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The microcomputer and image analysis in diagnostic pathology.

This paper presents a snapshot view of the influence and direction of microcomputer technology for image analysis techniques in diagnostic pathology. Microcomputers have had considerable impact in bringing image analysis to wider application. Semi-automated tracing techniques are a simple means of providing objective data and assist in a wide range of diagnostic problems. From the common theme of reducing subjectivity in diagnostic assessment, an extensive body of research has accrued. Some studies have addressed the need for quality control for reliable, routine application. Video digitizer cards bring digital image analysis within the reach of laboratory budgets, providing powerful tools for investigation of a wide range of cellular and tissue features. The use of staining procedures compatible with quantitative evaluation has become equally important. As well as assisting scene segmentation, cytochemical and immunochemical staining techniques relate the data to biological processes. With the present state of the art, practical use of microcomputer based image analysis is impaired by limitations of information extraction and specimen throughput. Recent advances in colour video imaging provide an extra dimension in the analysis of multi-spectral stains. Improvements will also be felt with predictable increase in speed of microprocessors, and with single chip devices which deliver video rate processing. If the full potential of this hardware is realized, high-speed, routine analysis becomes feasible. In addition, a microcomputer imaging system can play host to companion functions, such as image archiving and transmission. With this outlook, the use of microcomputers for image analysis in diagnostic pathology is certain to increase.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals

Three-dimensional graphical reconstruction from HVEM stereoviews of biological specimens by means of a microcomputer.

A microcomputer reconstruction technique has been developed in order to permit a larger exploitation of stereomicroscopy. The microcomputer facility consists of a digitizing tablet, a microcomputer, a graphics terminal, a graphics plotter and a printer. The technique has been applied to the study of HVEM stereopairs, performed by recording two images of the same area of a specimen (thick section of araldite-embedded leech ganglion neurons), tilted relative to the beam axis through an angle 0/20 degrees. Coordinates of N conjugate points of interest, expressed in a common reference system were obtained with the help of a digitizing tablet and the misorientation between the two images was determined by a method based on a least square technique. New projections of the object on different planes are provided by the microcomputer facility. Also the microcomputer method permits to obtain new stereopairs drawings, in various orientations and slices from a three-dimensional reconstruction of the object oriented in any direction in space. The method permits to obtain computed anaglyph drawings, printed here, which are stereoviews of the same object.

Animals

Rapid evolution of microcomputer use in a faculty of health sciences.

OBJECTIVE: To assist with educational planning we surveyed health sciences faculty members in 1989 to determine their use of microcomputers, desire for further instruction and perceptions on what microcomputer services should be provided for students. The 1989 results were compared with those of a similar survey performed in 1986. DESIGN: A self-completed, mailed questionnaire, with up to three reminders. SETTING: Faculty of Health Sciences, McMaster University, Hamilton, Ont. PARTICIPANTS: All full-time (FT) and part-time (PT) faculty members were sent the questionnaire; over 80% of the FT and 65% of the PT faculty members responded in 1986 and in 1989. RESULTS: The proportions of faculty members who used microcomputers increased significantly over the 3 years, from 71% to 87% among FT members (p = 2.2 x 10(-8)) and from 48% to 69% among PT members (p = 4.9 x 10(-8)). There were significant increases in the use of many of the applications, especially database and filing uses (from 10% to 41% among FT members [p less than 1 x 10(-9)] and from 6% to 34% among PT members [p less than 1 x 10(-9)]) and on-line access to bibliographic databases (from 7% to 37% among FT members [p less than 1 x 10(-9)] and from 3% to 18% among PT members [p less than 1 x 10(-9)]. These changes occurred mainly through individual initiative and voluntary continuing education. CONCLUSIONS: The extraordinary rate of adoption of microcomputers attests to their perceived usefulness. Curriculum planners need to consider how the success of microcomputer applications can be evaluated objectively and how successful applications can be integrated into educational programs.

Attitude of Health Personnel

Empirical tests of the intrinsic pseudorandom number generator on IBM-compatible microcomputers.

This paper reports results of frequency and serial correlation tests, for 30 different seeds and two different seeding mechanisms (the RANDOMIZE statement and the RND function), of a Microsoft pseudorandom number generator available on IBM-compatible (and some IBM) microcomputers. The generator is shown to perform well on these screening tests, in comparison to previously reported results for the Microsoft generator available on IBM-PC microcomputers. However, the generator seeding mechanisms--the RANDOMIZE statement and the RND function--exhibit anomalies similar to those of the IBM-PC generator, and could result in seeding which is inconsistent with the desire of the user. Furthermore, the differences in the randomness characteristics of sequences of numbers generated by IBM and IBM-compatible microcomputers have serious implications regarding the true compatibility of the two types of microcomputers.

