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PubMed2004

Casimage project: a digital teaching files authoring environment.

The goal of the Casimage project is to offer an authoring and editing environment integrated with the Picture Archiving and Communication Systems (PACS) for creating image-based electronic teaching files. This software is based on a client/server architecture allowing remote access of users to a central database. This authoring environment allows radiologists to create reference databases and collection of digital images for teaching and research directly from clinical cases being reviewed on PACS diagnostic workstations. The environment includes all tools to create teaching files, including textual description, annotations, and image manipulation. The software also allows users to generate stand-alone CD-ROMs and web-based teaching files to easily share their collections. The system includes a web server compatible with the Medical Imaging Resource Center standard (MIRC, http://mirc.rsna.org) to easily integrate collections in the RSNA web network dedicated to teaching files. This software could be installed on any PACS workstation to allow users to add new cases at any time and anywhere during clinical operations. Several images collections were created with this tool, including thoracic imaging that was subsequently made available on a CD-Rom and on our web site and through the MIRC network for public access.

CD-ROM↗
PubMed1996

Prevalence of mood and anxiety disorders in a working population in Japan.

To learn the prevalence of mood and anxiety disorders (as defined by the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised) in a working population in Japan, we analyzed data from a population-based survey. Among 140 respondents who had a job, 8% experienced any of seven mood and anxiety disorders in the past 6 months and 19% had in their lifetime. The 6-month and lifetime prevalence rates of major depressive episodes were 4% and 14%, respectively. The 6-month and lifetime prevalence rates of phobic disorders were both 4%. The lifetime prevalence rates for other anxiety disorders were 1% or less. The 6-month rate of any disorder, as well as 6-month and lifetime rates of phobic disorders, was higher in white-collar employees than in self-employed workers (P < 0.05). The multiple logistic regression confirmed the tendency after controlling for sex and age, although the result was not significant (P > 0.05).

Adolescent↗
PubMed2004

The relationship between hospital volume and outcome in bariatric surgery at academic medical centers.

OBJECTIVE: To examine the effect of hospital volume of bariatric surgery on morbidity, mortality, and costs at academic centers. SUMMARY BACKGROUND DATA: The American Society for Bariatric Surgery recently proposed categorization of certain bariatric surgery centers as "Centers of Excellence." Some of the proposed inclusion criteria were hospital volume and operative outcomes. The volume-outcome relationship has been well established in several complex abdominal operations; however, few studies have examined this relationship in patients undergoing bariatric surgery. METHODS: Using the International Classification of Diseases, 9th edition, diagnosis and procedure codes, we obtained data from the University HealthSystem Consortium Clinical Data Base for all patients who underwent Roux-en-Y gastric bypass for the treatment of morbid obesity between 1999 and 2002 (n = 24,166). Outcomes of bariatric surgery, including length of hospital stay, 30-day readmission, morbidity, observed and expected (risk-adjusted) mortality, and costs were compared between high-volume (>100 cases/year), medium-volume (50-100 cases/year), and low-volume hospitals (<50 cases/year). RESULTS: There were 22 high-volume (n = 13,810), 27 medium-volume (n = 7634), and 44 low-volume (n = 2722) hospitals included in our study. Compared with low-volume hospitals, patients who underwent gastric bypass at high-volume hospitals had a shorter length of hospital stay (3.8 versus 5.1 days, P < 0.01), lower overall complications (10.2% versus 14.5%, P < 0.01), lower complications of medical care (7.8% versus 10.8%, P < 0.01), and lower costs ($10,292 versus $13,908, P < 0.01). The expected mortality rate was similar between high- and low-volume hospitals (0.6% versus 0.6%), demonstrating similarities in characteristics and severity of illness between groups. The observed mortality, however, was significantly lower at high-volume hospitals (0.3% versus 1.2%, P < 0.01). In a subset of patients older than 55 years, the observed mortality was 0.9% at high-volume centers compared with 3.1% at low-volume centers (P < 0.01). CONCLUSIONS: Bariatric surgery performed at hospitals with more than 100 cases annually is associated with a shorter length of stay, lower morbidity and mortality, and decreased costs. This volume-outcome relationship is even more pronounced for a subset of patients older than 55 years, for whom in-hospital mortality was 3-fold higher at low-volume compared with high-volume hospitals. High-volume hospitals also have a lower rate of overall postoperative and medical care complications, which may be related in part to formalization of the structures and processes of care.

Academic Medical Centers↗
PubMed1997

Classification of user expertise level by neural networks.

