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At least 163 records · Page 9Linked to original sources

[Semi-automated quantification of MRI high signals observed in multiple sclerosis].

MR T2 Weighted sequences on the brain demonstrate disseminated "high signal zones" (HSZ) in patients with Multiple Sclerosis; these morphological alterations are corresponding to the plaques. From the very beginnings of MR in 1981, everybody recognizes the main importance of this fact. MR appears as the most sensible exploration in patients with M.S. But the signal alteration is not specific; the clinical considerations and the evolution are requested. The aim of this work is to give a reference tool for evolutive evaluation of the disease. A work station with a specially developed software are presented. The HSZ thresholding is partially automatic. The edition of a cerebral mapping is developed. These results are discussed.

Humans↗

The present and future medicolegal importance of record keeping in anesthesia and intensive care: the case for automation.

The anesthesia record is often crucial to successful defense in a meritless claim, because the adversarial role of the plaintiff's medical expert witness requires an attack on the record. Likewise the record may be pivotal in determining whether a defense should even be mounted as an alternative to an early settlement, because the failure of meaningful, supportive, or exculpatory documentation raises serious questions about the quality of care rendered. Advancing technology has made possible revolutionary changes in real-time monitoring and data recording. Concepts favoring the development and adoption of automated record systems for anesthesia are outlined through historic medicolegal perspectives on record keeping in general and computerization of the monitoring and recording methods in specific as a means of providing the best medicolegal evidence in defense of the anesthesiologist's performance. The analogy is often made between the successful development and acceptance of the flight data recorder and cockpit voice recorder combination in aviation and ongoing software development for automated recordkeeping and the quest for its use and professional acceptance in both anesthesia and intensive care settings.

Anesthesiology↗

Linear regression software for intraocular lens implant power calculation.

Regression equations for the calculation of intraocular lens power are popular. Because some of the variables in cataract surgery are surgeon-specific, every surgeon should ideally have a personalized formula. We have developed software enabling those with access to IBM-compatible microcomputers to develop equations based on their own data.

Computers↗

Software engineering tools.

We have looked at general descriptions and illustrations of several software development tools, such as tools for prototyping, developing DFDs, testing, and maintenance. Many others are available, and new ones are being developed. However, you have at least seen some examples of powerful CASE tools for systems development.

Data Display↗

Automated rejection of contaminated surface measurements for improved surface registration in image guided neurosurgery.

Most image guided Neurosurgery employs adhesively mounted external fiducials for registration of medical images to the surgical workspace. Due to high logistical costs associated with these artificial landmarks, we strive to eliminate the need for these markers. At our institution, we developed a handheld laser stripe triangulation device to capture the surface contours of the patient's head while oriented for surgery. Anatomical surface registration algorithms rely on the assumption that the patient's anatomy bears the same geometry as the 3D model of the patient constructed from the imaging modality employed. During the time interval from which the patient is imaged and placed in the Mayfield head clamp in the operating room, the skin of the head bulges at the pinsite and the skull fixation equipment itself optically interferes with the image capture laser. We have developed software to reject points belonging to objects of known geometry while calculating the registration. During the course of development of the laser scanning unit, we have acquired surface contours of 13 patients and 2 cadavers. Initial analysis revealed that this automated rejection of points improved the registrations in all cases, but the accuracy of the fiducial method was not surpassed. Only points belonging to the offending instrument are removed. Skin bulges caused by the clamps and instruments remain in the data. We anticipate that careful removal of the points in these skin bulges will yield registrations that at least match the accuracy of the fiducial method.

Artifacts↗

Economic analysis of immunization programmes.

Two economic analyses of immunization programmes, one from Denmark and one from Kenya, are described with emphasis on practical problems in relation to the collection of data. The Danish study was performed by a study group with participation of experts within health economics and epidemiology and a specifically designed computer programme was developed. The Kenyan study was performed by the management unit of the Kenyan immunization programme using standard computer software developed by WHO (EPICost) and without external assistance. Both studies yielded results of significant relevance for the dialogue with the administration and politicians.

Child↗

Constructing clinical applications: the GALEN approach.

A common problem for developers of clinical applications is coping with the diversity of medical language. Medical language as it is used all over the world varies widely, while the referents for these words stay essentially the same. Software developers must reconcile this diversity with the practical necessity of producing applications that are usable in a variety of hospitals, while ensuring that information can be shared between applications. Existing approaches center around coding and classification schemes, but these approaches must be supplemented by a range of sophisticated terminological services in order for the language barriers to be overcome. To address this, the GALEN project is developing an application called the Terminology Server to provide such a range of terminological services (e.g., conceptual and multilingual services). The software is built upon a re-usable core model of medical terminology. This paper reports on the development of a clinical application called the SCUI (Structured Clinical User Interface) which draws on these GALEN technologies and illustrates an innovative approach to the construction of future clinical applications. The SCUI was specifically developed and tested in the context of infectious diseases to satisfy the demands made by the medical intensive care unit on the Geneva Hospital's microbiology laboratory.

