Imagenología digital como recurso didáctico en el aprendizaje significativo de las Ciencias Médicas

RESUMEN La especialidad de Imagenología comprende áreas del conocimiento médico que utilizan diferentes tecnologías en creciente desarrollo y métodos que exteriorizan partes del cuerpo humano, por tal motivo, educar a través del diagnóstico por imágenes informatizadas constituye un desafío en la actualidad. El presente artículo plantea describir las características principales de los medios de enseñanza y el interés que brinda especialmente la imagen radiológica digital como recurso didáctico. Se recopiló y revisó bibliografía de mayor novedad y profundidad en el tratamiento del tema. La estrategia de búsqueda adoptada fue la utilización de las palabras clave o descriptores en español e inglés. En la Universidad de Ciencias Médicas las tecnologías modernas traen diversidad de herramientas didácticas en el marco de escenarios docentes que impulsan y motivan el desarrollo rápido de habilidades perceptivas, la utilización cada vez más frecuente de imágenes digitales como medio de enseñanza la convierten en un recurso muy utilizado actualmente que exige habilidades y manejo eficaz. Las imágenes digitales con fines docentes son una alternativa importante, pues reflejan la modernidad e incorporan el conocimiento, debido a que se transforman en un nuevo recurso destinado a comunicar.

ABSTRACT The specialty of Imaging includes areas of medical knowledge that use different technologies in growing development and methods that externalize parts of the human body, for this reason, educating through computerized imaging diagnosis is a challenge today. This article proposes to describe the main characteristics of the teaching aids and the interest that the digital radiological image offers especially as a didactic resource. Bibliography of greater novelty and depth in the treatment of the subject was collected and reviewed. The search strategy adopted was the use of keywords or descriptors in Spanish and English. In the University of Medical Sciences, modern technologies bring diversity of didactic tools within the framework of teaching scenarios that promote and motivate the rapid development of perceptual skills, the increasingly frequent use of digital images as a means of teaching make it a very useful resource. Currently used that requires skills and effective handling. Digital images for teaching purposes are an important alternative, as they reflect modernity and incorporate knowledge, because they become a new resource for communicating.

Influencia de la interpolación sobre la calidad de imágenes de microscopía celular / Influence of Interpolation on the Quality of Cell Microscopy Images

El presente trabajo tiene el propósito de analizar, para el caso particular de imágenes de microscopía celular de eritrocitos de sangre humana, en qué medida puede influir en la calidad de la imagen la aplicación de métodos de interpolación para mejorar la resolución de esta y con qué métodos se podrían obtener resultados satisfactorios. Se aplicaron para su comparación tres métodos de interpolación a las imágenes a color seleccionadas: splines cúbicos, bicúbico y bilineal y se evaluó la eficiencia computacional de estos. Se utilizaron dos factores de reducción de la resolución (2 y 4) por filas y columnas de la imagen digital. Las medidas utilizadas para valorar la calidad de las imágenes interpoladas fueron la relación señal-ruido y el error medio cuadrático, cuyos valores fueron procesados estadísticamente mediante las pruebas de Friedman y de Wilcoxon, esta última como test post-hoc. Los resultados permiten recomendar el método bicúbico de interpolación como el más favorable para este tipo de imágenes ya que fue el de mejor comportamiento entre los utilizados(AU)

The present work has the purpose of analyzing, for the particular case of cell microscopy images of erythrocytes from human blood, to what extent the application of interpolation methods to improve the image resolution can influence the image quality and with which methods satisfactory results might be obtained. Three interpolation methods were applied for their comparison to the selected color images: cubic splines, bicubic and bilinear and their computational efficiency was also evaluated. Two resolution reduction factors (2 and 4) were used for rows and columns of the digital image. The measures used to assess the quality of the interpolated images were the signal-to-noise ratio and the mean square error, whose values were statistically processed using the Friedman and Wilcoxon tests, the latter as a post-hoc test. The results make it possible to recommend the bicubic interpolation method as the most favorable for this type of images since it was the one with the best performance among those used(AU)

