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At least 1,801 records · Page 100Linked to original sources
PubMed1999

Two-dimensional versus three-dimensional radiographic measurements of polyethylene wear.

Because polyethylene wear adversely affects the outcome of total hip arthroplasty, reliable techniques for in vivo radiographic evaluation of femoral head penetration into the polyethylene liner are needed. With the recent development of software to measure three-dimensional femoral head penetration, the adequacy of two-dimensional head penetration measurements to estimate a three-dimensional process has been questioned. Thus, the purpose of the current study was to compare directly two-dimensional and three-dimensional radiographic measurements of femoral head penetration. Using two computer assisted radiographic techniques, the authors of this study measured the two-dimensional and the three-dimensional penetration of the femoral head into the polyethylene liner in 202 hips implanted with porous coated acetabular components. A comparison of two-dimensional and three-dimensional measurements showed that, on average, the mean amount of three-dimensional head penetration was larger than the mean amount of two-dimensional head penetration. However, linear regression analysis showed that the two measurements were highly correlated (r2 = 0.87, slope = 0.99, intercept = 0.08 mm). For most patients (95%), two-dimensional and three-dimensional measurements of femoral head penetration were nearly equal. However, there was a small subset of patients (5%) for whom three-dimensional radiographic penetration measurements were three times greater than corresponding two-dimensional radiographic penetration measurements. No common risk factor among this small subset of patients was identified. The current study provides practical information for the orthopaedic surgeon trying to assess polyethylene wear in hip replacement cases. It shows that for most patients head penetration can be measured sufficiently from anteroposterior radiographs alone. However, in a small percentage of patients (5% in the current study) the femoral head also moves perpendicular to the plane of the anteroposterior radiograph. For these cases, accurate analysis of head penetration requires three-dimensional analysis using anteroposterior and lateral radiographs.

Acetabulum↗
PubMedDate not supplied

Cumulative genetic damage in children exposed to preconception and intrauterine radiation.

Using a mathematical model and newly developed computer software, the data from the Tri-State Leukemia Survey involving different combinations of radiation exposures to the father and mother prior to conception and to the mother during pregnancy were analyzed. The hypothesis that radiation exposure produces genetic damage which may be expressed in the child both as indicator disease and as leukemia was tested. The genetic damage was estimated in terms of the proportion affected by a given exposure. The relative risk of leukemia and certain other indicator diseases among those "affected" could then be estimated. The results were obtained by direct minimization of the total chi-square. The results show that there are at least two distinguishable risk groups, one group with lower (one or two exposures), and the other group with higher (two or three) radiation exposures. The estimates for the proportion affected are 0.13 and .04 for the lower and higher exposure groups, respectively. The relative risks of leukemia and indicator diseases are 25.0 and 5.0, respectively. The 95% confidence intervals for the proportion affected in the lower and higher exposure categories are (.0075, .02) and (.028, .055), respectively, and for the relative risk of leukemia are (16.0, 35.0). These results have confirmed and extended the findings of our preliminary report published in the Journal of the American Medical Association in May 1977.

Adolescent↗
PubMedDate not supplied

Phantom testing of peripheral artery. Absolute blood flow measurement with digital arteriography.

A technique to measure absolute arterial blood flow in ml/min has been developed utilizing software programs with high-speed digital recording for the off-line analysis of intra-arterial injections of contrast medium. Measurements of pulsatile flow in a phantom for a physical flow model showed that calculations with the final upgrades were within 10% of known flow, using a recording rate of 30 frames/s, a diameter tubing of 5 mm, and flow rates of 300 to 400 ml/min. Quantitative absolute flow of a peripheral artery such as the internal carotid artery may be obtained during routine cerebral arteriography for comparison with anatomic data.

Angiography↗
PubMed1980

The use of three-dimensional computer display in the study of disk disease.

