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A surgical pathology reporting and encoding system using industry-standard hardware and software.

I describe an efficient, inexpensive, industry-standard computer system that is designed for word processing of surgical pathology reports as well as encoding in Systematized Nomenclature of Medicine (SNOMED) and data storage. This system is capable of maintaining a large database of patient information with coded diagnoses. It is designed to be utilized with readily available stock computer hardware and software without significant customization or any additional programming. The hardware is easily purchased from and can be maintained by a retail, business-oriented computer store. The system described incorporates WordPerfect for word processing and the CAP/SNOMED system for diagnosis encoding and data storage and retrieval.

Humans

Word segmentation processing: a way to exponentially extend medical dictionaries.

One of the most critical problems of automatic natural language processing (NLP) is the size of the medical lexicons. The set of compound medical words and the continual creation of new terms renders medical lexicons exhaustive beyond question. The structure of such dictionaries usually consists of two parts: 1) the morphological and sometimes syntactical information necessary to identify, on a grapheme level, a given word in a sentence, and 2) the part often devoted to conceptual knowledge associated with the recognized word. It is only when these two prerequisites are fulfilled that an attempt to understand the meaning of a whole expression is possible. The approach developed in this paper is a pragmatic way to rapidly increase the lexico-semantic part of medical dictionaries. We developed a semi-automatic tool, as a prototype to demonstrate the feasibility of this approach. This tool is able to translate almost any diagnosis expressed in French into its equivalent in the ICD-9CM coding scheme.

Dictionaries, Medical as Topic

Effect of imagery ability on letter-level and word-level processing.

In a letter-identification task, subjects matched a probe letter to the initial letter of a subsequently presented probe word. We varied word frequency and predicted that the performance of vivid imagers would resemble that of typical young adults, whereas the performance of poor imagers would fall in between that of typical young adults and of older adults, or would simply resemble the performance of typical older adults (a linear decrease in reaction time [RT] with word frequency; see Allen & Madden, 1989). The in-between function for young and older adults combined predicts a dip in RT for very-high-frequency words compared to medium-high-, low-, and very-low-frequency words. As predicted, vivid imagers exhibited increased latencies for medium-high-frequency words relative to the other three word-frequency categories, whereas poor imagers exhibited a dip.

Adult

Human hippocampal long-term sustained response during word memory processing.

Temporal behavior of activation associated with the neural substrate of human memory function was investigated during and after an auditorily instructed word memory task using multislice functional magnetic resonance imaging. The hippocampal formation, which is involved in human memory function, displayed a long-term sustained response that persisted significantly (approximately 90 s) beyond the duration of the memory task. This sustained period was approximately two-fold longer than the duration of the post-task activation observed in auditory areas and Broca's area, which are involved in the phonological loop of the verbal working memory. These observations suggest that the hippocampal memory processing involves sustained activation in the transitional function for the long-term memory over the working memory period.

Adult

Kanji word reading process analysed by positron emission tomography.

Positron emission tomography, involving the H2(15)O injection technique, was used to study changes in regional cerebral blood flow during Japanese kanji word reading. Three-times intrasubject averaging analysis revealed that the main cortical responses occurred in the bilateral (left-side dominant) posterior inferior temporal area for visual input. We believe the left posterior inferior temporal area processes highly complex morphological features of kanji. For language output, left-side dominant activation of the posterior inferior frontal gyrus and the basal ganglia was found.

Adult

Cerebral blood flow correlates of word monitoring in sentences: influence of semantic incoherence. A spect study in normals.

The aim of this study was to assess the cerebral blood flow (CBF) changes induced by the semantic incoherence of sentences whose words were to be monitored by the subjects. According to Marslen-Wilson and Tyler, word processing would be parallel (global) in semantically coherent sentences, and serial (local) in semantically incoherent ones. We hypothesized that, in comparison with the parallel mode, the serial mode of word processing would result in a preponderant activation of the frontal lobes and/or of the left hemisphere, hence in a flow increase in these regions. In addition, one could assume that the increase in task complexity resulting from the breaking of semantic coherence would reinforce the functional links between hemispheres. Furthermore, as interactions between the processing of semantically coherent vs incoherent of verbal materials and the processing of imageable vs non-imageable stimuli was recently suspected, we designed a study combining coherent vs incoherent sentences and imageable vs non-imageable words. The results we obtained in 12 normal volunteers by measuring regional cerebral blood flow by SPECT and IV injection of Xenon 133 during the four experimental conditions, did not allow us to firmly establish our hypotheses. Indeed, we failed to demonstrate any significant CBF changes across conditions and there was no interaction between coherent vs incoherent and imageable vs non-imageable conditions. However, the analysis of the inter-regional correlations pointed to an increase in the functional links between the hemispheres in the incoherent conditions, whatever the imageability.

Adult

[Comparison between anomia with word comprehension difficulty and Gogi aphasia due to lobar atrophy].

