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[Establishment of three-dimensional finite element models by using a series of plane section images processed with an image analysis system].

The geometric similarity and mesh dividing of finite element models directly create an effect on the results of analysis when a theoretical stress analysis is performed by the use of finite element method. The model is routinely established by means of sectioning the specimen. In this paper, a series of plane section CT images of the teeth and mandible, an image analysis system and a specially designed software for modeling three-dimensional finite element were used to establish a three-dimensional finite element model. It is a new preprocessing method for finite element applications in the field of oral biomechanism. The technique is characterized by the advantages of high similarity of the model to specimens and no damage to specimens; it is simple and easy. The images and figures can be repetitively used.

Biomechanical Phenomena↗

[Digital method of assessing bone radiographs].

The computerized method of bone radiographs assessment has been presented. The radiographs were taken by standard technique with the aluminum wedge on the film and known exposition parameters as energy, time and the distance between the source and the subject. Specially designed software served to evaluate the intensity of film darkening. The method may be particularly useful for quantitative assessment of the callus in the healing phase of fractured bone. It may also be an alternative method (as cheaper one) to QCT or DPX in bone density evaluation in patients with metabolic bone diseases.

Absorptiometry, Photon↗

[Digital picture archiving, processing and communication in diagnostic imaging with a Siemens Network (SIENET): initial results].

The concept of Picture Archiving and Communication System (PACS) in digital imaging offers substantial advantages: better data security, faster access to archived images, simultaneous availability of images at different sites, minimal space demand for archive medium, retrospective image post-processing opportunities and lower costs resulting from reduced film consumption and length of stay. However, practical experiences concerning reliability and efficiency of real PAC networks in radiological departments have to be made yet in order to improve network structure, software design and hardware performance. The ongoing stepwise installation and test of a Siemens PACS (SIENET) at the Department of Radiology at the Medical University of Lübeck will support the introduction of PACS concept into radiological practice.

Computer Communication Networks↗

The role of quality assurance in computer inspections.

Changing technology affords the Quality Assurance auditor with the challenge of applying computer validation concepts to a variety of computer system types. In addition, these technology changes have caused the developers role to change as well. In an innovative research facility, the developer may include an in-house professional group, a vendor, or an end-user. With these issues in mind, the QA auditor needs a tool to accomplish the task of inspecting systems as they are being created. The prospective inspection process is the tool for accomplishing this task. This inspection involves the QA auditor's involvement in the development of a new system, as a member of the development team, from the initial creation through the implementation of the computer system. This presentation will focus on illustrating the steps in conducting the prospective inspection process, from expected deliverables and document reviews to final report and management notification. The benefits of QA involvement in the development process will also be discussed.

Clinical Laboratory Information Systems↗

Preoperative and postoperative neuroradiologic evaluation of cervical disk disease.

For over five years, a 2.0 Tesla superconductive magnetic resonance imager (Elscint) has been available in Rockland County for neuroradiologic evaluation of cervical disk herniation, stenosis, and spondylosis. Refinement in surface coil design, software, and scanning technique seems to have overcome the problems of providing thin, artifact-free sections with high signal to noise and contrast to noise in a short amount of time. Noninvasive magnetic resonance imaging has been used routinely to preoperatively screen and to postoperatively diagnose patients with cervical radiculopathy and myelopathy. The only patients who underwent conventional myelography or computerized-tomographic myelography were extremely claustrophobic or had a contraindication to MRI such as an aneurysm clip or pacemaker.

Adult↗

Computerization of a nursing financial management system using continuous quality improvement as a framework.

The Nursing Financial Management System, developed by the Department of Nursing Administrative Services (DNAS), depended on a manual data-retrieval and report process to integrate patient acuity, nursing resource, and hospital financial data. Manual processes proved to be extremely labor-intensive and cost inefficient. Approximately 52% of DNAS resources, totaling $45,542 annually, were dedicated to data re-entry functions and report generation. Additionally, time required to produce manual reports created a service gap in that delays caused inefficient management of nursing resources at the unit level. The DNAS used a continuous quality improvement framework to improve data management by automating data retrieval and report generation. Computerization increased department staff productivity with subsequent labor cost savings/avoidance. After computerization, the report process consumed 6% of department labor resources compared with 52% using the manual process. Redistribution of DNAS resources prevented hiring additional staff to manage expanding workload. Finally, timely reporting to unit management resulted in significant reduction in hospital costs, because nursing resource use was matched with patient care demands.

Computer Communication Networks↗

Imaging evaluation of patients with spinal deformity.