Tips for studies with quantitative morphology (morphometry and stereology) / Consejos para los estudios de morfología cuantitativa (morfometría y estereología)

SUMMARY: The quantitative morphology contributes to making the studies less subjective and reproducible. Quantitative results are analyzed with statistics and should be based on a well-defined sample. Quantitative variables can be 'continuous' or 'discrete.' In this text, the term 'morphometry' is used to design a simpler procedure for measuring structures with a 'ruler.' The term 'stereology' is used in estimating quantities in the 3-dimensional space analyzing 2-D cut sections. Correction factors may be necessary for the retraction and compression of the tissues. In histological sections, the 'caps' of the objects that have been sectioned tangentially are lost when chemical agents remove the paraffin distorting the analysis. Moreover, the analyses based on digital images should consider the same format and the same size (pixels) to all pictures allowing a comparison between groups. Stereology can be 'model-based': points within a frame are counted to estimate the 'volume density' (Vv) of a structure, and intercepts are counted to assess the 'surface density' (Sv). Counting structures within a frame allow estimating the 'length density' (Lv). Newer and more complex 'design-based' procedures are considered unbiased. The key point is that design-based inference does not require assumptions about the material and uses the 'random sampling' approach. The estimation of the number of objects requires a 3-D (volume) probe and therefore the 'disector' technique. This review aimed to contribute to the execution of the project, the correct sampling and the data obtained with morphometry and stereology.

RESUMEN: La morfología cuantitativa contribuye a que los estudios sean menos subjetivos y reproducibles. Los resultados cuantitativos son analizados con estadística y deben basarse en una muestra bien definida. Las variables cuantitativas pueden ser "continuas" o "discretas". En este texto, el término 'morfometría' es usado para diseñar un procedimiento más simple para medir estructuras con una 'regla'. El término "estereología" se usa para estimar cantidades en espacio 3-D analizando secciones de corte en 2-D. Factores de corrección pueden ser necesarios por la retracción y compresión de los tejidos. En secciones histológicas, los "tapones" de las muestras que han sido seccionadas tangencialmente se pierden cuando los agentes químicos eliminan la parafina distorsionando así el análisis. Además, los análisis basados en imágenes digitales deben considerar el mismo formato y el mismo tamaño (píxeles) para todas las imágenes, lo que permite una comparación entre grupos. La estereología puede estar "basada en modelos": los puntos dentro de un marco se cuentan para estimar la "densidad de volumen" (Vv) de una estructura, y las interceptaciones o intersecciones son contadas para evaluar la "densidad de superficie" (Sv). Las estructuras contadas dentro de un marco permiten estimar la 'densidad de longitud' (Lv). Los procedimientos más nuevos y más complejos basados en el diseño se consideran imparciales y objetivos. El punto clave es que el diseño basado en la inferencia no requiere suposiciones acerca del material y utiliza el enfoque de "muestreo aleatorio". La estimación del número de objetos requiere una prueba 3-D (volumen) y, por lo tanto, la técnica "disector". Esta revisión tuvo como objetivo contribuir a la ejecución del proyecto, el muestreo correcto y los datos obtenidos con morfometría y estereología.

Software for automatic diagnostic prediction of skin clinical images based on ABCD rule / Software para predição diagnóstica automática de imagens clínicas da pele baseada na regra ABCD

