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Computer aided analysis of chromatin network and basophil color for differentiation of mononuclear peripheral blood cells.

Computer aided differentiation of plasmoblasts, Pfeiffer cells, immunoblasts, lymphocytes and centrocytes is achieved with the parameters of chromatin network arrangement and structure, and multispectral cytoplasm color. The digital methods involve: (a) segmenting the nuclear image into topographic sections and analyzing the optical density distribution from the chromatin in these sections; (b) determining the nuclear structure with a 7 x 7 median filter, gradient filter and contour following algorithms; and (c) clustering two-dimensional chromatic data from panoptically stained cellular components. The parameters reported here are a subset of those needed for the automated diagnosis of many hematologic diseases especially the leukemias.

Blood Cells

Evaluation of a fiber optic glove for semi-automated goniometric measurements.

Normal subjects were used to evaluate a fiber optic instrumented glove for semi-automated goniometric measurement. The glove electronically records and transmits hand and finger position to a host computer by measuring the amount of joint flexion. The glove was put through a series of range-of-motion (ROM) tests with five subjects. Metacarpal (MP) and proximal interphalangeal (PIP) joint angles of the five digits were compared during repetitive standardized motions to evaluate the glove's repeatability. The results showed an overall error of 5.6 degrees, as compared to an error of between 5 and 8 degrees with manual measurement. Additional tests were done to determine factors such as fit, grip force, and wrist motion that may contribute to the overall error. The glove should have applicability to some aspects of hand evaluation as a semi-automated goniometric measurement device.

Adolescent

Electrophoretic gel image analysis software for the molecular biology laboratory.

We present GelReader 1.0, a microcomputer program designed to make precision, digital analysis of one-dimensional electrophoretic gels accessible to the molecular biology laboratory of modest means. Images of electrophoretic gels are digitized via a desktop flatbed scanner from instant photographs, autoradiograms or chromogenically stained blotting media. GelReader is then invoked to locate lanes and bands and generate a report of molecular weights of unknowns, based on specified sets of standards. Frequently used standards can be stored in the program. Lanes and bands can be added or removed, based upon users' subjective preferences. A unique lane histogram feature facilitates precise manual addition of bands missed by the software. Image enhancement features include palette manipulation, histogram equalization, shadowing and magnification. The user interface strikes a balance between program autonomy and user intervention, in recognition of the variability in electrophoretic gel quality and users' analytical needs.

Computer Peripherals

Computer-aided cell colony counting.

Counting cell colonies is a tedious task when performed with the light microscope. Moreover, unless strict double-blind protocols are adhered to, biased counts are difficult to avoid. Presented here is a computer software application that performs accurate, reproducible cell colony counts with a minimum of user generated bias. The application is based upon the Apple IICX computer system with Image software and AppleScan. Colonies are grown on 24-well plates and prepared in such a way as to permit good quality scanning. The scans are then transferred to Image and the individual colonies in each well are counted. Good correlation with counts done by light microscopy is achieved.

Clone Cells

Electronic imaging workstations: ergonomic issues and the user interface.

The electronic imaging workstation serves as the interface between an electronic system and a user. Although the performance aspects of electronic displays are crucial considerations in workstation design, experience suggests that human factors in mechanical operation, software accessibility, and workstation environment are also important. Generally, workstations should have monitors arranged horizontally, and the work environment should be designed to minimize glare from lighting fixtures and to accommodate requirements for low luminance. Devices that control the workstation (eg, key pads, track balls) should be designed so that the user can operate primary and auxiliary controls with efficiency of hand and eye movements. Although many innovations in software (eg, graphical user interfaces) have allowed current workstations to be operated by users who have no knowledge of computer operations, further improvements in interactive software are necessary if such systems are to be accepted by radiologists.

Computer Peripherals

MACSPEC--a software system for fully automatic processing and analysis of large series of NMR spectra.

In vivo NMR spectroscopy often accumulates a large number of spectra (typically 100 individual files or even more) to follow metabolic changes with high time-resolution. The analysis of these spectra is very time-consuming for the spectroscopist and, furthermore, it requires the spectrometer's computer, needed for control of experiments. Here we report the software system MACSPEC developed for automatic processing and analysis of large series of individual NMR spectra on a peripheral personal computer. With this software the spectrometer's computer is kept available for experiments, and the necessary interaction of the spectroscopist is limited to a definition of the processing conditions at the beginning of the data analysis.

Electronic Data Processing

Bone loss in patients with rheumatoid arthritis--effect of steroids measured by low dose quantitative computed tomography.

For 2 years bone density changes in patients with rheumatoid arthritis were monitored to determine the effect of low dose corticosteroid treatment. Sixteen perimenopausal females were studied. Of these nine were treated with 5 to 20 mg prednisone per day and seven had no steroids. The differential effects on trabecular bone density and on cortical bone in the radius and the tibia were examined with high precision peripheral quantitative computed tomography (QCT). Steroid therapy did not influence cortical bone loss and had only a minor influence on trabecular bone density. Of greater importance was the influence of estrogen depletion. Corticosteroids and estrogen depletion, however, cannot explain fully the yearly loss of 5.7% in the trabecular and 4% in the cortical bone of the radius.

Adult

Eight year's experience with automated anesthesia record keeping: lessons learned--new directions taken.

