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Regression equations for the calculation of intraocular lens power are popular. Because some of the variables in cataract surgery are surgeon-specific, every surgeon should ideally have a personalized formula. We have developed software enabling those with access to IBM-compatible microcomputers to develop equations based on their own data.
Visual field is one of the important visual functions; it is the extent of the visual field defect that can be employed in judging whether the visual function is impaired. The rapid achievements in computer technologies do provide an impulse for improvement of visual field detection, making possible the automatic, rapid, accurate, detailed and large-scaled visual field detection. This paper gives a thorough description about development of the visual field analyzer, model TEC-2A, which is based on PC windows platform, Visual Basic software developing tool, ISA peripheral circuits, standard Goldmann visual field half-ball and standard stimulus.
The integration of medical images as part of the patient record has always been a critical component of documentation and information supporting clinical decisions. In the past two decades the increased number of imaging procedures that allows a more accurate and more specific diagnosis has significantly increased and their role in patient management has grown rapidly. With the evolution toward digital modalities and management of medical images in a fully digital environment with the deployment of enterprise wide Picture Archiving Communication Systems (PACS) a wider and more rapid access to the images by referring physicians and clinicians has become possible. The parallel evolution of electronic medical records (EMR) supporting all other documents and clinical data in electronic format led to the necessity of integrating medial image data with the rest of the patient record. Although the marriage of medical images and patient record data in electronic format seems a very natural and necessary combination it has often been very slow in development due to the lack of standardization and clear understanding of clinical workflows and clinical requirements. Several early implementations demonstrated the added value of combining medical images with the patient record and have shown that the availability of data and images facilitates and improves the accuracy and efficiency of patient management. Recent efforts in industry and the academic community to harmonize and improve the integration of medical images with patient record, with the promotion of new standards and better definitions of clinical workflows and standard mechanism of integration of different types of data into unified data models, has facilitated the deployment of modern EMR. Also, a shift in paradigm due to recent technological revolutions such as the development of the World Wide Web and the concepts of portal servers for accessing data for multiple sources has significantly boosted the trends into open systems which allows easier and more functional integration of medical data from different sources. Furthermore, the emergence of a new strategy for software development, based on open source components, allows software programs to be shared and exchanged between different institutions leading to more rapid deployment of standardized electronic patient record.
The application of correlation spectroscopy employing stochastic excitation and the Hadamard transform to time-domain Fourier transform electron paramagnetic resonance (FT-EPR) spectroscopy in the radiofrequency (RF) band is described. An existing, time-domain FT-EPR spectrometer system with a Larmor frequency (L(f)) of 300 MHz was used to develop this technique by incorporating a pseudo-random pulse sequence generator to output the maximum length binary sequence (MLBS, 10- and 11-bit). Software developed to control the EPR system setup, acquire the signals, and post process the data, is outlined. The software incorporates the Hadamard transform algorithm to perform the required cross-correlation of the acquired signal and the MLBS after stochastic excitation. To accommodate the EPR signals, bandwidth extension was accomplished by sampling at a rate many times faster than the RF pulse repetition rate, and subsequent digital signal processing of the data. The results of these experiments showed that there was a decrease in the total acquisition time, and an improved free induction decay (FID) signal-to-noise (S/N) ratio compared to the conventional coherent averaging approach. These techniques have the potential to reduce the RF pulse power to the levels used in continuous wave (CW) EPR while retaining the advantage of time-domain EPR methods. These methods have the potential to facilitate the progression to in vivo FT-EPR imaging of larger volumes.
We have looked at general descriptions and illustrations of several software development tools, such as tools for prototyping, developing DFDs, testing, and maintenance. Many others are available, and new ones are being developed. However, you have at least seen some examples of powerful CASE tools for systems development.
Most image guided Neurosurgery employs adhesively mounted external fiducials for registration of medical images to the surgical workspace. Due to high logistical costs associated with these artificial landmarks, we strive to eliminate the need for these markers. At our institution, we developed a handheld laser stripe triangulation device to capture the surface contours of the patient's head while oriented for surgery. Anatomical surface registration algorithms rely on the assumption that the patient's anatomy bears the same geometry as the 3D model of the patient constructed from the imaging modality employed. During the time interval from which the patient is imaged and placed in the Mayfield head clamp in the operating room, the skin of the head bulges at the pinsite and the skull fixation equipment itself optically interferes with the image capture laser. We have developed software to reject points belonging to objects of known geometry while calculating the registration. During the course of development of the laser scanning unit, we have acquired surface contours of 13 patients and 2 cadavers. Initial analysis revealed that this automated rejection of points improved the registrations in all cases, but the accuracy of the fiducial method was not surpassed. Only points belonging to the offending instrument are removed. Skin bulges caused by the clamps and instruments remain in the data. We anticipate that careful removal of the points in these skin bulges will yield registrations that at least match the accuracy of the fiducial method.