Cancer is responsible for about 7 million annual deaths worldwide. Among them, the melanoma type, responsible for 4% of the skin cancers, whose incidence has doubled in the last ten years. The processing of digital images has shown good potential for assistance in the early detection of melanomas. In this sense, the objective of the current study was to develop a software for clinical images processing and reach a score of accuracy higher than 95%. The ABCD rule was used as a guide for the development of computational analysis methods. MATLAB was used as programming environment for the development of the processing of digital images software. The images used were acquired from two banks of free images. They included images of melanomas (n=15) and nevi images (not cancer) (n=15). Images in RGB color channel were used, which were converted to grayscale, 8x8 median filter applications and 3x3 neighborhood approach technique. After, we proceeded to the binarization and inversion of black and white for later extraction of contour characteristics of the lesion. The classifier used was an artificial neural network of radial basis, getting accuracy for diagnosis of melanomas images of 100% and of 90.9% for not cancer images. Thus, global correction for diagnostic prediction was 95.5%. An area under the ROC graph 0.967 was achieved, suggesting a great diagnostic predictive ability. Besides, the software presents low cost use, since it can be run on most operating systems used nowadays.

O câncer é responsável por cerca de 7 milhões de óbitos anuais em todo o mundo. Entre eles, o tipo melanoma, responsável por 4% dos cânceres de pele, cuja incidência dobrou mundialmente nos últimos dez anos. O processamento digital de imagens tem mostrado um bom potencial para auxiliar no diagnóstico precoce de melanomas. Neste sentido, objetivo do presente estudo foi desenvolver um software para processamento digital de imagens clínicas para diagnóstico automático baseado na regra ABCD que alcançasse um percentual de acerto maior do que 95% dos casos. Utilizou-se como norteador a regra ABCD para o desenvolvimento de métodos de análise computacional. Empregou-se o MATLAB como ambiente de programação para o desenvolvimento de um software para o processamento digital de imagens. As imagens utilizadas foram adquiridas de dois bancos de imagens de acesso livre. Foram inclusas imagens clínicas de melanomas (n=15) e imagens de nevos (lesão melanocítica benigna) (n=15). Utilizaram-se imagens no canal de cor RGB, as quais foram convertidas para escala de cinza, aplicação de filtro de mediana 8x8 e técnica de aproximação por vizinhança 3x3. Após, procedeu-se a binarização e inversão de preto e branco para posterior extração das características do contorno da lesão. O classificador utilizado foi uma rede neural artificial de base radial, obtendo acerto diagnóstico para as imagens melanomas de 100% e para imagens benignas de 90,9%. Desta forma, o acerto global para predição diagnóstica foi de 95,5%. Obteve-se uma área sob a curva ROC de 0,967, o que sugere uma excelente capacidade de predição diagnóstica, sobretudo, com baixo custo de utilização, visto que o software pode ser executado na grande maioria dos sistemas operacionais hoje utilizados.

Estrategia pedagógica para perfeccionar el uso de las imágenes digitales en las ciencias médicas / Pedagogical strategy to improve the use of digital images in the medical sciences

INTRODUCCIÓN: en la enseñanza de las Ciencias Médicas el uso de las Tecnologías de la Información y las Comunicaciones, por la diversidad de estructuras que abordan en sus contenidos se hace imprescindible recurrir, en su enseñanza, al uso de las imágenes digitales. OBJETIVOS: diseñar una estrategia pedagógica de superación profesoral que contribuya al perfeccionamiento del uso de las imágenes digitales en la docencia de las asignaturas del ciclo básico y básico clínico biomédico. MÉTODOS: se realizó un estudio observacional descriptivo, de tipo transversal con elementos de enfoque cualitativo y cuantitativo que se inscribe como un proyecto de desarrollo en la Universidad de Ciencias Médicas de Villa Clara "Dr. Serafín Ruiz de Zárate Ruiz" en el período comprendido septiembre del 2012 a junio del 2013. El cual permitió diseñar una estrategia pedagógica de superación profesoral que contribuya al perfeccionamiento del uso de las imágenes digitales en la docencia de las asignaturas del ciclo básico y básico clínico biomédico. El diseño metodológico fue concebido en tres etapas una primera de diagnóstico, una segunda de diseño de la estrategia pedagógica de superación profesoral y una tercera de valoración por especialistas del producto diseñado. RESULTADOS: se pudo precisar que existen deficiencias relacionadas con la utilización de las imágenes digitales en la docencia de las ciencias médicas. A partir del diagnóstico realizado se diseñó una estrategia pedagógica de superación profesoral contextualizada en la facultad de Medicina, la que se caracterizó por su flexibilidad para su implementación y que fue valorada como adecuada por los especialistas seleccionados teniéndose en cuenta su estructura, pertinencia, utilidad, factibilidad y valor pedagógico, recomendándose su implementación de inmediato. CONCLUSIONES: la estrategia Pedagógica para la capacitación de los docentes de las Ciencias Médicas en el uso de las imágenes digitales en la docencia, corresponde con el diagnóstico realizado y contribuye a la superación de los docentes en el uso de las imágenes digitales.

