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468 Publications visible to you, out of a total of 468
Medical informatics education needs information system practicums in health care settings–experiences and lessons learned from 32 practicums at four universities in two countries
Management of health information systems

Abstract (Expand)

OBJECTIVES: To report about the themes and about experiences with practicums in the management of information systems in health care settings (health information management) for medical informatics … students. METHODS: We first summarize the topics of the health information management practicums/projects that the authors organized between 1990 and 2003 for the medical informatics programs at Heidelberg/Heilbronn, Germany, UMIT, Austria, as well as for the informatics program at the University of Leipzig, Germany. Experiences and lessons learned, obtained from the faculty that organized the practicums in the past 14 years, are reported. RESULTS: Thirty (of 32) health information management practicums focused on the analysis of health information systems. These took place inside university medical centers. Although the practicums were time-intensive and required intensively tutoring students with regard to health information management and project management, feedback from the students and graduates was mainly positive. DISCUSSION: It is clearly recommended that students specializing in medical informatics need to be confronted with real-world problems of health information systems during their studies.

Authors: Reinhold Haux, Elske Ammenwerth, A. Haber, Gudrun Hübner-Bloder, Petra Knaup-Gregori, G. Lechleitner, F. Leiner, R. Weber, Alfred Winter, A. C. Wolff

Date Published: 2006

Publication Type: Journal article

Modeling Interdependencies between Information Processes and Communication Paths in Hospitals
Management of health information systems

Abstract (Expand)

Objectives: For planning hospital information systems it is important to recognize the interrelation between business processes and the communication needs between supporting application systems. We … therefore present an approach to model, visualize and analyze those interdependencies. Methods: The approach is based on the concepts defined in 3LGM(2), a meta-model to describe health information systems (HIS). An information process is defined as a sequence of functions using or updating information; a communication path as a sequence of communication links between interfaces belonging to application systems. The search for communication paths belonging to an information process is interpreted as an all-pairs shortest-paths problem. To solve this problem the Floyd-Warshall algorithm is applied. Results: The resulting algorithm has been implemented as function of the 3LGM(2) tool, a tool to create 3LGM(2) compliant models. With it, it is possible to interactively define information processes at the domain layer and to analyze step by step whether the infrastructure at the logical tool layer is sufficient to communicate necessary data between application systems. Conclusions: The presented approach enables the representation and analysis of dependencies between information processes and communication paths. With it, the HIS architecture is directly associated with the business needs. This is an important condition for the systematic planning of hospital information systems.

Authors: B. Brigl, A. Strubing, T. Wendt, Alfred Winter

Date Published: 2006

Publication Type: Journal article

NAD(P)H oxidase and multidrug resistance protein genetic polymorphisms are associated with doxorubicin-induced cardiotoxicity.
GLA - German Lymphoma Alliance

Abstract (Expand)

BACKGROUND: A significant number of patients treated with anthracyclines develop cardiotoxicity (anthracycline-induced cardiotoxicity [ACT]), mainly presenting as arrhythmias (acute ACT) or congestive … heart failure (chronic ACT). There are no data on pharmacogenomic predictors of ACT. METHODS AND RESULTS: We genotyped participants of the German non-Hodgkin lymphoma study (NHL-B) who were followed up for the development of heart failure for a median of >3 years. Single-nucleotide polymorphisms (SNPs) were selected from 82 genes with conceivable relevance to ACT. Of 1697 patients, 55 developed acute and 54 developed chronic ACT (cumulative incidence of either form, 3.2%). We detected 5 significant associations with polymorphisms of the NAD(P)H oxidase and doxorubicin efflux transporters. Chronic ACT was associated with a variant of the NAD(P)H oxidase subunit NCF4 (rs1883112, -212A-->G; symbols with right-pointing arrows, as edited?' odds ratio [OR], 2.5; 95% CI, 1.3 to 5.0). Acute ACT was associated with the His72Tyr polymorphism in the p22phox subunit (rs4673; OR, 2.0; 95% CI, 1.0 to 3.9) and with the variant 7508T-->A (rs13058338; OR, 2.6; 95% CI, 1.3 to 5.1) of the RAC2 subunit of the same enzyme. In agreement with these results, mice deficient in NAD(P)H oxidase activity, unlike wild-type mice, were resistant to chronic doxorubicin treatment. In addition, acute ACT was associated with the Gly671Val variant of the doxorubicin efflux transporter multidrug resistance protein 1 (MRP1) (OR, 3.6; 95% CI, 1.6 to 8.4) and with the Val1188Glu-Cys1515Tyr (rs8187694-rs8187710) haplotype of the functionally similar MRP2 (OR, 2.3; 95% CI, 1.0 to 5.4). Polymorphisms in adrenergic receptors previously demonstrated to be predictive of heart failure were not associated with ACT. CONCLUSIONS: Genetic variants in doxorubicin transport and free radical metabolism may modulate the individual risk to develop ACT.