Real-time three-dimensional echocardiography (RT3DE) is an innovative cardiac imaging modality. However, partly due to lack of user-friendly software, RT3DE has not been widely accepted as a clinical tool. The object of this study was to develop and implement a fast and interactive volume renderer of RT3DE datasets designed for a clinical environment where speed and simplicity are not secondary to accuracy. Thirty-six patients (20 regurgitation, 8 normal, 8 cardiomyopathy) were imaged using RT3DE. Using our newly developed software, all 3D data sets were rendered in real-time throughout the cardiac cycle and assessment of cardiac function and pathology was performed for each case. The real-time interactive volume visualization system is user friendly and instantly provides consistent and reliable 3D images without expensive workstations or dedicated hardware. We believe that this novel tool can be used clinically for dynamic visualization of cardiac anatomy.
Two economic analyses of immunization programmes, one from Denmark and one from Kenya, are described with emphasis on practical problems in relation to the collection of data. The Danish study was performed by a study group with participation of experts within health economics and epidemiology and a specifically designed computer programme was developed. The Kenyan study was performed by the management unit of the Kenyan immunization programme using standard computer software developed by WHO (EPICost) and without external assistance. Both studies yielded results of significant relevance for the dialogue with the administration and politicians.
A common problem for developers of clinical applications is coping with the diversity of medical language. Medical language as it is used all over the world varies widely, while the referents for these words stay essentially the same. Software developers must reconcile this diversity with the practical necessity of producing applications that are usable in a variety of hospitals, while ensuring that information can be shared between applications. Existing approaches center around coding and classification schemes, but these approaches must be supplemented by a range of sophisticated terminological services in order for the language barriers to be overcome. To address this, the GALEN project is developing an application called the Terminology Server to provide such a range of terminological services (e.g., conceptual and multilingual services). The software is built upon a re-usable core model of medical terminology. This paper reports on the development of a clinical application called the SCUI (Structured Clinical User Interface) which draws on these GALEN technologies and illustrates an innovative approach to the construction of future clinical applications. The SCUI was specifically developed and tested in the context of infectious diseases to satisfy the demands made by the medical intensive care unit on the Geneva Hospital's microbiology laboratory.
This paper presents a new software developed for analyzing single strand conformation polymorphism (SSCP) electrophoresis patterns delivered by the genetic analyzer ABI310 (Applied Biosystems). SSCP is a molecular typing technique based on the PCR amplification of microbial 16S rDNA and used for the monitoring of complex microbial ecosystems dynamics. The software--a home-made MATLAB toolbox called MODIMECO--developed for the analysis of SSCP patterns is presented. MODIMECO includes a number of basic signal processing abilities as well as largely used statistical tools such as the well known principal component analysis. The use of the SSCP for assessing the hypothesis of the existence of a microbial signature of drinking waters illustrates the typical advantages of using such software tools. Results are discussed and conclusions drawn.
For imaging purposes of the spine, segmented image data provides the basis for a variety of modern clinical applications. However, the anatomical complex structure of the spine as well as the extensive degenerative bony deformations apparent in the clinical situation, generally complicate the application of a fully automated segmentation. To serve the special needs for image segmentation of the spine anatomy a newly developed software system is presented, that implements specially adapted interactive tools, taking its 'axis'-skeletal structure into account. A standardized protocol combines the newly developed interactive tools (rotation transformation, warped dissection plane) with standard segmentation tools to provide both a fast and accurate segmentation procedure. The introduced software environment has been valuable for the segmentation of cervical, thoracic and lumbar spines segments based on clinical routine and research images.
OBJECTIVE: To estimate mean level of trans fatty acid intakes using a representative sample of the US population. DESIGN: The study used food intake data from the 1989-1991 Continuing Survey of Food Intakes by Individuals (CSFII) and the trans fatty acid contents of specific foods calculated from a database compiled by the US Department of Agriculture (USDA) to estimate the mean level and deciles of trans fatty acid intake of the representative US population. SUBJECTS/SETTING: Trans fatty acid intakes were estimated for each subject (N = 11,258) in the CSFII data who completed both a 24-hour recall and a 2-day food record. STATISTICAL ANALYSES PERFORMED: Weights developed by USDA for the survey were used for all data analyses. The Technical Assessment Systems (TAS) International Diet Research System (TAS-DIET), software developed by TAS, was used to derive weighted estimates of the mean and percentiles of the intake distribution. PC CARP, software designed by Iowa State University, was used to estimate standard errors. RESULTS: Mean percentage of energy ingested as trans fatty acids was 2.6% and the mean percentage of total fat ingested as trans fatty acids was 7.4%. Across all age and gender groups examined, estimates ranged from 2.6% to 2.8% and 7.1% to 7.9%, respectively. APPLICATIONS/CONCLUSIONS: Dietetics practitioners can use the representative data of this study to help clients achieve desired changes in consumption levels of trans fatty acids.
