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PubMed2005

Laparoscopic specimen extraction: morcellation.

OBJECTIVES: To review our experience with intact extraction and morecellation of nephrectomy specimen, and the advantages and disadvantages of morcellation indicated by current reports. PATIENTS AND METHODS: In a previous study, 56 consecutive patients undergoing radical and simple transperitoneal laparoscopic nephrectomy were prospectively evaluated. Morcellation specimens (33) were extracted at the umbilical or lateral port sites and intact specimens (23) through an infraumbilical incision. Data were obtained on pathology, narcotic requirements, hospital stay, complications, estimated blood loss, size of renal mass based on preoperative imaging, specimen weight and extraction incision length. RESULTS: The mean incision length was 1.2 cm in the morcellation group and 7.1 cm in the intact group (P< 0.001). There were no significant differences in pain or recovery between the groups. In two cases of tumor nephrectomy, microscopic invasion of the perinephric adipose tissue in the intact specimen group were up-staged from clinical T1 to pT3a disease; there was no change in patient treatment based on this information. CONCLUSIONS: With proper technique, morcellation is safe for extracting renal tumours. The specimen can be evaluated for histology but not for pathological staging, limiting its use with transitional cell carcinoma. Port-site seeding is rare, and does not appear to be more frequent than with open nephrectomy. Although morcellation is cosmetically more desirable, there was no significant advantage in operating time, pain or duration of hospital stay. The choice od extraction method depends on the surgeon's preference and patient choice.

Adolescent↗

PubMed1992

An overview of networking for physicians and problems of network consulting in remote areas.

For computer networking the most suitable operating systems are UNIX or MS-DOS. As networking software UUCP and TCP/IP are most common. Hardware requirements are derived from the operating system and from the networking software. Low-cost solutions, for example, uuPC, a public domain version of UUCP, require only an 8088 processor and a 2400-baud modem. TCP/IP fares better with more powerful processors and requires permanent lines between the connecting computers. In developing countries the introduction of computer networks is hampered by several factors: lack of foreign exchange, price of hardware and software, unreliable electricity and telephone lines, lack of hardware and software support, large distances to the nearest center, and incompatibilities between existing systems and the network. Important aspects for clinical networking in developing countries include appointment scheduling in the referral hospitals, access to laboratory and pathology results from the central laboratory, and primary health care information such as epidemiologic data. Advanced systems, for example, for image processing, are not yet feasible in developing countries.

Computer Communication Networks↗

PubMed1993

Parametric in vivo brain imaging during activation to examine pathological mechanisms of functional failure in Alzheimer disease.

Alzheimer disease (AD) patients demonstrate reduced "resting state" regional cerebral metabolic rates for glucose (rCMRglc) and reduced regional cerebral blood flow (rCBF) in cortical association areas, early and throughout the course of disease. In this paper, we hypothesize that parametric cognitive or passive stimulation, during in vivo brain imaging, can be used to elucidate the pathological basis of these flow and metabolic abnormalities in individual AD patients. Experimental data suggest that sigmoidal relations (nonliner monotonically increasing relations reaching a horizontal asymptote) exist in the normal brain between rCBF or rCMRglc, and a function F(D,P) of task difficulty D (intensity, duration, pattern complexity) and subject performance P (reaction time, accuracy, effort, attention). Pathological mechanism I, under some conditions reversible and involving neural (including synaptic) element dropout or modification with retained capacity for full activation at high values of F(D,P), is expected early in AD and should shift the rising phase of the normal sigmoidal curve to the right. Observed rCBF responses in a face-matching task in mildly-moderately demented AD patients are consistent with mechanism I. Pathological mechanisms II and III, both irreversible and involving neural element dropout with loss of capacity for maximum activation, should alter the sigmoidal brain response at all values of F(D,P), and are expected late in disease. Our hypothesis predicts that activation paradigms with a wide range of F(D,P) values could help to distinguish among the reversible and irreversible pathological mechanisms in AD, and to evaluate drug action on these mechanisms.

Aged↗

PubMed1997

A rapid stain-clearing method for video based cytological analysis of cotton megagametophytes.