A neural network approach to low-level user modeling is described, in the context of text editing tasks using the Jove editor. Knowledge of a user's expertise is extracted automatically, based on their interaction with Jove over a two week period. A MLP classifier which uses rprop learning and incorporates output data fuzzification is developed to classify users into one of five expertise levels. Classification into the correct level is achieved in around 80% of the cases, with misclassification being restricted to adjacent classes. The neurofuzzy system is seen to outperform not only the binary classifier of Beale [1989], but also production rule and inductive expert systems developed especially for comparison purposes in this study.

Artificial Intelligence↗
PubMed2005

Distributed health assessment and intervention research software framework.

The DHAIR software system is a database-driven, web-based survey platform. It implements the delivery of survey instruments in packaged assessments, creation and editing of those assessments, researcher access to the results of the survey application, and a flexible authorization framework.

Data Collection↗
PubMed1991

[Recommendations for carrying out nuclear medicine kidney function tests with a gamma camera and computer].

Standardization of nuclear medicine renal studies is required in order to permit the comparison of study results of a patient obtained at different laboratories. Furthermore, standardization is a prerequisite for quality control of the analysis part of the procedure. The guidelines presented here are based on a survey carried out amongst nuclear medicine laboratories in Austria and have been edited and harmonized in a workshop organized by the Austrian Nuclear Medicine Society. The guidelines include detailed descriptions of the requirements of instrumentation, of the methods of acquisition, dosage and radiation dose of the commonly used radiopharmaceuticals and all aspects of the analysis of digital renograms. A comprehensive section deals with the determination of renal clearance from the renogram, further sections cover the usage and recommended methods of captopril renography for the diagnosis of unilateral renal artery stenosis and of the frusemide renogram for the diagnosis of nephropathy and uropathy.

Austria↗
PubMed1987

[Micromethods and gas chromatography analysis of carboxylic acids produced from the fermentation of glucose in the identification of Corynebacteria].

The identification of fermentative Corynebacteria currently isolated from human specimens is not very easy, even with the use of the useful guide edited by Hollis and Weaver. The purpose of this investigation is to present a classification based on the study of a large number of biochemical characters, including the use of micromethods, and the characterization of carboxylic acids produced from dextrose fermentation by gas-liquid chromatography. The results show that it is possible to classify fermenting Corynebacteria into two groups based on the production of propionic acid or the lack of it. We are thus able to separate distinctly Corynebacteria whose biochemical characters are very similar. Likewise, some tests included in the micromethods are useful for separating the species.

Carboxylic Acids↗
PubMed1980

Descriptive cataloging of serials: the National Library of Medicine versus the Library of Congress.

Descriptive cataloging practices for serial differ significantly in some respects between the Library of Congress and the National Library of Medicine. This paper compares some of these differences and indicates the impact they can have on the development of on-line cooperative data bases such as OCLC. Attention is also given to the possible impact of the second edition of the Anglo-American Cataloguing Rules on serials cataloging. The need for standardization is stressed.

Cataloging↗
PubMed1995

Where do panic attack sufferers seek care?

BACKGROUND: Although 40% of people with panic attacks never seek care for their attacks, those who do may use medical settings or mental health settings, or both. The purpose of this study was to examine where people seek care for their panic attacks within and outside the health care system, and to determine what variables predict the choice of a given site. METHODS: The Panic Attack Care-Seeking Threshold (PACT) study is a community-based survey of 97 subjects meeting the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III-R) criteria for panic attacks. A structured interview was used to collect information about panic attacks, family characteristics, psychiatric comorbidity, health care access and utilization, illness attitudes and behaviors, quality of life, and symptom perceptions. RESULTS: Forty-nine percent of the subjects seeking care for panic attacks presented to medical settings, whereas 26% of subjects used mental health settings. The family physician's office was the most frequent site of presentation (35%), followed by a hospital emergency department (32%). Only 13% of subjects sought care from a site outside the health care system. Variables predicting presentation to specific health care sites varied. Subject demographics, panic characteristics, and symptom perceptions were generally significant factors in care-seeking. Illness behaviors, readiness for sick role, health locus of control, and family measures failed to predict the seeking of care specific to any particular site. CONCLUSIONS: When subjects with panic attacks seek care, they most commonly present to a general or family physician's office or a hospital emergency department.

Adult↗
PubMed1993

[Clinicopathologic studies on esophageal carcinoma with basaloid features].

