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PubMed1997

Documenting the information content of images.

A standards-based message and terminology architecture has been specified to enable large-scale open and non-proprietary interchange of imaging-procedure descriptions and image-interpretation reports providing semantically-rich linkage of linguistic and non-linguistic information. The DICOM Structured Reporting Supplement, now available for trial use, embodies this interdependent message/terminology architecture. A DICOM structured report object is a self-describing information structure that can be tailored to support diverse clinical observation reporting applications by utilization of templates and context-dependent terminology from an external message/terminology mapping resource such as the SNOMED DICOM Microglossary (SDM), HL7 Vocabulary, or Terminology Resource for Message Standards (TeRMS).

Diagnostic Imaging↗
PubMed2026

Cytogenetic Diversity of Variant Philadelphia Translocations in Chronic Myeloid Leukemia.

INTRODUCTION: Chronic myeloid leukemia (CML) is a disease characterized by Philadelphia (Ph) translocations. These translocations can be classical or variant. The structural features and diagnostic implications of variant Philadelphia translocations remain incompletely defined, and they display considerable cytogenetic heterogeneity. METHODS: In this retrospective study, variant Ph translocations identified by conventional cytogenetic analysis and fluorescence in situ hybridization (FISH) were systematically classified among 639 patients diagnosed with CML. A total of 35 patients with variant Ph translocations were included in the analysis. Molecular follow-up data, when available, were assessed using RT-qPCR analyses in a subset of patients. RESULTS: Chromosome analysis revealed 2 simple and 33 complex variant Ph translocations. FISH analysis, performed in 20 patients, identified deletions involving BCR, ABL1, or both in a limited number of cases. Additional chromosomal abnormalities and secondary translocations accompanied variant Ph translocations in four patients. The partner chromosomes involved in variant Ph translocations showed marked diversity, involving multiple chromosomal loci. CONCLUSION: Variant Philadelphia chromosome translocations in CML exhibit substantial cytogenetic diversity, reflecting the complexity of their underlying genomic architecture. The rarity and heterogeneity of these rearrangements complicate their classification and interpretation in routine diagnostic practice. Descriptive reporting of variant Ph translocations may contribute to a better understanding of their diagnostic complexity and support more accurate cytogenetic interpretation in CML.

Humans↗
PubMed1987

Indications of the existence of ferroelectric units in excitable-membrane channels.

Previous work in excitability has focused primarily on the mathematical description of the phenomena, while mechanisms postulated to explain these were simple mechanical interpretations of the terms of this description. The problem considered here is that of the physical mechanism underlying excitation. The experimental facts to be explained must be not only the electrical behavior of the membrane, but also its electromechanical, electro-optic and thermoelectric behavior. Previous work on the physically grounded electrodiffusion theory foundered not because of the incorrectness of the electrodiffusion approach, but because the assumed description of the dielectric properties of the membrane was too simple. Extension of the dielectric equation of state to a nonlinear polynomial form converts the classical electrodiffusion system of equations into a nonlinear polynomial form converts the classical electrodiffusion system of equations into a ferroelectric electrodiffusion system. The consideration of ferroelectric behavior in excitable channels makes possible straight-forward physical explanation of the phenomena of membrane swelling during action potential, currents induced by temperature changes, transition temperatures, current-voltage hysteresis, nonlinear electrical behavior, voltage-dependent birefringence and rectangular pulses from single channels. The hypothesis is therefore proposed that excitable channels contain ferroelectric transmembrane units. These may be crystals or liquid crystals.

Animals↗
PubMed2005

Flirting on the internet and the hickey: a hermeneutic.

Nowadays, erotic behaviour in cyberspace is customary. Online dating is a million dollar industry. Within the everyday politics of erotic-romantic relationships, however, males and females still blush in each other's presence, caress tenderly and trade hickeys. Mainstream social science researches cyber-behaviour voluminously, but totally ignores commonplace fleshy phenomena. Our study probes this discrepancy. What does it mean that virtual sex is winning the current war between desire and technology? Why is the 'flesh' becoming increasingly marginalized? To accomplish our aim, we use a phenomenological-hermeneutic method. Our basic results are two narratives: (1) interpretations about Internet flirting; and (2) descriptive finding about the hickey. Then, in order to reach general conclusions, we interpret the two studies in light of each other. It is a double hermeneutic. The two target phenomena share the similarity of manifesting the same "lovemap," "solicitation and allure." But they also differ sharply. Internet flirting exemplifies "mirror enchantment"; whereas the hickey showcases a phenomenology of the eyes, touch, dialogue and physical presence. We explain Western culture's preference for technology to the neglect of 'live' embodiment as manifesting a repetition of Platonic-Christendom's contempt for the flesh and horror of passionate tenderness. Our culture, on the cusp between modernity and post-modernity, displays dread concerning the flesh by obsessive concerns with safety-security and with modulating excesses. Are not absolute control and perfect security, however, merely illusions? We showcase the positive aspects of seemingly unsafe values: psychological vulnerability, daring, and risk.