Optical "clearing" is a cost saving method for preparing large numbers of whole, dissected or thickly sectioned cytological specimens such as plant ovules and ovaries. Minimal labor is required and specimens retain three-dimensional integrity. Previous development of high contrast stain-clearing methods using hemalum to impart contrast has facilitated analysis and photography under bright field illumination for small ovules. The deep stain intensity of hemalum, however, often precludes adequate light transmission and contrast within internal focal planes, limiting the applicability of hemalum-based stain-clearing to small specimens. Having encountered this problem for nucelli of cotton (Gossypium barbadense L.), which are roughly 300 microns thick at fertilization, we have developed a modified stain-clearing system. The two key features of these new methods are the use of azure, C, which allows the intensity of staining to be readily regulated, and contrast manipulation via video signal and image processing. Intensity of azure C stain was readily controlled by modifying the staining and/or dehydration media to produce relatively low contrast specimens. Analysis was facilitated by indirect viewing on a video monitor using adjustments of sensitivity, exposure, and contrast of the charge-coupled device (CCD) camera. Digital processing provided further enhancement. Acceptable images were obtained from virtually all specimens. These methods, which combine low contrast (high transmittance) specimens with high contrast imaging, should facilitate data acquisition on reproduction, thus the developmental and genetic characterization of reproductive mutants. Other applications, e.g., in pathology and embryology, are readily envisioned.

Coloring Agents↗

PubMed2002

[New development of a cytological examination ordering system at Osaka National Hospital].

Effective and rapid use of cytological data are issue in Japan. We addressed this problem by development of an ordering system for cytological examinations at Osaka National Hospital. This system is located in the department of pathology and is a client-server system that consisted of 1 server and 6 clients. Five of the 6 clients are related to cytology and there are connections to microscopes with digital cameras. One client is for acceptance of cytological specimens at the department of pathology. Through a local area network, 100 Mbps, this system is connected to the hospital information system, which is of the order-entry type. After a clinician orders a cytological examination, these data are sent to both the Accounts and Pathology departments. A small bar-code label is simultaneously printed out, which is stuck on the form. By checking this label at the department of pathology by using a label reader, relevant clinical information is sent to the pathology server. After the cytological diagnosis has been made by senior cytotechnologist and cytopathologist, data on the diagnosis and microscopic images are sent to the hospital information system. Thus, clinicians can review the cytological diagnosis together with the photomicrographs. This new cytology system has brought great benefits to both cytotechnologist and clinicians with regard to the rapid transfer of cytological examination, and it seems to contribute to more advanced and efficient medical care.

Cytodiagnosis↗

PubMedDate not supplied

Contrast-enhanced, wide-band phase-inversion power Doppler imaging of hepatic focal nodular hyperplasia.

BACKGROUND/AIMS: To determine whether examination of hepatic focal nodular hyperplasia by wide-band, phase-inversion sonography offers any advantages over power and color Doppler sonography in the depiction of specific characteristics of these pathologies. METHODOLOGY: Twenty-six patients were examined. The presence of focal nodular hyperplasia was confirmed by ultrasound-guided biopsy, surgical resection, dynamic helical computed tomography or magnetic resonance. All patients, prior to enhanced sonography, had undergone B-mode gray-scale sonography, color Doppler, and power Doppler examinations. After injection of 2.5 g of Levovist intravenously, analysis of the contrast agent arrival was performed by wide-band, phase-inversion power Doppler sonography. RESULTS: The B-mode gray-scale sonography, color and power Doppler sonography were non-specific for focal nodular hyperplasia in 14 cases in our examination. However based on the wide-band, phase-inversion power Doppler sonography findings all patients with focal nodular hyperplasia were diagnosed. All typical anatomic features of focal nodular hyperplasia such as "star sign" or "spoke-wheel" pattern were clearly visible. In 3 cases, computed tomography and magnetic resonance imaging had failed to disclose pathology while phase-inversion sonographic images were completely suggestive which was later finally confirmed by histologic examination. CONCLUSIONS: Our data demonstrate the usefulness of wide-band, phase-inversion power Doppler sonography in the differential diagnosis of hepatic focal nodular hyperplasia by visualizing all characteristic anatomic details.

Adult↗

PubMed2004

Ultrasonographic findings 6 months after 11-gauge vacuum-assisted large-core breast biopsy.