We have developed a software system for three-dimensional dynamic display of organs from computed tomograms (CT). We are now beginning to evaluate the clinical usefulness of this software system. We have chosen the spine in general, and disk disease in particular, as the first step in this evaluation. The choice was to a large extent influenced by our belief that surgical planning can be improved if three-dimensional displays of the diseased disk and its surroundings are available. Patients who have been referred to us for CT evaluation were examined in the routine manner. In those cases in which the ordinary CT scans indicated potential usefulness, the softwar system was applied, and movies were produced showing the appearance of appropriate parts of the spine as if they were rotating in front of the user. It appears that the size and relative location of disk herniations are well represented by such displays. Proof of efficacy in surgical planning awaits a more thorough evaluation, but our initial study indicates that the method has great promise.

Adult↗
PubMedDate not supplied

Calculation of cross-sectional geometry of bone from CT images with application in postmenopausal women.

OBJECTIVE: The objectives of this study were to develop a software program that calculates bone cross-sectional area (CSA) and moments of inertia from digital images, test the computations for accuracy, and implement the software in a study of longitudinal changes in bone properties in a large group of postmenopausal women. MATERIALS AND METHODS: A program called SLICE was adapted to use computed tomography (CT) bone images as input. The main outcome variables of the resulting program, SLICE_CT, were bone CSA, areal moments of inertia, and mass-weighted moments of inertia. SLICE_CT was tested for accuracy using representative arrays of CT numbers that approximate cross-sections of cortical bone. Then the technique was applied to images from a 3 year longitudinal study of the radius in 86 postmenopausal women who underwent quantitative CT of the dominant radius at 30% the distance from the wrist to the elbow. The mean age of the subjects at entry into the study was 57 years. Images at baseline and at 3 years were analyzed, and the null hypothesis of no change in cross-sectional geometry was tested by a paired difference two-tailed t test. RESULTS: The error of SLICE_CT was < 1% with proper segmentation, using half-maximal height as the threshold. In the longitudinal study of postmenopausal women, the mean change of CSA of the radius was -1.4% (SD = 3.0%; p < 0.001). However, there was a compensatory 2.4% increase in the cross-sectional second polar moment of inertia (SD = 3.7%; p < 0.001). CONCLUSION: SLICE_CT is an accurate method with which to determine cross-sectional geometry of digital images and can be used to detect changes in cross-sectional geometry of the radius with age in postmenopausal women. The results indicate that the radius remodels to compensate for bone loss and decreasing material properties of bone associated with aging.

Bone and Bones↗
PubMedDate not supplied

Prediction of aortoiliac stent graft length: comparison of a semiautomated computed tomography angiography method and calibrated aortography.

OBJECTIVE: The aim of this study is to compare multislice computed tomography (MSCT) in combination with a newly developed semiautomated software program with calibrated aortography in patients who are scheduled for endovascular aortic stent graft placement. METHODS: From November 2000 until December 2001, seven patients with an abdominal aortic aneurysm (AAA) underwent both calibrated aortography and MSCT for preoperative endovascular stent graft planning. Both studies were performed within 14 days. Further, length measurements were performed with a semiautomated computerized tomographic angiography (CTA) calibration method and a conventional calibrated aortography technique using three differently configured tubes with variable tortuosity. The AAA length measurements of the semiautomated CTA calibration method and the calibrated aortography were compared. RESULTS: Statistical analysis included linear regression analysis and revealed a probability value of 0.000381 and an r2 value of 0.93. Using phantoms, it is proven by the authors that the accuracy of the semiautomated CTA calibration method increases with increasing tortuosity when compared with the conventional calibrated aortography technique. CONCLUSIONS: Our preliminary results show that the semiautomated CTA calibration method has a potentially advantageous role in preoperative stent graft planning regarding the aortic length measurements and seems to be more accurate than calibrated aortography, especially in extremely tortuous vessels. Further studies have to be performed, however.

Aged↗
PubMed2001

PQM--Psychiatry Quality Measurement.