We used naming and pointing tests and a proverb completion task to compare two cases of aphasia that exhibited a selective disturbance of word processing. One patient had anomia with word comprehension difficulty due to partial ablation of the left temporal lobe and the other patient had Gogi aphasia due to lobar atrophy with left temporal predominance. We presented 90 pictures of common objects divided into 9 categories in the naming and pointing tests, and used 10 well-known Japanese proverbs as stimuli in the proverb completion task. Performance of the naming and pointing tests was severely impaired in both patients. In the patient with anomia, words the patient could not name or point to varied from session to session and phonemic cue effects were frequently observed. The proverb completion phenomenon was positive. These findings indicate that the patient had an obstruction of the access route to the intact word store or a partial rarefaction of the word store itself. In the patient with Gogi aphasia, the words the patient could not name or point to were consistent from one occasion to another, and no phonemic cue effects or signs of familiarity were observed at all. The proverb completion phenomenon was totally negative. These findings indicate that the patient has lost the word store itself. MR images in the case of anomia revealed a lesion extending from the anterior to the central portion of the inferior part of the left temporal lobe. In the case of Gogi aphasia, the MR images displayed knife-edged focal atrophy in the anterior aspect of both temporal lobes, more prominently on the left.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Vascular surgical data registries for small computers.

Recent designs for computer-based vascular surgical registries and clinical data bases have employed large centralized systems with formal programming and mass storage. Small computers, of the types created for office use or for word processing, now contain sufficient speed and memory storage capacity to allow construction of decentralized office-based registries. Using a standardized dictionary of terms and a method of data organization adapted to word processing, we have created a new vascular surgery data registry, "VASREG." Data files are organized without programming, and a limited number of powerful logical statements in English are used for sorting. The capacity is 25,000 records with current inexpensive memory technology. VASREG is adaptable to computers made by a variety of manufacturers, and interface programs are available for conversion of the word processor formated registry data into forms suitable for analysis by programs written in a standard programming language. This is a low-cost clinical data registry available to any physician. With a standardized dictionary, preparation of regional and national statistical summaries may be facilitated.

Computers

A word processor-based pathology reporting system.

This report describes a pathology report generating system based on a programmable word processing system (Wang OIS-140). The system supports printing of preliminary and final draft reports as well as automatically producing index cards for insertion into a file of previous procedures. Completed pathology reports can be archived on floppy disks if desired. The pathology system is part of a multistation "shared logic" word processing system that serves the needs of several hospital departments. The programming capabilities included in the word processor permit it to handle anatomic pathology reporting functions without the need for an associated general-purpose computer system. Experience with the system indicates that it has produced a 60% increase in the number of reports a secretory can produce compared with the previous system based on magnetic card typewriters.

Computers

Event-related potentials and the phonological processing of words and non-words.

Event-related potentials (ERPs) were recorded during a task which required subjects to discriminate between rhyming and non-rhyming visually presented pairs of letter strings, consisting of equal proportions of word-word and word-non-word combinations. Pair members were presented sequentially with an interstimulus interval of 1.56 sec. As in a previous study [Rugg, M. D., Brain Lang. In press], ERPs elicited by rhyming and non-rhyming words were differentiated by a late negative component (N450) in waveforms following the non-rhyming words. This effect was greatest over the midline and the right hemisphere. The same rhyme/non-rhyme difference was also observed, to an equal extent, in ERPs elicited by non-words. It is concluded that N450, presumed to be related to the "N400" component observed under conditions of semantic incongruity [Kutas, M. and Hillyard, S.A., Science 207, 203-205, 1980] does not seem to depend on linguistic processing at the semantic level for its modulation.

Adult

[Product of the month: scientific text processing using the MS-DOS computer].

A new German word processing system, "Starwriter 6.0" for MS-DOS computers is introduced and important functions are described. The possibility of using different fonts, creating complex formulas, footnotes and endnotes, and using various functions for importing and exporting text and data files make this program highly suitable for scientific texts.

Germany

A microcomputer application curriculum for emergency medicine residents using computer-assisted instruction.

A microcomputer application curriculum using computer-assisted instruction was developed for emergency medicine residents. Other than introductory comments, the course was composed entirely of disk-based tutorials. No faculty time was necessary. Subjects covered included introduction to microcomputers, the disk operating system; word processing, data bases, and spread sheets. The entire course, including the tutorial floppy disks, was contained in one loose-leaf notebook. Residents who took the course were surveyed. The course took an average of three to six hours to complete. All found the course to be helpful, with word processing being the most useful module. The majority of residents thought that the course was so valuable that it should be given earlier in the residency. Thus, we have moved the course to the first postgraduate year, and the data base and spread-sheet modules have been made optional. The course is easily assembled, requires minimal faculty time, and can be modified to accommodate different hardware and software.

Computer-Assisted Instruction

Commercial software as the basis for an augmentative communication system on a personal computer.