Mathematical Computing

Multidimensional assessment of the elderly via a microcomputer: the SENOTS program and battery.

We compared the psychometric adequacy of a multidimensional self-report battery for use with cognitively able, elderly adults under conditions of microcomputer and interviewer administration. The SENOTS battery contains scales of Happiness/Depression, Financial Hardship, Physical Symptoms, Activity Limitation, and Activity Propensity. The SENOTS microcomputer program contains sequential phases intended to (a) select out respondents incapable of interacting adequately with the microcomputer, (b) train respondents to make appropriate keyboard responses. (c) administer the program, and (d) store and process the responses. The SENOTS battery was administered to 80 community residents and 80 institution residents by either a microcomputer or an interviewer. Results indicated a comparable psychometric adequacy to the SENOTS battery under both administration conditions. Internal consistencies were all at acceptable levels, and the scales differentiated the community residents from the institution residents.

Activities of Daily Living

Development of a microcomputer-based system to quantify the effective dose of drug through epithelial cells.

It is well documented that the rate-limiting step of pharmaceutical investigation is the amount of drug absorbed through the epithelial cells, not the total dose taken. To date, the only measure of the effective dose of medication is by measuring the circulating level of the ingested medication. This mode of measurement is neither accurate nor practical in determining the active ingredient required. However, a more efficient method of testing which constitutes simplicity and practically is desired. The aim of this project was the design of a microcomputer-based system for detecting and quantifying steroid hormones taken up by mucosal intestinal cells in vitro, for eventual in vivo application in animals and humans. A microcomputer-based system capable of controlling and monitoring four cell membranes simultaneously has been designed, consisting of a microcomputer system and a data acquisition subsystem. The data acquisition subsystem consists of instrumentation amplifiers with an analog-to-digital converter and digital-to-analog converter. This subsystem converts the ionic exchanges first to electrical signals, and then to digital format, to be processed and stored by the microcomputer. Subsequently, the stored information can be clinically interpreted. Due to the complexity of membrane behavior (nonlinear) in response to feedback control signals, software development was difficult. Therefore, a unique scheme was developed to control various unexcitable tissues in order to reach the predetermined values very rapidly, and then to collect cell membrane data periodically.

Drug Monitoring

Comparison of six microcomputer dietary analysis systems with the USDA Nutrient Data Base for Standard Reference.

We compared the general operating features and nutrient databases of six microcomputer dietary analysis systems. A 3-day food record with 73 food items was entered into each program; nutrient averages were compared with the US Department of Agriculture Nutrient Data Base for Standard Reference (USDA NDB), full version, release 9, for microcomputers. The six programs were found to vary widely in cost, number of foods and nutrients in the database, use of non-USDA data and imputation of data for missing values, number of print/export options, time to analyze the 3-day food record, and overall ease of use. Although all of the microcomputer dietary analysis systems were within 7% of the USDA NDB for energy, protein, total fat, and total carbohydrates, the proportion of other nutrients varying more than 15% from the USDA NDB varied considerably between programs. Variance among programs for 3-day food record nutrient values occurred because of differences in the number of food items included in the database (leading to varying degrees of substitution), the recency of the nutrient data (whether or not the most recent USDA releases had been incorporated), and the number of missing values (the degree to which non-USDA sources or estimated calculations were used to fill in the blanks from the USDA standard). Our results demonstrate that it is important for each dietitian to carefully choose a microcomputer dietary analysis system that is suitable to specific and predetermined needs.

Databases, Factual

Automated measurement of transplantable solid tumors using digital electronic calipers interfaced to a microcomputer.

Data collection for transplantable solid tumors has been automated with electronic digital calipers and a balance which have been coupled through an RS-232 interface to a microcomputer. BASIC programs handle data entry, calculations and data storage. A "PROTOCOL" program accepts keyboard input of sample name, notebook number, submitter and dose along with necessary information on tumor system, and then initial animal weights for treatment groups are sent from balance to computer. Data is stored as an ASCII file on floppy disks, and protocol reports are printed. When the test is to be measured, a "MEASURE" program prompts the user for keyboard entry of toxic deaths in each group. Then the computer requests input of width and length of tumors for each animal. These tumor dimensions are sent to microcomputer by pressing a button on the calipers. When a group is completed, final animal weights are sent from balance to microcomputer. Then tumor weights and percent inhibition as compared to appropriate control groups are calculated, and the data is appended to the file for that test. A hard copy is generated as tumors are measured, and reports including percent inhibition can be printed immediately after a test is measured. The data as an ASCII file is transferred via modem to mainframe computer, where another program transfers the information to a database management program. These automated procedures for tumor measurement save time and lessen the chance for error by eliminating manual recording of solid tumor dimensions and subsequent reentry of this data for calculation.