Authors: L. Wojnowski, B. Kulle, M. Schirmer, G. Schluter, A. Schmidt, A. Rosenberger, S. Vonhof, H. Bickeboller, M. R. Toliat, E. K. Suk, M. Tzvetkov, A. Kruger, S. Seifert, M. Kloess, H. Hahn, M. Loeffler, P. Nurnberg, M. Pfreundschuh, L. Trumper, J. Brockmoller, G. Hasenfuss

Date Published: 13th Dec 2005

Publication Type: Not specified

Delimitation of squamous cell cervical carcinoma using infrared microspectroscopic imaging.
ProstataCA

Abstract (Expand)

Infrared (IR) spectroscopic imaging coupled with microscopy has been used to investigate thin sections of cervix uteri encompassing normal tissue, precancerous structures, and squamous cell carcinoma. … Methods for unsupervised distinction of tissue types based on IR spectroscopy were developed. One-hundred and twenty-two images of cervical tissue were recorded by an FTIR spectrometer with a 64x64 focal plane array detector. The 499,712 IR spectra obtained were grouped by an approach which used fuzzy C-means clustering followed by hierarchical cluster analysis. The resulting false color maps were correlated with the morphological characteristics of an adjacent section of hematoxylin and eosin-stained tissue. In the first step, cervical stroma, epithelium, inflammation, blood vessels, and mucus could be distinguished in IR images by analysis of the spectral fingerprint region (950-1480 cm(-1)). In the second step, analysis in the spectral window 1420-1480 cm(-1) enables, for the first time, IR spectroscopic distinction between the basal layer, dysplastic lesions and squamous cell carcinoma within a particular sample. The joint application of IR microspectroscopic imaging and multivariate spectral processing combines diffraction-limited lateral optical resolution on the single cell level with highly specific and sensitive spectral classification on the molecular level. Compared with previous reports our approach constitutes a significant progress in the development of optical molecular spectroscopic techniques toward an additional diagnostic tool for the early histopathological characterization of cervical cancer.

Authors: W. Steller, J. Einenkel, L. C. Horn, U. D. Braumann, H. Binder, R. Salzer, C. Krafft

Date Published: 6th Dec 2005

Publication Type: Not specified

Human Diseases: cervical cancer

[Topographical anatomy of the female pelvis in ultrasound].
ProstataCA

Abstract (Expand)

AIM: Achieving a high quality gynaecological ultrasound examination requires thorough knowledge of topographic anatomy. To date, there are no guidelines for a standardised course of the examination. … The goal of the study was to define exact planes by means of cross-sectional anatomy and then to standardise the gynaecological ultrasound examination with the transabdominal, introital and transvaginal technique. METHOD: We developed a software tool based on IDL (Interactive Data Language) for the female data set of the Visible Human Project which generates free determinable planes in the volume. The organs of the female pelvis were divided into landmark- and target structures according to the ultrasonic visibility and the variability of the position, shape and structure. From this, a course for the gynaecological ultrasound examination was created and verified on 65 patients each with an inconspicuous ultrasound finding. In addition, the average duration of the examination was determined. RESULTS: The landmark structures could be demonstrated in all patients. Five planes were defined for each technique, and the course of the whole examination with 15 exact planes was described. The average duration of the examination was 4.5 minutes. CONCLUSION: As of now, the digitally reconstructed anatomical illustrations have achieved the best image resolution and quality regardless of the position of the plane in the examination volume. The standardised course of the gynaecological ultrasound examination can serve as a basis for the improvement of training quality and the evaluation of a general gynaecological ultrasound screening.