As a consequence of an increased awareness of quality management in psychiatry the Lundbeck Institute has developed a software program called Psychiatry Quality Measurement (PQM). This is an electronic documentation and quality measurement system with a large data-collecting function to record longitudinal data of the full psychiatric visit, covering all aspects of an evaluation and follow-up. Using the full ICD-10 and DSM-IV classifications, the system has been designed to assist with quality measurement in all psychiatric diagnoses. A full statistical package is included in the program to calculate outcomes of treatment (including relapse rates, improvements in psychopathology, severity and frequency of side-effects, and costs of treatment) as tables and graphs ready for presentation in a Powerpoint format. The system is fully translatable and flexible for various implementation settings, including stand-alone PCs or hospital network systems, all ICD-10 or DSM-IV diagnoses, and the possibility of the use of over 20 psychopathology and side-effect scales to measure the quality of care of all psychiatry patients.

Data Collection↗
PubMed2001

Patient education: designing a state-of-the-art consumer health information library.

Many patients believe that the education they receive about their health and their illnesses is inadequate or lacking. Nurse executives are in a key position to influence their patients' abilities to become more informed and to take greater responsibility for their healthcare decisions. In the article, the authors discuss Massachusetts General Hospital's state-of-the-art consumer health information library, including how the project was planned, organized, and implemented.

Boston↗
PubMed1998

Optimal location of a single distal interlocking screw in intramedullary nailing of distal third femoral shaft fractures.

OBJECTIVE: This biomechanical study was done to determine the effect of the level of a single distal screw in a static intramedullary (IM) femoral nail on the stability of fixation of a fracture in the distal third of the femur. DESIGN: Fifteen composite fiberglass femora were osteotomized transversely in the distal third of the femur. A Grosse-Kempf nail was implanted into the femurs, which were divided into three groups of five specimens. Single screw distal nail locking was varied distal to the osteotomy site for each group at 2.5, 5.0, and 7.5 centimeters, respectively. INTERVENTION: All instrumented femurs were mounted on a servohydraulic testing machine and fitted with transducers to measure axial, rotational, and bending displacements. Specimens were cyclically loaded (one hertz) in simultaneous torsion (moment: +/- 10 newton-meters) and axial compression (amplitude: 2,000 newtons) for 500 cycles with a 250-pound abductor force. MAIN OUTCOME MEASUREMENT: Data from linear and rotational transducers were sampled at 100 hertz for five cycles before cycling, every 100 cycles of loading, and immediately after cycling. Custom computer software was developed to convert transducer signals into static and dynamic measurements of axial motion (in millimeters), rotation (in degrees), and angulation (in degrees). RESULTS: Osteotomy site dynamic rotation increased significantly in specimens locked at 7.5 centimeters when compared with the 2.5-centimeter group. There was minimal difference between the stability of the 5.0-centimeter and 7.5-centimeter groups. There was no significant change in position at the fracture site before or after cyclic loading with respect to axial shortening, rotation, or bending. Both dynamic axial and angular displacements were also unaffected by screw position. CONCLUSION: The location of a single distal interlocking screw in static IM nail fixation of distal third femur fractures can significantly affect rotational stability but not axial or angular fixation.

Biomechanical Phenomena↗
PubMed1993

"Landmark injection" for localization of choroidal lesions using indocyanine green angiography.

To localize choroidal lesions demonstrated by indocyanine green (ICG) angiography, retinal blood vessels must be identified. Since retinal blood vessels are seen in early-phase ICG angiography and the choroidal lesions are best seen on the late-phase images, a technique has been developed to demonstrate retinal blood vessels in the late phase of the ICG angiography study. The technique requires the injection of 0.3 mg of ICG dye mixed in 3.0 cc of diluent. This injection is given between 30 and 40 minutes into the ICG angiogram. This technique allows visualization of retinal blood vessels, which can be used as landmarks to localize choroidal lesions. Additionally, this technique, when combined with newly developed computer software programs, permits the mapping and tracing of choroidal lesions of the fundus.

Angiography↗
PubMed1998

Compliance with doxycycline therapy in sexually transmitted diseases clinics.