For the past eight years, an automated anesthesia record keeping system, COMANDAS (COMputerized ANesthesia Data Acquisition System) has been used in the cardiovascular operating rooms at Mayo Clinic. The automated anesthesia record is designed to match the traditional hand-written record and becomes part of the official medical record. COMANDAS is interfaced with the physiologic monitor and mass spectrometer in each OR, and a number of other computers within the Mayo Medical Center. Since the introduction of COMANDAS over 24,000 surgical procedures have been charted. The anesthesia record is more complete, consistent in organization, and legible when compared to a hand-written record. Recently, it was determined that the computers and peripherals that make up COMANDAS were wearing out and that the vendors would no longer support or replace the equipment. A process to find a replacement for COMANDAS was then begun. Although the cardiovascular anesthesia group was satisfied with the automated anesthesia record, there were a number of areas in which improvement was desired. A systematic evaluation of the system was begun with a survey of the users. The majority of those surveyed felt that COMANDAS was a useful system which made parts of their job easier. The user interface, method of manual data entry, time to produce the record and difficulty learning the system were the source of the greatest dissatisfaction. Artifacts, networking, interfacing with other devices and computers were also issues for the replacement system. Most commercial systems were found wanting in one or more areas of significance. The most practical solution appeared to be the modification of a currently available intensive care unit patient data management system.

Anesthesiology

Recognition of synthetic speech by hearing-impaired elderly listeners.

The Modified Rhyme Test (MRT), recorded using natural speech and two forms of synthetic speech, DECtalk and Votrax, was used to measure both open-set and closed-set speech-recognition performance. Performance of hearing-impaired elderly listeners was compared to two groups of young normal-hearing adults, one listening in quiet, and the other listening in a background of spectrally shaped noise designed to simulate the peripheral hearing loss of the elderly. Votrax synthetic speech yielded significant decrements in speech recognition compared to either natural or DECtalk synthetic speech for all three subject groups. There were no differences in performance between natural speech and DECtalk speech for the elderly hearing-impaired listeners or the young listeners with simulated hearing loss. The normal-hearing young adults listening in quiet out-performed both of the other groups, but there were no differences in performance between the young listeners with simulated hearing loss and the elderly hearing-impaired listeners. When the closed-set identification of synthetic speech was compared to its open-set recognition, the hearing-impaired elderly gained as much from the reduction in stimulus/response uncertainty as the two younger groups. Finally, among the elderly hearing-impaired listeners, speech-recognition performance was correlated negatively with hearing sensitivity, but scores were correlated positively among the different talker conditions. Those listeners with the greatest hearing loss had the most difficulty understanding speech and those having the most trouble understanding natural speech also had the greatest difficulty with synthetic speech.

Adult

Comparative accuracies of a finger blood pressure monitor and an oscillometric blood pressure monitor.

A noninvasive blood pressure monitor (Finapres) that uses the methodology of Penaz to continuously display the arterial waveform from the finger has been introduced recently. The Finapres monitor overestimated systolic pressure by 5.8 +/- 11.9 mm Hg, while the Dinamap monitor underestimated systolic pressure by -6.9 +/- 9.2 mm Hg (P = 0.003). Dinamap mean and diastolic pressure biases were less than 2 mm Hg, while the Finapres biases for these variables were significantly greater (7.7 +/- 10.0 and 8.2 +/- 9.8 mm Hg, respectively). There was no difference in systolic or mean pressure precision between the two devices (approximately 10 mm Hg), but the diastolic precision of the Dinamap unit was superior to that of the Finapres. While in most patients the Finapres monitor provided continuous blood pressure data equivalent to the data from the radial artery, marked bias (greater than 15 mm Hg) was exhibited in 2 patients for all three pressure variables. Despite this bias, blood pressure changes were tracked closely in these 2 patients. We conclude that, in its current form, the Finapres monitor cannot be relied upon independently to accurately measure blood pressure in patients undergoing general anesthesia. Since the Dinamap monitor measures mean pressure reliably and accurately, we suggest that mean blood pressure values between the Finapres and Dinamap monitors be compared to guide one in interpreting Finapres data.

Adolescent

Quality monitoring of soft-copy displays for medical radiography.

As presentation of medical radiographic images on soft-copy displays (cathode ray tubes) becomes increasingly prevalent in electronic radiography, methods of quality assurance must be developed to ensure that radiologists can effectively transfer film-based reading skills. Luminance measurements provide the basis for evaluating the state of soft-copy displays. An integrated approach has been implemented at Mallinckrodt Institute of Radiology (MIR, Washington University, St Louis, MO) that facilitates measurement of geographically distributed soft-copy displays with centralized data logging, performance tracking, and calibration. MIR's central radiology image manager exercises the display station that drives the monitor, harvests the measurement data, stores the results, and submits the resulting data for additional processing. The luminance measurements are collected by a small, portable, photometric instrument designed at MIR that includes a serial port that is accessed via local area terminal service supported by the radiology image manager. The design details of the photometric instrument and example luminance characteristics of several soft-copy displays used at MIR are presented in this report.

Computer Peripherals

A simple polymerase chain reaction apparatus based on a computer printer.

We describe a very simple laboratory-made polymerase chain reaction (PCR) apparatus. The reaction tubes are placed in a holder fixed through a mechanical arm to the tape cartridge of a computer printer. A computer controls the horizontal movement of the tube carrier by sending the proper printing commands. The holder is raised or lowered by a frame fixed to the paper-advancing roller of the printer. The system allows the programmed movement of the test tubes within the holder, successively through three thermal baths placed in front of the printer. DNA from single lambda gtll lysis plaques was successfully amplified with this system in our laboratory.

Animals