Steven U. Brint

The display of photographic-quality images on the Web: a comparison of two technologies

Downloading medical images on the Web creates certain compromises. The tradeoff is between higher resolution and faster download times. As resolution increases, download times increase. High-resolution (photographic quality) electronic images can potentially play a key role in medical education and patient care. On the Internet, images are typically formatted as Graphics Interchange Format (GIF) or the Joint Photographic Experts Group (JPEG) files. However, these formats are associated with considerable data loss in both color depth and image resolution. Furthermore, these images are available in a single resolution and have no capability of allowing the user to adjust resolution as needed. Images in the photo compact disc (PCD) format have higher resolutions than GIF or JPEG, but suffer the disadvantage of large file sizes leading to long download times on the Web. Furthermore, native Web browsers are not currently able to read PCD files. The FlashPix format (FPX) offers distinct advantages over the PCD, GIF, and JPEG formats for display of high-resolution images on the Web. A Java applet can be easily downloaded for viewing FPX images. FPX images are higher resolution than JPEG and GIF images. FPX images offer rich resolutions comparable to PCD images with shorter download times.

Making the neurology clerkship more effective: can e-Textbook facilitate learning?

Abstract Objective: In 1998, the 4-week neurology elective clerkship was converted into a 2-week required neurology rotation at the University of Illinois at Chicago. We hypothesized that the interactive e-Textbook, a computer-assisted learning tool, could successfully replace a paper-based syllabus and a traditional neurology textbook during a 2-week rotation, while incorporating department teaching conferences to replace the medical student lecture series. Methods: We created an e-Textbook and made it available simultaneously in a CD-ROM format and on a password-protected website. The online quiz and course assessment were administered by the Blackboard Web Server. Results: After implementation of the e-Textbook over 6 years, the feedback shows high student satisfaction, and student evaluations of the neurology clerkship have risen. Creation of an e-Textbook for the neurology clerkship made our faculty more productive while increasing student satisfaction and facilitating learning efficacy. Discussion: The results show that the e-Textbook is an appropriate alternative to facilitate learning of basic and clinical neurology during a 2-week rotation. The students demonstrated successful learning in a computerized environment.

17O magnetic resonance imaging of the human brain

Abstract Here we show the first example of in vivo oxygen-17 (17O) magnetic resonance imaging of the human in natural abundance. Two-dimensional fast multi-planar gradient recalled 90 deg echo (FMPGR/90) pulse sequence and three-dimensional projection reconstruction pulse sequence methods were used.

Bilateral language representation demonstrated by language-activated SPECT and Wada test

AbstractLanguage activated SPECT may offer a valuable additional means of localizing language function in patients undergoing epilepsy surgery. In this case, the language activated SPECT confirmed bilateral language representation which was confirmed by Wada testing. [Neurol Res 1996; 18: 209–211]

In vivo natural-abundance17O/1H MRI of rhesus monkey body in a whole-body scanner

In vivo natural-abundance17O and1H magnetic resonance imaging (MRI) techniques were combined to image the whole body of a rhesus monkey. The results demonstrate the feasibility of acquiring consecutive fast17O and1H images with a standard MRI scanner. The method has applications in the field of functional MRI and in17O MRI measurements of metabolism rate.

Normalization of transcranial Doppler middle cerebral artery velocities after aneurysm clipping

BACKGROUND Factors that promote normalization of middle cerebral artery (MCA) velocities after cerebral aneurysm surgery may be important to identify in order to optimize management. Survival analysis of serial transcranial Doppler (TCD) MCA velocities in the setting of aneurysm surgery offers an additional means of analyzing outcome. METHODS We retrospectively studied serial MCA velocities obtained via TCD in 113 patients who underwent cerebral aneurysm clipping to analyze which factors promoted normalization. The presence of bleeding, aneurysm location, age, gender, ethnicity, initial blood pressure, hemoglobin, and clinical condition were examined. RESULTS Patients who did not bleed but were clipped still tended to have transient periods of abnormally elevated velocities. Of those patients who bled and were clipped, older patients normalized faster. Women showed a trend toward slower normalization only in the subarachnoid hemorrhage (SAH) absent group. Other parameters listed above did not effect normalization time. CONCLUSIONS Our data suggest aneurysm surgery in and of itself may promote transient rises in MCA velocities. Age appears to be a significant factor in predicting normalization of MCA velocities after SAH.

Acute stroke therapies

It is likely that thrombolytic agents will play a role in the management of acute ischemic stroke in well-selected patients, intravenous administration is most practicable. However, intra-arterial administration via superselective catheterization is an alternative option that may offer advantages is certain settings (e.g., angiography suite, intraoperatively). Tissue plasminogen activators appear safer than streptokinase. Fibrinolytic agents offer the unproven potential for improving stroke outcome with less risk of intracranial bleeding. LMWHs can be administrated subcutaneously with minimal blood monitoring. These agents may prove more useful for secondary stroke prevention rather than acute treatment. Introduction of other agents like monoclonal antibodies directed against leukocyte adhesion molecules, aspirin, or ticlopidine offer other potential approaches to improving stroke outcome.

Converting Laserdisc Video to Digital Video: A Demonstration Project Using Brain Animations

Interactive laserdiscs are of limited value in large group learning situations due to the expense of establishing multiple workstations. The authors implemented an alternative to laserdisc video by using indexed digital video combined with an expert system. High-quality video was captured from a laserdisc player and combined with waveform audio into an audio-video-interleave (AVI) file format in the Microsoft Video-for-Windows environment (Microsoft Corp., Seattle, WA). With the use of an expert system, a knowledge-based computer program provided random access to these indexed AVI files. The program can be played on any multimedia computer without the need for laserdiscs. This system offers a high level of interactive video without the overhead and cost of a laserdisc player.

A frame-based peripheral nervous expert system

We designed a framed-bawd cducalional system to teach medical srudents and house staff core knowledge about the peripheral nervous system. Ry integrating hypermedia and expen systems \echniques, we creatcd an interactive electronic book that combines text and images. This unit provides a tlexible and interactive introduction lo the peripheral nervous system. It maximizes feedback to the student while reducing the teaching load on the faculty.