Animals

Nonlinear least-squares regression programs for microcomputers.

Nonlinear least-squares regression can be performed on a microcomputer with BASIC language capability and 8K or more bytes of random access memory. At least five nonlinear regression programs written in BASIC exist, two of which have been implemented on microcomputers. These programs and some of their characteriscics are described. Advantages and disadvantages of performing nonlinear regression on microcomputers are contrasted with use of nonlinear regression programs requiring large computers.

Computers

A microcomputer system for on-line monitoring of pulmonary function during artificial ventilation.

Standard monitoring of the artificially ventilated patient in the intensive care unit (ICU) and during anaesthesia includes repeated determinations of arterial blood gases, airway pressure and expired volume. However, there is a need for more extensive monitoring of the critically ill ventilator treated patient, and this is possible by better utilization of modern technology. Information on a variety of variables related to both pulmonary mechanics and gas exchange has long been accessible in the lung-function laboratory. Small, inexpensive microcomputers (PCs), accurate and fast bedside monitors and modern ventilators have also made this information directly available to the ICU staff. This paper describes a microcomputer (PC-XT) system for on-line bedside monitoring of pulmonary function. The microcomputer receives airway pressure, gas-flow and timing signals from the ventilator and signals for carbon dioxide concentration from an infrared analyzer. Data related to pulmonary mechanics and gas exchange are derived and displayed on the computer screen, both numerically and as graphs. In studies of ten artificially ventilated patients the coefficients of variation (CV) were below 10% for directly obtained variables (tidal volume, airway pressure, end-tidal and mixed expired carbon dioxide, carbon dioxide production, airway dead space), whereas the derived variables (compliance, phase III carbon dioxide slope) were associated with greater variability, with CVs ranging from 1.3 to 24% (median 6.25% and 8.65% respectively). The accuracy in estimating dead space variations was checked in two ventilator-treated patients by adding known dead space volumes. Simple regression analysis yielded an r value of 0.98 indicating adequate correctness of measurements and calculations.

Airway Resistance

Adding a microcomputer bar-code network to a minicomputer-based radiology information system.

A bar-code terminal network under software control of a microcomputer was added to the minicomputer-based radiology information system at the Medical College of Georgia in Augusta. The bar-code network was specifically installed to address the inherent inaccuracies occurring when procedure information was entered at the time of registration before procedures were actually performed. Technologists now enter procedure data into bar-code terminals after procedures are performed, substantially reducing database errors. This approach allowed us to take advantage of a microcomputer product without the necessity of completely converting our highly customized information system software from mini-to microcomputer.

Electronic Data Processing

Microcomputer-assisted transmission of disaster data by cellular telephone.

Voice communication of information during disasters is often inadequate. In particular, simultaneous transmission by multiple callers on the same frequency can result in blocked transmissions and miscommunications. In contrast, nonvoice transmission of data requires less time than does voice communication of the same data, and may be more accurate. We conducted a pilot study to test the feasibility of a microcomputer assisted communication (MAC) network linking the disaster scene and the command hospital. The radio chosen to transmit data from the field disaster site to the command hospital was a cellular telephone connected to the microcomputer by modem. Typed communications between the microcomputer operators enabled dialogue between the disaster site and the hospitals. A computer program using commercially available software (Symphony by Lotus, Inc.) was written to allow for data entry, data transmission, and reports. Patient data, including age, sex, severity of injury, identification number, major injuries, and hospital destination were successfully transmitted from the disaster site command post to the command hospital. This pilot test demonstrated the potential applicability of MAC for facilitating transmission of patient data during a disaster.

Computer Communication Networks

Tabletop versus microcomputer-assisted speech management: response evocation phase.

This is the third in a series of studies on the use of microcomputers with speech-delayed children. Two repeated-measures designs (n = 15) and five case studies were completed to compare tabletop management at early and late stages of the response development phase with two comparable, computer-assisted drill-and-practice activities. Discrimination of correct articulatory responses was mediated by the clinician in all modes, rather than by speech recognition hardware, but all contingent reinforcement in the computer modes was presented by animation graphics. The two computer modes were identical except for the addition of fantasy involvement in one of the modes. Findings indicated that the three modes of intervention were equally effective, efficient, and engaging. Subject-level analyses suggested that microcomputer software has excellent potential to engage children in drill-and-practice for late-phase response evocation, when the target sound is stimulable, but limited usefulness with young children at early-phase response evocation, when specific articulatory behaviors need to be cued. Discussion considers learning, child, and hardware/software factors in microcomputer-assisted speech management.

