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PubMed1996

[Computers in a private surgeon's office. "Do it yourself" or "one is never served better than by oneself"].

In an attempt to minimise the administrative work involved in private surgical practice, the author naturally considered the use of computers. After studying the medical software market, he was convinced that most software was better adapted to general practice than to surgery. He concluded that the best person to design a surgical software would be the surgeon himself, provided he was prepared to spend some of his leisure time to develop a computer application. The software developed is a large integrated application facilitating all of the functions necessary to good functioning of the surgical office. It therefore ensures filing of medical records, correspondence, accounts, management of salaries, and appointments, as all of these sectors are related to the surgical activity itself. This approach led to the design of an application, and its functioning and the possibilities provided are described.

Humans↗

PubMed2003

[Construction of DICOM-WWW gateway by open source, and application to PDAs using the high-speed mobile communications network].

The author constructed a medical image network system using open source software that took security into consideration. This system was enabled for search and browse with a WWW browser, and images were stored in a DICOM server. In order to realize this function, software was developed to fill in the gap between the DICOM protocol and HTTP using PHP language. The transmission speed was evaluated by the difference in protocols between DICOM and HTTP. Furthermore, an attempt was made to evaluate the convenience of medical image access with a personal information terminal via the Internet through the high-speed mobile communication terminal. Results suggested the feasibility of remote diagnosis and application to emergency care.

Computer Communication Networks↗

PubMed1999

[Rudolf-Virchow Prize 1999. Genetics of respiratory tract carcinomas: correlation of genotype and phenotype].

In contrast to carcinomas of the upper respiratory tract lung cancer shows a considerable variety of histological differentiations and is particularly known for its morphological heterogeneity. Of clinical relevance, however, is only the distinction between small cell carcinomas (SCLC) and non-small cell lung cancer (NSCLC). We meanwhile investigated a tumor collective of several hundred respiratory tract carcinomas by Comparative Genomic Hybridization (CGH) and developed computer software for the statistical comparison of tumor groups. The analysis revealed recurrent patterns of chromosomal imbalances which are associated with morphological histotypes and biological phenotypes, e.g. there are chromosomal imbalances predominantly found in SCLC compared to NSCLC but also a considerable overlap between both entities. Specifically, the pattern of metastasizing lung squamous cell carcinomas (SCC) approaches that of SCLC. In addition, the analysis of a metastasizing combined SCLC after microdissection showed a clonal relationship between the SCC component of the primary tumor and the SCLC metastasis. These findings have direct consequences for the pathogenesis and classification of lung cancer. First, SCLC should be differentiated into primary and secondary carcinomas. Whereas primary SCLC as the predominant tumor type evolve directly from a precursor cell of probably epithelial origin, secondary SCLC develop via a NSCLC intermediate. Second, neuroendocrine differentiation in lung carcinomas should be used as a marker for dedifferentiation, worse prognosis and rapid tumor progression rather than an indicator of a putative tumor stem cell. The primary data is available at our online tumor database at http://amba.charite.de/cgh/.

Awards and Prizes↗

PubMed2002

Using BCMA software to improve patient safety in Veterans Administration Medical Centers.

Bar Code Medication Administration (BCMA) software, as developed by the Veterans Health Administration, is an innovative, automated system that uses wireless, point-of-care technology with an integrated bar code scanner. The system can dramatically reduce medication administration errors by letting clinicians verify a patient's identity and validate medications against active orders.

Delivery of Health Care, Integrated↗

PubMed2006

The potential role of dynamic thermal analysis in breast cancer detection.