Authors: J. Einenkel, U. D. Braumann, D. Baier, J. P. Kuska, L. C. Horn, M. Hockel

Date Published: 22nd Oct 2005

Publication Type: Not specified

Human Diseases: cervical cancer

Three-dimensional reconstruction and quantification of cervical carcinoma invasion fronts from histological serial sections.
ProstataCA

Abstract (Expand)

The analysis of the three-dimensional (3-D) structure of tumoral invasion fronts of carcinoma of the uterine cervix is the prerequisite for understanding their architectural-functional relationship. … The variation range of the invasion patterns known so far reaches from a smooth tumor-host boundary surface to more diffusely spreading patterns, which all are supposed to have a different prognostic relevance. As a very decisive limitation of previous studies, all morphological assessments just could be done verbally referring to single histological sections. Therefore, the intention of this paper is to get an objective quantification of tumor invasion based on 3-D reconstructed tumoral tissue data. The image processing chain introduced here is capable to reconstruct selected parts of tumor invasion fronts from histological serial sections of remarkable extent (90-500 slices). While potentially gaining good accuracy and reasonably high resolution, microtome cutting of large serial sections especially may induce severe artifacts like distortions, folds, fissures or gaps. Starting from stacks of digitized transmitted light color images, an overall of three registration steps are the main parts of the presented algorithm. By this, we achieved the most detailed 3-D reconstruction of the invasion of solid tumors so far. Once reconstructed, the invasion front of the segmented tumor is quantified using discrete compactness.

Authors: U. D. Braumann, J. P. Kuska, J. Einenkel, L. C. Horn, M. Loffler, M. Hockel

Date Published: 19th Oct 2005

Publication Type: Not specified

Human Diseases: cervical cancer

SOM portrayal of the peripheral blood transcriptome
LIFE - Leipzig Research Center for Civilization Diseases

Abstract (Expand)

Background: The transcriptome of healthy blood offers an option to characterize the physiological state of an individual with diagnostic impact. As a prerequisite such application requires the understanding … of the variability of the expression landscape of healthy individual’s as a function of factors such as age, gender, and aspects of the human constitution and lifestyle. Previous studies mostly were limited to only small population sizes and thus lack representativeness in many respects. Methods and data: The present thesis provides an extensive and detailed study on the gene expression landscape of peripheral blood of healthy individuals based on transcriptome data of 3,388 individuals screened in the population study LIFE between 2011 and 2014. For analysis we applied a neural network technique using self-organizing maps (SOM). Our home-made R-program ‘oposSOM’ enables to reduce the dimension of expression data from tens of thousands of genes to a few thousand ‘meta-genes’ and generates portraits of transcriptional activity that allowed us the sample-to-sample comparison of expression patterns. Results: We disentangled the expression patterns of the portraits into 15 well separated modules of co-expressed genes. Their activation patterns allowed us to aggregate the participants into three types (‘1’, ‘M’, ‘2’). Enrichment techniques extracts the functional context of the modules and revealed that corresponding cellular processes are selectively activated and de-activated in a type-specific fashion: For example, ‘Inflammation’ and ‘Blood coagulation’ are activated in type ‘1’ and ‘Metabolic activity’ and ‘Translation’ in Type ‘2’ samples. We map clinical parameters (complete blood count, lifestyle status, medication and the anthropometric body and BMI type) into the expression landscape in order to study the association between them and the transcriptome landscape. We found that red blood cell components, drug consumption of several drug classes affecting the cardio-vascular system or blood forming organs, tobacco and alcohol consumption, and the BMI types of obese participants highly correlate with meta-genes in the type ‘1’ area, whereas type ‘2’ meta-genes maximal correlate with the lymphocyte count and pre-obese characteristics of the participants. For blood count parameters and medication we found a gender-specific bias. Conclusion: Our analysis provides a comprehensive description of the human blood transcriptome in terms of a series of characteristic expression modules and of health-relevant factors. It provides a healthy reference system for blood transcriptome profiling studies in healthcare to extract potential associations between emerging diseases and the gene expression patterns in clinical research.

Author: M. Schmidt

Date Published: 9th Jul 2005

Publication Type: Not specified

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