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[The genetic architecture of emotionality in rats using Mendelian cross analysis].

Two inbred strains of Tsukuba Emotionality Rat (THE and TLE) and four hybrids derived from them were observed for ambulatory response in a novel environment as a measure of emotionality. The Runway Test (modified "timidity test") was run for successive three days. Mean transformed (square root) scores of ambulation for generation were subjected to Mendelian cross analysis. Total ambulation scores showed significant additive genetic effect, maternal effect and environmental effect. Directional dominance toward low level of response was present only for males. Daily ambulation scores showed changes in the genetic architecture over three days and the difference between males and females. For females, directional dominance occurred toward low level on Day 1, toward high level on Day 3, but no directional dominance was observed on Day 2. Males' directional dominance toward low level, on the other hand, declined with days. These findings on the genetic architecture of emotionality were discussed with reference to evolutionary adaptation.

Affective Symptoms↗

Intraepithelial lymphocytosis in architecturally preserved proximal small intestinal mucosa: an increasing diagnostic problem with a wide differential diagnosis.

CONTEXT: An increased intraepithelial lymphocyte density in an architecturally normal proximal small intestinal mucosal biopsy is a common finding facing surgical pathologists dealing with gastrointestinal biopsy specimens. Approximately 1% to 2% of all proximal small intestinal biopsies will show this change. It is increasingly recognized by surgical pathologists that gluten-sensitive enteropathy is an important cause of this pattern; however, gluten-sensitive enteropathy accounts for the minority of all cases. A wide variety of immunologic stimuli can raise intraepithelial lymphocyte numbers. Among the other common associations are enteric infection, autoimmune disease, drugs, and gastric Helicobacter infection. OBJECTIVE: To outline the causes of intraepithelial lymphocytosis, to highlight the importance and the difficulties faced in establishing gluten-sensitive enteropathy as the cause, and to aid the surgical pathologist in the routine sign out of these cases. DATA SOURCES: A review of the literature detailing the causes or associations of proximal small intestinal intraepithelial lymphocytosis is presented. CONCLUSIONS: Increased lymphocyte numbers in the epithelium of architecturally preserved proximal small intestinal biopsies is a morphologic feature associated with a broad differential diagnosis.

Autoimmune Diseases↗

[Histological grading of alveolar type renal cell carcinoma based on architectural variation].

Ninety-two of a total 107 renal cell carcinomas excluding papillary, sarcomatoid and other uncommon histological types were classified into 3 groups based on architectural variations. Statistically analyses were carried out for prognostic significance. Histological criteria of 3 groups were defined as follows. Group I consists predominantly of tubular formations with characteristic cystic change. Group III shows solid proliferation without tubular formations, and Group II shows small alveolar or trabecular structures with inconspicuous tubular formations. According to the survival curves (Kaplan-Meier method), the prognosis of Group I was significantly better than II and III. Ten year survival rate of each group was 88 +/- 7.8% in Group I, 39 +/- 8.8% in Group II, and 0% in Group III. The distribution of T and V stages in the 3 groups were not significantly different. Nuclear grading of Group I and II was not so different, though high grade cases predominated in Group III. Therefore, the present grading of alveolar type renal cell carcinoma based on architectural atypia was considered to be a useful prognostic parameter.

Aged↗

Genetic architectures of brain-related traits are shaped by strong selective constraints.

Genome-wide association studies (GWAS) have identified hundreds of significant loci for psychiatric disorders, yet the strength of these associations remains modest compared to other human complex traits with similar numbers of hits. Whether this pattern reflects statistical artifacts or real biological differences - and, if the latter, what underlies it - remains unclear. In addition to psychiatric disorders, we find that other traits with functional enrichment in the central nervous system (CNS), whether binary or quantitative, also share similar genetic architectures, characterized by GWAS hits of limited statistical significance and generally higher allele frequencies. To robustly compare traits that differ in GWAS statistical power, we demonstrate how binarizing a quantitative trait reduces power. This loss of power can be replicated by a matched "effective sample size" on the liability scale. After matching "effective sample sizes", we show that CNS-enriched traits have large mutational target sizes, with contributing variants and genes experiencing stronger selection than those for other traits. Our findings reveal heterogeneity among diseases and provide insights into traits that more effectively capture fitness-relevant processes. More broadly, our results suggest that the genetic architectures of complex traits are shaped by the tissues through which these traits are mediated.

Journal Article↗

Micro-tomographic imaging for the nondestructive evaluation of trabecular bone architecture.

