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[MEDLINE on compact disk as an information source at the Medical School Library in Novi Sad].

The transformation of the Library at the Medical Faculty of Novi Sad into a modern information center necessitated the introduction of an up-to-date technology and enforced the use of the latest information sources among which MEDLINE medical database is the most famous one. In the studied period, January 1993-current, 200 searches have been performed on the basis of which the following parameters were analyzed: institution, occupation, and degree of the user, purpose and accuracy of the order, relevant period, number and format of the references, assessment of the search quality and the quality of the library staff services. The analysis proved the initial belief that MEDLINE is a remarkably valuable data base necessary for medical libraries.

CD-ROM↗

Design of a compact disk-like microfluidic platform for enzyme-linked immunosorbent assay.

This paper presents an integrated microfluidic device on a compact disk (CD) that performs an enzyme-linked immunosorbent assay (ELISA) for rat IgG from a hybridoma cell culture. Centrifugal and capillary forces were used to control the flow sequence of different solutions involved in the ELISA process. The microfluidic device was fabricated on a plastic CD. Each step of the ELISA process was carried out automatically by controlling the rotation speed of the CD. The work on analysis of rat IgG from hybridoma culture showed that the microchip-based ELISA has the same detection range as the conventional method on the 96-well microtiter plate but has advantages such as less reagent consumption and shorter assay time over the conventional method.

Animals↗

[Literature searching on CD-ROM disks].

CD-ROM, Compact Disk Read Only Memory, is a powerful resource which combines the best features of both online and print access to the literature. In 1988 the Medical Library in Trondheim installed the Medline database from Dialog on CD-ROM for library users, and used the opportunity to launch a study to evaluate the new medium in the library (use, users, costs, etc.). The results are based on 651 questionnaires answered by 185 different users. Totally they searched for more than 1,200 different subjects during first six months that the library subscribed to the CD-ROM-disks. All users said that the system was easy to learn and to use (even the 50% who were not familiar with a PC). The study shows that retrieving information from CD-ROM databases is an easy and popular way to keep updated in a particular field.

CD-ROM↗

Are minidisc recorders adequate for the study of respiratory sounds?

Digital audio tape (DAT) recorders have become the de facto gold standard recording devices for lung sounds. Sound recorded on DAT is compact-disk (CD) quality with adequate sensitivity from below 20 Hz to above 20 KHz. However, DAT recorders have drawbacks. Although small, they are relatively heavy, the recording mechanism is complex and delicate, and finding one desired track out of many is inconvenient. A more recent development in portable recording devices is the minidisc (MD) recorder. These recorders are widely available, inexpensive, small and light, rugged, mechanically simple, and record digital data in tracks that may be named and accessed directly. Minidiscs hold as much recorded sound as a compact disk but in about 1/5 of the recordable area. The data compression is achieved by use of a technique known as adaptive transform acoustic coding for minidisc (ATRAC). This coding technique makes decisions about what components of the sound would not be heard by a human listener and discards the digital information that represents these sounds. Most of this compression takes place on sounds above 5.5 KHz. As the intended use of these recorders is the storage and reproduction of music, it is unknown whether ATRAC will discard or distort significant portions of typical lung sound signals. We determined the suitability of MD recorders for respiratory sound research by comparing a variety of normal and pathologic lung sounds that were digitized directly into a computer and also after recording by a DAT recorder and 2 different MD recorders (Sharp and Sony). We found that the frequency spectra and waveforms of respiratory sounds were not distorted in any important way by recording on the two MD recorders tested.

Algorithms↗

[Compact disk-read only memory].

The new technology has made possible the new information methods development. Isn't erasable, it is compatible with personal computers, and without additional online charge. The CD-ROM, Compact Disc Read Only Memory. These electronic media, used in the information digital storage, come from the compact audio disc. One CD-ROM covers over 250,000 text's pages, or 300,000 book's cards or 1,500 diskettes of 360 kbytes. In a compact disc there could be words, sounds, charts and images. MEDLINE database on compact disc, allows to search the current year on one CD-ROM, covering over 300,000 citations from 3,200 publications, material drawn from both English and foreign language publications.

CD-ROM↗

Reducing professional isolation: Support Scheme for Rural Specialists.