CT myelography and MRI provide the best means of preoperatively assessing patients with spinal deformities. Owing to its noninvasive nature and its superior soft-tissue contrast, MRI represents the single best modality in the evaluation of a patient with any deformity. MRI allows complete preoperative surgical planning and obviates the need for any additional studies. Screening of the entire cord in a patient with a deformity is best accomplished with sagittal and coronal (as needed) T1W images. These images allow assessment of the cord for compression, tethering, syrinx, enlargement, and Arnold-Chiari malformation. Evaluation of cord compression at the apex of a curve is the single most important consideration other than the diagnosis of intrinsic cord abnormality. Subsequent sagittal or axial T2W images may be helpful if specific abnormalities are noted on T1W screening images. Coronal images are particularly helpful in patients with prominent curves or in those with vertebral anomalies. Additionally, coronal images may be useful in assessing patients with suspected diastematomyelia. Advances in hardware and software design have resulted in marked improvements in the ability to satisfactorily image all aspects of patients with spinal deformities. New phased array coils allow rapid imaging of larger portions of the spine. For instance, a complete MRI of the spine can be performed in a child in the same length of time that would have been necessary for a single lumbar examination when MRI was in it's infancy. The use of fast spin-echo imaging also permits more rapid acquisition times. CT myelography remains useful for those patients who cannot undergo MRI or for those with specific abnormalities such as multilevel central spinal stenosis when dynamic information obtained during the myelogram might be helpful. CT myelography represents the only means of assessing the central spinal canal of patients with metallic instrumentation in place. With the exception of these limited applications, MRI has replaced CT myelography as the imaging study of choice in the evaluation and examination of patients with spinal deformities.

Humans↗

Tools and techniques for the development of secure software.

System development projects in health care have not properly addressed the issues of availability, confidentiality and integrity. The safety critical aspects of health care have not been well recognised in the context of information systems, as opposed to medical devices where considerable effort has been made to ensure the 'correctness' of the device before it is authorized for use. Consideration should be given at the start of the development process to the particular requirements of the project and the project should be structured to ensure that the specific functional requirements for security are satisfied. In addition the development process itself must be conducted in a rigorous fashion in order to ensure-and to demonstrate--that the end product has the appropriate degree of 'correctness'. Suitable tools and techniques will be required to assist the efficiency and the integrity of this process.

Computer Security↗

A computerized tomography (CT) scan appliance for optimal presurgical and preprosthetic planning of the implant patient.

This article describes the technique for using the CT (computerized axial tomography) scans, with specially designed software and an adjunct appliance, for accurate planning of dental implants and implant-supported restorations. The available bone can be evaluated, surgical problems anticipated, and errors in placement avoided. The learning objective of this article is an enhanced knowledge of the extended application of the CT scans and the use of the orientation and immobilization appliance.

Dental Implantation, Endosseous↗

[Determination of the instantaneous center of rotation of the shoulder using the ELITE system. Application to the study of normal and pathological abduction].

The authors determined the in vivo displacement of the instantaneous center of rotation (ICR) of the shoulder from data supplied by an optoelectronic system (ELITE System) which uses a specifically designed software program to achieve 3-dimensional analysis of abduction. The study involved 10 control subjects and 20 patients suffering from a periarticular disorder of the shoulder capsule retraction in 10 cases and rotator cuff tears before and after rehabilitation in 10 cases. This method provides an objective assessment of humeral head misalignment in relation to the glenoid cavity induced by the periarticular shoulder disorder and of the realignment achieved through rehabilitation. The proposed ICR calculation technique is entirely harmless for the patient in (particular because it requires no radiation analysis).

Adult↗

Morphometric evaluation of rat liver after castration: effects of testosterone.

In men and animals subject to orchiectomy, varying degrees of hypotrophy have often been observed, even involving non-reproductive organs. Liver hypotrophy appears particularly interesting in view of the metabolic alterations that could possibly ensue. We have applied the morphometric approach to the study of this kind of hypotrophy in castrated rats and in animals receiving a substitutive, testosterone-based treatment after castration. The morphometric model adopted was built on the basis of an interactive approach, using an image analyser (IBAS) with specially-designed software, and consists of number and size, as well as surface and volume fractions, of hepatocytes, their nuclei, cytoplasm, and the relevant relation to the sinusoidal bed. The effects of castration were revealed by a reduction of the mean volume of hepatocytes, associated with a reduction of the sinusoidal bed. Such reduction is correspondingly associated with an increase of the extraparenchymal components (endothelia, Glisson capsule). In the testosterone-treated group, while no appreciable symptoms of retrieval were yet observable in the volume of hepatocytes, the sinusoidal bed was instead superimposable onto the control group data as far as both volume and blood/hepatocyte interface were concerned. In the castrated animals the number of hepatocytes per mm3 was found to be increased. The group of testosterone-administered rats also showed a high level for this parameter which, associated with the spread of the capillary bed, could be compatible with a picture of precocious hyperplastic response to the therapy. The correlation between the available morphometric data and the biochemical results which are being currently sought will further clarify the meaning of this phenomenon.

Animals↗

[Plasmid size determination using 3 methods].