BACKGROUND: It is presently well accepted that the breast exhibits a circadian rhythm reflective of its physiology. There is increasing evidence that rhythms associated with malignant cells proliferation are largely non-circadian. Cancer development appears to generate its own thermal signatures and the complexity of these signatures may be a reflection of its degree of development. The limitations of mammography as a screening modality especially in young women with dense breasts necessitated the development of novel and more effective screening strategies with a high sensitivity and specificity. The aim of this prospective study was to evaluate the feasibility of dynamic thermal analysis (DTA) as a potential breast cancer screening tool. METHODS: 173 women undergoing mammography as part of clinical assessment of their breast symptoms were recruited prior to having a biopsy. Thermal data from the breast surface were collected every five minutes for a period of 48 hours using eight thermal sensors placed on each breast surface [First Warning System (FWS), Lifeline Biotechnologies, Florida, USA]. Thermal data were recorded by microprocessors during the test period and analysed using specially developed statistical software. Temperature points from each contra-lateral sensor are plotted against each other to form a thermal motion picture of a lesion's physiological activity. DTA interpretations [positive (abnormal thermal signature) and negative (normal thermal signature)] were compared with mammography and final histology findings. RESULTS: 118 (68%) of participating patients, were found to have breast cancer on final histology. Mammography was diagnostic of malignancy (M5) in 55 (47%), indeterminate (M3, M4) in 54 (46%) and normal/benign (M1, M2) in 9 (8%) patients. DTA data was available on 160 (92.5%) participants. Using our initial algorithm, DTA was interpreted as positive in 113 patients and negative in 47 patients. Abnormal thermal signatures were found in 76 (72%) out of 105 breast cancer patients and 37 of the 55 benign cases. Then we developed a new algorithm using multiple-layer perception and SoftMax output artificial neural networks (ANN) on a subgroup (n = 38) of recorded files. The sensitivity improved to 76% (16/21) and false positives decreased to 26% (7/27) CONCLUSION: DTA of the breast is a feasible, non invasive approach that seems to be sensitive for the detection of breast cancer. However, the test has a limited specificity that can be improved further using ANN. Prospective multi-centre trials are required to validate this promising modality as an adjunct to screening mammography especially in young women with dense breasts.

Journal Article↗

PubMed2002

Physical outcome measurements via the Internet: reliability at two Internet speeds.

We have developed a software application to enable interactive rehabilitation via the Internet. The reliability of the telemedicine application was examined by comparing it with face-to-face assessment. The physical outcome measures assessed were knee range of motion, quadriceps muscle strength, limb girth and an assessment of gait. One therapist performed both in-person and Internet-based measurements of all outcome measures on 20 normal subjects. There was good agreement between the two techniques (the 95% limits of agreement included zero for all the variables studied). Internet assessments were conducted at two bandwidths: ISDN at 128 kbit/s and the telephone network at 17 kbit/s. Bandwidth had no significant influence on any of the measures. This study suggests that Internet-based physiotherapy interventions delivered to the home are suitable for further development.

Journal Article↗

PubMedDate not supplied

QSH: a minimal but highly portable image display and handling toolkit.

We describe a software system developed to handle images obtained from different sources, namely, computer-assisted tomography, positron emission tomography, single photon emission tomography and magnetic resonance imaging. In developing the system, it was necessary to address the following points. (1) The types of values that were encountered in both the header information and the pixel elements, namely, integers, floating point numbers, complex numbers and strings. (2) The use of domain-dependent sets of keys, that is, how to choose keys and how to stabilize the use of keys among the user population. This is, for example, how information such as the patient name, or the activity in becquerel is kept. It is necessary to keep both the key values and the units. (3) The development of a method for providing a database using flat files, i.e. linear text. (4) The maintenance of a history of values and operations. This is necessary in order to address the problem of determining from an image how that image was produced. The connection between an image and how it was derived is analogous to describing how a secondary standard is derived from a primary one.

Algorithms↗

PubMed2004

Electroanatomic mapping of the right atrium with a right atrial basket catheter and three-dimensional intracardiac echocardiography.