OBJECTIVE: To determine rates of compliance with doxycycline therapy for patients attending two inner city sexually transmitted diseases (STD) clinics using the MEMS (Medication Event Monitoring System) technology (Aprex Corporation, Fremont, CA). DESIGN: An observational study. SETTING: Two STD clinics in Brooklyn, New York and Birmingham, Alabama. PATIENTS: Patients warranting doxycycline as antichlamydial therapy by usual clinical criteria (e.g., documented chlamydial infections, gonococcal urethritis, mucopurulent cervicitis) were enrolled consecutively from both clinics into four separate categories according to gender and the presence or absence of symptoms: symptomatic men (77), asymptomatic men (30), symptomatic women (83), asymptomatic women (33). INTERVENTION: In the clinic area, patients were given their doxycycline in standard 30-dram medication bottles fitted with the MEMS cap, which is capable of recording the date and time of each bottle opening and closing. This information was then retrieved using a software program developed by the manufacturer. Patients were instructed to return the bottle and cap at the completion of therapy. Efforts were made to contact those who did not return their bottles by both telephone and mail. OUTCOME MEASURES: Bottle openings as recorded by the MEMS were considered to represent use of medication. Patients were considered strictly compliant with prescription instructions if bottle openings and closings occurred at least twice daily for 6 consecutive days. Noncompliance was defined as initially opening the medication more than 48 hours after leaving the clinic or opening the bottle less than once daily for 5 consecutive days. Usage between these extremes was classified as intermediate. RESULTS: Eighty percent of 223 patients enrolled completed the study by returning their bottles. The rate of strict compliance with prescription instruction was 25%. The rate of noncompliance was 24%. Fifty-one percent used some intermediate amount of medication. There was no statistical difference in compliance by gender, presence or absence of symptoms, or site of enrollment. CONCLUSIONS: Few patients administered doxycycline in an STD clinic can be expected to take medication precisely as prescribed. Although most probably take enough to eradicate uncomplicated chlamydial infections, a sizable portion can be expected to use an inadequate amount of medication. This may contribute to persistence of genital chlamydia infections in the community.

Adult↗
PubMed1998

Imaging sports injuries: the future.

OBJECTIVE: To review the application of new imaging technologies to the practice of sports medicine. DATA SYNTHESIS: Musculoskeletal imaging has dramatically evolved over the past decade. Plain film acquisition, archiving, storage, and interpretation have undergone revolutionary changes, moving into the electronic era. Viewing hard-copy film is becoming obsolete as digital image acquisition and display will eventually render radiology departments filmless. Although it seems unlikely that a new modality will enter the imaging arena in the near future, we will continue to see the development of software and hardware technology that allows rapid acquisition of superior quality cross-sectional image data. CONCLUSION: As these technologies continue to flourish, diagnosis and treatment planning of the injured athlete will become both more expedient and more accurate.

Athletic Injuries↗
PubMed2003

Use of personal digital assistants with acute care nurse practitioner students.

Personal digital assistants (PDAs) are attaining increased functionality by acute care nurse practitioners (ACNPs). Supplemented by recently developed medical software, these devices assist nurse practitioners in having information available at the point of care. This article reviews the introductory use of PDAs throughout ACNP graduate training with an emphasis on clinical and classroom application.

Computers, Handheld↗
PubMed2006

Diagnosing glaucoma progression: current practice and promising technologies.

PURPOSE OF REVIEW: An update on recent work is provided that has broadened our understanding of the evaluation of visual function and structure, and their use in evaluating glaucoma progression. RECENT FINDINGS: The challenge of determining visual-field progression and the implications of long-term fluctuation are reviewed and data to support the magnitude of the fluctuation are cited. The use of confirmatory testing can limit the over diagnosis of glaucoma progression. Focusing visual-field testing on the locations of present scotomas or using frequency doubling technology may provide new approaches to assessing visual function. New standardized techniques to interpret visual fields, including neural networks, unsupervised machine learning and pointwise linear regression, may provide more quantitative means for visual-field interpretation. These techniques, along with structural evaluation of the optic nerve and nerve fiber layer, are essential in glaucoma management. Optic-nerve-head photography is still a mainstay in evaluating glaucoma progression, although many technologies including scanning laser tomography, scanning laser polarimetry and optical coherence tomography offer more quantitative means to follow structural change. These modalities, in different ways, show promise in providing additional information regarding the stability of glaucoma. SUMMARY: Identifying the functional visual component as well as structural changes is essential in evaluating glaucoma progression. New techniques of testing and evaluating visual fields, the optic-nerve head, and the retinal nerve fiber layer offer exciting opportunities to more accurately identify glaucoma progression, and are likely to become more central as imaging devices and software support develop further.