The structural properties of trabecular bone have been shown to vary significantly with age, anatomic location, and metabolic condition. Micro-computed tomography (microCT) is an emerging technique for the nondestructive assessment and analysis of the three-dimensional trabecular bone architecture. Within the framework of the European Union BIOMED I project "Assessment of Bone Quality in Osteoporosis," a total of 350 bone biopsies from five different anatomical locations were harvested post mortem from 70 donors (aged 23 to 92 years). These biopsies were measured using a newly devised compact micro-tomographic system, also referred to as desk-top microCT. Samples with a diameter from a few millimeters to a maximum of 18 mm and a length of up to 55 mm can be measured. For this study fresh, untreated bone biopsies with a diameter of 8 mm were measured micro-tomographically with a nominal isotropic resolution of 14 microns. For all samples, the volumes of interest (4 x 4 x 4 mm3) were binarized using a uniform threshold. Subsequently, standard structural indices such as bone volume density (BV/TV), bone surface density (BS/BV), trabecular plate number (Tb.N), trabecular thickness (Tb.Th), trabecular separation (Tb.Sp) and the degree of anisotropy (DA) were computed for all specimens incorporating mean intercept length (MIL) measurements. Regression analysis was used to estimate the correlations of single structural parameters with age or with a second parameter and also among different measurement sites. The nondestructive microCT measurements allowed not only to perform quantitative bone morphometry but also to assess other important microstructural features in the determination of the mechanical integrity of trabecular bone such as the incidence and prevalence of microcallus formations. The findings from the BIOMED I study are expected to improve our understanding of the relative importance of bone architecture, damage accumulation, and bone mineralization in the characterization of bone quality in the progress of age- and disease-related bone loss.

Adult↗

A flexible and extensible object-oriented 3D architecture: application in the development of virtual anatomy lessons.

"Anatomic VisualizeR" represents the first application to be developed using a 3D architectural framework created at the University of California, San Diego, School of Medicine. This application combines 3D anatomic models (based on the Visible Human dataset) with supporting 2D media (e.g., diagnostic imagery, surgical videos, etc.) to establish a comprehensive learning environment for anatomy. "Guided lessons" are being created to address complex curricular and learning objectives. Faculty expertise is represented in these preconfigured lessons, in part through the specification of appropriate content and the incorporation of activities to enhance visualization. These lessons are an intellectual framework which ensures that clinically-relevant issues and ancillary learning opportunities are available. The curricular exercises are non-sequential and can be interrupted at any time; users are encouraged to freely explore the environment. At the core of Anatomic VisualizeR's object-oriented architecture is the ability to identify, access, view, and manipulate heterogeneous content. The capacity to query a database gateway to retrieve specified resources has been built into the application. Encapsulation of individual elements to form 3D display objects ("blocks") enables Anatomic VisualizeR to efficiently manage 3D models, 2D images, text, sound, and video. The "block" paradigm also allows Anatomic VisualizeR to associate contextually appropriate display characteristics and behaviors with the various content elements. For example, the anatomic model block provides the capability to "link" and "unlink" the anatomic models and to alter their transparencies. The anatomic models can be displayed concurrently with other blocks to facilitate structural comparisons. Anatomic VisualizeR marks a major milestone in our developmental efforts. While lessons and database content are still not complete, we are confident that it will become the first tangible realization of our vision.

Anatomy↗

A federated schema-based middleware architecture for hospital information systems.

An important concern in distributed hospital information systems is the integration of information across heterogeneous subsystems. Consistent data replication is a central problem to be solved in this domain. The specific requirements and problems for integration of information within hospitals are discussed and a middleware architecture which has been designed according to these requirements is presented. Communication servers are often deployed in hospitals to connect heterogeneous subsystems. This paper discusses some problems with this approach and presents a federated schema-based middleware architecture as an alternative solution for propagation of information updates across heterogeneous subsystems within hospitals.

Database Management Systems↗

Component architecture in HIS: a drug order entry case study.

Historically, many healthcare information systems (HIS) have been designed around monolithic architectures that rely upon a single organization to provide most, if not all, of the system's business logic. Recent advances in distributed systems technology and healthcare standards make a component-based architecture feasible in building today's HIS. The First DataBank Drug Toolkit is used as a case study for the role of components in the design of a HIS. Several technical challenges associated with building truly plug and play components are discussed.

California↗

Migration towards a component based HIS architecture.

Changing requirements for health care information systems force the development of an open, modular architecture in which components can be integrated. This offers a flexible means for integrating different (heterogeneous) systems used by different users. Migration towards such an open, modular architecture is a difficult task. It consists of breaking down existing systems in components and integrating these components. Many authors on migration strategies focus attention on the ordering of the steps to be taken without detailing how these steps were arrived at. This paper presents a more rigorous approach for deriving a migration strategy.