INTRODUCTION: In the teaching of the Medical Sciences, the use of Information Technology and Communications, the diversity of structures that they address in their content makes it imperative to use, in their teaching, to the use of digital images. OBJECTIVE: To design a pedagogical strategy of professorial improvement that contributes to the improvement of the use of digital images in the teaching of the basic subjects and of biomedical clinical cycle. METHODS: A descriptive study of transversal elements of qualitative and quantitative approach at the University of Medical Sciences of Villa Clara was performed in the period from September, 2012 to June, 2013, which allowed to design a professorial teaching strategy of improvement that contributes to the improvement of the use of digital images in the teaching of basic subjects of basic cycle and clinical Biomedical cycle. The methodological design was conceived in three stages; a first one of diagnosis, a second one for the designing of the pedagogical strategy for professorial teaching improvement and a third one for the valuation by specialists of the product designed. RESULTS: It could be noted that there are deficiencies regarding the use of digital images in the teaching of the medical sciences. From the diagnosis made, a pedagogical strategy for overcoming the professorial improvement contextualized in the Faculty of Medicine was designed, which was characterized by its flexibility for its implementation and was rated as adequate by the selected specialists and recommended for implementation immediately. CONCLUSION: The Pedagogical Strategy for training teachers of the Medical Sciences in the use of digital images in the teaching process corresponds to the diagnosis made and contributes to the improvement of teachers in the use of the digital images.

Conventional and digital radiographic assessment of tooth enamel de-/remineralization processes: An experimental study.

Objective: This study aimed to compare digital techniques for evaluating dental enamel de-/remineralization. Materials and Methods: Sixty extracted molars were subjected to a process of de- and remineralization. Radiographs were taken before and after each stage. These radiographs were evaluated by the conventional method and were then scanned and analyzed either with or without the use of image enhancement. Moreover, the gray levels (GLs) of the affected areas were measured. Results: All methods exhibited low sensitivity and identical levels of specificity (99.4%). Analysis of the grayscale levels found statistically significant differences between the initial radiographs (P < 0.05). The mean GL of the carious group was significantly lower than that of the remineralized group. The GL did not differ significantly between the initial and final radiographs of the remineralized group, although the mean of the first group was lower than that of the second, which demonstrated that the remineralization process restored the normal density of the dental enamel. Conclusion: Measurement of the mean GL was sufficiently sensitive to detect small alterations in the surface of the enamel.

Enhancing histology slide identification skills of 1st year undergraduate medical students.

Introduction: First year undergraduate medical students find it difficult to identify histology slides in the laboratory, even though they have a good theoretical knowledge about them. Aim: The present study was undertaken to improve histology slide identification skills of the students using a new innovative method and also to compare the same with traditional methods of teaching histology. Materials & Methods: 150 first year medical undergraduates (MBBS) from JIPMER, Pondicherry formed the subjects of the present study. Digital images from slides available at our department in JIPMER (Jawaharlal institute of post graduate medical education and research), Pondicherry were labeled and used in lecture classes as well as for subsequent student assessment. Results: 94% of the students identified all the slides correctly and mentioned important identifying points using the newer method whereas only 52% and 64% of the students identified all the slides correctly and mentioned important identifying points using pointers in the eye piece method and live/ real time demonstration (older/traditional methods ) respectively. Conclusion: The new method has been shown to be effective and makes efficient use of the available time and superior to older methods of teaching histology.