Computer support for research in biotechnology has developed rapidly and has provided several tools to aid the researcher. This report describes the capabilities of new computer software developed in this laboratory to aid in the documentation and planning of experiments in molecular biology. The program, POLLUX, provides a graphical medium for the entry, edit and manipulation of DNA constructs and a textual format for display and edit of construct descriptive data. Program operation and procedures are designed to mimic the actual laboratory experiments with respect to capability and the order in which they are performed. Flexible control over the content of the computer-generated displays and program facilities is provided by a mouse-driven menu interface. Programmed facilities for mutagenesis, simulated cloning and searching of the database from networked workstations are described.
The combination of volumetric MRI and multivoxel localized MR spectroscopic imaging (MRSI) data provides the potential for quantifying variations in tissue morphology and function. These techniques have numerous applications for the evaluation of neurological diseases. While state-of-the-art whole-body MR scanners are able to acquire both types of data, there have been relatively few reports which have presented clinical applications of the technology. One of the reasons for this has been the need to develop software for reconstruction and reliable interpretation of 3D imaging and spectral data. In this article, we describe the strategy developed for quantitative analysis of combined MRI and MRSI examinations from patients with brain tumors and evaluate the key components of this procedure using both simulations and empirical data from phantoms, normal volunteers, and patients. Important factors are the use of volume or interleaved multislice anatomic images as a reference, the reconstruction and correction of the spectral data for frequency, phase, and baseline distortions and consideration of the characteristics of the coil, RF pulses used for spatial selection, and phase encoding procedures. These studies show that the metabolic parameters most critical for distinguishing tumor from normal and necrotic tissue were relative levels of choline and NAA. Levels of creatine and lactate were found to be variable, both in terms of their spatial distribution within individual lesions and between different patients.
Endoscopic retrograde cholangiopancreatography (ERCP) has evolved from a mainly diagnostic to a mainly therapeutic endoscopic technique. Training in ERCP is labor-intensive and time-consuming. Computer- and animal-model-based simulations have been developed in the hope of standardizing and accelerating training. They also may be useful for evaluating trainees. Early efforts to develop computer simulations of endoscopic procedures were hampered by lack of processing power and memory and the cost of software development. Biologic systems seem to offer more realism at lower cost. Hybrid computer-biologic systems seem likely to be the next generation of ERCP simulators.
The potential of matrix-assisted laser desorption ionization (MALDI) and MALDI-post-source decay (PSD) time-of-flight mass spectrometry for the characterization of peptides and proteins is discussed. Recent instrumental developments provide for levels of sensitivity and accuracy that make these techniques major analytical tools for proteome analysis. New software developments employing protein database searches have greatly enhanced the fields of application of MALDI-PSD. Peptides and proteins can be easily identified even if only a partial sequence information is determined. Derivatization procedures have been optimized for MALDI-PSD to increase the structural information and to obtain a complete peptide sequence even in critical cases. They are fast, simple and can be performed on target. MALDI-PSD is also a very powerful tool to characterize or elucidate post-translational or chemically induced modifications. In association with database searches, proteins issued from electrophoretic gels can be identified after specific enzymatic cleavages and peptide mapping.
The availability of the genome sequences of human and mouse, human sequence variation data and other large genetic data sets will lead to a revolution in understanding of the human machine and the treatment of its diseases. The success of the international genome sequencing consortiums shows what can be achieved by well coordinated large scale public domain projects and the benefits of data access to all. It is already clear that the availability of this sequence is having a huge impact on research worldwide. Complete genome sequences provide a framework to pull all biological data together such that each piece has the potential to say something about biology as a whole. Biology is too complex for any organisation to have a monopoly of ideas or data, so the collection, analysis and access to this data can be contributed to by research institutes around the world. However, although it is possible for all this data to be accessible to all through the internet, the more organisations provide data or analysis separately, the harder it becomes for anyone to collect and integrate the results. To address these problems of intergration of data, open standards for biological data exchange, such as the 'Distributed Annotation System' (DAS) are being developed and bioinformatics (Dowell et al., 2001) as a whole is now being strongly driven by the open source software (OSS) model for collaborative software development (Hubbard and Birney, 1999). The leading provider of human genome annotation, the Ensembl project (http://www.ensembl.org), is entirely an OSS project and has been widely adopted by academic and commerical organisations alike (Hubbard et al., 2002). Accurate automatic annotation of features such as genes in vertebrate genomes currently relies on supporting evidence in the form of homologies to mRNAs, ESTs or protein. However, it appears that sufficient high quality experimentally curated annotation now exists to be used as a substrate for machine learning algorithms to create effective models of biological signal sequences (Down and Hubbard, 2002). Is there hope for ab initio prediction methods after all?
A multiterminal system --NUMEDICS--has been developed to study the problems of on-line acquisition, processing, and display of scintigraphic data. The hardware-software configuration of NUMEDICS permits simultaneous and independent operation of terminals in the Division of Nuclear Medicine, the Physics Research Laboratory, and the Cyclotron Laboratory of the Massachusetts General Hospital. This paper describes the hardware and software developments in NUMEDICS which have been proven to be of value in clinical and research applications. These features are illustrated by applications to the evaluation of left ventricular performance, three-dimensional imaging, and functional imaging of rCBF.