Computer Systems↗

A new Object Request Broker architecture in implementing a medical picture retrieval system.

This paper describes the approach we used to implement the world wide web user interface of MediPict, a medical picture retrieval system. The best software architecture seemed to be the three-tier client/server architecture using Objects Request Brokers (ORB) which appears to have many benefits. Although CORBA appears to be the standard ORB, we found it more adequate to develop a different approach. This new ORB resolves many of CORBA's weaknesses (non coherent types, need of a static IDL, maintenance difficulties) by using the same language on the top and middleware tiers.

Computer Communication Networks↗

Migrating towards a client server architecture: a successful application in a 2,200-bed general hospital.

Asan Medical Center (AMC) completed a major migration process of the hospital information system from a mainframe towards an open Unix client server architecture from August of 1993 to August of 1996. Along with the east wing extension of AMC, the number of inpatient beds is greatly increased from 1,000 to 2,200 and information transaction increased from 300,000 to 700,000. A gradual departmental migration strategy with local area network connection and data conversion between the two systems were applied. The successful migration process towards a client server architecture provided improved user interface, enhanced flexibility and productivity of the system, better integration with diverse medical devices and improved networking flexibility.

Academic Medical Centers↗

An architecture for implementing customizable medical image processing systems.

Monolithic image processing systems containing a superset of imaging algorithms are difficult to use and require specialized knowledge of image processing. Thus they increase the workload of medical personnel instead of making the work situation easier. Customizable medical image processing systems on the other hand may be easily adapted to address various problems in the medical image processing domain integrating only the necessary subset of image processing functionality presented in on intuitive way. In this work we present an architecture for creating customizable image processing systems for the medical domain. We address three major topics: 1.) easy, goal-oriented customization of imaging systems by using a generalized algorithm model and repository, 2.) dynamic, data-oriented parameterization of the selected algorithms and 3.) semi-automated generation of user interface components for each new algorithm to be inserted in an imaging system based on cognitive ergonomics. We conclude with the presentation of an initial implementation of the architecture in form of an object-oriented framework for the creation of components for customizable medical imaging systems.

Algorithms↗

High resolution structure and sequence of T. aurantiacus xylanase I: implications for the evolution of thermostability in family 10 xylanases and enzymes with (beta)alpha-barrel architecture.

Xylanase I is a thermostable xylanase from the fungus Thermoascus aurantiacus, which belongs to family 10 in the current classification of glycosyl hydrolases. We have determined the three-dimensional X-ray structure of this enzyme to near atomic resolution (1.14 A) by molecular replacement, and thereby corrected the chemically determined sequence previously published. Among the five members of family 10 enzymes for which the structure has been determined, Xylanase I from T. aurantiacus and Xylanase Z from C. thermocellum are from thermophilic organisms. A comparison with the three other available structures of the family 10 xylanases from mesophilic organisms suggests that thermostability is effected mainly by improvement of the hydrophobic packing, favorable interactions of charged side chains with the helix dipoles and introduction of prolines at the N-terminus of helices. In contrast to other classes of proteins, there is very little evidence for a contribution of salt bridges to thermostability in the family 10 xylanases from thermophiles. Further analysis of the structures of other proteins from thermophiles with eight-fold (beta)alpha-barrel architecture suggests that favorable interactions of charged side chains with the helix dipoles may be a common way in which thermophilic proteins with this fold are stabilized. As this is the most common type of protein architecture, this finding may provide a useful guide for site-directed mutagenesis aimed to improve the thermostability of (beta)alpha-barrel proteins. Proteins 1999;36:295-306.

Amino Acid Sequence↗

Evolution of aminoacyl-tRNA synthetases--analysis of unique domain architectures and phylogenetic trees reveals a complex history of horizontal gene transfer events.

