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Portable image-manipulation software: what is the extra development cost?

A hospital-wide picture archiving and communication system (PACS) project is currently under development at the University Hospital of Geneva. The visualization and manipulation of images provided by different imaging modalities constitutes one of the most challenging component of a PACS. It was necessary to provide this visualization software on a number of types of workstations because of the varying requirements imposed by the range of clinical uses it must serve. The user interface must be the same, independent of the underlying workstation. In addition to a standard set of image-manipulation and processing tools, there is a need for more specific clinical tools that can be easily adapted to specific medical requirements. To achieve this goal, it was elected to develop a modular and portable software called OSIRIS. This software is available on two different operating systems (the UNIX standard X-11/OSF-Motif based workstations and the Macintosh family) and can be easily ported to other systems. The extra effort required to design such software in a modular and portable way was worthwhile because it resulted in a platform that can be easily expanded and adapted to a variety of specific clinical applications. Its portability allows users to benefit from the rapidly evolving workstation technology and to adapt the performance to suit their needs.

Costs and Cost Analysis↗

3DVIEWNIX-AVS: a software package for the separate visualization of arteries and veins in CE-MRA images.

Our earlier study developed a computerized method, based on fuzzy connected object delineation principles and algorithms, for artery and vein separation in contrast enhanced Magnetic Resonance Angiography (CE-MRA) images. This paper reports its current development-a software package-for routine clinical use. The software package, termed 3DVIEWNIX-AVS, consists of the following major operational parts: (1) converting data from DICOM3 to 3DVIEWNIX format, (2) previewing slices and creating VOI and MIP Shell, (3) segmenting vessel, (4) separating artery and vein, (5) shell rendering vascular structures and creating animations. This package has been applied to EPIX Medical Inc's CE-MRA data (AngioMark MS-325). One hundred and thirty-five original CE-MRA data sets (of 52 patients) from 6 hospitals have been processed. In all case studies, unified parameter settings produce correct artery-vein separation. The current package is running on a Pentium PC under Linux and the total computation time per study is about 3 min. The strengths of this software package are (1) minimal user interaction, (2) minimal anatomic knowledge requirements on human vascular system, (3) clinically required speed, (4) free entry to any operational stages, (5) reproducible, reliable, high quality of results, and (6) cost effective computer implementation. To date, it seems to be the only software package (using an image processing approach) available for artery and vein separation of the human vascular system for routine use in a clinical setting.

Algorithms↗

Practitioner-patient communication software: an aid in the prescription of dental prostheses.

A questionnaire designed for psychometric evaluation was used to develop communication software that helps us understand patients' expectations of their prostheses. This enables the practitioner to select and suggest the type of prosthesis that best responds to the hopes, as well as the needs, of patients. At the end of the treatment process, the practitioner is able to ascertain whether the patient's expectations have indeed been met. With this software, we can also compare various types of prostheses based on evaluation by patients as well as conduct multi-center studies.

Communication↗

[Methodical basis for creation of the military telemedicine system in the Russian Federation Armed Forces].

Today the telemedicine (TM) is the perspective and rapidly developing direction in the health service. It also concerns the military medicine. In the RF Armed Forces' interests the work on creation of military telemedicine system within the framework of experimental-and-designers' work "Telemed" is conducted. During the development of software to realize the functions of military telemedicine system and to provide the development of its functional potentials the work was done connected with problem description in order to realize all medical technologies for each direction of its application. To solve this problem there are enough specialists in the field of computer and informative technologies capable of bringing the diagnostic and consultation possibilities of district (naval) and Central Military Hospitals as well as republican and regional centers closer to the solution of medical problems of distant garrisons.

Aerospace Medicine↗

A system for computer analysis of cancer cell movement.

BACKGROUND: Motility of cancer cells is a principal cellular parameter, essentially required in the invasion and formation of distant metastasis in human cancer. Measures to stimulate or inhibit motility of cancer cells may play an important part in the understanding of metastasis biology. The aim of this study was to develop a computer system to analyse and evaluate the movement of cells. METHOD: Software was developed which enabled cell boundary definition by specifying salient points around the cell. The position of the centre of area was calculated. Six human cancer cells treated with a motogen and cells without added motogen were analysed by the system. RESULTS: We observed higher velocities and greater variation in area and velocity of the cells treated with HGF/SF motogen compared with control cells. CONCLUSION: The system enables rapid analysis of cell area, velocity and movement, and may thus be of value in further understanding cell motility.

