The graphic display of computer-processed data.
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The ability to internalize alpha-fetoprotein (AFP) and serum albumin, which is characteristic of embryonic and fetal elements undergoing differentiation, may reappear in some cultured neoplastic cells (i.e., the MCF-7 human breast cancer cell line). The in vivo uptake of AFP by spontaneous carcinomas of the CH3/Bi mouse was investigated. Nineteen mice were given i.v. injections of approximately 10 muCi of mouse 125I-AFP (0.6 to 4 micrograms of AFP according to the specific ratio of the preparation used). Four to 7 days later, the animals were sacrificed. The radioactivity concentration in the tumor was the highest among all solid tissues examined. Tumor:liver radioactivity ratios were clearly positive [3.6 +/- 0.3 (S.E.)] in 27 of 31 specimens studied. Microscopy examination of autoradiograms from various tissue sections confirmed the selective accumulation of radioactive AFP in the tumors. In order to assess the specificity of AFP uptake by mammary tumors, 4 mice were given simultaneous injections of 125I-AFP and 131I-ovalbumin, respectively. Compared to AFP, the retention of ovalbumin was very low in all tissues studied, including the tumor. The possibility of tumor localization of radiolabeled AFP by external photoscanning was also explored. Two mice were given injections of 131I-AFP, one mouse received 131I-serum albumin, and one was given 131I-ovalbumin. Images were obtained 6 days after with a standard gamma-camera linked to a computer with data display. About 50% of the total radioactivity retained was concentrated in the tumor areas of mice given injections of iodinated AFP, while it was only 15% in the mouse that received 131I-serum albumin. No tumor image could be detected in the mouse given ovalbumin. These results show that the ability to internalize AFP, common to many tissues during ontogenesis, may also be shared by neoplastic cells which develop later in life. They also prove the preferential uptake of AFP by the tumors compared to normal tissues and the usefulness of AFP as a radiotracer for mammary carcinomas. The latter represents a novel approach to tumor detection.
A pregnancy calculating disk - a loose-leaf insert for the antenatal record card--is intended to improve and relieve the prenatal service. A pregnancy calculating disk together with tables containing signs of risks and times for consultations helps towards speedy orientation in daily practice. The data displayed in graphic form gives the pregnant women information on the official guide-lines regarding recommended consultations and ultrasonic examinations during the course of a normal pregnancy.
Traditionally, neurologists have emphasized qualitative techniques for assessing results of clinical trials. However, in recent years qualitative evaluations have been increasingly augmented by quantitative tests for measuring neurologic functions pertaining to mental state, strength, steadiness, reactions, speed, coordination, sensation, fatigue, gait, station, and simulated activities of daily living. Quantitative tests have long been used by psychologists for evaluating asymptomatic function, assessing human information processing, and predicting proficiency in skilled tasks; however, their methodology has never been directly assessed for validity in a clinical environment. In this report, relevant contributions from the literature on asymptomatic human performance and that on clinical quantitative neurologic function are reviewed and assessed. While emphasis is focused on tests appropriate for evaluating clinical neurologic trials, evaluations of tests for reproducibility, reliability, validity, and examiner training procedures, and for effects of motivation, learning, handedness, age, and sex are also reported and interpreted. Examples of statistical strategies for data analysis, scoring systems, data reduction methods, and data display concepts are presented. Although investigative work still remains to be done, it appears that carefully selected and evaluated tests of sensory and motor function should be an essential factor for evaluating clinical trials in an objective manner.
The variety of services provided by clergy on behalf of mentally retarded persons and their families was investigated. Rating scales, administered during semi-structured interviews, were used with a diverse sample of 40 pastors to explore: services already provided; willingness to undertake other services; felt competence to provide the services on a comprehensive list; suggestions for dividing the responsibility for each service among parents, clergy, and secular professionals. The data displayed a wide range of services provided by the sample as a whole, revealed substantial individual differences, and showed clear preferences for some areas of service over others. Involvement in a given area was strongly associated with feelings of competence but not feelings of responsibility. Relationships with secular specialists and prospects for enhancing the clergy's involvement were discussed.
