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Compact Disc Interactive (CD-i) multimedia project.

In 1993, the National Library of Medicine (NLM), in collaboration with the National Cancer Institute (NCI), developed a Compact Disc Interactive (CD-i) program: "Cervical Cancer: Screening For Life." This was NLM's first experience in developing for an all-digital interactive medium, containing motion video, graphic images, and text. In 1994, the original CD-i was expanded to include a telecommunications capability that allowed the user to obtain the NCI's most recent screening and treatment information related to cervical cancer.

Compact Disks↗

Interactive videodisc and compact disc-interactive for ophthalmic basic science and continuing medical education.

BACKGROUND: The authors designed and implemented a complete curriculum in ophthalmic pathology using IBM- and Macintosh-based interactive videodisc (IVD) technology. They also redesigned a portion of this curriculum for a new television-based platform, compact disc-interactive (CD-I). METHODS: The following issues were addressed: curriculum design, instructional design, the assembly of illustrations and the ownership of such materials, the generation of computer-based medical art and animation, and programming. The issue of academic credit for faculty participating in this effort also was considered. RESULTS: The computer-based IVD program provides the following features: (1) rapid access to thousands of high-quality illustrations with the option of superimposing graphic labels and text directly over pictures; (2) the ability to view enlargements of photographs; (3) an online glossary to view definition of terms coupled with high-quality photographs; and (4) a dynamic introduction to pathophysiology using interactive animation sequences. The authors were able to incorporate the same interactive features into the CD-I version. High-quality medical illustrations can be used effectively on the CD-I platform. CONCLUSIONS: Computer-based multimedia workstations are relatively expensive for personal use but may be useful if the equipment can be shared in a learning center or library. Compared with interactive computer-based solutions, consumer-oriented television-based technology such as CD-I is a relatively inexpensive vehicle for providing continuing medical education programs intended for use in the individual practitioner's office or home.

Compact Disks↗

1,25-Dihydroxyvitamin D3 (calcitriol) suppresses IL-2 induced murine thymocyte proliferation.

1,25-dihydroxyvitamin D3 (Calcitriol) inhibits mitogen stimulated T cell proliferation by blocking the production of Interleukin-2 (IL-2). The present study was initiated to determine whether the action of calcitriol was limited only to inhibition of IL-2 production, or if it influenced other events as well. To avoid the use of lectins, thymocytes from CD-I Swiss mice were chosen, which proliferate in response to Interleukin-I (IL-I) or IL-2 without the addition of lectins. Calcitriol inhibited (80-90%) IL-I induced CD-I mouse thymocyte proliferation, whereas 25-OH-D3 was ineffective. Further addition of IL-I failed to overcome this suppression. Surprisingly, calcitriol also inhibited IL-2 induced thymocyte proliferation (60-80%). Further addition of IL-2, in the presence of calcitriol, was ineffective in enhancing thymocyte proliferation. Similar results were obtained with C57BL/10 mouse thymocytes. Additional studies excluded the possibilities that calcitriol mediated inhibition was due to calcitriol IL-2 binding or damage to thymocytes by calcitriol. Thus, calcitriol not only blocks IL-2 production, but these results strongly suggest, that it also interferes with IL-2-thymocyte interaction, which in turn results in inhibition of thymocyte proliferation.

Animals↗

Skin papillomas and other neoplasms induced by murine sarcoma viruses in mid-gestation-infected mice.

During extensive investigations on the effects of oncogenic retroviruses in developing rodents, the ability of MSV to mount a neoplastic response in CD-I Swiss mouse embryos was determined. By infecting the animals directly in utero at selected stages of post-implantation development, we detected a peculiar reaction of the embryonal tissues to certain MSVs: when mice were exposed to KiMSV at mid-gestation, the newborn developed characteristic tumors, in addition to mesenchymal cell sarcomas, not induced in fetuses and neonates. These included pulmonary alveologenic tumors and skin papillomas and were seen in mice infected on days 8 and 10 of pregnancy, roughly corresponding to 15 and 35 somites, respectively. To determine the specificity of these events, other 8- and 10-day-old embryos were infected with retroviruses of the same or different families. HaMSV and MoMSV also induced mesenchymomas and a low incidence of skin papillomas (10% and 15% compared to 40% in the KiMSV group) but not pulmonary tumors. In contrast, FBRMSV was inactive in this respect and only osteogenic sarcomas were detected in the offspring. Infecting the embryos on day 7 of pregnancy produced no tumors. Later infections (in 15-day-old fetuses and neonates) mainly induced mesenchymal sarcomas. No congenital malformations were detected in the embryos exposed to MSV during organogenesis, although some abortions and resorptions were seen.

