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Storage and retrieval of SNOP-coded pathologic diagnoses using offsite computing and optical character recognizing systems.

A computerized cross-reference system for retrieving autopsy and surgical pathology cases on the basis of case number or diagnosis has been implemented. The system achieves economy and flexibility by using offsite computer service bureaus for job production, eliminating the need for expensive onsite equipment. Coded diagnoses may be typed using the OCR (Optical Character Recognition) font simultaneously with or separately from the clinical documentation. The flexibility of new OCR equipment permits production of machine-readable code sheets with an ordinary pencil and completely eliminates the need for typing. The system produces year-to-date books that list all diagnoses, on an accumulating basis, in alphabetic order by SNOP* topology, morphology, etiology and function, and will be compatible with SNOMed. Because all data are stored on magnetic tape, they may be manipulated and retrieved as desired through user programming. The initial setup cost was dollar 1,000 for programming and testing, and production runs and all report printing cost about dollar 1,000 per year (autopsies and surgical pathology cases), which is about 1.1 cents per diagnosis.

Computer Systems↗

Unsuspected and unrelated pathology noted on limited computed tomographic scans of the paranasal sinuses and temporal bone.

Modern imaging includes many studies performed to examine limited fields of view (i.e., paranasal sinus studies). These studies are frequently retrospectively coned to the limited field of view and are often examined only at one window and level setting. However, classic radiology teaching demands that all irradiated structures be examined by a qualified physician; for examples, on an intravenous pyelogram the examiner should look at not only the kidneys, ureters, and bladder, but also the bones, soft tissues, and gas patterns. This article illustrates unsuspected intracranial pathology noted on computed tomographic examinations of the paranasal sinuses and temporal bones.

Adult↗

High resolution lung computed tomography. Normal anatomic and pathologic findings.

The use of high resolution computed tomography (HRCT) for evaluating the lung parenchyma requires an understanding of normal lung anatomy and the pathologic alterations in anatomy that occur in the presence of disease. Most important is an understanding of the secondary pulmonary lobule; HRCT can show many features of the secondary lobule in both normal and abnormal lungs, and many lung diseases, particularly interstitial diseases, produce characteristic alterations in lobular anatomy. HRCT is capable of diagnosing interstitial abnormalities, air-space consolidation airway diseases, and emphysema.

Air↗

Churg-Strauss pulmonary vasculitis. High-resolution computed tomography scanning and pathologic findings.

A case of Churg-Strauss vasculitis was studied by high-resolution computed tomography (HRCT) scanning. HRCT scanning demonstrated enlarged, irregular and stellate-shaped arteries, and small patchy opacities were present in the pulmonary parenchyma. These findings correlated with the histologic appearance of the pulmonary parenchyma on open lung biopsy. The arteries were enlarged due to eosinophilic infiltration in the vessel walls, and the adjacent lymphatics were dilated. This observation suggests that HRCT scans may be of value in the evaluation of pulmonary vasculitis because these findings are distinct from those of other diffuse lung lesions.

Adult↗

Computed tomography evaluation of pathologic processes in the potential spaces of the mediastinum.

The potential spaces of the mediastinum can be involved in a variety of disease processes and become evident by computed tomography study. The potential spaces may be distended with air, blood, inflammatory exudate, excessive fat, or tumor which separates and displaces the normal mediastinal structures. Seven cases with various pathologic processes are selected to demonstrate the computed tomography characteristics of such lesions. We emphasize the importance of computed tomography in evaluating and understanding various disease processes involving the potential spaces in an often widened mediastinum.

Adult↗

[Comparison of computed tomography results and pathological findings after laparotomy with splenectomy in Hodgkin's disease].

In 69 patients (pts) with Hodgkin's disease (HD) in I-IIIA clinical stage results of abdominopelvic computed tomography (CT) were compared with pathological staging. Concordance (specificity) of CT scan with results of macroscopic evaluation of HD lesions in the abdomen during laparotomy with splenectomy was 83%. Accuracy CT results and microscopic findings was 80%. False positive results of CT were found in 11.6% of patients and false negative in 8.6%. Specificity and sensitivity of CT versus to pathological staging were 84% and 63% respectively. The results presented here confirm, that pathological staging after laparotomy with splenectomy in HD was some advantage in precise prediction of some patients to radiotherapy and planning of irradiated fields.

Adolescent↗

Split-half and test-retest Hand Test reliabilities for pathological samples.

Computed split-half and test-retest reliabilities for some major Hand Test scoring categories for a group of 100 Ss of mixed psychopathology. All correlations were significant; the rs ranged from "modest" to "high.' Withdrawal, the most serious of all indices of psychopathology, showed the most consistency across both split-half and test-retest formats. Results were interpreted as lending credence to Hand Test rationale. Reliabilities appear high enough to justify the clinical use of the technique.

Adult↗

Anatomic CT demonstration of the peritoneal spaces, ligaments, and mesenteries: normal and pathologic processes.

Computed tomography (CT) has become increasingly useful in the detection of intraabdominal disease. Owing to the widespread use of CT, it is essential that radiologists have a thorough understanding of the peritoneal spaces and the ligaments and mesenteries that form their boundaries. The majority of ligaments and mesenteries in the abdomen are formed from remnants of the ventral and dorsal mesenteries, which suspend the primitive gut. Unlike the abdominal ligaments, the pelvic ligaments are mainly formed by reflections of peritoneum over the pelvic organs or structures. The mesenteries and ligaments form the boundaries of the peritoneal spaces; this knowledge aids in localizing fluid collections, allowing the differential diagnosis to be narrowed. The ability to localize fluid collections accurately is also important if percutaneous or surgical drainage is to be performed. In addition, neoplasms can be more accurately staged when the pathway of spread through adjacent ligaments and mesenteries is understood.