Cell Movement↗

CROPPER: a metagene creator resource for cross-platform and cross-species compendium studies.

BACKGROUND: Current genomic research methods provide researchers with enormous amounts of data. Combining data from different high-throughput research technologies commonly available in biological databases can lead to novel findings and increase research efficiency. However, combining data from different heterogeneous sources is often a very arduous task. These sources can be different microarray technology platforms, genomic databases, or experiments performed on various species. Our aim was to develop a software program that could facilitate the combining of data from heterogeneous sources, and thus allow researchers to perform genomic cross-platform/cross-species studies and to use existing experimental data for compendium studies. RESULTS: We have developed a web-based software resource, called CROPPER that uses the latest genomic information concerning different data identifiers and orthologous genes from the Ensembl database. CROPPER can be used to combine genomic data from different heterogeneous sources, allowing researchers to perform cross-platform/cross-species compendium studies without the need for complex computational tools or the requirement of setting up one's own in-house database. We also present an example of a simple cross-platform/cross-species compendium study based on publicly available Parkinson's disease data derived from different sources. CONCLUSION: CROPPER is a user-friendly and freely available web-based software resource that can be successfully used for cross-species/cross-platform compendium studies.

Animals↗

An exhaustive DNA micro-satellite map of the human genome using high performance computing.

The current pace of the generation of sequence data requires the development of software tools that can rapidly provide full annotation of the data. We have developed a new method for rapid sequence comparison using the exact match algorithm without repeat masking. As a demonstration, we have identified all perfect simple tandem repeats (STR) within the draft sequence of the human genome. The STR elements (chromosome, position, length and repeat subunit) have been placed into a relational database. Repeat flanking sequence is also publicly accessible at http://grid.abcc.ncifcrf.gov. To illustrate the utility of this complete set of STR elements, we documented the increased density of potentially polymorphic markers throughout the genome. The new STR markers may be useful in disease association studies because so many STR elements manifest multiallelic polymorphism. Also, because triplet repeat expansions are important for human disease etiology, we identified trinucleotide repeats that exist within exons of known genes. This resulted in a list that includes all 14 genes known to undergo polynucleotide expansion, and 48 additional candidates. Several of these are non-polyglutamine triplet repeats. Other examinations of the STR database demonstrated repeats spanning splice junctions and identified SNPs within repeat elements.

Alleles↗

[Computer-assisted radiologic quantification of hand and foot changes in rheumatoid arthritis].

Driven by the increasing implementation of electronical picture archiving and communications system (PACS) into every days practice a fully operative Java application software was developed to support the efficacy of the scoring process in rheumatoid arthritis. This software, namely the "Rheuma-Coach" offers the possibility to use the Larsen- or the Ratingen-Score. We measured time savings of approximately 20% per case if this computer assistance was used. The lack of a standard for the positioning of limbs was confirmed.

Arthritis, Rheumatoid↗

[Evaluation of the physical development of adolescents of call-up age and armed forces personnel].

At present, there are no methods for evaluating the physical development of subjects of call-up age, which present problems during recruitment of those who can adequately cope with set problems for armed forces. A large number of conscripts were examined, by using anthropometry, physiometry, the Stange test, and exercise test. A classification system was developed on the basis of mathematical models derived by means of discriminant analysis. The procedure tested by the authors could determine the informative value of indices and identify the most important indices for the objective evaluation of an individual's physical development. The software implementation of the proposed approaches will permit a rapid evaluation of physical development both during the work of a draft board' and in the military unit.

Adolescent↗

[Management of personal health examination data for a population by use of a portable computer].