Study of annual activity cycle of ants parasited with Dicrocoelium lanceolatum. Effect of some climatic factors (temperature, rainfall) on seasonal variations of the number of clinching parasited ants. A close analysis of the data displays a double correlation: the increase of the number of clinching ants indirectly brought about by precipitations and this with some delay; a strong decrease by high temperatures in the height of summer. Setting of a calendar including the different stages of the developing cycle of Dicrocoelium lanceolatum in Limousin and proposition of a forecasting technic established from land observations.
Technical characteristics, acquisition modality and data representations as well as examination protocols and main clinical applications of spiral CT angiography (CTA) are described. The different methods of 2D (MPR, CPR) and 3D (SSD, MIP) data display and their advantages and limitations were investigated. We describe the examination technique representing an important tool to achieve good image quality and to make the correct diagnosis. The clinical effectiveness and the main applications in the body were studied. CTA already has a clinical role for arterial system study, while it is less indicated in the venous system because good and continuous contrast agent opacification is difficult to obtain. In our preliminary experience, CTA can be considered an effective alternative to DSA in the assessment of vascular conditions because it is easier to perform, more rapid and less invasive.
Myocardial sympathetic nerve function can be evaluated by 123I-metaiodobenzylguanidine (MIBG) scintigraphy. Congestive heart failure is closely related to myocardial sympathetic nerve function. This study evaluated the severity of congestive heart failure in 30 patients with valvular heart disease [aortic regurgitation (AR): n = 20, mean age = 70 +/- 13 years; mitral regurgitation (MR): n = 10, mean age = 61 +/- 18 years], who had chronic heart failure by MIBG myocardial scintigraphy. Single photon emission computed tomography (SPECT) and anterior planar myocardial images were obtained 15 minutes (initial images) and 4 hours (delayed images) after injection of MIBG (111MBq). Defect score was determined by the delayed SPECT images visually as a semi-quantitative index. Myocardial MIBG uptake was quantified by the heart to upper mediastinum uptake ratio on the delayed anterior planar images (H/M) and mean cardiac MIBG washout rate during 4 hours was calculated from the bull's eye display data (clearance). These indices were compared with the NYHA class and echocardiographic findings of the patients. MIBG regional defect in the delayed image was most frequently seen in the inferoposterior wall, and defect score and clearance were significantly higher and the H/M ratio was significantly lower in NYHA class III patients than in class II patients. In patients with AR, clearance significantly correlated with left ventricular end-systolic dimension. In patients with MR, both the H/M ratio and clearance significantly correlated with left atrial dimension. Defect score, H/M, and clearance were closely related to the severity of AR and MR. These results indicate that MIBG scan can be used to assess the severity of valvular heart disease.
The object of this study was to assess the reliability of measurements of left ventricular volumes and ejection fraction by acoustic quantification by the method of summation of discs in acute myocardial infarction. Thirty-two patients with an average age of 55.9 +/- 12 years were studied prospectively on average 6 +/- 2 days after the onset of myocardial infarction. Within 48 hours, the patients underwent TM echocardiography (Teichholz's method) two-dimensional echocardiography (Simpson's method on freeze frames and acoustic quantification) before left ventricular angiography and isotopic ventriculography, considered as the reference methods for comparing left ventricular volumes and ejection fractions. The data displayed in real time by acoustic quantification correlated well with the results of left ventricular angiography (r = 0.77; p = 0.0001) and moderately underestimated (+4.1 +/- 11.9%) the ejection fraction, but were relatively disappointing for estimating volumes. When compared with isotopic ejection fraction, the correlation coefficient was r = 0.71 (p = 0.0004) and the values were overestimated. In this study, acoustic quantification was the most reliable echocardiographic method of assessing the left ventricular ejection fraction with reference to contrast angiography (Teichholz: r = 0.56; p = 0.0014; Simpson: r = 0.76; p = 0.001). The authors conclude that assessing the left ventricular ejection fraction with acoustic quantification is reliable in acute myocardial infarction. However, the method is not very accurate in measuring end systolic and end diastolic volumes.