The Support Scheme for Rural Specialists project is a federally funded initiative aimed at reducing professional isolation among rural medical specialists. The Australasian College of Dermatologists became involved in this project in July 2003. We report the results of a survey designed to collect demographic data and establish a technology option for remote delivery of metropolitan clinical meetings. These are a major component of continuing professional development activity among metropolitan colleagues. An interactive compact disk format was developed, containing recorded footage and presentation slides from meetings, which replicated attendance as closely as possible. Following distribution to rural dermatologists, continuing professional development points were awarded for viewing and appraising the 'virtual' meeting on compact disk. Evaluation of the technology found a statistically significant increase in continuing professional development involvement. The success of this project has led to its expansion, refinement and continuation in 2004.

Australia↗

Radiologic-assisted endotracheal intubation.

UNLABELLED: We accomplished endotracheal intubation by using fluoroscopic direction in a patient presenting a difficult airway both on the basis of a preanesthetic physical examination and on the basis of a potential for cervical cord injury associated with complicated laryngoscopy. Under topical anesthesia, a multipurpose angiographic (MPA) catheter over a Bentson wire was advanced into the trachea under intermittent C-arm fluoroscopic guidance while the occiput, cervical spine, and mandible remained in a neutral position. The endotracheal tube was then easily advanced over the MPA catheter into the trachea, where the location was documented by fluoroscopic view. Because of judicious use of topical anesthesia and the small diameter and flexibility of the MPA catheter, the unsedated patient remained comfortable throughout the procedure. The stored data were later transferred to a compact disk, and a copy was provided to the patient as an adjunct to Medic-Alert. Unlike fiberoscopy, with which the view can be totally obscured by secretions, blood, and abnormal anatomy, the direction and location of the MPA catheter within the airway were easily identifiable throughout the procedure. The small diameter of the MPA (1.5-mm outer diameter) should allow placement of endotracheal tubes as small as 3.0-mm inner diameter--an option not available even with pediatric instruments. Although time was not a consideration, the procedure was accomplished in <12 min with 22 s of fluoroscopy. We believe that with experience, atraumatic intubation of a difficult airway could be accomplished routinely in less than 2 min with radiological-assisted intubation. IMPLICATIONS: Radiologic-assisted intubation facilitated endotracheal intubation without sedation, instrumentation, or significant movement of the occiput, cervical spine, or mandible. The procedure was accomplished in <12 min and with only 22 s of fluoroscopy. This approach provides the ultimate adjunct to the preoperative airway physical evaluation while providing for immediate (or delayed) atraumatic endotracheal intubation. The diagnostic information and procedure can be recorded on a compact disk.

Aged↗

Carcinogenicity evaluations and ongoing studies: the IARC databases.

Many thousands of chemicals are produced industrially and many more occur naturally. Information on the toxicology of these chemicals is often minimal or absent. The International Agency for Research on Cancer (IARC) has published evaluations of the carcinogenic risk to humans of over 700 chemicals, groups of chemicals, and complex mixtures as a regular series of monographs. A database has been created containing summaries of all the relevant epidemiological, animal carcinogenicity, and other relevant biological data for each chemical or mixture evaluated. Additional databases have been created for ongoing epidemiological studies of cancer in humans and for long-term carcinogenicity studies in rodents, as well as a database containing information on genotoxic and related effects of chemicals. Some of these databases have been published in print form. IARC now plans to publish them electronically, together with other databases, in the form of a CDROM (compact disk, read-only memory). The objective will be to make the entire IARC database of cancer information as widely available as possible in an integrated format conducive to efficient and combined exploitation of all the component databases.

Animals↗

Implementation of a filmless mini picture archiving and communication system in ultrasonography: experience after one year of use.

This article details our experience in developing and operating an ultrasound mini-picture archiving and communication system (PACS). Using software developed in-house, low-end Macintosh computers (Apple Computer Co. Cupertino, CA) equipped with framegrabbers coordinate the entry of patient demographic information, image acquisition, and viewing on each ultrasound scanner. After each exam, the data are transmitted to a central archive server where they can be accessed from anywhere on the network. The archive server also provides web-based access to the data and manages pre-fetch and other requests for data that may no longer be on-line. Archival is fully automatic and is performed on recordable compact disk (CD) without compression. The system has been filmless now for over 18 months. In the meantime, one film processor has been eliminated and the position of one film clerk has been reallocated. Previously, nine ultrasound machines produced approximately 150 sheets of laser film per day (at 14 images per sheet). The same quantity of data are now archived without compression onto a single CD. Start-up costs were recovered within six months, and the project has been extended to include computed tomography (CT) and magnetic resonance imaging (MRI).