Many severely speech-impaired individuals have a need or desire to maintain the capability for computerized speech generation while performing a variety of other computer-supported tasks such as word processing, financial analysis, or database management. Criteria are presented for augmentative communication systems that both incorporate a personal computer (PC) and provide capabilities for voice output to satisfy this requirement. Current approaches to such systems are categorized and reviewed in light of these criteria. A new method is then described in which word processing or other appropriate PC software is used for speech production, providing a natural integration of written and spoken communication. The approach separates the computer access and voice output functions to allow great flexibility in the choice of an alternative access system. This flexibility combined with appropriate exploitation of PC software features has the potential to yield a high communication rate as well as maximum compatibility with application software.

Communication Devices for People with Disabilities

A functional neuroimaging description of two deep dyslexic patients.

Deep dyslexia is a striking reading disorder that results from left-hemisphere brain damage and is characterized by semantic errors in reading single words aloud (e.g., reading 'spirit' as 'whisky'). Two types of explanation for this syndrome have been advanced. One is that deep dyslexia results from a residual left-hemisphere reading system that has lost the ability to pronounce a printed word without reference to meaning. The second is that deep dyslexia reflects right-hemisphere word processing. Although previous attempts to adjudicate between these hypotheses have been inconclusive, the controversy can now be addressed by mapping functional anatomy. In this study, we demonstrate that reading by two deep dyslexic patients (CJ and JG) involves normal or enhanced activity in spared left-hemisphere regions associated with naming (Broca's area and the left posterior inferior temporal cortex) and with the meanings of words (the left posterior temporo-parietal cortex and the left anterior temporal cortex). In the right-hemisphere homologues of these regions, there was inconsistent activation within the normal group and between the deep dyslexic patients. One (CJ) showed enhanced activity (relative to the normals) in the right anterior inferior temporal cortex, the other (JG) in the right Broca's area, and both in the right frontal operculum. Although these differential right-hemisphere activations may have influenced the reading behavior of the patients, their activation patterns primarily reflect semantic and phonological systems in spared regions of the left hemisphere. These results preclude an explanation of deep dyslexia in terms of purely right-hemisphere word processing.

Brain Mapping

Office automation.

By now, the term "office automation" should have more meaning for those readers who are not intimately familiar with the subject. Not all of the preceding material pertains to every department or practice, but certainly, word processing and simple telephone management are key items. The size and complexity of the organization will dictate the usefulness of electronic mail and calendar management, and the individual radiologist's personal needs and habits will determine the usefulness of the home computer. Perhaps the most important ingredient for success in the office automation arena relates to the ability to integrate information from various systems in a simple and flexible manner. Unfortunately, this is perhaps the one area that most office automation systems have ignored or handled poorly. In the personal computer world, there has been much emphasis recently on integration of packages such as spreadsheet, database management, word processing, graphics, time management, and communications. This same philosophy of integration has been applied to a few office automation systems, but these are generally vendor-specific and do not allow for a mixture of foreign subsystems. During the next few years, it is likely that a few vendors will emerge as dominant in this integrated office automation field and will stress simplicity and flexibility as major components.

Computers

Automatic processes in word perception: an analysis from illusory conjunctions.

When asked to report the color of a target letter in a briefly presented word or pseudoword, Ss were more likely to report the color of letters from the same syllablelike unit than the color of other letters. Because Ss were not required to make a lexical decision or naming response, the multiletter units that are revealed by this task arise automatically. It was found that the syllablelike units are not phonological but correspond to orthographic patterns and morphemes. These units affect performance regardless of changes in letter-case, suggesting that the units are based on abstract letter identities. Unit formation was also not affected by visual field of presentation. Several experiments demonstrated that the morphological and orthographic units arise from different processes: The morphological units depend on lexical access, and the orthographic units do not. Finally, the effects of orthography are stronger for good readers than for poor readers.

Adolescent

[Effects of video games on visual function in children].

Health effects of video games were examined with a questionnaire survey and an experimental study. In the survey, age, sex, playing time with video games in a day, viewing distance between the eyes and the television screen, subjective symptoms of eye strain, and changes of visual acuity were investigated in 2,034 male and 2,321 female primary school children. In the experimental study, the visual loads of a one-hour word processing task and a video game were compared with various indices, such as critical flicker fusion, near point distance, blinking counts, eyeball movement, pupillary reflex and subjective fatigue symptoms in ten healthy male college students. The results of this study were as follows: 1) The viewing distance between the eyes and the TV screen was shorter for video games than for watching TV programs. 2) The rate of complaints related to eye strain in children who played video games over 120 min per day was significantly higher than that of other children. 3) The eye movements during video games were more rapid and frequent than those during conventional VDT work. 4) A decrease in CFF value and an extension of near point distance and an increase in subjective fatigue symptoms were demonstrated for both the word processing task and the video game. No significant differences were observed between the above two experimental conditions. This suggests that the visual loads for video games are similar to those for VDT work. These findings suggest that regulating the playing times to 60 minutes or less per day is necessary to prevent negative health effects in children.

Asthenopia