A new system was developed for processing annual personal health examination data with a portable microcomputer utilizing commercial software by converting the IBM formatted data file of the law mandated health examination for adults into an MS-DOS file. The sequential data file was further transferred into a random access data file by a simple program and software was developed for the presentation of annual personal data by table and graphs. Printout of data and selected comments filed on disc by the public health nurse or physician could become retrievable. This system is easily operated by a beginner in micro-computers from conversion of the original data to actual demonstration. This system was utilized for a small village of about 700 adults. By using part of the main memory as a RAM disc, presentation of 5 years' data was possible. File capacity was dependent on population size and also on the type of software for Japanese language input. In the case of a larger population, use of hard disc or expansion of memory may be recommended to shorten computer start-up time. Once necessary data has been placed into the field buffer's memory, retrieval of data requires less than one second. The results of health examination were usually provided by hard copies to village. But by use of this system, a more effective transfer of data between computerized systems by using a floppy disc is possible.

Humans↗

Computer software for pharmacy oncology services.

A computer program designed to manage the informational, clinical, and data requirements for a pharmacy oncology service is described. Specialized pharmacy oncology software was developed at Rhode Island Hospital and implemented in a multihospital, integrated health system. The software performs various safety functions, supplies on-screen access to pertinent drug and patient information, manages data, and assists in the product formulation process. The programmed safeguards can be modified to meet changing requirements. The system has been in use for more than seven years and has helped detect prescribing errors and prevent preparation and administration errors. A pharmacy oncology computer program streamlines pharmacists' work and helps prevent errors in antineoplastic drug therapy.

Clinical Pharmacy Information Systems↗

Design of a high resolution image cytometer with open software architecture.

A relatively inexpensive, non-proprietary high resolution color pathology workstation is described. Hardware consists of a JVC frame capture camera with adjustable resolution up to 4416 x 3456, matching frame grabber and a Unix workstation. Analytic software was developed using Khoros 1.0.5, a powerful and flexible system for the development of image analysis applications that is based on a visual programming language. Applications have been developed for DNA ploidy, quantitative immunohistochemistry and texture and shape analysis. The instrument's software is uniquely extensible and transparent, and has been made publicly available over the Internet.

Cell Physiological Phenomena↗

Advanced modeling environment for developing and testing FES control systems.

Realistic models of neuromusculoskeletal systems can provide a safe and convenient environment for the design and evaluation of controllers for functional electrical stimulation (FES) prior to clinical trials. We have developed a set of integrated musculoskeletal modeling tools to facilitate the model building process. Simulink models of musculoskeletal systems are created using two software packages developed in our laboratory, Musculoskeletal Modeling in Simulink (MMS) and virtual muscle, in addition to one software package available commercially, SIMM (Musculographics Inc., USA). MMS converts anatomically accurate musculoskeletal models generated by SIMM into Simulink(R) blocks. It also removes run-time constraints on kinetic simulations in SIMM, and allows the development of complex musculoskeletal models without writing a line of code. Virtual muscle builds realistic Simulink models of muscles responding to either natural recruitment or FES. Models of sensorimotor control systems can be developed using various Matlab (Mathworks Inc., USA) toolboxes and integrated easily with these musculoskeletal blocks in the graphical environment of Simulink.

Computer Simulation↗

[Reporting echocardiography exams with the G8-Cardio ANMCO software].

BACKGROUND: The availability of a common computerized program for echocardiographic study archiving and reporting at national and/or international level could make it possible to standardize the echo reports of different echocardiographic laboratories, and to use the wealth of data thus obtainable with echocardiography, and to exploit its capillary territorial distribution, with the aim of collecting echocardiographic data in a standard format for epidemiological, scientific and administrative purposes. METHODS: To develop such a software, an ad hoc joint National Association of Hospital Cardiologists and Italian Society of Echocardiography task force worked in conjunction with the Italian Branch of Agilent Technologies to standardize the phraseology of accepted echocardiographic terms and of the quantitative parameters derived from transthoracic and transesophageal echocardiographic examination at rest as well as during exercise and pharmacological stress, and to develop an ad hoc software. This echocardiographic study archiving and reporting program is part of the whole G8-Cardio ANMCO software developed to computerize the whole cardiological chart. The software has been developed by Agilent Technologies to provide a fast, easy-access and easy to use report generator for the non-computer specialist using DBMS Oracle 7.3 database and Power Builder 5.0 to develop a user-friendly interface. RESULTS: The number of qualitative and quantitative variables contained in the program is 733 for echocardiography at rest, while it depends on the stressor and on the length of the examination for the stress echo (dipyridamole 214-384, dobutamine 236-406, exercise 198-392). The program was tested and refined in our laboratory between November 1999 and May 2000. During this time period, 291 resting and 56 stress echocardiographic studies were reported and recorded in a database. On average, each resting echocardiographic study lasting 10 +/- 4 (range 5-17) min was recorded using 50 +/- 11 (range 33-67) variables and 41,566 bytes of hard-disk memory space. Stress echocardiographic studies, each lasting 7 +/- 5 (range 5-21) min, were recorded using 143 +/- 74 (range 38-194) variables and 38,531 bytes of hard-disk memory space. CONCLUSIONS: To our knowledge this software represents the first experience of a common computerized program for echo archiving and reporting carried out at national level.