Compact Disks↗

Digital camera documentation system for facial nerve outcome assessment.

OBJECTIVE: To describe the use of a digital camera to document facial nerve function after skull base surgery. SETTING: Patients undergoing skull base surgery at a tertiary care otologic and neurotologic clinic were used in the study. INTERVENTIONS: None. RESULTS: A digital camera system provided still images and a video strip lasting less than a minute to document facial nerve motion. CONCLUSIONS: An inexpensive digital camera system can be used to capture still and moving images of facial nerve function on a floppy disk. The images can then be transferred to compact disks for storage of many patient files. Such a system allows documentation for research, exchange of data between offices, and patient education, and it can be used for medical-legal purposes among other uses.

Documentation↗

Digital image archiving: challenges and choices.

In the last five years, imaging exam volume has grown rapidly. In addition to increased image acquisition, there is more patient information per study. RIS-PACS integration and information-rich DICOM headers now provide us with more patient information relative to each study. The volume of archived digital images is increasing and will continue to rise at a steeper incline than film-based storage of the past. Many filmless facilities have been caught off guard by this increase, which has been stimulated by many factors. The most significant factor is investment in new digital and DICOM-compliant modalities. A huge volume driver is the increase in images per study from multi-slice technology. Storage requirements also are affected by disaster recovery initiatives and state retention mandates. This burgeoning rate of imaging data volume presents many challenges: cost of ownership, data accessibility, storage media obsolescence, database considerations, physical limitations, reliability and redundancy. There are two basic approaches to archiving--single tier and multi-tier. Each has benefits. With a single-tier approach, all the data is stored on a single media that can be accessed very quickly. A redundant copy of the data is then stored onto another less expensive media. This is usually a removable media. In this approach, the on-line storage is increased incrementally as volume grows. In a multi-tier approach, storage levels are set up based on access speed and cost. In other words, all images are stored at the deepest archiving level, which is also the least expensive. Images are stored on or moved back to the intermediate and on-line levels if they will need to be accessed more quickly. It can be difficult to decide what the best approach is for your organization. The options include RAIDs (redundant array of independent disks), direct attached RAID storage (DAS), network storage using RAIDs (NAS and SAN), removable media such as different types of tape, compact disks (CDs and DVDs) and magneto-optical disks (MODs). As you evaluate the various options for storage, it is important to consider both performance and cost. For most imaging enterprises, a single-tier archiving approach is the best solution. With the cost of hard drives declining, NAS is a very feasible solution today. It is highly reliable, offers immediate access to all exams, and easily scales as imaging volume grows. Best of all, media obsolescence challenges need not be of concern. For back-up storage, removable media can be implemented, with a smaller investment needed as it will only be used for a redundant copy of the data. There is no need to keep it online and available. If further system redundancy is desired, multiple servers should be considered. The multi-tier approach still has its merits for smaller enterprises, but with a detailed long-term cost of ownership analysis, NAS will probably still come out on top as the solution of choice for many imaging facilities.

Capital Expenditures↗

Computer-based radiology information system: from floppy disk to CD-ROM.

The authors have developed a comprehensive computer-based radiology information system known as "Radiology Resource and Review" (R3). The content is divided into 10 radiology information categories spanning the entire human body and presently includes more than 4 Mbytes of text, 9,000 topics, and 6,000 images. The R3 software and the information content are stored on compact disk, read-only memory (CD-ROM) media. The images are compressed by using a standard compression algorithm. Images and text are cross-indexed with more than 13,000 key words, which can be linked together in searches by using Boolean logic. Four different retrieval interfaces support browsing of text and image information, diagnosis decision making, self-study, and teaching file preparation. The 10-year university-funded evolution of R3 is an example of the transition in storage media from floppy disk to CD-ROM.

CD-ROM↗

CD-ROM. A new advance in medical information retrieval.

The massive production of medical information is being met by new technologies for storing and retrieving knowledge. Recent years have witnessed the maturation of time-sharing information utilities into a full-blown industry. In medicine these services have provided bibliographic information but have recently expanded to full-text availability of journals and books. Now optical storage technology, most conspicuously the compact disk read only memory (CD-ROM), provides similar massive information storage and retrieval affordable to microcomputer users. Such devices might replace many of the functions of time-sharing.