Animals↗

Activation of phospholipases during masculine differentiation of embryonic genitalia.

We have investigated whether the androgen-induced masculine differentiation of the sex organs involves an induction of phospholipases. We have measured phosphatidylinositol-specific phospholipase C and phosphatidylcholine-specific phospholipase A2 in the reproductive tract of male and female mouse (CD-I) fetuses at the 18th day of gestation. We report here that (1) the activity of these two enzymes is higher in the male genitalia than in the female genitalia; (2) exogenous testosterone at the 13th to 17th day of pregnancy induces both phospholipase A2 and phospholipase C in the female fetal genitalia; and (3) prenatal administration of cyproterone acetate, an antiandrogen, known to produce feminized males, completely prevents the stimulation of phospholipase A2 and C by testosterone in the female fetuses. In the male fetuses, however, cyproterone acetate inhibits the PLC activity but is unable to alter phospholipase A2 activity. These findings provide evidence that the mechanism by which testosterone organizes the genitalia may involve a modification of phospholipases A2 and C.

Animals↗

Investigation of the role of Von Korff fibers during murine dentinogenesis.

The existence and significance of Von Korff fibers during early dentinogenesis are still very controversial. The purpose of the present study was to re-examine the questions of the existence, nature and significance of Von Korff's fibers using light microscopy and immunohistochemistry. Specimens were obtained from 3 days-old CD-I mice and mandibles were carefully dissected under constant irrigation and immediately fixed in 10% neutral buffered formalin for light microscopy. Sections were treated or not with collagenase prior to silver staining. For immunohistochemistry, specimens were fixed in 95% ethanol and embedded in paraffin. Sections were reacted with goat anti-human-bovine type I or type III collagen and a rhodamine (RITC) labelled rabbit anti-goat IgG was then reacted as a secondary antibody. Slides were then examined under a Zeiss II photomicroscope equipped with epifluorescence. Our results have confirmed the presence of argyrophilic material concentrated at the periphery of the dental papilla and stretching from the subodontoblastic layer to the future dentino enamel junction. The distribution of type III collagen was very similar to the distribution of the silver staining at the cervical loop area. Type I collagen distribution was different and concentrated in areas where odontoblasts were fully differentiated. Our study showed that Von Korff fibers are not artefactual. We have established the presence of an apical compartment containing type I collagen fibers and a basal compartment containing type III collagen to explain the image of continuous silver staining crossing the entire thickness of the odontoblast layer.

Animals↗

Effects of dexamethasone on the development of radiation nephropathy in the rat.

Low-dose, chronic administration of the synthetic glucocorticoid, dexamethasone, to male CD-I rats in the drinking water or by osmotic minipumps implanted subcutaneously after supralethal irradiation of the kidneys (20 Gy) was studied. The effectiveness of treatment with dexamethasone in the drinking water at concentrations of 23 micrograms/l to 188 micrograms/l and treatment times varying from 33 to 166 days was evaluated. At monthly intervals kidney function was assayed by measuring the clearance of 51Cr-ethylenediaminetetraacetic acid. All dexamethasone treatment regimens increased survival times significantly and delayed the development of kidney dysfunction. The most effective combination of concentration of dexamethasone in drinking water and treatment interval after irradiation with respect to survival was 94 micrograms/l and 88 days. However, a slightly longer survival and a better functional result was obtained if an equivalent amount of dexamethasone was administered by minipumps. Shielding the adrenal glands during kidney irradiation did not prolong survival. This shows that the beneficial effect of dexamethasone is not due to compensation for reduced adrenal glucocorticoid production resulting from concomitant exposures of these glands during kidney irradiation.

Adrenal Glands↗

Effects of nicotine on murine incisor development.

