Initial evaluation of a continuous speech recognition program for radiology

The aims of this work were to measure the accuracy of one continuous speech recognition product and dependence on the speaker's gender and status as a native or nonnative English speaker, and evaluate the product's potential for routine use in transcribing radiology reports. IBM MedSpeak/Radiology software, version 1.1 was evaluated by 6 speakers. Two were nonnative English speakers, and 3 were men. Each speaker dictated a set of 12 reports. The reports included neurologic and body imaging examinations performed with 6 different modalities. The dictated and original report texts were compared, and error rates for overall, significant, and subtle significant errors were computed. Error rate dependence on modality, native English speaker status, and gender were evaluated by performing ttests. The overall error rate was 10.3 +/- 3.3%. No difference in accuracy between men and women was found; however, significant differences were seen for overall and significant errors when comparing native and nonnative English speakers (P = .009 and P = .008, respectively). The speech recognition software is approximately 90% accurate, and while practical implementation issues (rather than accuracy) currently limit routine use of this product throughout a radiology practice, application in niche areas such as the emergency room currently is being pursued. This methodology provides a convenient way to compare the initial accuracy of different speech recognition products, and changes in accuracy over time, in a detailed and sensitive manner.     

Limited posterior thoracotomy for the correction of intra cardiac anomalies–current perspectives

Background Though the use of median stermotomy has been fairly standardized for the approach to the heart and great vessels, since the advent of cosmetically appealing incisions, thoracotomy has come to be a justifiable alternative incision. This paper presents our experience with this approach and the advantages over the conventional approach as well as over other incisions for the correction of intra-cardiac anomalies. Methods 93 patients underwent open cardiac procedures using the posterior thoracotomy approach since June 1997 to December 2000. There were 69 patients with ostium secundum atrial septal defects and 12 patients with sinus venous defects. Other anomalies included perimembranous ventricular septal defects in 3 patients, partial atrioventricular septal defects in 3 patients and transitional atrioventricular septal defects in 2 patients. Besides these, one patient each underwent atrial septectomy with right modified Blaloc—Taussing shunt and correction of hemianomalous pulmonary venous connection with intact atrial septum using this approach. The median age of the patients was 8 years with a range of 10 months to 41 years. 10 patients were males. Results The median operation time (skin to skin) was 236 minutes. Median bypass times and aortic cross clamp times were 63 minutes and 31.5 minutes respectively. The median ICU stay was 25.2 hours. There were no significant immediate post operative complications requiring intervention in any patient. The mean chest drainage was 80 ml per 24 hours. One patient had a superficial wound dehiscence which healed with daily dressings One patient had atelectasis of the right upper lobe which recovered with chest physiotherapy. All patients are on regular follow up to assess the status of their scars. One patients developed a mass on the right atrial free wall following closure of atrial septal defect one year earlier and the underwent reoperation for removal of the mass. Patients on follow up were interrogated and all were satisfied with the cosmesis of their scars. None of the patients had any physical disability due to their scars. Conclusions The limited posterior thoracotomy incision offers a cosmetically attractive approach to the heart in selected patients. The approach is easy and the techniques reproducible. The technique carries with it no additional risk and has the advantage of not interfering with future development of the breast in young pre pubertal girls.     

早产儿的发展性照顾[日]

过去10至15年间,关于对早产儿必须提供适宜的环境的论点,已被众多的研究者反复论证.通过减少有害的刺激如光、声、人员往来,并且给予适当的体位和护理,早产儿护理的效果显著好转.     

Human burst-forming units-erythroid need direct interaction with stem cell factor for further development

To understand the factors that regulate the early growth and development of immature erythroid progenitor cells, the burst-forming units-erythroid (BFU-E), it is necessary to have both highly purified target cells and a medium free of serum. When highly purified human blood BFU-E were cultured in a serum-free medium adequate for the growth of later erythroid progenitors, BFU-E would not grow even with the addition of recombinant human interleukin-3 (rIL-3), known to be essential for these cells. However, the addition of recombinant human stem cell factor (rSCF), which supports germ cell and pluripotential stem cell growth, stimulated BFU-E to grow equally well in serum-free as in serum-containing medium. Limiting dilution studies showed that rSCF acts directly on the BFU-E that do not require accessory cells for growth. Furthermore, rSCF was necessary for BFU-E development during the initial 7 days of culture, until these cells reached the stage of the late progenitors, the colony-forming units-erythroid (CFU-E). These studies indicate that early erythropoiesis is dependent on the direct action of SCF that not only affects early stem cells but is continually necessary for the further development of committed erythroid progenitor cells until the CFU-E stage of maturation.     

糖基化恢复冷藏血小板的存活率

血小板冷藏会使血管假性血友病因子受体复合物(von Willebrand factor receptor complex)聚集成簇。巨噬细胞αMβ2 整合素结合在成簇复合物的GPIbα亚基,导致输注的冷藏血小板被快速清除。因此输注用血小板不能冷藏,但现在的室温保存方式也存在很大缺点。我们已证明αMβ2是一种凝集素,它能识别GPIbα的N-连接葡聚糖上暴露的β-N-乙酰葡萄胺。冷藏血小板的酶促半乳糖苷化阻止了αMβ2的这种识别,延长了有