Clinical Laboratory Information Systems↗

Estimated intakes of trans fatty and other fatty acids in the US population.

OBJECTIVE: To estimate mean level of trans fatty acid intakes using a representative sample of the US population. DESIGN: The study used food intake data from the 1989-1991 Continuing Survey of Food Intakes by Individuals (CSFII) and the trans fatty acid contents of specific foods calculated from a database compiled by the US Department of Agriculture (USDA) to estimate the mean level and deciles of trans fatty acid intake of the representative US population. SUBJECTS/SETTING: Trans fatty acid intakes were estimated for each subject (N = 11,258) in the CSFII data who completed both a 24-hour recall and a 2-day food record. STATISTICAL ANALYSES PERFORMED: Weights developed by USDA for the survey were used for all data analyses. The Technical Assessment Systems (TAS) International Diet Research System (TAS-DIET), software developed by TAS, was used to derive weighted estimates of the mean and percentiles of the intake distribution. PC CARP, software designed by Iowa State University, was used to estimate standard errors. RESULTS: Mean percentage of energy ingested as trans fatty acids was 2.6% and the mean percentage of total fat ingested as trans fatty acids was 7.4%. Across all age and gender groups examined, estimates ranged from 2.6% to 2.8% and 7.1% to 7.9%, respectively. APPLICATIONS/CONCLUSIONS: Dietetics practitioners can use the representative data of this study to help clients achieve desired changes in consumption levels of trans fatty acids.

Adolescent↗

POLLUX: a program for simulated cloning, mutagenesis and database searching of DNA constructs.

Computer support for research in biotechnology has developed rapidly and has provided several tools to aid the researcher. This report describes the capabilities of new computer software developed in this laboratory to aid in the documentation and planning of experiments in molecular biology. The program, POLLUX, provides a graphical medium for the entry, edit and manipulation of DNA constructs and a textual format for display and edit of construct descriptive data. Program operation and procedures are designed to mimic the actual laboratory experiments with respect to capability and the order in which they are performed. Flexible control over the content of the computer-generated displays and program facilities is provided by a mouse-driven menu interface. Programmed facilities for mutagenesis, simulated cloning and searching of the database from networked workstations are described.

Base Sequence↗

Peptide and protein identification by matrix-assisted laser desorption ionization (MALDI) and MALDI-post-source decay time-of-flight mass spectrometry.

The potential of matrix-assisted laser desorption ionization (MALDI) and MALDI-post-source decay (PSD) time-of-flight mass spectrometry for the characterization of peptides and proteins is discussed. Recent instrumental developments provide for levels of sensitivity and accuracy that make these techniques major analytical tools for proteome analysis. New software developments employing protein database searches have greatly enhanced the fields of application of MALDI-PSD. Peptides and proteins can be easily identified even if only a partial sequence information is determined. Derivatization procedures have been optimized for MALDI-PSD to increase the structural information and to obtain a complete peptide sequence even in critical cases. They are fast, simple and can be performed on target. MALDI-PSD is also a very powerful tool to characterize or elucidate post-translational or chemically induced modifications. In association with database searches, proteins issued from electrophoretic gels can be identified after specific enzymatic cleavages and peptide mapping.

Amino Acid Sequence↗

NUMEDICS: a system for on-line data processing in nuclear medicine.

A multiterminal system --NUMEDICS--has been developed to study the problems of on-line acquisition, processing, and display of scintigraphic data. The hardware-software configuration of NUMEDICS permits simultaneous and independent operation of terminals in the Division of Nuclear Medicine, the Physics Research Laboratory, and the Cyclotron Laboratory of the Massachusetts General Hospital. This paper describes the hardware and software developments in NUMEDICS which have been proven to be of value in clinical and research applications. These features are illustrated by applications to the evaluation of left ventricular performance, three-dimensional imaging, and functional imaging of rCBF.

Nuclear Medicine↗

Neurosurgical robot Minerva: first results and current developments.

We describe the development and approach to clinical application of the neurosurgical robot Minerva, including the mechanical structure of the robot and the software developed to perform intracranial neurosurgical operations with accuracy, smoothness, and safety. The first eight operations have been undertaken on patients requiring stereotactic brain biopsy. We describe the ongoing developments, including improved sterilization features, force sensors, nonlinear electrostimulation probe, and implantation of living encapsulated cells, all of which have entered a test phase. The goals are increased safety and capability to perform simple three-dimensional operations. This research should ease the way for new complex operations that are difficult to perform manually today.

Biopsy↗

Critical care medicine in cyperspace: Internet resources and techniques for the intensivist.

The internet, is an informational tool of impressive proportions and capabilities. New software developments puts the use of this informational technology into the hands of all physicians. The use of Internet informational resources allows the intensivist to stay abreast of new developments in critical care medicine, communicate in a matter of seconds with colleagues half a world away, acquire medically related software, access remote database structures, obtain continuing medical education, and in the near future to "see' patients and obtain physiological data in real time. This tutorial will introduce the Internet and it's current tool suite.