Child

Uses and limitations of microcomputers for epidemiological research in occupational health.

The rapid improvements in microcomputer systems have contributed to ease of performance of epidemiological research in occupational health. Computers now available can aid in all stages of research- from the early stages of literature review to data collection, analysis and presentation. Optical storage devices now allow large occupational health data bases to be stored on a single compact disc, with the information accessible by microcomputer. Hand-held computers and optical scanners allow paperless collection of field data. Epidemiological analysis and data presentation is easily done with software packages, some of which are in the public domain. However, there are limitations in the use of computers for any epidemiological research. Investment of time is required to learn the use of a computer. Care needs to be taken to ensure accurate data entry, and correct choice has to be made of methods for subsequent statistical analysis. Microcomputers are valuable as labour saving devices, but cannot replace proper planning, execution and appropriate data analysis in epidemiological research in occupational health.

Health Services Research

[Effects of noise on sleep. Part 1. Development of an automatic analysing system for all-night sleep polygraphy by microcomputer].

In order to assess the effects of noise on sleep, the authors have developed a microcomputer system which determines the sleep stage based on an all-night EEG (electroencephalogram), rapid eye movement and an EMG (electromyogram). All the polygraphic parameters for each epoch (including spindle, rapid eye movement, alpha and delta waves, and amount of muscle tension), which are necessary to determine the sleep stage, were determined by a microcomputer using a digital data processing program. Recognition of EEG waves is based on Fujimori's method with some modifications. The rules of Rechtschaffen et al. were adopted for judging sleep stage with a slight modification. Data were obtained from six healthy students of a university. Each student was polygraphed for five to six nights under various conditions of noise exposure. Judgements of the sleep stage were made by two medical doctors. Using randomly selected 10 nights' data, the agreement between judgements by the microcomputer system and by the doctor was 77%. The percentage of agreement increased to 84% for the epochs in which the two doctors agreed. It takes about one hour to determine all-night sleep stages by this system.

Adult

A microcomputer-photocell system to monitor periparturient activity of sows and transfer data to remote location.

A microcomputer-photocell system to record, summarize and transfer data on the postural changes of crate-confined sows was developed. The system uses an infrared photocell system mounted on farrowing crates to detect changes in sow body postures prior to parturition. When a sow breaks the infrared beam by standing or sitting, the lack of reflection back to the photocell activates a relay. The relays are connected to an input/output card inside the primary ("host") microcomputer. A second microcomputer, at a location remote to the animal facility, and the host computer both are equipped with multi-tasking operating systems. The host computer uses a data acquisition program written in BASIC to record posture changes, the sow's identifying number, date and time. Both computers are equipped with communications software so that the host computer can transfer data to the remove location while continuing to collect data. Either computer can be used to summarize, graph and examine the accumulated data. Knowledge of periparturient activity patterns allows the observer to predict farrowing time and to determine whether farrowing has begun without being present in the farrowing facility.

Animals

Microcomputers enhance student health fairs.

To stimulate student interest in learning about health, faculty assigned students the task of planning and implementing a university health fair. Two questions were posed: (1) Could sophomore students effectively plan and implement a health fair as a learning opportunity? (2) Could microcomputers be used appropriately to influence client participation and to enhance the nurse-client interactions? Literature regarding the efficacy of the health fair as a mode of health care delivery and as a student learning opportunity and literature addressing the advantages of microcomputer use were reviewed. Two health fairs were piloted. Microcomputers were employed in three areas: nutrition, stress, and substance abuse. Students, with faculty guidance, developed educational materials using principles of teaching, learning, and health promotion. Clients rated the health fair as congruent with their health needs. Students identified learning gained from the experience. Students and clients were receptive to computer use. Future directions are discussed.

Community Participation

Microcomputer applications in allied health education: some new alternatives.

Allied health educators should consider that today low-cost microcomputer hardware and software that can significantly enhance the efficiency and effectiveness of teaching are available. These alternative educational applications of microcomputer technology in allied health can be developed by faculty themselves without programming or reliance on computing experts. Such applications include word-processing software for creation and revision of syllabi, exams, and handouts; data base management software for creation of large sets of bibliographic references, storage and retrieval of data on student admissions and matriculation, and management of clinical affiliations; spreadsheet software for preparation of budgets, calculation of student grades and test item analyses, and demonstration of physiologic and biologic phenomena; and graphics software for production of graphs and charts and printing of graphic images. These instructional support uses of microcomputers hold the greatest promise for near-term cost benefit in allied health education.

Audiovisual Aids