Kaiser Permanente's Convergent Medical Terminology.

This paper describes Kaiser Permanente's (KP) enterprise-wide medical terminology solution, referred to as our Convergent Medical Terminology (CMT). Initially developed to serve the needs of a regional electronic health record, CMT has evolved into a core KP asset, serving as the common terminology across all applications. CMT serves as the definitive source of concept definitions for the organization, provides a consistent structure and access method to all codes used by the organization, and is KP's language of interoperability, with cross-mappings to regional ancillary systems and administrative billing codes.

Capabilities and limitations of pupil-plane filters for superresolution and image enhancement.

The use of pupil-plane filters in microscopes has been proposed as a method of producing superresolution. Here it is shown that pupil-plane filters cannot increase the support of the transfer function for a large class of optical systems, implying that resolution cannot be improved solely by adding pupil-plane filters to an instrument. However, pupil filters can improve signal-to-noise performance and modify transfer-function zero crossing positions, as demonstrated through a confocal fluorescence example.

Optimal skin prick wheal size for diagnosis of cat allergy.

Background: The skin prick test is the diagnostic procedure of choice for determination of immediate hypersensitivity. A wheal diameter of 3 mm or larger is generally accepted as the cutoff for a positive test result, although the validity of this assumption has not been rigorously demonstrated.

Objective: To determine the skin prick wheal size that best identifies clinical allergy to cat.

A practice-based study of patients with acute and chronic low back pain attending primary care and chiropractic physicians: two-week to 48-month follow-up.

Objective: This study reports pain and disability outcomes up to 4 years for chiropractic and medical patients with low back pain (LBP) and assesses the influence of doctor type and pain duration on clinical outcomes.

Design: Prospective, longitudinal, nonrandomized, practice-based, observational study.

Setting: Fifty-one chiropractic and 14 general practice community clinics.

Changes in body composition after a 12-wk aerobic exercise program in obese boys.

Unlabelled: Previous studies have shown that vigorous aerobic training programs for obese children result in minimal weight changes, and concluded that they may not be beneficial. Weight change alone may not detect important beneficial changes in body composition associated with vigorous training in these children. Fifteen obese boys (aged 9-12 yr, body mass index (BMI) 31.

Image enhancement by acoustic conditioning of ultrasound contrast agents.

A novel contrast imaging technique has been developed for use with microbubble contrast agents. It employs two acoustic fields: there is an excitation field for conditioning microbubbles and an imaging field for detecting microbubbles. The maximum increases (due to microbubble conditioning) in scattered first and second harmonic signals were 14.

Diagnosing breast lesions with contrast-enhanced 3-dimensional power Doppler imaging.

Objective: To compare mammography with contrast-enhanced 2- and 3-dimensional power Doppler imaging for the diagnosis of breast cancer.

Methods: Fifty-five patients, who underwent breast biopsies with histopathologic assessment, participated in a study of mammography and contrast-enhanced sonography. Levovist (Berlex Laboratories, Montville, NJ) and Optison (Mallinckrodt, St Louis, MO) were administrated to 22 and 33 patients, respectively.

Catheter-based intraluminal sonography.

With the development of interventional and minimally invasive surgical techniques in the last decade, a strong interest in intraluminal sonography has arisen because of the need for better imaging information and management of the interventional procedure. High-resolution intraluminal sonography is a unique approach for the evaluation of a wide range of abnormalities within the luminal structures throughout the body. This imaging technique has been able to obtain information not available with even the most sophisticated percutaneous sonography, CT, or MRI.

Sentinel lymph nodes in a swine model with melanoma: contrast-enhanced lymphatic US.

Purpose: To determine if lymphatic channels and sentinel lymph nodes (SLNs) with and without metastases can be detected with lymphatic ultrasonography (US) after peritumoral injection of a US contrast agent and to determine if lymphatic US can be used to assess SLNs for the presence of metastatic infiltration.

Materials And Methods: Six swine with 17 melanomas were evaluated. Conventional gray-scale, color flow, and gray-scale phase-inversion harmonic US examinations were performed.

[Three dimensional ultrasound volumetric assessment of the synovial fluid in the ankle and hindfoot: Technique and normative data].

Purpose: Since synovial fluid is an important marker of disease, we performed three-dimensional ultrasound volumetric measurements of synovial fluid to provide baseline normative data.

Materials And Methods: Volume data were acquired using a 7-10 MHz three dimensional ultrasound probe on 40 ankles in 20 volunteers (25-61 years). Amounts of fluid were assessed in the ankle joint recesses, bursae and tendon sheaths.

MRI of the lung gas-space at very low-field using hyperpolarized noble gases.