The effects of daily injections of nicotine sulfate on incisor development in CD-I mice were studied. Pregnant animals, injected with 0.1% nicotine sulfate at a dose of 1.67 mg/kg body weight from the 6th to the 15th day of gestation, were sacrificed on the 18th postcoital day. The 130 nicotine treated fetuses, as well as the 348 control fetuses were embedded in paraffin and sectioned in the frontal plane. The developing incisors of the experimental fetuses were retarded, less differentiated, and reduced in breadth and length. The developing incisors of the control fetuses were in the early appositional stage of odontogenesis, whereas those of the experimental population were either in the late cap or early bell stage, depending on the presence or absence of palatal cleft, which occurred in 9.6% of the fetuses.

Ameloblasts↗

Neonatal development altered by maternal sulfur dioxide exposure.

Sulfur dioxide (SO2) is one of the commonly encountered environmental contaminants. Experiments were carried out to test for neonatal behavioral alterations associated with maternal SO2 exposure. Pregnant CD-I mice were exposed to 0, 32, or 65 PPM SO2 in environmental chambers from gestation day 7 to 18 (plug = day 1). The SO2 air flow was set at 500 ml/min. Food and water were available at all times. The dams were allowed to deliver and neonatal behavioral development of the pups was studied. Maternal SO2 exposure did not affect the mean number of live pups born/litter; however, the exposure at the high level significantly decreased the mean pup weight on day 1 of birth. SO2 exposure at both levels significantly increased the time required for the righting reflex on day 1 of birth and negative geotaxis on day 10 of birth. The SO2 exposure did not affect the aerial righting score of the pups on day 12 of birth. The data suggest that maternal SO2 exposure can affect the neuromuscular coordination and may produce deficits in the functional capability of the developing offspring. The functional deficits appear to be associated with the birth weight of the offspring.

Animals↗

Immune insulitis and antibodies to nucleic acids induced with streptozotocin in mice.

Streptozotocin (STZ), a known beta cell toxin, given in a single injection of either a high (100 mg/kg body weight) or a low dose (60 mg/kg body weight) to young (45 days old) CD-I mice induced permanent hyperglycaemia which led to insulin-dependent diabetes (IDD). Further study, however, revealed that the course of the disease was strikingly different between the groups. The average latent period of the high-dose group (n = 20) before the development of hyperglycaemia was only 3 days while that of the low-dose group was 7 weeks (n = 30). Islets of pancreas in the high-dose group showed extensive acute necrosis of the islets with only two out of 20 showing limited mononuclear cell infiltration. In contrast, 20 out of 30 mice in the low-dose group had 45% of their islets heavily infiltrated with mononuclear cells (P less than 0.001). In addition, the deposition of IgG was found in 40% of the islets in 23 out of 30 mice in the low-dose group, in contrast to only two out of 20 in the high-dose group (P less than 0.005). The incidence of antibody to nucleic acids, polyadenylic-polyuridylic acid, polyinosinic-polycytidylic acid, single-stranded DNA and anti-nuclear antibody was significantly higher in the low-dose group as compared to the high-dose group or controls (P less than 0.01). Since the findings in the low-dose group are similar to pathological and serological changes reported in man with recent-onset IDD, this model should be of value in the study of the pathogenesis of this disease.

Animals↗

Killed vaccine in adjuvant and protection of mice against an intraperitoneal challenge of Brucella: kinetic studies.

CD-I female mice were immunized with a subcutaneous injection of heat-inactivated Brucella melitensis (strain 53 H 38) incorporated into a water-in-oil emulsion. One month later, the effectiveness of this immunization was investigated by studying quantitatively in the spleen the fate of an intraperitoneal challenge inoculum of approximately I X 10(6) viable B. abortus strain 544. In unvaccinated mice, the number of viable challenge bacteria increased until about the 10th day, decreased and then remained at a nearly constant level. In animals vaccinated with a suitable dose of inactivated Brucella in adjuvant, the number of challenge organisms decreased on the first two days, then increased, but remained at a lower level than that found in control animals; the spleens of control animals reached higher weights than those of vaccinated ones. The effect of graduated doses of challenge on immunized mice was investigated: the splenic infection diminished sooner when the challenge dose was weaker. The findings are discussed in relation to the methods used to test the potency of Brucella vaccines.