OBJECTIVE: To assess the ultrasonographic features of post-biopsy change 6 months after 11-gauge vacuum-assisted large-core breast biopsy of pathologically proven benign lesions. Using the literature as a reference, we hypothesized that large-core breast biopsy would result in tissue changes that may mimic malignancy and may be more apparent on ultrasonography than on mammography. METHODS: Two radiologists whose subspecialty is breast imaging retrospectively reviewed the pre-biopsy and 6-month follow-up sonograms of 24 patients with pathologically proven benign lesions. The images were assessed for the number and type of ultrasonographic features. A Breast Imaging Reporting and Data System (BI-RADS) category was assigned to each lesion before biopsy and at 6-month follow-up. The composition of breast tissue surrounding the lesion was assessed as fatty, mixed fibroglandular or dense. RESULTS: The frequency of ultrasonographic changes at 6 months after 11-gauge vacuum-assisted large-core breast biopsy was more frequent than the rate of post-biopsy change previously reported to occur mammographically. The nature of these changes may mimic malignancy in some cases. CONCLUSION: The ultrasonographic appearance of the breast after large-core breast biopsy may mimic malignancy and is, therefore, a potential pitfall when interpreting a post-biopsy sonogram.

Biopsy, Needle↗

PubMed2005

[Clinical study of CT virtual endoscopy in staging diagnosis of bladder tumors].

OBJECTIVE: To evaluate CT virtual endoscopy (CTVE) based on spiral CT in the staging diagnosis of bladder neoplasms and its clinical application. METHODS: Forty patients with bladder neoplasms and 10 normal patients underwent volume scanning using spiral CT. All images with thin collimation and overlapping reconstruction were transferred to computer workstation to obtain the images of CTVE. The results of all CTVE findings were compared with those of conventional CT, cystoscopy, operation and pathological data. RESULTS: CTVE showed the normal anatomical structure of bladder as actual cystoscopy. The size, configuration, location and extension of bladder neoplasms was detected by CTVE scans agreed with that of actual cystoscopy. CTVE revealed the structure of trigone of urinary bladder that were not available in actual cystoscopy, and they were confirmed operatively and compared with the pathological results according to the TNM classification of malignant neoplasms. The sensitivity of CTVE for bladder tumors and accuracy in preoperative neoplasms staging was 98% (39/40) and 85% (33/39), respectively. The sensitivity of mass detection of diameter > or = 0.5 cm was 100%. The results were studied in a blind way. CONCLUSIONS: CTVE is a noninvasive, safe and reliable procedure in the staging diagnosis of bladder neoplasms. CTVE can well show bladder neck anatomy and serve as an important complementary method to conventional cystoscopy. The limitation of CTVE is that it can not observe change of mucosal appearances and perform biopsy.

Adolescent↗

PubMed2005

Pituitary cysts in childhood evaluated by MR imaging.

BACKGROUND AND PURPOSE: Pituitary cysts are common findings on pathologic examination and imaging studies. They are generally considered to be rarer in children than in adults; however, no good data exist to substantiate this opinion. We reviewed MR imaging studies to evaluate the frequency and imaging features of pituitary cysts in children. METHODS: We retrospectively reviewed T1-weighted sagittal images in 341 patients <15 years of age to evaluate for pituitary cysts. Paramagnetic contrast was administered in 86 of the 341 patients. Sagittal or coronal fast spin-echo T2-weighted images were performed in 166 patients. For patients having pituitary cysts, pituitary function was examined by assessing blood levels of pituitary hormones. RESULTS: A cystic pituitary lesion was recognized in 4 patients (1.2%) aged 1-4 years. None of the 4 manifested endocrinologic signs or symptoms or were the results of their laboratory studies abnormal. All the lesions were sharply demarcated and situated just posterior to the anterior pituitary lobe. All were iso- or hypointense compared with the pons on T1-weighted images without contrast enhancement, suggesting a Rathke cleft cyst. MR imaging of a patient with probable low-grade gliomas in the left hypothalamic region and optic chiasma showed complete resolution of a pituitary cyst at a 1-year follow-up study. CONCLUSION: The frequency of pituitary cysts on MR imaging in childhood is almost equal to that of Rathke cleft cysts, as assessed in autopsy studies of subjects aged 10 to 29 years. These cysts are common in children and should be considered, in the absence of signs or symptoms of pituitary dysfunction, as incidental findings.

Brain Neoplasms↗

PubMed2005

[The importance of the autopsy in quality control of medicine (possibilities in the Hungarian conditions)].