Diagnosis, Computer-Assisted↗

[Digital registration and analysis of visual information in behavioral experiment].

A new software for recording, registration and computer analysis of behavior of laboratory animals, EthoStudio, has been developed. The software allows the latency, number and duration of up to 10 behavioral patterns to be simultaneously registered with parallel recording of video on a hard disk. The video records can be played back to track animal locomotion using a computer. EthoStudio was applied to study mouse behavior in the open field test. The numbers of rearings and groomings as well as accumulated time of grooming were interactively assayed by pressing and holding buttons on a computer keyboard. The number of squares crossed, the number of entries into the center and the time spend therein were assayed by computer analysis. EthoStudio can be applied to objectively study various kinds of animal behavior with reliability and accuracy necessary for modern ethological, physiological and pharmacological experiment.

Animals↗

Facilitating knowledge maintenance of clinical guidelines and protocols.

Clinical protocols and guidelines are widely used in the medi-cal domain to improve disease management techniques. Different software systems are in development to support the de-sign and the execution of such guidelines. The bottleneck in the guideline software developing process is the transformation of the text-based clinical guidelines into a formal representation, which can be used by the execution software. This paper introduces a method and a tool that was designed to provide a solution for that bottleneck. The so-called Guideline Markup Tool (GMT) facilitates the translation of guidelines into a formal representation written in XML. This tool enables the protocol designer to create links between the original guideline and its formal representation and ease the editing of guidelines applying design patterns in the form of macros. The usefulness of our approach is illustrated using GMT to edit Asbru protocols. We performed a usability study with eight participants to examine the usefulness of the GMT and of the Asbru macros, which showed that the proposed approach is very appropriate to author and maintain clinical guidelines.

Clinical Protocols↗

Development of an animal model for across-herd genetic evaluation of number born alive in swine.

An animal model and computer software were developed to conduct across-herd genetic evaluations using data from producers participating in the Sow Productivity Index program of the American Yorkshire Club. The final data set consisted of 61,596 litter records from 1986 to early 1990. The animal model included fixed contemporary group effects and random additive direct, service sire, permanent environmental, and residual effects. Additive genetic relationships among animals were included. A separate relationship matrix for service sires and their sires was also included. A data set similar to the Yorkshire field data was simulated to use in testing the animal model. The simulated data set consisted of 40 herds, each with 120 reproducing dams and either four or five sires. Six generations of simulated data were produced, resulting in 20,605 litter records. These records were then evaluated using the animal model for number of pigs born alive. Finally, correlations between the true breeding values from the simulation and the predicted breeding values were computed. The correlation between the 918 true and predicted sire breeding values was considerably lower for the animal model without a service sire effect than when it was included (.53 vs .74, respectively). However, the difference was cut in half (.66 vs .77) when only sires with greater than five daughter records were included. The high accuracy of the animal model with a random service sire effect indicates that the proposed model adequately accounts for the variation found in records for number of pigs born alive.

Animals↗

TeleMedMail: free software to facilitate telemedicine in developing countries.

Telemedicine offers the potential to alleviate the severe shortage of medical specialists in developing countries. However lack of equipment and poor network connections usually rule out video-conferencing systems. This paper describes a software application to facilitate store-and-forward telemedicine by email of images from digital cameras. TeleMedMail is written in Java and allows structured text entry, image processing, image and data compression, and data encryption. The design, implementation, and initial evaluation are described.

Computer Communication Networks↗