Técnica de cuantificación de la agregación eritrocitaria por análisis digital de imágenes / Erythrocyte aggregation quantification technique using digital image analysis / Técnica de quantificagáo do agregado eritrocitário por análise digital de imagens

La caracterización de agregados eritrocitarios es importante para analizar las posibles alteraciones en la microcirculación observadas en ciertas patologías vasculares como la hipertensión y la diabetes. El objetivo de este trabajo fue estandarizar una técnica que pueda ser utilizada por cualquier operador con un equipamiento similar. Para ello se prepararon distintas suspensiones de glóbulos rojos de dadores sanos en plasma autólogo, que fueron observadas con un microscopio óptico invertido. Se registraron para su análisis las imágenes de los agregados con una cámara digital. Se realizaron los recuentos de células individuales, agregados de 2 a 4 células, agregados de 5 ó más células y amas (redes de agregados de gran tamaño). Se midió el perímetro y el área, obteniéndose un parámetro de forma (ASP) de cada agregado de 5 ó más células. Los resultados obtenidos permitieron estandarizar el protocolo de trabajo concluyendo que la dilución óptima de glóbulos rojos en plasma autólogo para esta técnica es 0,5%.

Characterization of erythrocyte aggregates is important in the analysis of the possible alterations observed in the microcirculation of certain vascular pathologies such as hypertension and diabetes. The objective of this work was to standardize a technique that can be used by any operator having similar equipment. For that purpose, different suspensions of red blood cells from healthy donors were prepared in autologous plasma and then observed with an inverted light microscope. The images of the aggregates were recorded with a digital camera in order to be later analyzed. Individual cell count was carried out, as well as 2 to 4 cell- aggregates, 5 or more cell- aggregate and amas (big aggregate networks). Measurement of perimeter and area of each of the aggregates made up of 5 or more cells was performed, getting a shape parameter (ASP). Due to the results obtained, this working protocol has been standardized and it can be concluded that the optimal dilution of red blood cells in autologous plasma is 0.5% for this particular technique.

A caracterizagáo de agregados eritrocitários é importante para analisar as possíveis alteragóes na microcirculagáo observadas em certas patologias vasculares como a hipertensáo e a diabetes. O objetivo deste trabalho foi padronizar uma técnica que possa ser utilizada por qualquer operador com um equipamento similar. Para isso foram preparadas diversas suspensóes de glóbulos vermelhos de doadores saudáveis em plasma autólogo, que foram observadas com um microscópio óptico invertido. Foram registradas para a sua análise as imagens dos agregados com uma camera digital. Realizaramse as recontagens de células individuais, agregados de 2 a 4 células, agregados de 5 ou mais células e amas (redes de agregados de grande tamanho). Foi medido o perímetro e a área, obtendo um parametro de forma (ASP) de cada agregado de 5 ou mais células. Os resultados obtidos permitiram padronizar o protocolo de trabalho concluindo que a diluigáo ótima de glóbulos vermelhos em plasma autólogo para esta técnica é de 0,5%.

Evaluation of histopathology class in which medical students use digital microscopic images / 医学教育

1) Because some students cannot find target lesions with a microscope during the traditional histopathology class, they become anxious and frustrated. 2) Histopathology class, in which medical students learn with digital microscopic images on a computer display without a microscope, was supported by 75.8% of the students.3) Histopathology class with digital microscopic images should be adopted as a strategy to decrease the nervousness and frustration of medical students.

