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Organizational aspects of IMAC introduction. Nordic model of radiological/clinical conference.

The organization of radiological practices differs in Scandinavian countries from that of many other countries. Regular formal meetings take place daily in the radiology department where the senior radiologist demonstrates findings from the imaging procedures of the previous day for the clinicians at the hospital. This procedure which is considered very valuable, should become even more effective with the planned IMAC installations. The article describes routines common to Nordic radiological departments that hopefully can be implemented in future IMAC.

Computer Systems↗

Clinical application of a magneto-optical disk image filing system/image save and carry (ISAC) system.

We propose the utilization of portable magneto optical disks for image filing. The main problems in PACS are the need for a high-speed local area network (LAN) and a large mass storage device. An image filing system--image save and carry (ISAC)--is one solution for these problems in present PACS and requires minimal additional hardware and cost for the installation. Whenever a patient is examined, the clerk carries the medical record and the ISAC magneto-optical disk for recording image data, and after inspection records the image data into the magneto-optical disk. We investigated the number of image retrievals done for inpatients and outpatients in 1988 at our radiation therapy department. The data storage requirements were on the average 18.5 MB for outpatients and 173.9 MB for inpatients. An ISAC display console needs also an easy-to-use man/machine interface for specifying images and image display characteristics in order to realize the ISAC system.

Computer Systems↗

User requirements for IMACS.

User requirements of an IMACS are briefly reviewed with special reference to image matrix, number of simultaneous images for review, and connection to the hospital information system. In addition, the problems of information transmission between clinicians and radiologists are discussed--an aspect which varies between different medical communities. Methods of limiting the amount of archived data are also briefly commented upon.

Computer Systems↗

Computed radiography and image workstation from the radiologist's point of view.

A computed radiography system (Digiscan, Siemens) connected to an image workstation (Siemens) has been used for 1 1/2 years in our department. The image quality is good and it has been possible to reduce radiation dose by about 30% without any appreciable loss of image quality. The image workstation has been used in cases where image postprocessing is considered to be useful. For routine reporting of X-ray images the workstation is too slow although the image quality is comparable to that of the computed radiography film.

Computer Systems↗

Planning for PACS at Osaka University Hospital.

We have a plan to adopt PACS as a medical image information system in the new hospital. In order to construct PACS suitable for our hospital, a preliminary survey was carried out to determine how PACS should be introduced and what are the physicians requirements for a new medical image system. The most important requirement of the physicians was a good quality workstation. Our plan of a new medical image information system is as follows. A primary database will be constructed according to each of modalities in the Department of Radiology. In the Department of Medical Information Science, we will make a secondary database according to the patient. Although it may be difficult for us to obtain a sufficient budget digitalizing all medical images by our move to the new hospital, our goal is to establish total PACS throughout the new hospital in 1995.

Computer Communication Networks↗

GCG Stacks: a friendly interface for the GCG programs.

A 'PLUS' stack which provides a friendly user interface for the GCG suite of programs is presented. The interface takes advantage of the whole set of programming tools available in a graphical and object-oriented environment and its major features include: (i) an efficient management of the on-line help documents, and (ii) a flexible editor for macrocommands. The former facilitates finding specific information in the huge documentation bundled with the GCG suite, and the latter is useful whenever several GCG programs must be run in sequence with automatic piping of the intermediate results.

Database Management Systems↗

Picture archiving and communications systems (PACS).

Although there has been a recent increase in interest in picture archiving and communications systems (PACS) topics, little has been published to assist the non-technical person in understanding the complexities of the technologies required for a PACS implementation. This issue of Current Problems in Radiology defines each PACS component and explains why each is important in a system design. PACS installations at the University of Florida are used as examples to tie the concepts together. The infrastructure required for PACS consists of the information system interfaces, networks, and databases. Information system interfaces guarantee consistent patient data across all platforms and reduce labor requirements by eliminating duplicate data entry. Data networks move information from the originating location to users around the hospital, clinic, campus, city, or world. In the PACS environment, the data consist of patient and study information as well as images and information about these images. Databases organize the data from multiple sources into a coherent package that can be queried for many different purposes, such as retrieving images, reviewing patient and study information, studying practice statistics, and performing outcomes analysis. PACS components consist of acquisition nodes, archives, and output devices. Acquisition nodes may include "digital modalities" such as CT, MRI, nuclear medicine, and computed radiography (CR), along with devices to convert from analog to digital, such as digitizers and frame grabbers. Options for archives are discussed along with configuration schemes. Output devices include both hard copy (film and paper prints) and soft copy (workstations for display and diagnosis). Finally, a description of the PACS installations at the University of Florida is presented, with comments on some of the difficulties and complexities encountered. A discussion of the cost and benefits of PACS is included, along with a forecast of the future of PACS.