Eight unusual esophageal carcinomas chiefly composed of basaloid cells were defined as "esophageal carcinomas with basaloid features", and analyzed by clinicopathologic findings and immunohistochemical staining with antibodies against S-100, actin, vimentin, and cytokeratin. These tumors were classified into five basaloid-squamous cell carcinomas (BSC), 2 adenoid cystic carcinomas (ACC), and 1 non-small cell type-undifferentiated carcinoma based on the Guidelines for the Clinical and Pathologic Studies on Carcinoma of the Esophagus edited by the Japanese Society for Esophageal Disease. Some histologic patterns of BSC, ACC, or undifferentiated carcinoma were resembled to each others. However, BSC was characterized by solid growth of basaloid cells with microcystic pattern or peripheral palisading arrangement, and it showed simultaneous presence of squamous cell carcinoma or squamous differentiation. In immunohistochemical staining, immunoreactivity for cytokeratin alone was positive in one of five BSCs. On the other hand, ACC showed cribiriform pattern and high mitotic activities, excluding typical cribriform pattern in ACC of the salivary gland. In addition to these features, the presence of foci of squamous cell carcinoma was occasionally found and positive immunoreactivities for S-100 and actin were recognized. Therefore, the immunohistochemical staining was useful for distinction among ACC and other tumors. As to the prognosis, BSC and ACC have been reported that both tumors are aggressive neoplasm with poor prognosis. In our studies, all of 5 patients with BSC were survived more than three years after surgery. In contrast, the patients with ACC or undifferentiated carcinoma died within one year.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Specific 3' sequences flanking a minimal apolipoprotein B (apoB) mRNA editing 'cassette' are critical for efficient editing in vitro.

Apolipoprotein B (apoB) mRNA in mammalian intestine undergoes direct conversion of cytidine to uridine at nucleotide 6666, generating a UAA stop codon which defines the carboxyl-terminus of apoB48. We have identified three distinct sequence elements which are required for efficient apoB RNA editing in vitro and have defined a 20 nucleotide 'editing cassette' which will support efficient editing in the context of a variety of AT-rich apoB mRNA backgrounds. An important question remaining to be addressed is whether this cassette can support editing in a GC-rich background characteristic of other mRNAs. We demonstrate that the context into which the editing cassette is inserted may determine the efficiency of editing site utilization. When an editing cassette is placed in the context of human albumin mRNA sequence, editing is reduced 6-fold relative to a construct of similar length in which the cassette is surrounded by apoB mRNA sequence. Chimeric RNA substrates may be efficiently edited, however, when albumin sequence resides only 5' of the editing cassette. The data suggest that the proximal of an AT-rich, apoB-like, mRNA sequence is only required 3' of the editing cassette. These results should prove useful in evaluating the potential for editing on mRNAs where similar cassettes can be found.

APOBEC-1 Deaminase↗
PubMed2005

Which older patients are competent to drive? Approaches to office-based assessment.

OBJECTIVE: To review three proposed approaches to office-based assessment of older drivers and to evaluate recommendations made about dementia and driving. QUALITY OF EVIDENCE: The American Medical Association's (AMA's) Physcian's Guide to Assessing and Counseling Older Drivers gives recommendations for office-based assessment of older patients' medical fitness to drive. Other approaches examined were those outlined in the sixth edition of Determining Medical Fitness to Drive produced by the Canadian Medical Association (CMA) and SAFE DRIVE. Recommendations for dementia and driving from these documents and other sources were reviewed. All evidence was level III. MAIN MESSAGE: The AMA document usefully identified ways to detect drivers at risk and key areas for assessment (vision, cognition, motor function). Recommendations on evaluating these areas require validation. .he CMA guide and SAFE DRIVE were overly broad in their recommendations. How best to detect cognitive impairment that tocld affect driving remains unclear. CONCLUSION: Office-based approaches to identifying older drivers who are either unsafe to drive or require more extensive evaluation need to be validated.

Aged↗
PubMed1994

Translation of nad9 mRNAs in mitochondria from Solanum tuberosum is restricted to completely edited transcripts.

The pool of partially and completely edited mRNAs present in plant mitochondria could potentially be translated into a mixture of divergent proteins. This possibility was investigated for the nad9 gene in potato by characterization of the mRNA population and the corresponding protein sequence. The deduced amino acid sequence of the nad9 gene product has significant similarity to the nuclear-encoded 30 kDa subunit of the bovine and Neurospora NADH:ubiquinone oxidoreductase (complex I) and to the chloroplast ndhJ gene product. Immunoprecipitation of a 27 kDa in-organello 35S labelled mitochondrial translation product with an antibody directed against the wheat nad9 gene product demonstrates its functional expression in potato and wheat. Comparison of the nad9 genomic DNA and cDNA sequences reveals seven codons to be changed by a C to U RNA-editing. Direct sequencing of RT-PCR products derived from cDNAs of different tissues of potato plants shows the presence of a significant portion of only partially edited nad9 transcripts in the various tissues. Amino acid sequencing of internal peptides of the isolated 27 kDa protein from potato tubers demonstrates homogenous translation products of only completely edited nad9 mRNAs even in the presence of partially edited mRNAs. This result suggests a pretranslational selection between edited and incompletely edited mRNAs in plant mitochondria.

Amino Acid Sequence↗
PubMed1998

Kinetoplastid RNA-editing-associated protein 1 (REAP-1): a novel editing complex protein with repetitive domains.