Diagnostic Techniques, Ophthalmological↗
PubMed2004

Nonuniform hybridization: a potential source of error in oligonucleotide-chip experiments with low amounts of starting material.

Low amounts of starting material are a significant limitation of gene-expression profiling of microprepared pathologic specimens. Linear RNA amplification has become the method of choice to overcome this problem. Thus, transcriptomal analyses by oligonucleotide-chips or cDNA microarrays are now feasible with labeled complementary RNA generated from total RNA samples in the lower nanogram range. However, in case of oligonucleotide-chips, it has been underestimated so far that individual complementary RNA molecules are shorter in length than and display a 3' bias in comparison to the sequence stretch represented by oligonucleotides on the chip. This can lead to incorrect interpretation of raw data. We have analyzed this problem testing ex vivo-microprepared endothelial cells with Affymetrix GeneChips U133A. Only a small subset of housekeeping genes showed adequate uniform hybridization. We developed a software tool for objective evaluation of oligonucleotide-chips based on automated analysis of as well as normalization to this subset of housekeeping genes. We analyzed the gene expression profile of microprepared lymphatic vascular endothelial cells. We show that optimized normalization prevented exclusion of angiopoietin-2, a lymphatic endothelial marker, from the lymphovascular transcriptome.

Endothelial Cells↗
PubMed2005

The negative predictive value of electrical impedance scanning in BI-RADS category IV breast lesions.

OBJECTIVES: We sought to prospectively assess the value of electrical impedance scanning (EIS) in discriminating benign from malignant lesions classified as BI-RADS category IV in mammography in comparison with ultrasound (US), with a special focus on negative prediction. MATERIALS AND METHODS: EIS was performed on 128 BI-RADS category IV lesions in 121 women (mean, 51.8 years). The newly developed EIS software 2.67 calculates a BI-RADS-like level of suspicion (LOS) on a 5-grade scale. LOS 1, 2, and 3 were considered negative; LOS 4 and 5 were considered positive. Histopathologic results were obtained in all lesions. RESULTS: Histology proved 37 lesions malignant, 91 benign. Sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of EIS compared with US were 94.6%, 74.7%, 80.5%, 60.3%, 97.1% versus 90.5%, 33.8%, 47.2%, 29.7%, 92.0%, respectively. In 43 lesions sized < or = 10 mm, EIS demonstrated better sensitivity, specificity, accuracy, PPV, and NPV of 100%, 83.3%, 90.7%, 82.6%, and 100%, respectively. Although NPV was also high, US showed no sufficient results in 39 (30.5%) lesions because of microcalcifications. Receiver operating curve analysis revealed best results for a combined use of US and EIS. CONCLUSIONS: With a NPV of 97.1% of EIS in BI-RADS category IV breast lesions, a negative result in these lesions could be firm indication to manage them as BI-RADS-category III and refer patients for a 6-month short-interval follow-up rather than performing a biopsy. The best adjunctive diagnostic performance can be achieved by a combination of US and EIS. Costs and patient morbidity could be minimized.

Breast↗
PubMed2002

The generic genome browser: a building block for a model organism system database.

The Generic Model Organism System Database Project (GMOD) seeks to develop reusable software components for model organism system databases. In this paper we describe the Generic Genome Browser (GBrowse), a Web-based application for displaying genomic annotations and other features. For the end user, features of the browser include the ability to scroll and zoom through arbitrary regions of a genome, to enter a region of the genome by searching for a landmark or performing a full text search of all features, and the ability to enable and disable tracks and change their relative order and appearance. The user can upload private annotations to view them in the context of the public ones, and publish those annotations to the community. For the data provider, features of the browser software include reliance on readily available open source components, simple installation, flexible configuration, and easy integration with other components of a model organism system Web site. GBrowse is freely available under an open source license. The software, its documentation, and support are available at http://www.gmod.org.

Animals↗

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