The continuum of health informatics educational efforts.
Explore the source record for details and available documents.
Chicago↗
Biomedical subjects
W B Panko
Publications and source records attributed to W B Panko.
Preparing chief information officers for the clinical information systems environment.
Over the past decade, the chief information officer (CIO) in the health care enterprise has gained recognition as a member of the senior management team based on an understanding of business processes and business language. The clinical information system (CIS) in the health care environment poses a new frontier for CIOs, who are generally unfamiliar with both clinical languages and clinical processes. The authors discuss the role formal informatics training can have in preparing learners for future careers as CIOs in CIS environments. The health information management (HIM) specialization within the MBA program at the University of Illinois at Chicago is one example of an educational program designed to train future CIOs who can manage the business, technical, and clinical aspects of the health care environment.
Humans↗
Limitations of distributed segmentation for three-dimensional radiological modeling.
While the use of three-dimensional models has been shown to be useful clinically, the specialized computational equipment and expertise necessary for their construction and use keeps these tools out of reach of most physicians. This paper explores the construction of a Web-based Java application that allows medical radiological models to be built on a remote server and navigated locally on the physician's desktop PC. This paper will also address issues that arose from a public, unrestricted testing of usability over the Internet, such as model size management, easy navigation, processor loading and security. Based on observations and data collected, we suggest what steps are necessary to make a telemedicine application useable in a true clinical setting.
Humans↗
The Virtual Pelvic Floor, a tele-immersive educational environment.
This paper describes the development of the Virtual Pelvic Floor, a new method of teaching the complex anatomy of the pelvic region utilizing virtual reality and advanced networking technology. Virtual reality technology allows improved visualization of three-dimensional structures over conventional media because it supports stereo vision, viewer-centered perspective, large angles of view, and interactivity. Two or more ImmersaDesk systems, drafting table format virtual reality displays, are networked together providing an environment where teacher and students share a high quality three-dimensional anatomical model, and are able to converse, see each other, and to point in three dimensions to indicate areas of interest. This project was realized by the teamwork of surgeons, medical artists and sculptors, computer scientists, and computer visualization experts. It demonstrates the future of virtual reality for surgical education and applications for the Next Generation Internet.
Anatomy↗
The Internet: will this highway serve the digital library?
The future of the biomedical enterprise and the biomedical libraries that serve it is tied closely to digital information. The changing nature of this type of information will create new pressures on libraries, particularly in health care organizations. Libraries must learn to deal with these pressures. Currently, libraries depend on the Internet primarily for connections to resources and other libraries; thus enhancements to the Internet will impact the libraries of the present and future significantly. This paper provides an overview of the technical capabilities that will be available in the near to midterm, what libraries will be able to do with those capabilities, and how libraries can position themselves to take advantage of the impending changes.
Computer Communication Networks↗
Networking: an overview for leaders of academic medical centers.
Organizations face a unique challenge over the next decade. When technology was expensive, it was arguably necessary to use an undifferentiated, or monolithic, model for computer-based solutions to problems. This has fundamentally changed. Technology is now so inexpensive that solutions are not limited by costs, but rather by how well the implementors understand the many different problem domains. Thus, academic medical centers are faced with successive waves in information technology use. First, there will be a wave of innovation, driven by the need for specialization in problem solving. This will be followed by consolidation of the best of the approaches into the core systems of the institution. The average level of heterogeneity (cost) will be higher, but the overall quality of the solutions (benefit) will also be higher. If one can develop a strategy for managing and creatively limiting the heterogeneity, the cost-benefit ratio will be much more favorable. While there may be other strategies that will do this, we support the use of a strategy centered on enterprise networking. This strategy emphasizes not simply technology but also the cultural and organizational changes that empower innovation--within a framework that makes it possible to simply implement interoperability and data sharing within nearly all solutions. The organizations that survive the coming period of change and external pressure will be those that do the best job of managing their resources. Information will continue to be one of the most important resources.(ABSTRACT TRUNCATED AT 250 WORDS)
Academic Medical Centers↗
A path to integration in an academic health science center.
This article describes a networking and integration strategy in use at the University of Michigan Medical Center. This strategy builds upon the existing technology base and is designed to provide a roadmap that will direct short-term development along a productive, long-term path. It offers a way to permit the short-term development of incremental solutions to current problems while at the same time maximizing the likelihood that these incremental efforts can be recycled into a more comprehensive approach.
Integrated Advanced Information Management Systems↗
A new model for enhanced information services in an academic medical center.
The information base used in the biomedical enterprise, already large, continues to expand at a striking rate. Networking and desktop computing technology is playing a more important role in the operations of academic medical centers. Integration efforts aimed at enhancing information access by using distributed computing are very substantial technical challenges. However, if these integration efforts focus only on the technical aspects, they are doomed to failure. New organizational approaches are also needed. This paper describes an new model for enhanced information services. This model calls for the central information supplier to provide a set of core services. Users, who may be individuals or units and generally have more insight into the nature of their problems, will be encouraged to add value to these core services in the form of specialization or customization to meet their unique and critical needs. This model provides a way to adapt and transform current organizational elements to effectively use the large information technology investments and to meet the increasing challenges of biomedical information use.