Kinetoplastid RNA editing consists of the addition or deletion of uridines at specific sites within mitochondrial mRNAs. This unusual RNA processing event is catalyzed by a ribonucleoprotein (RNP) complex that includes editing site-specific endoribonuclease, RNA ligase and terminal uridylnucleotidyl transferase (Tutase) among its essential enzymatic activities. To identify the components of this RNP, monoclonal antibodies were raised against partially purified editing complexes. One antibody reacts with a mitochondrially located 45 kDa polypeptide (p45) which contains a conserved repetitive amino acid domain. p45 co-purifies with RNA ligase and Tutase in a large ( approximately 700 kDa) RNP, and anti-p45 antibody inhibits in vitro RNA editing. Thus, p45 is the first kinetoplastid RNA-editing-associated protein (REAP-1) that has been cloned and identified as a protein component of a functional editing complex.

Amino Acid Sequence↗
PubMed1989

RNA editing: a novel mechanism for regulating lipid transport from the intestine.

Human apolipoprotein (apo)-B mRNA undergoes a novel tissue specific editing reaction which replaces a genomically templated cytidine with uridine. This substitution converts codon 2153 from glutamine (CAA) in apo-B100 mRNA to a stop codon (UAA) in apo-B48 mRNA. This novel RNA editing process is responsible for the generation of hepatic apo-B100 and intestinal apo-B48. We have established the following concerning this process: (1) by transfection of a series of deletion mutants into the rat hepatoma cell line McArdle 7777, which makes both apo-B100 and apo-B48, we have defined a minimum sequence of 26 nucleotides that is required for apo-B mRNA editing. The sequence containing the modified nucleotide forms a 26 nucleotide highly conserved stem loop with the modified nucleotide occurring in an 8-base loop. (2) Conversion in vitro of apo-B mRNA has been established, using cell free S100 cytoplasmic extract and synthetic RNA templates. Activity was abolished by protease treatment. (3) Transgenic mice were created which expressed a human apo-B construct spanning the stop codon. Apo-B mRNA was found in all tissues examined and this was shown to undergo editing. (4) In the rat liver, which produces apo B-100 and apo-B48, modulation of the relative proportion of these proteins by thyroxine was demonstrated to be mediated at the level of the RNA editing mechanism. It is concluded that apo-B mRNA is edited by a generally expressed protein and editing is highly regulated.

Animals↗
PubMed1998

The effect of patient attrition on estimates of the frequency of dementia following stroke.

BACKGROUND: Given that prevalence surveys may underestimate the magnitude of the association between an exposure and a disease with high morbidity or mortality, we investigated the effects of patient attrition on estimates of the frequency of dementia following ischemic stroke. PATIENTS AND METHODS: We examined 251 patients 3 months after stroke and diagnosed dementia in 66 (26.3%) based on the results of neuropsychological and functional assessments and modified criteria from the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised. Those 251 patients were drawn from a larger cohort of 297 patients, with the majority of the remaining 46 patients being unavailable for assessment due to death, severe stroke, or comorbid medical disorders. Using the coefficients in a logistic model of the clinical determinants of dementia based on the 251 patients who were examined, we calculated the probability of dementia for each of the 46 patients who were not examined. We considered a patient to have dementia when that probability was higher than the mean of the median probabilities of dementia in the groups of patients with and without dementia who completed the examinations. RESULTS: The sensitivity and specificity of our diagnostic method were 75.8% and 72.4%, respectively. We recognized dementia in 21 (45.7%) of the 46 unavailable patients, a significantly higher frequency than among examined patients. Additional analyses determined that the factors that increased the risk of becoming unavailable for follow-up, which included more severe stroke, left and right hemisphere infarct locations, and a history of prior stroke, are similar to the factors that increase the risk of dementia after stroke. CONCLUSION: Our findings suggest that dementia is differentially associated with early patient attrition, potentially resulting in the underestimation of its frequency and underrecognition of its importance as an outcome of ischemic stroke.

Aged↗
PubMed2006

Identification of RNA editing sites in chloroplast transcripts of Phalaenopsis aphrodite and comparative analysis with those of other seed plants.

RNA editing sites were systematically examined for the transcripts of 74 known protein-coding genes in the chloroplasts of Phalaenopsis aphrodite. A total of 44 editing sites were identified in 24 transcripts, the highest reported in seed plants. In addition, 21 editing sites are unique to the Phalaenopsis orchid as compared with other seed plants. All editing is C-to-U conversion, and 42 editing sites bring about the changes in amino acids. One of the remaining two editing sites occurs in the transcripts of the ndhB pseudogene, and another in the 5'-untranslated region of psbH transcripts.

Base Sequence↗