Computers↗

Web-based continuing medical education (I): field test of a hybrid computer-mediated instructional delivery system.

BACKGROUND: The Internet and the World Wide Web (the Web) present exciting new possibilities for distributing educational materials at a distance and facilitating collaborative learning among geographically isolated physicians. This article provides a brief overview of the Web as an instructional delivery platform and discusses its strengths and weaknesses as a potential medium for enhancing distance learning opportunities for rural and remote physicians. It also describes an innovative hybrid instructional delivery model that was field tested by the Telemedicine Centre to determine its efficiency and effectiveness for providing Web-based instruction. A hybrid model merges the Web and CD-ROMs (compact disk read-only memory) to use several of the more valuable instructional components of Web-based education (i.e., multimedia, interactive forms, hypermedia, and computer-mediated communications). The results of the field test indicate that the hybrid delivery model was an efficient means for delivering computer-mediated continuing medical education instruction on dermatologic office procedures to a group of rural physicians in low telecommunication bandwidth regions.

CD-ROM↗

Web-based continuing medical education. (II): Evaluation study of computer-mediated continuing medical education.

BACKGROUND: Over the years, various distance learning technologies and methods have been applied to the continuing medical education needs of rural and remote physicians. They have included audio teleconferencing, slow scan imaging, correspondence study, and compressed videoconferencing. The recent emergence and growth of Internet, World Wide Web (Web), and compact disk read-only-memory (CD-ROM) technologies have introduced new opportunities for providing continuing education to the rural medical practitioner. This evaluation study assessed the instructional effectiveness of a hybrid computer-mediated courseware delivery system on dermatologic office procedures. METHODS: A hybrid delivery system merges Web documents, multimedia, computer-mediated communications, and CD-ROMs to enable self-paced instruction and collaborative learning. Using a modified pretest to post-test control group study design, several evaluative criteria (participant reaction, learning achievement, self-reported performance change, and instructional transactions) were assessed by various qualitative and quantitative data collection methods. RESULTS: This evaluation revealed that a hybrid computer-mediated courseware system was an effective means for increasing knowledge (p < .05) and improving self-reported competency (p < .05) in dermatologic office procedures, and that participants were very satisfied with the self-paced instruction and use of asynchronous computer conferencing for collaborative information sharing among colleagues.

Adult↗

High-resolution anatomy from in situ human brain.

We have generated a spatially accurate, high-resolution three-dimensional (3D) volume of brain anatomy from cryosectioned whole human head. The head of a female cadaver was cryosectioned on a heavy duty cryomacrotome (PMV, Stockholm Sweden) modified for quantitative digital image capture. Serial images (1024(2), 24-bit) were captured directly from the cryoplaned specimen blockface in 500-micron intervals and reconstructed to a 3D data volume. Data were placed into the Talairach coordinate system to create a volume of brain anatomy for atlas reference. We resampled the volume at 500 microns along the sagittal, coronal, and horizontal planes and enhanced the images by digitally editing the background. The spatial resolution of the original digitized images provided sufficient anatomic detail to clearly delineate gray and white matter and neural structures, including major fiber pathways, subthalamic nuclei, and laminae. We developed a compact disk and controlling software program to enable the viewer to select planes of orientation, display, and copy individual to sections at higher resolution. Animation proved useful in the conveyance of system anatomy as structures are shown traversing through the neuroaxis. Postmortem cryosectioning paired with this computerized presentation allowed the complete 3D volume data to be distributed and shared as an educational, clinical, and research resource.

Aged↗

Transition from film to electronic media in the first-year medical school gross anatomy lab.

For the benefit of the first-year gross anatomy students, we digitized and published on a Web site images that had been collected over a 30-year period. We provided a CD-ROM (compact disk, read-only media) containing the image set in higher quality format to students and faculty. We supplemented basic images with hot topics such as CT angiography, virtual colonography, computer-aided diagnosis, and 3D post-processing. Full motion video and moving JPEG (Joint Photo Expert Group) animations were integrated into the atlas. On the post course questionnaire medical students reported that the images on CD-ROM were helpful during the course and for review prior to examinations. Faculty and medical students used the CD-ROM for problem-based learning sections and facilitator training. The images were clear and easily projected during review sessions and were useful for the small group sessions, where they served as examples of normal anatomy.

Anatomy, Cross-Sectional↗