Image analysis of mesothelioma. II. Discrimination of mesothelioma from metastatic serous ovarian adenocarcinoma.

OBJECTIVE: To examine the utility of karyometric measurements in the differentiation of mesothelioma from metastatic serous ovarian adenocarcinoma. STUDY DESIGN: High-resolution images of 1,631 nuclei from 32 cases of mesothelioma and 742 nuclei from 15 cases of ovarian adenocarcinoma were recorded. A stepwise discriminant analysis and nonparametric classifier were applied. RESULTS: Nuclei from these two diagnostic categories appear very similar and occupy feature space with significant overlap. A nonparametric classification procedure provided acceptable correct classification. CONCLUSION: For certain regions in feature space, cases could be unequivocally classified.

Image analysis of mesothelioma. I. differentiation of mesothelioma from adenocarcinoma of the lung.

OBJECTIVE: To explore the usefulness of nuclear micromorphometric analysis for the differentiation between epithelial mesothelioma and metastatic adenocarcinoma in the chest wall. STUDY DESIGN: High-resolution images of 2,100 nuclei from 27 cases of epithelial mesothelioma and 15 cases of adenocarcinoma of the lung were recorded. Stepwise discriminant analysis and a nonparametric classifier were applied to derive estimates for a case diagnosis correct classification rate. RESULTS: Nuclei from epithelial mesothelioma and adenocarcinoma of the lung showed statistically significantly different properties, but there was a region of overlap in feature space such that approximately 15-20% of cases could not be correctly classified. The lesion signatures derived from the mesothelioma cases with discriminant function scores that might result in case misclassification and the cases of adenocarcinoma of the lung spanned a similar range of degree of nuclear abnormality. However, the distribution of nuclear abnormality values for the mesothelioma cases has a mode at 0.87 SD from normal, whereas the distribution seen in lung adenocarcinoma cases had a mode at about 3.7 SD. CONCLUSION: Cases of epithelial mesothelioma and adenocarcinoma of the lung have nuclei with a wide range of deviation from normal in the spatial and statistical distribution of their nuclear chromatin. For approximately 80% of cases, correct case classification can be provided by nuclear micromorphometric analysis. Cases of epithelial mesothelioma with highly abnormal nuclei overlap in feature space with nuclei from adenocarcinoma of the lung. However, it is possible that characterization by a lesion signature may allow correct assignment for those cases.

Nuts and bolts issues to consider when selling your practice.

Ten issues are provided that will help physicians and administrators through the process of selling a practice. Those issues include determining the buyers reasons for buying, determine your reason for selling, finding the right people, how the buyer is valuing your practice, how you value your practice, preparing the selling package, employment agreements and compensation packages, negotiating the operating contract, tax consequences and knowing when to walk away from the deal.

Supporting telemicroscopy and laboratory medicine activities. The Greek "TELE.INFO.MED.LAB" project.

In this paper the authors present the basic results of the study for the "TELE.INFO.MED.LAB" project. This study is based on the local experience of the Metaxas Cancer Institute case and on international references. The possibilities rendered by current developments in telemedicine and particularly in telepathology accelerate and facilitate the communication of crucial medical data and creation of "second level" medical services overcoming the geographical particularities of the country. The availability of data transmission (signals, images, texts, etc.) enables the creation of a "uniform market" for various services. This system must take into account the financial realities, geographical aspects transportation problems and technological developments. Organization of this system, the choices of technical standards and the realization of a complete pilot project are described. For this system we also describe the functional and technical aspects, as well as software and hardware components for the different types of units.

A new expert system for histopathological diagnosis of human ovarian epithelial cancer.

A new rule-based expert system designed to assist pathologists in the histological diagnosis of human ovarian epithelial cancer has been developed. The system was implemented using the INSIGHT II+ EXPERT System Shell and runs on IBM compatible microcomputers. It operates using knowledge acquired through the literature, research and experience, formulated into a total of 195 IF-THEN rules. The WHO International Histological Classification of Tumours is being used throughout. The system can quickly focus on a differential problem, thereby reducing the time necessary to reach a conclusion. It has been tested on a set of 34 cases, previously examined by pathologists of the Metaxas Memorial Cancer Institute, and has been found to reach good agreement with the pathologists' diagnoses.

Information retrieval for pathology information systems.

In a medical information system there is a serious need for assessing patient information in various ways. There is also a need for summarizing information in simple statistical tabular form. In this part we present and evaluate different techniques for query formulation, such as: QBE (Query-by-Example), SQL (Structured Query Language), GCL (Graphical Query Language). We also present a query processor for use in a pathology information system. This software system incorporates: a) A semi graphical tree structure interface (SGTSI) for query formulation, and b) Summary tables handling.

Telepathology in Greece. Experience of the Metaxas Cancer Institute.

This paper deals with the description of a telecommunication project which is initiated by Metaxas Pathology Laboratory. In the first section we discuss a comprehensive computer supported information system which was installed in the laboratory. Special emphasis is given at the design of the communication subsystem. Then, the configuration of the diagnostic equipment is described. The last section of the paper focuses on the discussion of the experimental use of an integrated "low cost" system for interconnection among the Metaxas Pathology laboratory, the Pathology Department of the University of Crete, and the Technological Educational Institute (TEI) of Athens.

New role of a medical documentation system.

Architecture of a new medical documentation system (MDS) is proposed. First, we studied the traditional MDS in terms of organizational structure, main functions, means (resources) and personnel. Special emphasis is given to the information retrieval (IR) system which is the kernel of a MDS. Then, some achievements of information technology is summarized, and concept of a mixed IR system which is the kernel of the new system is presented. New architecture is then presented. Units which compose the entire system are: host documentation centre, local documentation centres, and documentation units. Eventually, objective and features of every part are discussed.

A model for understanding benefit segmentation in preventive health care.

The marketing of traditional health care services, such as hospital and physician services, has matured with the integration of research from the medical sociology discipline and the marketing literature. In this article, we present a model to illustrate how an understanding of predispositions to health care behavior, integrated with benefit segmentation analysis, can contribute to more focused and effective marketing strategies for health-related products and services.

A system approach to new service development for hospitals.

A systematic approach to evaluating, planning and implementing new consumer services is necessary to ensure a successful program. Presented here are the three phases of the new service development process for hospitals--assessment, development, and execution--and the evolution and interaction among the health care delivery system, service, and market dimensions. Before, during, and after development, the need for hospital communications and effective marketing is also stressed.