Academic Medical Centers↗
Dihydrotestosterone heptanoate: synthesis, pharmacokinetics, and effects on hypothalamic-pituitary-testicular function.
Dihydrotestosterone heptanoate (DHT-hp), a seven-carbon fatty acid ester of DHT, was synthesized, and its pharmacokinetics and effects on hypothalamic-pituitary-testicular function were determined in men and pubertal boys. Plasma DHT levels markedly increased 24 h after im injection of DHT-hp, reached their peak during the first week, and fell to baseline levels after 4-6 weeks. An estimated 43-55% of DHT-hp was converted to DHT 4-6 weeks after injection. Plasma testosterone, estradiol, LH, and FSH levels decreased by 4 days after DHT-hp injection, were lowest during the second week, and returned to baseline values after 4-6 weeks. The LH and FSH responses to GnRH were diminished by chronic administration of DHT-hp to pubertal boys at 3-week intervals for 15 weeks. The affinity of DHT-hp was 100 times less than the affinity of DHT for the human androgen receptor, and no affinity for the estrogen receptor in breast tissue could be demonstrated. Since DHT is a nonaromatizable androgen, and neither DHT nor DHT-hp binds readily to the estrogen receptor, suppression of LH and FSH secretion by this drug probably occurs via an androgen-dependent mechanism. Receptor binding and pharmacokinetic data indicate that unesterified DHT is the active principle. DHT-hp is a useful derivative of DHT, since prompt, predictable, and sustained rises in DHT occur after its administration.
Adult↗
Carcinoembryonic antigen and steroid receptors in the cytosol of carcinoma of the breast. Relationship to pathologic and clinical features.
Cytosols of 159 primary breast carcinomas were assayed for estrogen and progesterone receptors and 60 of these for carcinoembryonic antigen (CEA). The relationships of pathologic and clinical features previously shown to be of prognostic significance and the biochemical parameter measured were examined. It was found that degree of histologic differentiation was significantly related to receptor status. There were significant inverse relationships between estrogen receptor and lymphocytic infiltrate as well as tumor necrosis. Relationships between estrogen, but not progesterone, receptor and patient age, menstrual status, and race existed. Cytosol CEA, on the other hand, related only to pathologic stage and not to histologic differentiation and other pathologic variables. Therefore, steroid receptors and CEA appear to provide information about different biologic characteristics of a carcinoma. Furthermore, the information provided by CEA appears to be independent of many known pathologic, clinical, and biochemical prognostic indicators.
Age Factors↗
Mechanism of androgen-receptor augmentation. Analysis of receptor synthesis and degradation by the density-shift technique.
The ductus deferens smooth muscle tumor cell line (DDT1MF-2) contains receptors for, and is stimulated by, androgens. Cells cultured in the absence of androgens maintain a basal level of androgen receptors. Following incubation with various concentrations of the synthetic androgen methyltrienolone (R1881) for 1-6 h, the concentration of these receptors increased from 6.0 to 12.2 fmol/micrograms of DNA, while the equilibrium dissociation constant (Kd) of 0.5 nM for this steroid remained unchanged. The steroid-induced increase in androgen receptor levels was specific for androgens and dependent upon protein synthesis. The mechanism of receptor augmentation was examined by utilization of isotopically dense amino acids to determine rates of receptor appearance and degradation in the presence or absence of [3H]R1881. In the absence of androgens, the half-life of the androgen receptor was 3.1 h, with a rate constant (kD) of 0.22/h. In the presence of 1 nM [3H]R1881, however, the half-life was 6.6 h, with kD = 0.11/h. The rate constant for receptor synthesis (ks) in the absence or presence of [3H]R1881 was calculated to be 1.35 and 2.23 fmol/micrograms of DNA/h, respectively. Thus, androgen-induced androgen-receptor augmentation is explained by an increase both in receptor half-life and in rates of receptor synthesis.
Animals↗
Steroid hormone binding macromolecules in meningiomas. Failure to meet criteria of specific receptors.
Cytoplasmic estrogen and progesterone binding proteins were assayed in 26 meningiomas using an assay developed for the measurement of estrogen and progesterone receptors in human target tissue. The steroid specificity of the binding proteins was studied in both individual and pooled meningioma tissue by competitive binding assays. Eight meningiomas contained significant amounts of estrogen-binding protein and 18 contained significant amounts of progesterone-binding protein. There was no correlation between the amount of hormone-binding protein and patient age, sex, menstrual status or presentation, or tumor occurrence, location, or pathologic features. The competition studies demonstrated a lack of steroid specificity for these hormone-binding proteins. Therefore, the authors conclude that, contrary to recent reports, the hormone-binding proteins found in meningiomas are unlikely to be specific steroid receptors.
