The demand for automatically recognizing and retrieving medical images for screening, reference, and management is growing faster than ever. In this paper, we present an intelligent content-based image retrieval system called I-Browse, which integrates both iconic and semantic content for histological image analysis. The I-Browse system combines low-level image processing technology with high-level semantic analysis of medical image content through different processing modules in the proposed system architecture. Similarity measures are proposed and their performance is evaluated. Furthermore, as a byproduct of semantic analysis, I-Browse allows textual annotations to be generated for unknown images. As an image browser, apart from retrieving images by image example, it also supports query by natural language.

SUMMARY Three hundred and eleven patients with classical or definite rheumatoid arthritis were observed over an 11-year period. This group is of particular interest since 214 patients were given cytotoxic therapy, 203 were treated with azathioprine (52 of these also received chlorambucil or cyclophosphamide), and 11 were treated with cyclophosphamide or chlorambucil alone. Forty-six patients died. This is an excess mortality compared with the expected rate for the general population matched with respect to age and sex. The death rate was higher than expected in the age group 45-64 years but lower in those aged 75 years or over. There were more deaths from neoplasia and ischaemic heart disease in the younger age group. One patient died of lymphosarcoma; treatment had been with corticosteroids, gold, and chloroquine. No other tumours of the reticuloendothelial system were recorded, and no patient developed leukaemia.Several controlled studies have demonstrated suppression of disease activity in rheumatoid arthritis by azathioprine.'-' Since this treatment does not produce a lasting remission, long-term administration would be expected in many instances. This focuses attention on the adverse effects of prolonged administration of azathioprine, including bone marrow suppression, susceptibility to infection, and the potential development of malignant tumours.

Sucrose polyester (SPE) is a tasteless, odourless substance which reduces plasma cholesterol concentrations and may therefore be valuable as a fat substitute in human foodstuffs. It has recently been approved for use in snack foods by the United States Federal Drug Administration. The current study was designed to investigate its effects on gastrointestinal physiology and nutrient absorption in human subjects. A 6-month (2 × 3-month periods) double-blind, placebocontrolled, randomized, cross-over trial of SPE and control fat was performed in healthy freeliving volunteers. Subjects consumed 20-40 g of SPE daily (mean 26 . 8 (se 6 . 8) g) which reduced the intake of total and saturated fat but had no effect on energy intake or body weight. Plasma cholesterol and triacylglycerols were reduced. The frequency of bowel movements and their urgency were increased and anal leakage occured in 7 . 2 % of subjects. Abdominal pain was more frequent in subjects receiving SPE and was significantly greater than in the control group after 8 weeks feeding. The plasma concentrations of vitamin E and six carotenoids were significantly reduced. Routine haematology and biochemistry, other vitamins, intestinal biopsies, bile-salt retention, rectal prostaglandins, fractional Ca absorption and aminopyrine metabolism were unaffected. The ingestion of foods containing 20-40 g SPE daily provoked significant gastrointestinal problems. This intake is greater than that to be expected from the use of SPE in savoury snack foods, for which it has been approved by the United States Federal Drug Administration. However, the favourable effects on lipid profiles must be balanced against the reduction in the concentrations of vitamins and carotenoids, as these compounds may have beneficial effects on health through protection from free-radical oxidative stress. Sucrose polyester: Absorption: Cholesterol

Physicians are beginning to be able to gain access, through the Internet, to the world's collections of multimedia medical information such as MRI (magnetic resonance imaging) and CT (computer tomography) image archives, videos of surgical operations and medical lectures, textual patient records and media annotations. New techniques and tools are needed to represent, index, store and retrieve digital content efficiently across large collections. In this review, we trace the development of visual information systems for healthcare and medicine from Picture Archiving and Communications Systems (PACS) to the recent advances in content-based image retrieval, whereby images are retrieved based on their visual content similarity - that is, colour, texture, and shape. Medical images, unlike consumer-oriented images, pose additional challenges to content-based image retrieval, in that visual features of normal and pathological images are typically separated by only subtle differences in visual appearance. Intelligent image retrieval and browsing therefore requires a combination of prior knowledge of the medical domain, image content and image annotation analysis. To this end, we also overview theI-Browse project, conducted jointly by the Clinical School of the University of Cambridge and the City University of Hong Kong, which aims to develop techniques which enable a physician to search over image archives through a combination of semantic and iconic contents

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