Culture↗
PubMed1998

1998 ARRS Executive Council Award. Radiology in the emergency department: technique for quantitative description of use and results. American Roentgen Ray Society.

OBJECTIVE: We sought to develop quantitative methods to describe the use and results of imaging studies in emergency department patients. MATERIALS AND METHODS: A computerized nonrelational database containing records of 3.5 million diagnostic reports generated by our radiology department from 1988 to 1997 was queried using Boolean and natural language search tools. Each record contained data fields for patient demographics, examination description and billing code, names of interpreting radiologists and referring physicians, patient history, report body, and report impression. RESULTS: Emergency department admissions and imaging studies were stable from 1991 to 1997, averaging 60,000 and 52,000 per year, respectively. Bone radiographs comprised 45.1% of examinations; chest radiographs, 44.6%; and abdominal radiographs, 10.4%. The percentages of radiographs interpreted as normal were 75.9% in 1992 and 75.3% in 1996, with cervical spine (88.7%), thoracic spine (86.3%), and knee (86.3%) yielding the highest proportion of studies with normal findings. The number of CT studies of the body increased from 1840 in 1993 to 3101 in 1997. Studies of the abdomen accounted for most of this increase (52.3% in 1993 to 66.0% in 1997). During evaluations for cervical spine injury, a mean of 6.5% of radiographic studies were followed by CT studies, and the findings of 89.0% of those CT studies were interpreted as normal. CONCLUSION: Radiology report databases represent a resource from which broad descriptions of the use and results of imaging studies can be obtained. Such descriptions may be useful in departmental and hospital administration, technology assessment, cost-effectiveness studies, and health policy formulation.

Algorithms↗
PubMed1999

Lack of consistency in research papers over the definition of pre-eclampsia.

The most common definition of pre-eclampsia involves hypertension and proteinuria. This has changed little in over a hundred years despite advances in understanding the underlying pathological process. However, a number of variations in definition exist, and this paper demonstrates a lack of consistency in research articles in defining pre-eclampsia. A quarter of papers omit description, and many authors choose their own interpretation of the standard classification. Editors and reviewers should ensure that papers include a clear description of the definition used and an adequate description of the population studied to allow meaningful interpretation of research findings.

Female↗
PubMed2000

[Computer-assisted cardiotocogram analysis--from descriptive to perinatal expert system].

The interpretation of cardiotocograms is essentially for perinatal management, it remains labour intensive and depends on training and experience. With the development of modern analysing systems with conventional classification techniques, it seems possible to introduce expert systems and neuronal networks for a better interpretation and classification of cardiotocograms. Techniques of artificial intelligence are powerful tools and should be integrated in future systems. Because CTG-analysis--as a single procedure--is only of limited value for sufficient fetal prognosis, we conclude that computer aided CTG-analysis in combination with additional fetal parameters, for example partial oxygen pressure, will allow the development of future sufficient perinatal expert systems. Nothing should hinder future integration of computerized cardiotocogram analysing systems into everyday clinical routine and to connect it to obstetrical databases.

Cardiotocography↗
PubMed1999

Sonography of solid breast lesions: observer variability of lesion description and assessment.

OBJECTIVE: The purpose of this study was to measure the level of inter- and intraobserver agreement and to evaluate the causes of variability in radiologists' descriptions and assessments of sonograms of solid breast masses. MATERIALS AND METHODS: Sixty sonograms of solid masses were evaluated independently by five radiologists. Observers used the lexicon of a recently published benchmark report on sonographic appearances of breast masses to determine mass shape, margin, echogenicity, echo texture, presence of echogenic pseudocapsule, and acoustic transmission. Final diagnostic assessments were determined by applying the rule-based model of the same benchmark report to the radiologists' descriptions. In addition, one observer interpreted each case twice to evaluate intraobserver variability. Inter- and intraobserver variability were measured using Cohen's kappa statistic. We also investigated causes of variability in radiologists' descriptions. RESULTS: Interobserver agreement ranged from lowest for determining the presence of an echogenic pseudocapsule (kappa = .09) to highest for determining mass shape (kappa = .8). Intraobserver agreement was lowest for mass echo texture (kappa = .24) and greatest for mass shape (kappa = .79). Variability in descriptions of lesions contributed to interobserver (kappa = .51) and some intraobserver (kappa = .66) inconsistency in assessing the likelihood of malignancy. CONCLUSION: Lack of uniformity among observers' use of descriptive terms for solid breast masses resulted in inconsistent diagnoses. The need for improved definitions and additional illustrative examples could be addressed by developing a standardized lexicon similar to that of the Breast Imaging Reporting and Data System.