The authors have examined the importance of the autopsy from several aspects of view as the primary cause of death, comparison between clinical and pathological diagnosis, recognition of clinically unknown diseases, as well as new anatomical constellations, epidemiological data, assessment of effectiveness of modern imaging technics, authenticity of statistic concerning the cause of death and the quality control in medicine general. Data of the literature and computer system of authors based on several thousands autopsies proves that the post mortem investigation is the most effective method in evaluation of reliability of imaging technics too. The autopsy even in the XXI. century seems to be of greatest value for quality control of medical activity, except in cases when clinical diagnosis can be made biochemically only. In order to fulfill these requirements mentioned above a high level technical control of the autopsy technic itself is also needed.

Autopsy↗

PubMed1993

Comparison of anatomically-defined versus physiologically-based regional localization: effects on PET-FDG quantitation.

The potential of anatomic imaging to improve the quantitative accuracy of functional brain imaging through refined regional definition is widely accepted. However, there are little data addressing the impact of approach to regional localization on quantitation of metabolic images in the absence of gross structural pathology. We compared MRI-based versus PET-based approaches to the analysis of PET 18F-fluorodeoxyglucose (FDG) images using a standard adjustable template based on simple geometric regions. For the MRI-based approach, templates and individual regions were adjusted to each individual's anatomy, whereas the PET-based definition involved only global proportional adjustment of the standard templates. Metabolic rates for glucose and volume-to-whole brain ratios were determined by two operators for 78 volumes of interest in five subjects. Pairwise correlations indicated high interoperator agreement for each approach and high intraoperator agreement for MRI-based versus PET-based metabolic values. The stability of the metabolic rates and ratios among operators and analysis approaches was supported by low coefficients of variation across measurements and small average differences in paired comparisons. Thus, within the current spatial resolution of PET imaging, quantitation of metabolic images is relatively robust to image analysis approach in the absence of gross structural abnormality. To take advantage of the greater quantitative accuracy promised by high-resolution anatomic and functional imaging, more refined delineation of anatomic images will be necessary.

Brain↗

PubMed1996

Supplementary sensorimotor area epilepsy in adults.

Based on stimulation studies, observation of seizure phenomena in patients with epilepsy, and diagnostic studies documenting SSMA anatomic and functional abnormalities, there is evidence that epileptic involvement of the SSMA results in a set of clinical phenomena that include asymmetric tonic posturing of the extremities, abduction and elevation of the contralateral upper extremity, and speech arrest with preserved consciousness. Auras and vocalization occur less frequently. These seizures tend to be brief and to have an abrupt onset and cessation. They are more common during sleep than during wakefulness, and they tend to occur multiple times per night. The abolition of seizures following a resection limited to the SSMA provides conclusive evidence that the SSMA is the epileptogenic zone in some patients with this type of seizure. On the other hand, there is variation in seizure phenomena among patients whose seizures originate in the SSMA. In addition, there are patients with seizures suggestive of SSMA involvement whose seizures originate in a broad epileptogenic zone that includes the SSMA, other patients whose seizures originate outside the SSMA and spread to the SSMA, and still other patients whose seizures originate outside the SSMA and remain outside the SSMA. To better understand the phenomena associated with SSMA seizure onset and to determine the specificity of certain phenomena to SSMA involvement, additional data are needed from structural and functional imaging studies, video and EEG monitoring studies with noninvasive and invasive electrodes, and pathologic and surgical outcome studies. Since one cannot be certain at this time of the specificity of seizure phenomena to SSMA involvement, and because localization for possible surgery is the primary rationale for detailed study of these patients, we recommend that the term SSMA seizure refer only to those seizures that originate in the SSMA and that SSMA epilepsy refer only to epilepsies in which the patient's seizures originate in the SSMA. Since the present classification of epileptic seizures is not of value in describing the major phenomena of a partial seizure or in localization of the site of onset, a descriptive classification is needed to improve communication concerning seizure phenomena and to provide clues to localization.

Adult↗

PubMed2004

Folate receptor-mediated targeting of therapeutic and imaging agents to activated macrophages in rheumatoid arthritis.