Phylogenetic analysis of aminoacyl-tRNA synthetases (aaRSs) of all 20 specificities from completely sequenced bacterial, archaeal, and eukaryotic genomes reveals a complex evolutionary picture. Detailed examination of the domain architecture of aaRSs using sequence profile searches delineated a network of partially conserved domains that is even more elaborate than previously suspected. Several unexpected evolutionary connections were identified, including the apparent origin of the beta-subunit of bacterial GlyRS from the HD superfamily of hydrolases, a domain shared by bacterial AspRS and the B subunit of archaeal glutamyl-tRNA amidotransferases, and another previously undetected domain that is conserved in a subset of ThrRS, guanosine polyphosphate hydrolases and synthetases, and a family of GTPases. Comparison of domain architectures and multiple alignments resulted in the delineation of synapomorphies-shared derived characters, such as extra domains or inserts-for most of the aaRSs specificities. These synapomorphies partition sets of aaRSs with the same specificity into two or more distinct and apparently monophyletic groups. In conjunction with cluster analysis and a modification of the midpoint-rooting procedure, this partitioning was used to infer the likely root position in phylogenetic trees. The topologies of the resulting rooted trees for most of the aaRSs specificities are compatible with the evolutionary "standard model" whereby the earliest radiation event separated bacteria from the common ancestor of archaea and eukaryotes as opposed to the two other possible evolutionary scenarios for the three major divisions of life. For almost all aaRSs specificities, however, this simple scheme is confounded by displacement of some of the bacterial aaRSs by their eukaryotic or, less frequently, archaeal counterparts. Displacement of ancestral eukaryotic aaRS genes by bacterial ones, presumably of mitochondrial origin, was observed for three aaRSs. In contrast, there was no convincing evidence of displacement of archaeal aaRSs by bacterial ones. Displacement of aaRS genes by eukaryotic counterparts is most common among parasitic and symbiotic bacteria, particularly the spirochaetes, in which 10 of the 19 aaRSs seem to have been displaced by the respective eukaryotic genes and two by the archaeal counterpart. Unlike the primary radiation events between the three main divisions of life, that were readily traceable through the phylogenetic analysis of aaRSs, no consistent large-scale bacterial phylogeny could be established. In part, this may be due to additional gene displacement events among bacterial lineages. Argument is presented that, although lineage-specific gene loss might have contributed to the evolution of some of the aaRSs, this is not a viable alternative to horizontal gene transfer as the principal evolutionary phenomenon in this gene class.

Amino Acid Sequence↗

Bone architecture and image synthesis.

3-D bone architecture can now be measured by micro-computer tomography or micro-magnetic resonance imaging. The principles of the micro-computer technique is reviewed and new architectural parameters can be computed. In addition, the method allows the contruction of polymer models by stereolithography, a method that can be used to perform repetitive mechanical studies on the same bone sample. These non destructive methods are interesting in the pre-clinical studies on bone diseases and in the investigation of animal trials on new pharmacological compounds active on bone.

Animals↗

Integrating a modern knowledge-based system architecture with a legacy VA database: the ATHENA and EON projects at Stanford.

We present a methodology and database mediator tool for integrating modern knowledge-based systems, such as the Stanford EON architecture for automated guideline-based decision-support, with legacy databases, such as the Veterans Health Information Systems & Technology Architecture (VISTA) systems, which are used nation-wide. Specifically, we discuss designs for database integration in ATHENA, a system for hypertension care based on EON, at the VA Palo Alto Health Care System. We describe a new database mediator that affords the EON system both physical and logical data independence from the legacy VA database. We found that to achieve our design goals, the mediator requires two separate mapping levels and must itself involve a knowledge-based component.

Artificial Intelligence↗

Architecture for a multipurpose guideline execution engine.

Integration of guideline knowledge into the clinical workflow is essential, for improving adherence to guidelines. Guidelines in structured formats can be utilized by computer programs to provide decision support in clinical information systems, as well as to facilitate workflow. We have designed an architecture for a flexible guideline execution engine that can be utilized in clinical decision support applications. The engine may be utilized for other applications such as referral management, medical education, and conducting clinical trials. The engine executes guidelines that are defined in an extension of the Guideline Interchange Format (GLIF). GLIF was extended to support representation of constructs that are essential to the execution of the guideline. A prototype of the engine was implemented based on this architecture. The engine is being utilized in two clinical applications that draw on guidelines for decision support. The engine was also used for developing an educational application aimed at testing knowledge of guideline recommendations.

Computer Systems↗

A new architecture for enterprise information systems.

Irresistible economic and technical forces are forcing healthcare institutions to develop regionalized services such as consolidated or virtual laboratories. Technical realities, such as the lack of an enabling enterprise-level information technology (IT) integration infrastructure, the existence of legacy systems, and non-existent or embryonic enterprise-level IT services organizations, are delaying or frustrating the achievement of the desired configuration of shared services. On attempting to address this matter, we discover that the state-of-the-art in integration technology is not wholly adequate, and itself becomes a barrier to the full realization of shared healthcare services. In this paper we report new work from the field of Co-operative Information Systems that proposes a new architecture of systems that are intrinsically cooperation-enabled, and we extend this architecture to both the regional and national scales.

Clinical Laboratory Information Systems↗