Adolescent↗
PubMed2002

Comprehending spoken metaphoric reference: a real-time analysis.

Speakers and writers often use metaphor to describe someone or something in a referential fashion (e.g., The creampuff didn't show up for the fight to refer to a cowardly boxer). Research has demonstrated that readers do not comprehend metaphoric reference as easily as they do literal reference (Gibbs, 1990; Onishi & Murphy, 1993). In two experiments, we used a naming version of the cross-modal lexical priming (CMLP) paradigm to monitor the time-course of comprehending spoken metaphoric reference. In Experiment 1, listeners responded to visual probe words of either a figurative or literal nature that were presented at offset or 1000 ms after a critical prime word. Significant facilitatory priming was observed at prime offset to probes consistent with the metaphorical interpretation of the figuratively referring description, yet no priming was found for either probe type at the downstream location. In Experiment 2, we partially replicated Experiment 1 results at prime offset and found no priming at a probe point placed 1000 ms upstream from prime onset. Taken together, the data from these two experiments indicate that listeners are able to comprehend metaphoric reference faster than literal reference. Moreover, the effect appears to be strongest at prime offset, suggesting that activation of the nonliteral interpretation is closely tied to the relationship between the figuratively referring description and the intended referent. Implications for theories of metaphor comprehension, as well as for research in spoken metaphor, are discussed.

Adult↗
PubMed1993

Ventilation-perfusion scintigraphy in the PIOPED study. Part I. Data collection and tabulation.

The Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) study of more than 700 patients is the largest existing study of the accuracy of lung scintigraphy in the diagnosis of acute pulmonary embolism. Perfusion scans were obtained in all patients and ventilation scans in almost all, using standardized techniques. Chest radiographs were obtained in all patients within 12 hr of the lung scan. Most patients underwent pulmonary arteriography. The images were interpreted according to a set of interpretive criteria which remained constant throughout the trial. A standardized, detailed description of each image set was derived by consensus of teams of two readers blinded to clinical and arteriographic findings. This communication reports the methods used to describe and categorize the ventilation-perfusion scintigrams obtained in patients who were enrolled in the PIOPED study. Scintigraphic technique is reviewed briefly, probability assessment is described and the scan description is reviewed in detail. The form used to describe the findings on ventilation-perfusion scans is reproduced. Use of this standardized description permits retrospective evaluation of the PIOPED interpretive criteria. In addition, it represents a rigorous approach to scan analysis which could facilitate application of formal interpretive schemes and enhance the reproducibility of lung scan interpretations in the clinical setting.

Data Collection↗
PubMed2002

Assessment training for practice in American Indian and Alaska Native settings.

The collaborative assessment model is extended as a training model. The experience of psychological assessment in American Indian and Alaska Native communities is often negative due to culturally inappropriate services and test interpretation. It is productive to address this negative experience, using it as a catalyst for learning. Training in measurement and construct validation provides initial basis for critique of negative experience. Training in collaborative assessment procedures then focuses on culturally appropriate assessment service practices, cultural orientation's affect on test interpretation, and multicultural assessment ethics. Writing skills are emphasized, including procedures in report writing for description of local adaptations, norms, and interpretative rules, and integration of the Diagnostic and Statistical Manual for Mental Disorders (4th ed., text revision; American Psychiatric Association, 2000) cultural formulation. Development of local norms and emic tests are emphasized.

Alaska↗
PubMed2004

Patient control and end-of-life care part I: the advanced practice nurse perspective.

PURPOSE/OBJECTIVES: To explore understanding of preferences of adult patients with cancer for control in the context of end-of-life care and to explore strategies that oncology advanced practice nurses (APNs) use to assist patients in achieving personal control at the end of life. RESEARCH APPROACH: Descriptive, naturalistic using Denzin's model of interpretive interactionism. SETTING: A variety of settings throughout the state of Texas. PARTICIPANTS: 9 oncology APNs. METHODOLOGIC APPROACH: Participants were recruited via a mailed invitation to APN members of the Oncology Nursing Society who resided in Texas. Interviews were recorded on audiotape and analyzed via Denzin's interpretive process of data analysis. MAIN RESEARCH VARIABLES: Patient control. FINDINGS: APNs' descriptions of patient preferences for control at the end of life included engagement with living, turning the corner, comfort and dignity, and control over the dying process. APN roles included presenting bad news in a context of choices, managing physical care and emotional needs, and facilitating care services and systems. CONCLUSIONS: Patient desire for control manifests in a wide variety of actions and desires to live fully and remain actively involved in personal decision making in the context of an advanced cancer diagnosis. APNs play a pivotal role in determining and facilitating patient preferences for control. INTERPRETATION: Academic programs to prepare oncology APNs must include attention to communication skills, clinical care needs, and care management strategies for the end-of-life continuum of care. APNs may need to increase efforts to dispel patient and family misperceptions about value and timing of palliative care and hospice services.