Computer Systems↗

Systems integration for PACS.

A successful PACS (Picture Archiving and Communications System) implementation requires an eclectic integration of a number of key technologies. Among these are equipment interfaces, communications, storage, and display. Coincident with this, the software architecture must support a distributed system of heterogeneous structures, provide for protocol and format conversions to a unified system standard, be scalable to accommodate expansion, and provide a measure of fault tolerance. In this paper we survey the current state of the UCLA PACS components and architecture.

Computer Systems↗

Clinical experience with PACS at the University of Pennsylvania.

A Picture Archiving and Communication System (PACS) was installed in the Medical Intensive Care Unit of the Hospital of the University of Pennsylvania. For one year, 8 week periods of FILM ONLY usage were alternated with 8 week periods of PACS OR FILM usage. The time interval between obtaining portable chest images and taking image dependent actions decreased when the PACS was used, however, about 40% of the action decisions were made without a radiologist's consultation. Only 5% of action decisions were made without consultation during the FILM ONLY periods. A new clinical study for measuring diagnostic accuracy and efficiency as well as communication patterns is described.

Computer Systems↗

From multimodality digital imaging to multimedia patient record.

The constant improvement in computer power and performance nowadays offers convenient and efficient means of manipulating images, graphics, and movies on off-the-shelf workstations. With this improvement the trend toward integration of multimodality clinical documents from patient records comes naturally. Images and graphs are certainly the most important part of the complementary information that must accompany the text and numerical data. It is, however, possible to include sounds and voice messages together with all the other modalities. In medicine that could certainly help conveying hart murmur or sounds, but could also offer a convenient way of including vocal messages and comments. These new possibilities will certainly change the way physicians use workstations for direct communication. The computer industry will soon offer means of interactive communication between remote users through computer workstations. That alone will open a completely new era in cooperative computing and remote consultation scenarios in medicine. More than the technology itself, a complete change in behavior and work habits can be expected in the medical community.

Computer Communication Networks↗

Medical workstations for applied imaging and graphics research.

We present a medical workstation for the efficient implementation of research ideas related to image processing and computer graphics. Based on standard hardware platforms the software system encompasses two major components: A turnkey application system provides a functionally kernel for a broad community of clinical users working with digital imaging devices, including methods of noise suppression, interactive and automatic segmentation, 3D surface reconstruction and multi-modal registration. A development toolbox allows new algorithms and applications to be efficiently implemented and consistently integrated with the common framework of the turnkey system. The platform is based on an elaborate object class structure describing objects for image processing, computer graphics, study handling and user interface control. Thus expertise of computer scientists familiar with this application domain is brought into the hospital and can be readily used by clinical researchers.

Algorithms↗

From data banks to data bases.

The information collected in national and international libraries on nucleotide and protein sequences cannot be directly treated for proper handling by existing software. Therefore we evaluated the feasibility of constructing a data base for Escherichia coli using the data present in the banks. The knowhow thus acquired was applied to Bacillus subtilis. Specific examples of the general procedure are given.

Bacillus subtilis↗

Genome mapping databases: data acquisition, storage and access.

The introduction of the genome database to the human gene mapping community in September 1990 heralded the advent of a new generation of databases to serve the needs of the human genome initiative over the coming years. The databases will act as a fulcrum around which the activities of the human genome initiative can be coordinated at an international level.

Animals↗

The Complex Carbohydrate Structure Database.

The Complex Carbohydrate Structure Database (CCSD) and CarbBank, an IBM PC/AT (or compatible) database management system, were created to provide an information system to meet the needs of people interested in carbohydrate science. The CCSD, which presently contains more than 2000 citations, is expected to double in size in the next two years and to include, soon thereafter, all of the published structures of carbohydrates larger than disaccharides.