Evaluation of the effects of processing delays and protective plastic cases on image quality of a photostimulable phosphor plate system

This ex vivo study evaluated the quality of digital radiographic images obtained with the photostimulable phosphor plate system (Digora) according to the processing delay and maintenance of optical plates in either opaque (supplied with the system) or transparent protective plastic cases during this period. Five radiographs were obtained from the mandibular molar region of a dry human mandible using optical plates. These plates were placed in the protective plastic cases before obtaining the radiographs and were processed immediately or after processing delays of 5, 60 and 120 min, when the case was removed. The results revealed a reduction in image quality when processing was delay 120 min compared to the other times. The opaque case provided better protection to the sensor than the transparent case. In conclusion, a 120-min processing delay for the Digora system caused a reduction in image quality, yet without interfering with the quality of diagnosis. The opaque case supplied by the system's manufacturer provided better protection to the optical plate than the transparent case.

Sistema radicular de três porta-enxertos para lima ácida 'tahiti' no estado do Piauí / Evaluation of three rootstocks root system for acid lime 'tahiti' at Piauí state

O objetivo deste trabalho foi avaliar o desenvolvimento radicular de três porta-enxertos para lima ácida‘Tahiti’ [Citrus latifolia (Yu.Tanaka) Tanaka]: limão Cravo (C. limonia Osbeck); citrumelo Swingle[Poncirus trifoliata (L.) Raf. x C. paradisi Macf.]; trifoliata Flying Dragon (P. trifoliata (L.) Raf.var. (FD),no município de José de Freitas, Piauí, localizado a 04º 52’ latitude S e 42º 42’ longitude W, e altitude de110m, onde predomina clima Aw. Foram abertas trincheiras com quatro repetições, para colocação dequadro-gabarito de madeira, com divisórias de 0,1 m na profundidade por 0,2 m na largura, perfazendocinco camadas na profundidade e seis posições na largura, definindo quadrículas de 200 cm2 na parededas trincheiras, de onde foram obtidas fotografias digitais. Estas fotografias foram analisadas pelosoftware SIARCS 3.0 para dimensionamento do sistema radicular e os dados obtidos, submetidos àanálise de variância e posteriormente ao teste de Tukey, ao nível de 5% de probabilidade. O delineamentoexperimental foi inteiramente casualizado. Os sistemas radiculares dos porta-enxertos tiveramconcentração de 90% até a profundidade de 0,4 m, sendo que nos primeiros 0,2 m concentrou-se 60% docomprimento das raízes. O sistema radicular do limão Cravo demonstrou ser superior, em comprimento(cm.200 cm-2), aos dos porta-enxertos trifoliata Flying Dragon e citrumelo Swingle.

The objective of this work was to evaluate the development of the root system of three rootstocks for'Tahiti'acid lime [Citrus latifolia (Yu.Tanaka) Tanaka]: Rangpur lime (C. limonia Osbeck); Swinglecitrumelo [Poncirus trifoliata (L.) Raf. x C. paradisi Macf.]; Flying Dragon trifoliate (P. trifoliata (L.)Raf.var. (FD) ­ in the soil and environment conditions of the county of José de Freitas, Piauí, located on04º 52' latitude S and 42º 42' longitude W and 110 m of altitude, in Aw climate. It was used the trenchmethod. A wooden frame divided into 0.1 x 0.2 m parts was fixed in the soil profile and a digital photographwas taken from each part. These photographs were analyzed by software SIARCS 3.0 for sizing of theroot system and the data gotten, submitted to the analysis of variance with Tukey test at the level of 5%of probability. The experimental design was entirely randomized, with three treatments (rootstocks) andfour replications (trenches). The root systems of the rootstocks had 90% of concentration until thedepth of 0,4 m, and it was observed that 60% of the roots were concentrated in the first 0,2 m. The rootsystem of the Rangpur lime demonstrated to be superior, in lenght (cm.200 cm-²) to the Flying Dragontrifoliate and Swingle citrumelo root systems.