The ablation of arrhythmias progresses towards an approach based upon application of linear lesions between nonconducting anatomic/electrical areas. Hence the identification of detailed anatomy together with electrical behavior becomes increasingly important. This study aims to achieve true electroanatomic mapping by the use of three-dimensional intracardiac imaging of the right atrium combined with use of a right atrial basket to obtain detailed electrical information. We studied nine patients, seven requiring atrial flutter ablation. A 9 Fr, 9 MHZ intracardiac echo catheter was pulled back from SVC to IVC using respiratory and ECG gating. The images, recorded on a Clearview ultrasound machine, were reconstructed using commercially available software. The intracardiac basket was placed into the atrium using the markers and fluoroscopy to allow orientation. Isochronal maps were obtained from the basket in sinus rhythm, pacing from different sites within the atrium and in atrial flutter. Isochronal maps were constructed and superimposed on the ICE image. The maps with pacing were consistent with that which was expected, confirming the validity of this approach. We were able to visualize changes in activation sequence following the placement of bidirectional isthmus block. True electroanatomic mapping is possible by the use of three-dimensional ICE reconstruction of the right atrium with electrical activation obtained from an intracardiac basket. This has significance for anatomically based arrhythmia ablations such as the ablation of atrial flutter, atrial fibrillation, with transcatheter MAZE procedures and pulmonary vein isolation. Further developments in software will allow such maps to be produced simultaneously with greater rapidity.

Adolescent↗

PubMed2005

Simultaneous quantification and identification using 18O labeling with an ion trap mass spectrometer and the analysis software application "ZoomQuant".

Stable isotope labeling with (18)O is a promising technique for obtaining both qualitative and quantitative information from a single differential protein expression experiment. The small 4 Da mass shift produced by incorporation of two molecules of (18)O, and the lack of available methods for automated quantification of large data sets has limited the use of this approach with electrospray ionization-ion trap (ESI-IT) mass spectrometers. In this paper, we describe a method of acquiring ESI-IT mass spectrometric data that provides accurate calculation of relative ratios of peptides that have been differentially labeled using(18)O. The method utilizes zoom scans to provide high resolution data. This allows for accurate calculation of (18)O/(16)O ratios for peptides even when as much as 50% of a (18)O labeled peptide is present as the singly labeled species. The use of zoom scan data also provides sufficient resolution for calculating accurate ratios for peptides of +3 and lower charge states. Sequence coverage is comparable to that obtained with data acquisition modes that use only MS and MS/MS scans. We have employed a newly developed analysis software tool, ZoomQuant, which allows for the automated analysis of large data sets. We show that the combination of zoom scan data acquisition and analysis using ZoomQuant provides calculation of isotopic ratios accurate to approximately 21%. This compares well with data produced from (18)O labeling experiments using time of flight (TOF) and Fourier transform-ion cyclotron resonance (FT-ICR) MS instruments.

Amino Acid Sequence↗

PubMed2005

An OGSA-based integration of life-scientific resources for drug discovery.

OBJECTIVES: The rapid progress of life-scientific research has the potential to dramatically change the paradigm of drug discovery. Efficient utilization of life-scientific resources, i.e., databases and analytic software tools, poses a challenging issue with regard to the reduction of time and cost in the drug discovery process. In this paper, a variety of heterogeneous Web-based life-scientific resources are integrated toward the improvement of drug discovery performance. METHODS: For the integration of heterogeneous life-scientific resources, a database federation technique based on three-layer architecture has been utilized. With the federation technique, life-scientific resources are integrated step by step through database layers, database integration layers and analysis layers to encapsulate complexity and heterogeneity. In this study, we have taken advantage of the latest Grid technology based on OGSA (Open Grid Services Architecture) for the implementation of our approach. RESULTS: The actual case of life-scientific resources for drug discovery demonstrates that our prototype system developed with the proposed technique works well for the identification process of candidate compounds to a target protein. In other words, the prototype system allows a researcher to retrieve candidate compounds with less effort than before. CONCLUSIONS: The usefulness of the prototypic system represents the ability of our approach to integrate heterogeneous life-scientific resources, which have the potential to dramatically improve efficiency in drug discovery, resulting in the shortening of drug development. On the other hand, the system requires further consideration from the aspect of practical use. Dynamic aggregation of the resources is one example of such a consideration.

Biological Science Disciplines↗

PubMed1989

Computerized analysis of ionic channel multi-state conductance in planar lipid bilayers.