Abdomen↗

Fibrosing alveolitis: CT-pathologic correlation.

Computed tomography (CT) was performed within 10 days of open lung biopsy in nine patients with fibrosing alveolitis. One-centimeter collimation contiguous scans through the chest were obtained in all patients. Additional 1.5-mm collimation scans were obtained in the area in which lung biopsy was later performed in six patients. In seven patients, CT demonstrated patchy involvement of the lung parenchyma, areas with a reticular pattern being intermingled with areas of normal lung. The reticular pattern was associated with cystic spaces 2-4 mm in diameter and was more severe in the lung periphery. Histologically, the reticular pattern corresponded to areas of irregular fibrosis. One patient had diffuse honeycombing (2-20-mm cysts), and one had honeycombing only in the lung periphery. In all patients, CT clearly defined the architectural changes seen on open lung biopsy. These changes were much better seen on the 1.5-mm than on the 10-mm collimation scans. CT may be helpful in determining the pattern and distribution of lung involvement in patients with fibrosing alveolitis and in guiding the surgeon to the most appropriate area(s) for biopsy.

Adult↗

[Mediastinal lymph node metastasis from esophageal carcinoma: CT assessment with pathologic correlation].

Computed tomographic (CT) scans were performed in 179 patients with esophageal carcinoma to evaluate mediastinal lymph node metastasis. Histopathologic findings were compared with CT findings in a total of 7,218 resected lymph nodes. First, the criterion for lymph node metastasis on CT scans was 10 mm or more in long transverse diameter. The overall sensitivity and positive predictive value (PPV) were 19% (60 of 317 nodes) and 33% (60 of 180 nodes), respectively. Analysis of each of the eight subgroups of mediastinal nodes revealed that the PPV was more than 70% in node Nos. 105, 108, 110, and 112. In other subgroups, however, the PPV was less than 60%. Sensitivity was less than 50% in all eight subgroups. Second, the criterion for metastasis was 10 mm or more in short transverse diameter. The overall sensitivity and PPV were 8% (26 of 317 nodes) and 63% (26 of 41 nodes), respectively. Analysis of subgroups showed that the PPV in No. 106 nodes increased to 92%. In No. 106 nodes, use of a 5 mm criterion in long transverse diameter increased sensitivity to only 55%. Of the 317 histopathologically proven metastatic lymph nodes, 90 nodes (28%) were 10 mm or more in size, 112 (35%) were 5-10 mm, and 115 (36%) were less than 5 mm. Of the 6,901 non-metastatic lymph nodes, 473 nodes (7%) were 10 mm or more in size. Small (less than 5 mm in size) metastatic nodes were present in all eight subgroups. Among No. 107 and 109 nodes, large (10 mm or more in size) nonmetastatic nodes were prominent, resulting in low sensitivity and PPV. We conclude that CT does not provide an accurate assessment of metastatic versus non-metastatic mediastinal lymph nodes in patients with esophageal carcinoma.

Esophageal Neoplasms↗

Correlative study of the computed tomographic, ultrasonographic, and pathological characteristics of cavernous versus capillary hemangiomas of the orbit.

Pathologic and ultrasonographic features of cavernous and capillary hemangiomas were correlated with the computed tomographic (CT) characteristics of these two tumors to show that these hemangiomas can be differentiated by their contrast enhancement characteristics. Specifically, all five cases of adult cavernous hemangiomas were enhanced proportionately less than extraocular muscles, whereas capillary hemangiomas were enhanced proportionately more than extraocular muscles. The capillary hemangioma that demonstrated the lowest relative enhancement was in an older child, it may have represented a more mature form of a capillary hemangioma. We correlated these CT findings with the ultrasonographic and pathologic features to explain the differences in these CT characteristics.

Adult↗

[The use of the class of KUVT-86 computers for examination of pathologic anatomy].

Examination in pathology with a test control of the theoretical part is carried out with the use of the computer class KUVT-86. The degree of knowledge is evaluated by means of the 1st level test. A student receives 3 tickets for general, special and specific pathology, respectively. Every ticket includes list of questions from a respective part of pathology consisting of 4 tests of distinction, 4 tests of identification and 2 classification tests (40 elements altogether). The number of questions for all examination is 120. The verification of knowledge occurs without paper forms. The calculation of the degree of knowledge is done by the computer during the examination. The student is given the estimation of his answers to every question. The results are fixed on the external information carriers which can be used for the evaluation of the student knowledge survival several years later.

Computer-Assisted Instruction↗

Computer simulation of normal and pathological copper metabolism in man.

A digital computer simulation of copper metabolism was used to simulate human copper metabolism. The simulation agrees well with the normal data extant. Wilson's disease (hepatolenticular degeneration) and Menkes' disease (steely-hair syndrome) were simulated. Simulation of the unavailability of accumulated liver copper simulated Wilson's disease if it was assumed that the increased urinary excretion was due to induction of an enzymic mechanism for enhanced excretion. This would be consistent with the genetic defect causing only the sequestering of unavailable copper in the liver. Other genetic defects need not be present. Menkes' disease is also a genetic disease affecting the newborn. It was simulated successfully as a defect in absorption of copper from the gastrointestinal tract.

Adult↗