Adjuvants, Immunologic↗

Using interactive videos in general practice to inform patients about treatment choices: a pilot study.

Our objective was to assess the acceptability of using an interactive video system in a general practice setting to inform patients about treatment choices. A descriptive cohort study was carried out in eight general practices in Oxfordshire. Fifty-four patients with mild hypertension and 29 with benign prostatic hypertrophy were studied. Patients' views of the video, treatment preference, level of involvement in treatment decision and satisfaction with decision-making process and GPs' views of the effect of the video on subsequent consultations were measured. Both patients and GPs reported favourable impressions of the interactive video system: 71% of patients said it definitely helped with their treatment decision; GPs said they found the video helpful in 82% of cases. The results of this pilot study were sufficiently encouraging to indicate the need for a randomized controlled trial to evaluate the impact of the video on the doctor-patient relationship, on subsequent treatment decisions and on health outcomes and patients' well-being.

Aged↗

Using interactive multi-media to teach the anatomy and pathology of the temporo-mandibular joint.

An interactive multi-media courseware on the Temporo-mandibular Joint is presented. All the latest technological innovations are integrated into this document to make the learning process more enjoyable for the user. We believe that the complex anatomy and physiology of this joint, and mostly its various disorders will be better understood with this interactive multi-media approach. The courseware is intended for continuing education in dentistry and medicine.

Anatomy↗

"Informed consent" interactive videodisc for patients having a colonoscopy, a polypectomy, and an endoscopy.

These "informed consent" interactive videodisc programs use both graphic and live action sequences to describe in detail the diagnostic procedures of Endoscopy, Colonoscopy, and Polypectomy. Both benefits and possible risks are listed and described. After each sequence, the patient is asked whether the explanation is understood and/or whether the patient would like to discuss the procedure in more detail with a physician. The programs were designed for use with marginally literate patients and require no reading ability. Both programs are also ideal for general patient education.

Analog-Digital Conversion↗

Learning medical and dental sciences through interactive multi-media.

Health professionals in various fields of Medicine and Dentistry must acquire comprehensive technological knowledge in order to practice their professions. A large portion of that knowledge cannot be found in a textbook. Examples of this type of information are data gleaned from viewing microscopic slides and dissecting cadavers. In order to fully comprehend an area of study in medicine, the student relies on various resources (often physically unrelated, like the x-ray department and the dissection room). This situation makes the teaching and learning processes much more difficult to accomplish, since the instructor and students have to manipulate multiple media and take the courses in various sites. Today's technology allows us to design and create teaching and learning tools that can alleviate these difficulties. Personal computers are now used to capture and display a vast array of information through many different media: text, sound, images, photographs, illustrations, animation and video. This information can be presented to the user with audio-visual interfaces designed to facilitate efficient communication of ideas. It is controlled primarily by the use of the mouse, at one's own pace. This interactive, multi-media approach to teaching and learning is called "Edutainment" (Education and Entertainment). This demonstration will show how these new tools are used to teach and learn about various subjects related to Medicine, particularly in Dermatology and Dentistry. Several courseware applications were developed, addressing various aspects of the field: Cancers of the Skin, Dental Development, the Temporomandibular joint, the Masticatory Muscles etc. These programs provide anthropological data on growth collected through longitudinal research, diagnosis and treatments of pigmented lesions of the skin, thousands of digitized x-rays accessible through a relational database, the latest imaging technology used to diagnose the temporomandibular disorders, high-quality photographs of dissecting room material of the head and neck region, 3-dimensional animation of physiological principles of the temporomandibular joint movements, digital video of examination techniques, and other valuable resources to the user. The software were developed for both platforms, Macintosh and PC/Compatible, and all of them are in English and French, with some titles available in Spanish. To facilitate their distribution and usage, they were written to hybrid CD-ROMs, i.e., one CD-ROM was produced for each application, containing versions for both platforms in all languages. The CD-ROMs were recorded in our premises. During the presentation, the technical aspects of the development and production of a Multi-media document will be discussed along with the scientific content of the CD-ROM.

CD-I↗