In hyperpolarized (HP) noble-gas magnetic resonance imaging, large nuclear spin polarizations, about 100,000 times that ordinarily obtainable at thermal equilibrium, are created in 3He and 129Xe. The enhanced signal that results can be employed in high-resolution MRI studies of void spaces such as in the lungs. In HP gas MRI the signal-to-noise ratio (SNR) depends only weakly on the static magnetic field (B(0)), making very low-field (VLF) MRI possible; indeed, it is possible to contemplate portable MRI using light-weight solenoids or permanent magnets.

Computer-aided classification of breast masses in ultrasonic B-scans using a multiparameter approach.

Classification of breast masses in ultrasonic B-scan images is undertaken using a multiparameter approach. The parameters are generated on the basis of a non-Rayleigh statistic model of the backscattered envelope from the breast tissue. They can be computed automatically with minimal clinical intervention once the location of the mass is known.

Classification of breast masses in ultrasonic B scans using Nakagami and K distributions.

Classification of breast masses in greyscale ultrasound images is undertaken using a multiparameter approach. Five parameters reflecting the non-Rayleigh nature of the backscattered echo were used. These parameters, based mostly on the Nakagami and K distributions, were extracted from the envelope of the echoes at the site, boundary, spiculated region and shadow of the mass.

ROC analysis of ultrasound tissue characterization classifiers for breast cancer diagnosis.

Breast cancer diagnosis through ultrasound tissue characterization was studied using receiver operating characteristic (ROC) analysis of combinations of acoustic features, patient age, and radiological findings. A feature fusion method was devised that operates even if only partial diagnostic data are available. The ROC methodology uses ordinal dominance theory and bootstrap resampling to evaluate A(z) and confidence intervals in simple as well as paired data analyses.

Resonance Raman spectra of carbon nanotubes by cross-polarized light.

Resonance Raman studies on single wall carbon nanotubes (SWNTs) show that resonance with cross polarized light, i.e., with the E(mu,mu+/-1) van Hove singularities in the joint density of states needs to be taken into account when analyzing the Raman and optical absorption spectra from isolated SWNTs.

Trypanocidal activity of conformationally restricted pentamidine congeners.

A series of conformationally restricted congeners of pentamidine in which the flexible pentyl bridge of pentamidine was replaced by trans-1,2-bismethylenecyclopropyl, phenyl, pyridinyl, piperazinyl, homopiperazinyl, and piperidinyl groups were synthesized. The compounds were evaluated for trypanocidal activity in vitro and in vivo against one drug-sensitive and three drug-resistant trypanosome isolates. The DNA binding affinity of the compounds was also studied using calf thymus DNA and poly(dA-dT).

Effectiveness of pulse oximetry screening for congenital heart disease in asymptomatic newborns.

Objective: To determine the sensitivity, specificity, predictive value, and accuracy of a program of pulse oximetry screening of asymptomatic newborns for critical congenital cardiovascular malformation (CCVM).

Methods: Pulse oximetry was performed on asymptomatic newborns in the well-infant nurseries of 2 hospitals. Cardiac ultrasound was performed on infants with positive screens (saturation 24 hours).

Genomic organization of glycinin genes in soybean.

Glycinin is the predominant seed storage protein in most soybean varieties. Previously, five major genes (designated Gy1 to Gy5) encoding glycinin subunits have been described. In this report two new genes are identified and mapped: a glycinin pseudogene, gy6, and a functional gene, Gy7.

Power Doppler assessment of vascular changes during fracture treatment with low-intensity ultrasound.

Objective: To study the use of power Doppler sonography for assessing changes in vascularity during treatment of fracture sites with low-intensity ultrasound.

Methods: In 6 dogs (3 pairs), subcutaneous dissection of the midshaft of the ulna allowed symmetrical osteotomies to be made with a reciprocation saw. Three dogs were treated and 3 were used as controls.

Classification of breast masses in ultrasonic B-mode images using a compounding technique in the Nakagami distribution domain.

Classification of masses in ultrasonic B-mode images of the breast tissue using "normalized" parameters of the Nakagami distribution was recently investigated. The technique, however, did not yield performances that were comparable to those of an experienced radiologist, and utilized only a single image for tissue characterization. Because radiologists commonly use two to four images of a mass for characterization, a similar procedure is developed here.

Computer aided classification of masses in ultrasonic mammography.

Frequency compounding was recently investigated for computer aided classification of masses in ultrasonic B-mode images as benign or malignant. The classification was performed using the normalized parameters of the Nakagami distribution at a single region of interest at the site of the mass. A combination of normalized Nakagami parameters from two different images of a mass was undertaken to improve the performance of classification.