Analysis of bacterial plasmid profiles has been shown to be very important in epidemiological studies, especially those involving outbreaks of nosocomial infections. The molecular weight size of unknown plasmids is determined by comparing their band pattern obtained in agarose gel electrophoresis with those obtained with plasmids that have been used as molecular weight or size standards. In this study, we determined the size of plasmids present in clinical samples of Enterobacter cloacae comparing their electrophoresis mobility with seven plasmids of known size, using three different mathematical methods. For plasmids with molecular weight ranging from 2 kb to 100 kb. The most accurate determinations were obtained by power-function. Analyses using the exponential variables obtained with these plasmids were accurate for two types of plasmids, those with size ranging from 50 kb to 100 kb and those with size ranging from 2 kb to 30 kb. We also observed discrepancies among the methodologies described, including one used by a computer software designed for calculating the size of plasmids DNA.

Algorithms↗

An overview of the Heidelberg Retina Tomograph.

BACKGROUND: The Heidelberg Retina Tomograph (HRT) is a new ophthalmic diagnostic instrument which uses confocal laser scanning microscopy to quantify precisely, in vivo, the topography of the posterior fundus. HRT technology permits accurate, highly reproducible documentation of the posterior fundus, along with software designed for longitudinal study of the optic nerve in glaucoma. This technology provides the practitioner with a new dimension for examination of the posterior fundus. METHODS & RESULTS: The current literature is reviewed to gather information about the HRT technology and its clinical applications. HRT's technology is highly reproducible and accurate, offering many advantages over other imaging techniques for optic nerve head analysis. The ability of the HRT to provide a precise change analysis over time may allow for early detection of subtle alterations in the topography of the optic nerve head before visual field loss occurs. The HRT may also be applied to the topographical analysis of other posterior fundus conditions, such as papilledema, macular edema, macular holes, and tumors. CONCLUSIONS: As with any new instrument, there are many questions regarding confocal laser scanning technology that remain unanswered. Key questions regarding the specific stereometric parameters that are most important for detecting glaucoma and their progression (before conventional photography or visual field testing) remain to be answered. HRT is still a relatively new area of research, and more studies are required.

Adult↗

A component-based, distributed object services architecture for a clinical workstation.

Attention to an architectural framework in the development of clinical applications can promote reusability of both legacy systems as well as newly designed software. We describe one approach to an architecture for a clinical workstation application which is based on a critical middle tier of distributed object-oriented services. This tier of network-based services provides flexibility in the creation of both the user interface and the database tiers. We developed a clinical workstation for ambulatory care using this architecture, defining a number of core services including those for vocabulary, patient index, documents, charting, security, and encounter management. These services can be implemented through proprietary or more standard distributed object interfaces such as CORBA and OLE. Services are accessed over the network by a collection of user interface components which can be mixed and matched to form a variety of interface styles. These services have also been reused with several applications based on World Wide Web browser interfaces.

Computer Communication Networks↗

Computational tools for the modern andrologist.

With such a wide array of computational tools to solve inference problems, andrologists and their mathematical or statistical collaborators face perhaps bewildering choices. It is tempting to criticize a method with which one is unfamiliar for its apparent complexity. Yet, many methods are quite elegant; neural computation uses nature's own best biological classifier, for example, and genetic algorithms apply rules of natural selection. Computer scientists will likely find no one single best inference engine to solve all classification problems. Rather, the modeler should choose the most appropriate computational tool based on the specific nature of a problem. If the problem can be separated into obvious components, a Markov chain may be useful. If the andrologist would like to encode a well-known clinical algorithm into the computer, the programmer may use an expert system. Once a modeler builds an inference engine, that engine is not truly useful until other andrologists use it to make inferences with their own data. Because a wide variety of computer hardware and software exists, it is a significant endeavor to translate, or "port," software designed and built on one machine to many other different computers. Fortunately, the World Wide Web offers a means by which computational tools may be made directly available to multiple users on many different systems, or "platforms." The World Wide Web refers to a standardization of information traffic on the global computer network, the Internet. The Internet is simply the linkage of many computers worldwide by computer operators who have chosen to allow other users access to their systems. Because many different types of computers exist, until recently only communication in very rudimentary form, such as text, or between select compatible machines, was available. Within the last half-decade, computer scientists and operators began to use standard means of communication between computers. Interpreters of these standard languages, such as Mosaic and Netscape, are now widely available, and they allow the casual user to access the most sophisticated multimedia aspects of computer information on a variety of different systems. Andrologists may thus use the World Wide Web to make inference engines that they have programmed available to other clinicians and researchers. For example, we programmed a World Wide Web interface to the neural networks that we trained in order to solve a number of andrology classification problems. Interested users connect to our address (at this writing http:@godot.urol.uic.edu), and they may fill out electronic forms with their own patient data, press a "predict" button, and nearly immediately view the results of our neural networks' prediction on their own computers. With the explosion in computer hardware technology, mathematics and computer science that once seemed esoteric can now be investigated on computers available to nearly all andrologists. Rapid advances in computer network technology now render a tool developed by one andrologist immediately available to many. Clearly, andrologists may expect that computational investigations in their field will be a productive ground in the near and far future.

Algorithms↗