Rheumatoid arthritis (RA) is an autoimmune disease that is characterized by inflammation of the joints and destruction of cartilage and bone, often compromising both the quality and duration of life. The disease pathology is complex, involving the infiltration and activation of various populations of immune cells along with the release of destructive inflammatory mediators into the synovium of affected joints. Although it is still debatable whether activated macrophages are the primary promoters of RA, emerging data clearly show that the biological activity of this subset of inflammatory cells greatly contributes to both the acute and chronic stages of the disease. The further discovery of folate receptor expression on these activated (but not quiescent) macrophages in both animal models and human patients with naturally occurring RA has opened the possibility of exploiting folic acid to target attached drugs to this population of pathologic cells. Indeed, recent studies have shown that folate-linked imaging and therapeutic agents can be selectively delivered to arthritic joints, allowing both visualization and treatment of RA, with little or no collateral toxicity to normal tissues. This review will first summarize data documenting specific expression of the folate receptor on activated macrophages and then focus on the development of folate-targeted diagnostic and therapeutic agents for guided intervention into rheumatoid arthritis.

Animals↗

PubMed1988

Insulin sensitivity in anorexia nervosa: a mirror image of obesity?

Although, in many respects and from a metabolic point of view, obesity and AN are clearly two opposite pathological conditions, the available data concerning insulin sensitivity in these two syndromes are not so obviously opposite. Indeed, whereas everybody is convinced that obesity is characterized by an increased insulin resistance, the papers reporting insulin sensitivity parameters in AN contain some apparently contradictory results. The observations of simultaneously low fasting blood glucose and plasma-insulin levels in anorectic patients could suggest increased insulin sensitivity in AN. However, if this is the case, it would be present despite other metabolic and hormonal changes (increased plasma concentrations of free fatty acids, cortisol, and growth hormone) which are known factors of insulin resistance. During an oral glucose-tolerance test, an impaired glucose-tolerance occurring despite sustained insulin response to glucose is usually found in anorectic patients before treatment; these abnormalities are, at least partially, reversed after successful refeeding. From these results, such conclusive, if indirect, evidence exists for relative insulin insensitivity in untreated AN. Similar results were initially reported with the intravenous glucose-tolerance test. Typically, the coefficient of glucose assimilation K was reduced in anorectic patients before treatment and increased after realimentation. This seemed to occur despite a relative increase in insulin response to glucose, which again may be related to insulin resistance in these undernourished subjects. However, more recent data demonstrated that the early insulin response is significantly lower in anorectic patients than in controls and that more than half of these patients have normal glucose-tolerance despite decreased peripheral plasma insulin levels. These latter observations, on the contrary, suggest an increased insulin sensitivity, at least in some patients with AN. Only the recently developed minimal model method allows us to discriminate between changes in insulin secretion and action after intravenous glucose injection and thus to infer accurately the sensitivity of the tissues to insulin. Unfortunately, this technique has not been applied to anorectic patients, until now, to solve the controversy. The simplest way to assess the action in vivo of insulin is to perform an intravenous insulin-tolerance test. However, the initial findings with this test, which showed exaggerated fall in plasma-glucose values and delayed return to basal levels after intravenous injection of insulin in AN, do not necessarily mean increased insulin sensitivity in these self-starved patients.(ABSTRACT TRUNCATED AT 400 WORDS)

Anorexia Nervosa↗

PubMed1999

Brainstem glioma: comparative study of clinico-radiological presentation, pathology and outcome in children and adults.

Although the clinical and imaging features and behaviour of brain stem gliomas in children are well documented, similar data are not available, for adults. We have carried out a retrospective study, on 101 consecutive patients (71 children and 30 adults) with a histologically verified brain stem glioma. Duration of symptoms, clinical features, imaging characteristics, histopathology and outcome were specifically compared in children and adults with brain stem glioma. Peak incidence was in the first decade in children and in the third and fourth decades in adults. Mean duration of symptoms before admission was 9.7 months in adults and 3.6 months in children (P < 0.001). There were no significant differences in the clinical features between adults and children. Imaging characteristics revealed no major differences except that diffuse hypodense lesions involving the whole brainstem accounted for 41.2% of the lesions in children and only 11.1% of adults (P < 0.001). A stereotactic biopsy was performed in 92 patients and an open biopsy or partial excision in 9 patients. Histopathological examination showed that the majority of gliomas were diagnosed as grade II astrocytomas in both groups. Survival was significantly shorter in children when compared to adults (P < 0.01). While the tumour grade was a significant factor in predicting survival in adults, in children it did not correlate with outcome. Therefore, determination of the grade of a brain stem glioma may be of prognostic significance in adult patients.

Adolescent↗

PubMed2006

Susceptibility-weighted imaging to visualize blood products and improve tumor contrast in the study of brain masses.