Adult↗
Heterogeneity of estrogen binding sites in mammary tumors.
This paper provides a brief summary of our recent work on the heterogeneity of estradiol binding sites in mammary tumors of the mouse and human. Mammary tumors from both species contain the classical estrogen receptor and a second site(s) which we call type II. These type II sites are found in the cytoplasmic and nuclear compartments of both tumors, and can interfere with the measurement of estrogen receptors. The function of type II sites is not known; however, an assessment of these sites in conjunction with an accurate measurement of the estrogen receptor may provide a clearer picture of the true hormone dependence of breast tumors.
Animals↗
Human chorionic gonadotropin detected in urinary concentrates from patients with malignant tumors of the testis, prostate, bladder, ureter and kidney.
Human chorionic gonadotropin levels in concentrated 24-hour urine and serum were determined by a specific radioimmunoassay of beta-human chorionic gonadotropin in 47 patients with genitourinary carcinoma. Elevated human chorionic gonadotropin levels in urine were observed in 6 of 8 patients with active testicular tumor, 3 of 14 with prostatic cancer, 2 of 10 with bladder cancer, 1 of 2 with ureteral or renal pelvic tumors and 2 of 6 with renal cancer. Of the 14 patients with positive urinary human chorionic gonadotropin 4 had undetectable human chorionic gonadotropin levels in the serum. The tumors of all 8 patients with nontesticular cancer who had increased urinary human chorionic gonadotropin levels were in an advanced clinical stage or of poor histological differentiation. Our results suggest that some nontrophoblastic carcinomas of the genitourinary system are capable of ectopic production of human chorionic gonadotropin, particularly if the malignancy is advanced or poorly differentiated. The radioimmunoassay of beta-human chorionic gonadotropin in concentrated 24-hour urine specimens enhances the sensitivity of detection of ectopic human chorionic gonadotropin production.
Aged↗
Pathology through the looking glass.
Explore the source record for details and available documents.
Computers↗
Lack of correlation of a histochemical method for estrogen receptors analysis with the biochemical assay results.
Forty-nine specimens of carcinoma of the breast were analyzed for estrogen receptor content using the sucrose gradient method and a histochemical method using a conjugate of estradiol (6-BSA-Fluor-CMO-17 beta-estradiol). The specimens analyzed by the histochemical method were graded for fluorescent intensity, percentage of cells fluorescing, and cellularity. Only 53.1% (26/49) of the specimens were classified into the same three categories (positive, negative and ambiguous) as classified by the biochemical assay. If the negative and ambiguous categories were combined, the degree of correspondence rose to only 63.3% (31/49). Because the classification scheme was arbitrary and because the results of the biochemical assay might be correlated with one or more factors, univariate and multivariate analyses were used to examine the data for any underlying relationships. Only the age of the patient was significantly correlated with the results of the biochemical assay. Importantly, neither the percentage of cells fluorescing nor the fluorescent intensity was correlated with the results of the biochemical assay. Terms to account for various interactions of parameters did not enhance the association with the biochemical results. While this histochemical assay may eventually prove to be effective in selecting patients for endocrine therapy, it does not seem to be a substitute for the standard biochemical assay for estrogen receptors presently used.
Adult↗
Estrogen receptors in canine mammary tumors.
The presence of estrogen receptor in 67 canine mammary lesions was correlated with pathological features of the disease. All tissue specimens were analyzed for estrogen receptor content by a sucrose gradient ultracentrifugation method previously used in analyzing human breast cancer cytosols. Pathological features of the tissues were assessed by a veterinary pathologist without knowledge of results of estrogen receptor analysis. Sixty-two (92.5%) of the tissue samples analyzed were classified as epithelial neoplastic lesions, and 38 of these (61.3%), including 24 adenocarcinomas, were estrogen receptor for positive (i.e., estrogen receptor concentration equal to or greater than 10 fmol/mg cytosol protein). All five of the nonepithelial neoplastic lesions were estrogen receptor negative. Canine and human breast cancers share common histological types and have similar biological behavior. If a significant percentage of canine mammary cancer is also estrogen dependent, the dog may be a useful model for hormonal studies and for the development of models of endocrine therapy for human breast cancer.
Adenocarcinoma↗
Estrogen binding sites in the nucleus of normal and malignant human tissue: optimization of an exchange assay for the measurement of specific binding.
An exchange assay has been validated and used to measure the total concentration of estrogen receptors in the nuclei of cells from human breast tumors and myometrium. Tissue homogenates were centrifuged through 1.2 M sucrose pads to separate crude chromatin from soluble ane membranous fractions. The yield of DNA by this procedure was approximately 80%. Total binding sites were measured by incubating the sedimented pellets with tritiated estradiol at 30 degrees for 60 min and then precipitating the receptor-steroid complexes with protamine sulfate. Saturation analysis by this procedure provides evidence for the presence of a specific, nuclear estrogen-binding site in addition to the established estrogen receptor in both these tissues.
Breast Neoplasms↗