children in 1995/96 three other factors for the same time period; dentist:population ratio, percent of children registered and standardised mortality ratio (SMR), were also included in the model. This did not change the negative relationship between dmft and the care index. CONCLUSIONS: The strong negative relationship between the care index and mean dmft/DMFT levels indicated that in a situation where disease levels are reducing over time, the care index would be expected to increase. Conversely in a situation where disease levels were increasing the care index would be expected to fall.

Adolescent↗
PubMed1992

Association of aneuploidy in index adenomas with metachronous colorectal adenoma development and a comparison.

BACKGROUND: Features of index adenomas in the colorectum may be important for the prediction of metachronous adenoma development. METHODS: Complete colonoscopic follow-up for a mean period of 10 years was achieved in 70 of 124 patients after endoscopic polypectomy of an adenoma from the colorectum. On the basis of the clinical outcome, the patients were divided into three groups: Group I, patients who had a colorectum free of adenomas and cancer; Group II, patients who had one or more metachronous adenomatous polyps; and Group III, patients who subsequently had a colorectal carcinoma. The clinical characteristics of the patients were collected, and the neoplastic specimens were re-examined with regard to pathologic parameters and flow cytometrically determined nuclear DNA content. RESULTS: Aneuploid stemlines were found in 35% of the index adenomas. Significantly more aneuploid adenomas were found in the index adenomas of Group I patients than in the adenomas of Group II patients (r = -0.20; P = 0.05). However, in the index adenomas of Group II patients, aneuploidy was associated with villous architecture (P < 0.05) and inversely related to cellular atypia (P < 0.05). Such relations were not found in the adenomas from Group I. In addition, in the Group II adenomas, aneuploidy was found frequently in the more proximally localized adenomas in the large intestine. Remarkably, all adenocarcinomas of the Group III patients were localized in the right colon. No significant differences were found in ploidy and mean DNA index between index adenomas and metachronous adenomas of the Group II patients. However, the ploidy class of the index adenomas was found not to be related to that of the metachronous adenomas in the individual patients. CONCLUSIONS: These results demonstrate that DNA cytometry in adenomas alone is not helpful in the prediction of the possibility of the development of a metachronous adenoma. However, aneuploidy in a villous adenoma located more proximally in the colon might indicate a higher risk for metachronous neoplasia development. Index and metachronous adenomas are similar in DNA content but show no relation with respect to ploidy class.

Adenoma↗
PubMed1981

An integrative index of biological effects of lead.

Biological indicators of lead effects on the central nervous system (as measured by performance tests), hematogenous bone marrow (hemoglobin levels) and kidney function (BUN Levels) can be combined in an integrative index (INDEX). This integrative index can be in turn related to indicators of lead exposure and absorption. Such an index was calculated by removing age effects in measures of performance and kidney function and then transforming all the variables to Z (standard) units. Secondary lead smelter workers and a control group were studied. In secondary lead smelter workers this INDEX was found to be significantly correlated with ZPP, blood lead levels, and duration of lead exposure. In this population the magnitude of the correlation coefficients with ZPP levels was much higher than than for blood lead levels. INDEX had a higher correlation with ZPP than with each of its components: performance test scores, hemoglobin, and BUN levels. Although performance test scores, hemoglobin, and BUN levels were shown to discriminate between the control, non-lead-exposed population, and the lead-exposed group, INDEX (and particularly one pair of its components, CNS and hemoglobin levels) achieved the best discrimination between groups. The concept of an integrative index of biological effects of lead may be especially useful in defining populations at high risk for developing chronic, potentially irreversible neurologic and kidney dysfunction, and in assessing the severity of lead effects in individual cases.

Analysis of Variance↗
PubMed2004

Monitoring the biological activity of the composting process: Oxygen uptake rate (OUR), respirometric index (RI), and respiratory quotient (RQ).

Composting of several organic wastes of different chemical composition (source-separated organic fraction of municipal solid waste, dewatered raw sludge, dewatered anaerobically digested sludge and paper sludge) was carried out under controlled conditions to study the suitability of different biological indexes (oxygen uptake rate, respirometric index, and respiratory quotient) to monitor the biological activity of the composting process. Among the indexes tested, oxygen uptake rate (also referred to as dynamic respirometric index) provided the most reliable values of microbial activity in a compost environment. On the other hand, values of the static respirometric index measured at process temperature, especially in the early stages of the composting process, were significantly lower than those of the dynamic index, which was probably due to oxygen diffusion limitations present in static systems. Both static and dynamic indexes were similar during the maturation phase. Static respirometric index measured at 37 degrees C should not be used with samples obtained during the thermophilic phase, since it resulted in an underestimation of the respiration values. Respiratory quotient presented only slight variations when changing the process temperature or the waste considered, and its use should be restricted to ensure aerobic conditions in the composting matrix.

Algorithms↗