数字化手术室的开发和建设

数字化手术室属于信息技术与医学技术的交叉点。从目前的应用环境来看。将实时数据监测与查询和远程医学影像技术相结合，应用到手术室环境中，具有重要意义。数字化手术室的开发和建设，是利用先进的远程会议技术和图像处理技术，集成了HIS和PACS信息，提高了医院临床教学水平，同时提高了医生手术效率和安全性。     

Transient loss of resistance to pulmonary tuberculosis in p47(phox-/-) mice

Mycobacterium tuberculosis is an important respiratory pathogen the growth of which is controlled primarily by cytokine-activated macrophages. One of the principal mediators of this control is nitric oxide; however, superoxide has recently been shown to be protective in systemic mycobacterial infections. To determine whether superoxide is important in controlling M. tuberculosis during primary pulmonary infection, mice lacking the cytosolic p47(phox) gene (which is essential for effective superoxide production by the NADPH oxidase) were infected aerogenically. The lack of superoxide during an aerosol infection with M. tuberculosis resulted in a significant increase in bacterial growth over the early period of infection. Once antigen-specific gamma interferon-producing lymphocytes were detected in the draining lymph nodes, however, bacterial growth in the lung stopped. One interesting consequence of the lack of superoxide was an increase in neutrophilic infiltrates within the granuloma. This may be a consequence of increased tissue damage due to more rapid bacterial growth or may reflect a role for superoxide in controlling inflammation.     

An edge spread technique for measurement of the scatter-to-primary ratio in mammography

An experimental measurement technique that directly measures the magnitude and spatial distribution of scatter in relation to primary radiation is presented in this work. The technique involves the acquisition of magnified edge spread function (ESF) images with and without scattering material present. The ESFs are normalized and subtracted to yield scatter-to-primary ratios (SPRs), along with the spatial distributions of scatter and primary radiation. Mammography is used as the modality to demonstrate the ESF method, which is applicable to all radiographic environments. Sets of three images were acquired with a modified clinical mammography system employing a flat panel detector for 2, 4, 6, and 8 cm thick breast tissue equivalent material phantoms composed of 0%, 43%, and 100% glandular tissue at four different kV settings. Beam stop measurements of scatter were used to validate the ESF methodology. There was good agreement of the mean SPRs between the beam stop and ESF methods. There was good precision in the ESF-determined SPRs with a coefficient of variation on the order of 5%. SPRs ranged from 0.2 to 2.0 and were effectively independent of energy for clinically realistic kVps. The measured SPRs for 2, 4, and 6 cm 0% glandular phantoms imaged at 28 kV were 0.21+/-0.01, 0.39+/-0.01, and 0.57+/-0.02, respectively. The measured SPRs for 2, 4, and 6 cm 43% glandular phantoms imaged at 28 kV were 0.20+/-0.01, 0.35+/-0.02, and 0.53+/-0.02, respectively. The measured SPRs for 2, 4, and 6 cm 100% glandular phantoms imaged at 28 kV were 0.22+/-0.02, 0.42+/-0.03, and 0.88+/-0.08, respectively.     

Genetic analysis, phenotypic diagnosis, and risk of venous thrombosis in families with inherited deficiencies of protein S

Protein S deficiency is a recognized risk factor for venous thrombosis. Of all the inherited thrombophilic conditions, it remains the most difficult to diagnose because of phenotypic variability, which can lead to inconclusive results. We have overcome this problem by studying a cohort of patients from a single center where the diagnosis was confirmed at the genetic level. Twenty-eight index patients with protein S deficiency and a PROS1 gene defect were studied, together with 109 first-degree relatives. To avoid selection bias, we confined analysis of total and free protein S levels and thrombotic risk to the patients' relatives. In this group of relatives, a low free protein S level was the most reliable predictor of a PROS1 gene defect (sensitivity 97.7%, specificity 100%). First-degree relatives with a PROS1 gene defect had a 5.0-fold higher risk of thrombosis (95% confidence interval, 1. 5-16.8) than those with a normal PROS1 gene and no other recognized thrombophilic defect. Although pregnancy/puerperium and immobility/trauma were important precipitating factors for thrombosis, almost half of the events were spontaneous. Relatives with splice-site or major structural defects in the PROS1 gene were more likely to have had a thrombotic event and had significantly lower total and free protein S levels than those relatives having missense mutations. We conclude that persons with PROS1 gene defects and protein S deficiency are at increased risk of thrombosis and that free protein S estimation offers the most reliable way of diagnosing the deficiency. (Blood. 2000;95:1935-1941)     

Non-invasive assessment of phonatory and respiratory dynamics.

Evaluation of vocal pathology and the accompanying dysphonia should include an assessment of laryngeal structure and mobility as well as respiratory dynamics. Laryngeal structure is best observed through laryngoscopy which provides an accurate assessment of the tissues and their mobility. Respiratory measures of lung volume, air-flow and pressure, and breathing dynamics are typically determined via spirometry and pneumotachography. While the above are traditional invasive procedures which interfere with normal speech production, recent advances in electronic technology have resulted in the development of non-invasive procedures to assess phonatory and respiratory dynamics. These procedures, when used as an adjunct to laryngoscopy, can provide information that is useful in the diagnosis and management of vocal tract dysfunction. The Laryngograph and Computer-Aided Fluency Establishment Trainer, described here, are examples of this new technology.