Ionic transport through cell membranes controls many physiological processes in living organisms. Transport across the cell surface is mediated by membrane proteins (channels), which form hydrophilic pathways permeable to various ions. Also, many synthetic peptides and bacterial toxins form ionic channels when incorporated in lipid bilayer membranes. Changes in boundary physico-chemical conditions and modifications of protein conformation, or sequence, give rise to ionic current signals with different characteristics. A low-cost MS-DOS-based system interfaced to a 12 bit analog/digital/analog (A/D/A) board was used for data acquisition and analysis of square-shaped signals due to the open-closed transitions of single-channel molecules. A dedicated software was developed to investigate the conductance of channels that generate bursts of current, i.e. a sequence of current events due to the rapid flickering of the protein between the open and closed configurations. Up to three current levels present within the same burst can be identified from the best fit of current histogram distribution with the sum of three gaussians. Results obtained from the incorporation of a tetanus toxin channel into phosphatidylserine planar bilayers are reported.

Analog-Digital Conversion↗

PubMed1998

The Multi Unit Activity analyzer: a Windows based hardware-software system for low cost, high speed analog to digital data conversion, data acquisition and window discrimination.

The Multi Unit Activity analyzer is a hardware-software package for multi-purpose, two-channel data acquisition, with a computer dependent maximal digitizing frequency selectable from 1 to 27,000 s(-1) on both channels simultaneously. The hardware is connected to an IBM compatible PC through one of the serial ports (standard RS 232 interface). Software was developed to view digitized signals and record or read them on or from the harddisk. The program can also perform amplitude based window discrimination on the raw signal, on-line or during replay. The system is used for recording and analyzing multi unit activity from neuronal tissue in our electrophysiology lab but it can be applied in a variety of other settings. Basic programming routines are available that allow customized data acquisition.

Analog-Digital Conversion↗

PubMed1989

Nuclear chromatin texture to differentiate follicular and papillary carcinoma of the thyroid.

This study presents the results of an automatic classification of six purely papillary, five purely follicular and five mixed papillary-follicular carcinomas of the thyroid. All cases were correctly classified with only two chromatin textural parameters obtained in the Olga's scan software package developed in our laboratory. Chromatin texture lines were generated by a unidirectional grey level gradient, obtained as a natural logarithmic function of the integrated optical density of each nucleus; this increased the difference between clear papillary and granular follicular nuclei. The accuracy of the method allowed a follicular carcinoma to be correctly classified as a mixed follicular-papillary. Finally a columnar-cell carcinoma of the thyroid was detected by means of its atypical DNA histogram.

Adenocarcinoma↗

PubMed1998

The uncertainty associated with the predictive value of test results.

The uncertainty associated with predictive value of test results was taken into consideration, as concerns both sampling error (related to the size of the statistical reference samples) and analytical imprecision (unavoidably involved by the measurement itself). A software package, developed for the statistical calculations, was used for the treatment of the results obtained for serum free thyroxin in euthyroid and dysthyroid subjects, assumed as an experimental model. Examples are shown for the obtainable functions predictive value vs. estimate and the related uncertainty regions. These data could help in comparing test results and, in particular, in preparing fully informative laboratory reports. The difficulties involved by an extensive application of the procedure are discussed.

Humans↗

PubMed1998

Automated routing of DICOM CT, MR, and CR images: solving the pitfalls of vendor-specific DICOM implementations.

This paper details our experience in developing and implementing an automated DICOM Image Router. This workstation serves as a gateway between image acquisition devices and image display and storage devices. Images are checked for demographic input errors and data format inconsistencies between the source and destination devices. Based on the configured rules, and image may be held for manual correction and/or distributed to multiple locations. Distribution is based on easily configured environmental variables and rules files which may be changed as needed. For example, CT images are typically sent to the archive and to a radiologist's display workstation. If the patient came from the Emergency Department, a copy of the images are sent to a clinician display workstation located in the Emergency Department. If the patient has suffered trauma to the head, a copy of the images are sent to a display workstation in the Neurosurgery Department for possible consultation. The software was developed on a UNIX-based platform and utilizes a Fast Ethernet network. To date, images from a variety of devices have been acquired: General Electric HiSpeed CT/I scanner, General Electric Signa MRI scanner, Philips Thoravision Digital Chest unit, and Fuji AC-3CS Computed Radiography (CR) unit. Each device has presented new challenges in providing a uniform look to patient demographics in the PACS archive. The workstation also provides a buffer in the event of network outages, storing images for later transmission when the network and/or a workstation recover.