Avaliação da densidade óptica de três pastas de hidróxido de cálcio / Evaluation of three calcium hydroxide pastes' optical density

A radiopacidade é uma das propriedades físicas requeridas pelos diferentes materiais de uso endodôntico, permitindo avaliar o preenchimentodo sistema de canais radiculares. O objetivo deste estudo foi avaliar a densidade óptica de três pastas de hidróxido de cálcio – hidróxido de cálcio pró-análise (Biodinâmica) + propilenoglicol 400 (Farmácia Extrato Puro), pasta Calen (SS White) e pasta UltraCal XS (UltraDent), associadas a um simulador de tecidos. Foram confeccionados 15 corpos-de-prova a partir de um tubo de polietileno, que originou três grupos experimentais, com cinco tubos preenchidos com cada uma das pastas avaliadas. Com o intuito de averiguar a interferência do tubo utilizado na radiopacidade, foram incluídos como amostras, mais dois grupos; um composto apenas com o dente e outro com um tubo vazio inserido no interior do canal radicular. Foram obtidas 25 imagens digitais padronizadas, utilizando o sistema Visualix, sendo 5 para cada grupo. As imagens foram exportadas para o programa Adobe Photoshop v. 7.0, no qual foi determinada a média e o desvio padrão da densidade óptica em uma área padronizada da imagem, correspondente à posição do tubo. Os valores médios de densidade óptica encontrados foram, em ordem decrescente, pasta UltraCal XS (236,25 ± 2,96), pasta Calen (230,32 ± 3,49) e pasta Pró-análise + Propilenoglicol (210,95 ± 3,29). O sistema Visualix foi capaz de identificar diferentes padrões de radiopacidade para os materiais testados, sendo que todas as pastas apresentaram radiopacidade significativamente maior que a do conduto radicular vazio e diferiram significativamente entre si.

Radiopacity is one of the physical properties requested by the different materials of endodontic use, which evaluate the filling of the pulp canal system. The aim of this study was to evaluate the radiopacity of three calcium hydroxide pastes: calcium hydroxide pro-analysis (biodynamics) + Propilenoglicol 400 (pharmacy pure extract), Calen (SS white) and UltraCal XS (Ultra Dent), associated to a tissue simulator. Fifteen samples were manufactured using a polyethylene tube, originating three experimental groups, with five tubes filled with each one of the pastes evaluated. In order to find out the interference of the tube in the radiopacity, another two groups were included: one composed just by the tooth and other with an empty tube inserted in the root canal. Using the Visuallix system, 25 standardized digital images were obtained (5 of each group). The images were exported to Adobe Photoshop v. 7.0 software, in order to obtain the mean values and standard deviation of gray levels in a standardized area of the image, corresponding to the tube position. The mean values of optic density were, in decreasing order, UltraCal XS (236,25 +2,96), Calen (230,32 + 3,49) and pro-analysis+ propilenoglicol (210,95 + 3,29). The Visualix system was able to identify different patterns of the radiopacity in the tested materials, which were more radiopaque than the empty root canal and significantly different in terms of radiopacity.

Web Based Emergency Room PACS

PURPOSE: We wished to develop the web based Picture Archiving and Communication System in the emergency room for early decision making in emergency treatment planning at a full PACS Hospital. MATERIALS AND METHODS: The program tools were Microsoft Visual Studio 6.0 - Visual C++ 6.0, and the Microsoft SQL 7.0 under the Microsoft Windows 2000 server(R) operation system. The achievement of images was performed by an auto transport program installed in the ER and the radiology department. RESULTS: The average compression rates were 5:1 for CT and MR, and 20:1 for CR with JPEG 2000 lossy compression. All the images were stored on hard disk for 3 months. The patients' information was displayed for 2 weeks for reducing the security risk. For interdepartmental consultation, patient query by patient hospital number was available. CONCLUSION: Our Web based ER PACS could be useful system for early decision making for treatment planning in the emergency room because it reduces the risk factors for the security of the Web PACS by using a system independent from PACS in the hospital and minimizing the information patients.