A generalizable, computerized method has been designed to describe in detail interactive events that occur within phases of a process involving two or more interactants. The objectives of the method are: (A) visual discernment of patterns of events within and across phases through graphically displayed data and (B) summarization of events within phases for comparison of events across phases. Stages of the implementation of these objectives are illustrated with data obtained from observations of mother-infant feeding interaction. The method provides a means for an investigator to structure the exploration of patterns of behaviors in the context of the social activity in which the behaviors occur and to develop hypotheses about the data.
Four tabular and two graphical techniques for the presentation of laboratory test results were evaluated in a reaction time experiment with 25 volunteers. Artificial variables and values were used to represent sets of 12 laboratory tests to eliminate the possible effects of clinical experience. Analyses focused on four types of errors in interpretation. Color-coded tables and one of the color-coded graphs greatly (2.8 times or better) reduced the number of incorrectly classified test results, as compared to the reference presentation technique. This was mainly due to a reduction of the number of abnormal test results that were not noticed by the subjects when using these presentation techniques.
A software system (The Observer) was used in combination with a hand-held event recorder to study the ecology of older people with dementing illness who were residents of special care units in a nursing home. Methods and problems in the use of this behavior stream technology are discussed. Directly observed behaviors, positions, locations, and contexts were observed in real time on 154 residents over 16 10-minute periods each. The resulting observations were downloaded directly into a personal computer for analysis. Reliability and programming processes for the production of individual subject analytic files are reported. Descriptive data displayed characteristics of the ecology of these residents: concentration of time in a single spatial area (lounge, 73% of all behavior), alone (83%), inactive gaze (40%), and totally passive behaviors (24%). Social interaction (13%) and positively engaged activities (4%) were infrequent. Concurrent validity was tested through correlations between behavior stream aggregate time and core measures of function. Although the sizes of the correlations were modest, their pattern generally confirmed the expected relationships. Advantages and disadvantages of the method are discussed.
BACKGROUND: The possibilities of using computer in physician's research work are presented as an example of statistical analysis of axial eyeball length in relation to the age in myopic children with low birthweight. MATERIAL AND METHODS: The study group consisted of 100 children aged from 3 to 15 years, with birthweight from 580 to 2450 g, where in 180 eyes myopia ranging from -1.5 to -22.0 Dsph and axial length of the eye from 20.0 to 30.9 mm were present. The dynamics of eyeball's axial length increase was compared between two groups: one-in which no symptoms of retinopathy of prematurity were present (no-RROP), and the second--in which signs of regressed retinopathy of prematurity were observed (RROP). RESULTS: The results of the analysis are shown in analytical and graphical modes. Statistically significant differences were shown between axial lengths of eyeball's in the analysed groups of mean 9-year-old premature children (no-RROP: 25.19 mm and RROP: 24.33 mm). It was shown that the use of a computer reduces the time of performing statistical analysis of large amount of data.
This is the second in a two-part series discussing and illustrating the application of statistical process control (SPC) in hospital epidemiology. The basic philosophical and theoretical foundations of statistical quality control and their relation to epidemiology are emphasized in order to expand the mutual understanding and cross-fertilization between these two disciplines. Part I provided an overview of the philosophy and general approach of SPC, illustrated common types of control charts, and provided references for further information or statistical formulae. Part II now discusses alternate possible SPC approaches, statistical properties of control charts, chart-design issues and optimal control limit widths, some common misunderstandings, and more advanced issues. The focus of both articles is mostly nonmathematical, emphasizing important concepts and practical examples rather than academic theory and exhaustive calculations.
We are developing the Patient Clinical Information System (PatCIS) project at Columbia-Presbyterian Medical Center to provide patients with access to health information, including their own medical records (permitting them to contribute selected aspects to the record), educational materials and automated decision support. The architecture of the system allows for multiple, independent components which make use of central services for managing security and usage logging functions. The design accommodates a variety of data entry, data display and decision support tools and provides facilities for tracking system usage and questionnaires. The user interface minimizes hypertext-related disorientation and cognitive overload; our success in this regard is the subject of on-going evaluation.
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