Diagnostic Imaging↗

PubMed1996

[Computer graphics methods for 3-dimensional imaging of intrapulmonary space-occupying lesions of CT and MRI images].

AIM: To improve the pre-operative planning of interventional procedures in thorax surgery different methods of computer-graphical visualization of intrapulmonary lesions and adjacent anatomical structures based on CT and MR data were realized and compared to each other. DESIGN: In 21 patients with intrapulmonary lesions the image data was segmented by interactive and automatic algorithms and different reconstruction techniques were applied (maximum intensity projection; color-encoded and transparent surfaces; volume rendering). Based on these three-dimensional reconstructions, different views from arbitrary perspectives (including simulated endoscopic images) were generated and animated film sequences of the 3D scene were displayed with 30 frames/second. RESULTS: For all patients under review, a high-quality presentation of the relevant structures was obtained by use of the applied computer-graphical techniques. Even combinations of different visualization methods in one image can be generated with the software we developed. CONCLUSIONS: The various methods for image segmentation allow a fast and comfortable processing even of large data sets. The calculated values of tumor surface and volume can be used for quantitative studies and therapy control. The planning of surgical and interventional procedures can be supported by the simultaneous visualization of the intrathoracic lesion and the surrounding structures.

Aged↗

PubMed2006

Development and temporal organization of compulsive checking induced by repeated injections of the dopamine agonist quinpirole in an animal model of obsessive-compulsive disorder.

Rats treated chronically with the dopamine D2/D3 receptor agonist quinpirole develop locomotor sensitization and exhibit compulsive checking of specific places in an open-field arena, a behavioral profile that may represent an animal model of obsessive-compulsive disorder. However, it is not known how compulsive checking develops across quinpirole injections nor whether checking behavior possesses a particular temporal structure. Male rats received quinpirole (0.5mg/kg, twice weekly x 10) or an equivalent regimen of saline and were placed in a large open field for 55 min where their behavior was digitally tracked for subsequent analysis of checking behavior using existing and newly developed computer software. Results showed that the measures of compulsive checking did not follow a singular profile across injections: some remained constant and others changed monotonically reaching their near-maximum levels after about 5-7 quinpirole injections. Moreover, results showed that checking behavior was organized into bouts of checking, with the number of bouts, as well as the rate of checking within a bout, increasing across injections to reach near maximal levels after about 5-7 administrations of quinpirole. Finally, quinpirole-treated rats showed a paucity of long inter-bout intervals. These results suggest that (a) compulsive checking emerges from the operation of at least two underlying processes: a regulated process and a process of sensitization that intensifies the performance of checking behavior; and (b) quinpirole treatment may attenuate a sense of satiety that could underlie the compulsive nature of checking. Finally, because key variables measured using the newly developed algorithms showed the expected profile, the present study provides validation for the use of this methodology for the analysis of checking behavior.

Analysis of Variance↗

PubMed2006

[Nursing physical examination of the full-term neonate: self-instructional software].

The purpose of this research is to elaborate software about the physical examination of full-term newborns (TNB) for neonatal nursing teaching at undergraduate level. The software was developed according to the phases of planning, content development and evaluation. The construction of the modules was based on Gagné's modern learning theory and structured on the Keller Plan, in line with the systemic approach. The objectives were to elaborate and evaluate the contents of the self-instructional modules, to be used as a teaching strategy in the undergraduate course. After being structured, the material was reviewed and analyzed by 11 neonatal nursing experts, who rated the 42 exposed items as good or excellent.

Humans↗