Carbohydrates↗

MRA calibration and measurement capabilities--radioactivity.

The practical realisation of the Mutual Recognition Arrangement relies on its two main Appendices, B and C. Appendix B relates to the equivalence of national measurement standards. The dissemination of these standards is achieved by the provision of physical standards and measurement services, where the associated measurement values are traceable to the SI. Appendix C specifies the quantities and ranges for which participating institutes recognise the validity of calibration and measurement certificates issued by other participating institutes and these are detailed in the database devoted to these standards and services, commonly referred to as calibration and measurement capabilities. Each participating institute has the opportunity to submit entries, via its Regional Metrology Organisation (RMO), to the database but, in order for users to be able to make informed choices, it is important that the data are entered to a common standard. The Joint Committee of the RMOs and the Bureau International des Poids et Mesures is responsible for the coordination of data provided by the RMOs. It is for individual RMOs to ensure the correctness of their own entries and to review and comment on those from others. This paper details that process and describes the various entries in the tables. It also addresses some of the remaining issues that still need to be resolved, in particular, the magnitudes of uncertainties and the need for supporting comparisons, both of which still present some significant problems.

Calibration↗

A website dedicated to ionizing radiation metrology.

In order to disseminate information about decay data and their evaluation, as well as other topics in the field of ionizing radiation, the Bureau National de Métrologie-Laboratoire National Henri Becquerel (BNM-LNHB) has published a website. Most of the web pages are concerned with the international working groups in which the BNM-LNHB takes part. In particular, a library of uranium and plutonium spectra is now available, as well as the results of evaluation of decay data of nuclides of special interest.

Calibration↗

SiMCAL 1 algorithm for analysis of gene expression data related to the phosphatidylserine receptor.

OBJECTIVE: SiMCAL 1 (simple multilevel clustering and linking, version 1) is a novel clustering algorithm for time-series microarray data, presented here with an application to a specific data set. The purpose of the algorithm is to present a complete feature set not found in either Jarvis-Patrick clustering, from which it is derived, or in other popular clustering methods such as hierarchical and k-means. The data concern the activity of the phosphatidylserine receptor (PSR) which is believed to be a crucial molecular switch in the mediation of inflammatory response in apoptosis and lysis. By analyzing the behavior of PSR-related genes in mouse macrophages, we hope to elucidate the mechanisms involved in this important biological process. METHODS AND MATERIALS: SiMCAL 1 is implemented in the Python programming language using the Numerical Python extensions, and the data are stored using the MySQL database management system. The data are derived from exposures of multiple Affymetrix mouse gene microarray chips to elevated levels of PSR antibody and control conditions. Code and data are available at (accessed: 17 January 2005). RESULTS: The algorithm meets its objectives: it is simple, in that it is computationally inexpensive; it is multilevel, in that it provides a small number of clearly defined hierarchical levels of clusters; and it offers linking between clusters at the same level in each hierarchy. Clustering and linking results indicate previously unknown co-regulation for genes expressing PGH synthase (COX2) and PGE2, appear to confirm increased production of proteins for clearance of apoptotic cells in the presence of PSR antibody, and correspond to other findings regarding the temporal relationship between PGE2 production and B cell proliferation and differentiation. These results are promising but should be taken as highly preliminary. CONCLUSION: Both the algorithm and its application to this problem show great potential for future development. We plan to improve and extend the SiMCAL family of algorithms, and to obtain new data so that the algorithm(s) may be further applied to this and other problems of interest.

Algorithms↗

Parmodel: a web server for automated comparative modeling of proteins.

Parmodel is a web server for automated comparative modeling and evaluation of protein structures. The aim of this tool is to help inexperienced users to perform modeling, assessment, visualization, and optimization of protein models as well as crystallographers to evaluate structures solved experimentally. It is subdivided in four modules: Parmodel Modeling, Parmodel Assessment, Parmodel Visualization, and Parmodel Optimization. The main module is the Parmodel Modeling that allows the building of several models for a same protein in a reduced time, through the distribution of modeling processes on a Beowulf cluster. Parmodel automates and integrates the main softwares used in comparative modeling as MODELLER, Whatcheck, Procheck, Raster3D, Molscript, and Gromacs. This web server is freely accessible at .

Algorithms↗