PURPOSE: To evaluate the diagnostic value of susceptibility-weighted imaging (SWI) for studying brain masses. MATERIALS AND METHODS: SWI is a high-resolution, three-dimensional, fully velocity-compensated gradient-echo sequence that uses both magnitude and phase data. Custom postprocessing is applied to enhance the contrast in the magnitude images between tissues with different susceptibilities. This sequence was applied to 44 patients (24 males and 20 females, 15-89 years old, mean age = 50.3 years) with brain masses, pre- and/or postcontrast, and compared with conventional sequences (T1, T1 postcontrast, T2, proton density (PD), fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted imaging (DWI) at 1.5T). Correlation with pathology was obtained in 12 cases. All images were reviewed independently by three radiologists. RESULTS: In the evaluation of tumor visibility, boundary definition, blood products, venous vasculature, architecture, and edema, SWI gave better information than the standard T1-weighted postcontrast images in 11%, 14%, 71%, 73%, 63%, and 75% of the data, respectively, in a subgroup of 38 patients. This demonstrates that the information presented by SWI is complementary in nature to that available from conventional methods. On the whole, SWI was much more sensitive for showing blood products and venous vasculature. SWI showed a useful FLAIR-like contrast and complemented the information obtained by conventional T1 postcontrast sequences regarding the internal architecture of the lesions. Good pathologic correlations were found for blood products as predicted by SWI. CONCLUSION: SWI should prove useful for tumor characterization because of its ability to better highlight blood products and venous vasculature and reveal new internal architecture.

Adolescent↗

PubMed2003

Cerebral perfusion in infants and neonates: preliminary results obtained using dynamic susceptibility contrast enhanced magnetic resonance imaging.

BACKGROUND: Previous studies have used the dynamic susceptibility contrast enhanced (DSCE) magnetic resonance (MR) imaging technique to measure cerebral perfusion in adults. OBJECTIVE: To assess the feasibility of the technique in a heterogeneous cohort of sick human infants and identify cerebral perfusion abnormalities. METHODS: Perfusion measurements were made by characterising the changing concentration of an injected bolus of contrast agent using a series of MR images acquired during the first pass of the contrast bolus. Qualitative values of relative cerebral blood flow (rCBF) were then calculated from these data on a pixel by pixel basis to generate parametric maps of perfusion. RESULTS: Images of perfusion were successfully calculated from 12 out of 27 neonates and infants, all with established cerebral pathology. Normal vascular anatomical structures such as the circle of Willis were identified within all calculated images. Values of rCBF were generally larger in grey matter than in white matter. In several patients, perfusion abnormalities resulted in structural abnormalities which were detected in conventional MR imaging at follow up. The acquisition of perfusion data was most difficult when the least mature brains were examined because of motion artefacts and a smaller head size with a lower level of rCBF than adults. CONCLUSIONS: This preliminary study shows that: (a) maps of rCBF can be acquired from neonates and infants; (b) characterisation of the bolus passage becomes progressively easier as the brain matures; (c) early abnormalities in cerebral perfusion may have negative prognostic implications; (d) the main difficulty when using the DSCE technique to study neonates relates to image artefacts resulting from bulk head motion.

Brain↗

PubMed2004

Web-based health services and clinical decision support.

The purpose of this study was the development of a Web-based e-health service for comprehensive assistance and clinical decision support. The service structure consists of a Web server, a PHP-based Web interface linked to a clinical SQL database, Java applets for interactive manipulation and visualization of signals and a Matlab server linked with signal and data processing algorithms implemented by Matlab programs. The service ensures diagnostic signal- and image analysis-sbased clinical decision support. By using the discussed methodology, a pilot service for pathology specialists for automatic calculation of the proliferation index has been developed. Physicians use a simple Web interface for uploading the pictures under investigation to the server; subsequently a Java applet interface is used for outlining the region of interest and, after processing on the server, the requested proliferation index value is calculated. There is also an "expert corner", where experts can submit their index estimates and comments on particular images, which is especially important for system developers. These expert evaluations are used for optimization and verification of automatic analysis algorithms. Decision support trials have been conducted for ECG and ophthalmology ultrasonic investigations of intraocular tumor differentiation. Data mining algorithms have been applied and decision support trees constructed. These services are under implementation by a Web-based system too. The study has shown that the Web-based structure ensures more effective, flexible and accessible services compared with standalone programs and is very convenient for biomedical engineers and physicians, especially in the development phase.

Adult↗