Computer Communication Networks↗

Topographical brain electrical activity mapping on an IBM-compatible personal computer.

A new system for computing brain electrical activity maps on a standard IBM-compatible computer has been developed. The EEG is recorded using a CED1401 intelligent laboratory interface and stored in the computer; colour coded maps are generated using software developed in Turbo PASCAL and displayed on the EGA graphics screen. An acceptable computation time of 1.2 s for a 64 x 64 map displayed as a 128 x 128 pixel image has been achieved by incorporating assembly language routines and a maths coprocessor. The system may be readily upgraded as improved hardware becomes available and further software can be added. In addition to triggering auditory, visual and somatosensory stimulators, it provides the potential for the generation of complex stimuli for cognitive experiments by means of mass RAM and digital-to-analogue converters.

Brain Mapping↗

Photo CD and medical archives.

Most people involved in medical photography and illustration are aware of the difficulties of efficient archiving and retrieval of picture information. The recent developments in Photo CD now enable cost effective storage of high resolution images. Applications already exist for easy archive management and new software developments make it simple to tailor standard systems for professional people in very specific fields without the necessity of commissioning programmers and system developers with the consequential cost implications.

Archives↗

Automated identification by computer of the mass spectra of drugs in urine or serum extracts.

Gas chromatography/mass spectrometry (GC/MS) is the method of choice for confirming the presence of drugs tentatively identified in urine or serum by thin-layer chromatography, gas chromatography, or immunoassay. One of the most widely used GC/MS systems is the Hewlett-Packard (HP) Model 5970 mass selective detector equipped with a work station programmed in Pascal. Searching of mass spectra after a GC/MS run must be done manually, and this can take hours, especially when there are many peaks in a chromatogram to check. I have developed software that allows the unattended searching of all peaks in a run, using a forward search algorithm with a custom-made drug library developed over a period of 5 years, and a reverse search with a 1600+ drug library from HP or another in-house drug library. Using these libraries with the two algorithms maximizes the chances of finding a drug peak and identifying it correctly. Individual searches take about 5 seconds each. Overall search time of nearly 200 mass spectra per run takes about 40 minutes, including printing time. This software has proven to be both labor saving and effective in positively identifying drugs.

Electronic Data Processing↗

Automated comet assay analysis.

BACKGROUND: Recently the "comet assay" or "single-cell gel electrophoresis assay" has been established as a sensitive method for the detection of DNA damage and repair. Most of the software now available to quantify various parameters for DNA damage requires the interaction of a human observer. In this report, we describe an automated analysis system that is based on self-developed software and hardware and needs minimal human interaction. METHODS: The image analysis is divided into two parts: 1) automatic cell recognition and comet classification and 2) quantification of desired comet parameters. Image preprocessing, segmentation, and feature classification were developed with algorithms based on mathematical morphology. To enhance evaluation speed, we have introduced parallel processing of data under the Windows NT operating system (Microsoft Corporation, Redmond, WA). Use of an analogue real-time autofocus unit (Böcker et al.: Phys Med Biol 1997;42:1981-1992) allows for faster analysis. RESULTS: Our recognition software shows a sensitivity of 95.2% and a specificity of 92.7% when tested on test samples from routine work with DNA damage by low-dose radiation (0-2 Gy). The parallel hardware and software concept enables us to analyze 100 comets on one slide in less than 15 min. CONCLUSIONS: A comparison of measurements made on the same samples by manual and automated analysis systems revealed that there are no significant differences. The slope of the dose-response curves and the repair kinetics are very similar and demonstrate that automatic comet assay analysis is possible.

Algorithms↗

A computer-assisted electrocardiographic analysis system: methodology and potential application to cardiovascular toxicology.

An automated analysis of electrocardiographic (ECG) waveforms, based on a precise one-dimensional analysis of features within a generalized computer-enhanced ECG waveform, has been developed in our laboratory. ECG signals are monitored, amplified, and recorded using standard techniques. The recorder output signal is distributed to a microcomputer system. Software developed for the microcomputer slows the signal playback rate and permits operator review of the slowed signal for arrhythmia analysis. The analysis program identifies and superimposes 10-40 individual ECG complexes, depending on the heart rate, and generates an "ensembled" waveform. Operator interaction permits delineation of specific points on the displayed waveform and calculation of heart rate and duration of components within the ECG complex. The primary advantages of this system include (1) extensive automation--computer support decreases analytical time, increases precision, and permits rapid screening of large numbers of animals; (2) enhanced sensitivity--the use of functional parameters should provide a more sensitive index of toxicity than morphological parameters; (3) broad utility--this system provides the capability to utilize a variety of animals, both anesthetized and unanesthetized, ranging in age from fetuses to geriatrics, and permits studies of block as well as longitudinal design; and (4) ease of replication--standardization of equipment and techniques facilitates replication by other laboratories.

Animals↗