Adult↗
PubMed1988

[Phase contrast microscopy demonstration of glomerular erythrocytes in urine: practicable in ambulatory practice?].

The use of phase-contrast microscopy in microhematuria, as proposed in 1979 by Birch and Fairley, renders morphological changes in red cells easily detectable and makes it possible to distinguish glomerular from non-glomerular bleeding. The aim of this study was to evaluate the practicability of this method as a routine laboratory test in ambulatory care. 60 patients with asymptomatic microhematuria (greater than or equal to 2 erythrocytes per high power field) were followed up over a one-year period. All patients were investigated by intravenous pyelography, ultrasound of urinary tract and three cytological examinations of the urine. The description of urine samples was done with phase-contrast microscopy by a first investigator at the beginning of the study and by a second after 12.8 months, blinded to clinical results and previous examinations. In 21 patients a definitive diagnosis was possible. In 18 patients the morphologic descriptions of the two investigators correlated with the clinical results. Only in two patients with established diagnosis there were differences between the urine description of the two investigators, and in one patient the interpretations of both investigators were wrong. These incorrect descriptions concerned patients with low-grade microhematuria. Thus, phase-contrast microscopy is a practicable method for the practitioner's use as a routine laboratory investigation. In low-grade microhematuria the method seems to be of minor value.

Ambulatory Care↗
PubMed1996

Interpretive and procedural skills of the internal medicine clerkship: performance and supervision.

This descriptive study prospectively examined the performance and supervision of interpretive and procedural skills during an internal medicine clerkship. Students (N = 150) documented having done 7 required and 12 elective skills. Preceptors of required skills were interns (44%), residents (29%), attending physicians (12%), and others (16%). The elective procedures and the percentage of students doing them were as follows: skin tests, 78%; nasogastric tube insertion, 57%; paracentesis, 44%; bone marrow sampling, 35%; lumbar puncture, 34%; thoracentesis, 34%; Papanicolaou smear, 29%; central line placement, 27%; cardioversion, 13%; bladder catheter insertion, 11%; arthrocentesis, 9%; and skin biopsy, 7%. Elective procedures per student ranged from 0 to 9 (mean = 4) and were done less often in the first clerkship group than later in the academic year. Preceptors of electives were interns (46%), residents (39%), and attending physicians (9%). House staff were more likely and faculty less likely to precept electives than required procedures. Students' exposures to these skills are unequal. Their preceptor are generally house staff. To prepare medical students for postgraduate training, technical skills should be specifically addressed in the curriculum.

Analysis of Variance↗
PubMed1994

Physiological time-series analysis: what does regularity quantify?

Approximate entropy (ApEn) is a recently developed statistic quantifying regularity and complexity that appears to have potential application to a wide variety of physiological and clinical time-series data. The focus here is to provide a better understanding of ApEn to facilitate its proper utilization, application, and interpretation. After giving the formal mathematical description of ApEn, we provide a multistep description of the algorithm as applied to two contrasting clinical heart rate data sets. We discuss algorithm implementation and interpretation and introduce a general mathematical hypothesis of the dynamics of a wide class of diseases, indicating the utility of ApEn to test this hypothesis. We indicate the relationship of ApEn to variability measures, the Fourier spectrum, and algorithms motivated by study of chaotic dynamics. We discuss further mathematical properties of ApEn, including the choice of input parameters, statistical issues, and modeling considerations, and we conclude with a section on caveats to ensure correct ApEn utilization.

Algorithms↗
PubMed2005

Radiologic evaluation following Roux-en-Y gastric bypass surgery for morbid obesity.

Morbid obesity is an increasing health problem, and bariatric surgery is becoming a popular treatment option. Radiologists must be familiar with performing and interpreting studies in this patient population. The typical postoperative findings of the Roux-en-Y gastric bypass (RYGBP) procedure for morbid obesity on upper gastrointestinal (UGI) series are presented. An overview of the potential complications that may be diagnosed with contrast studies and computed tomography (CT) is provided in addition to a description of potential pitfalls in interpreting these studies.

Anastomosis, Roux-en-Y↗
PubMed1996

An intelligent system for the diagnosis of complex images.

An intelligent system suitable to perform a computer aided diagnosis of complex images should have a knowledge base containing all information related both to the images to be interpreted and to their symbolic description. In this paper, a system able to classify unknown medical digital images into four classes is proposed (searched pathology recognized, searched pathology absent, different pathology from the searched one recognized, unknown pathology). A main component of this system is a knowledge base that, startling from information deduced from sample images, can be processed to create synthetic reference models that, in turn, permit the interpretation of real scenes. The system has been tested on digitized plain film of the thorax, in order to perform a computer-aided diagnosis of pneumothorax cases.

Artificial Intelligence↗