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References

www.drugs.com
www.medicinenet.com
www.webopedia.com

CASE STUDY OF MYCIN

MYCIN is one of the most widely known of all expert system
applications developed. And this despite the fact that it has never
been put into practice. However, MYCIN is significant to the history of
expert/knowledge-based systems for two particular reasons. First,
unlike DENDRAL, which used a 7 model of a particular molecule as
the basis for its reasoning, MYCIN was constructed from interviews
with various doctors in the particular domain. Therefore, MYCIN
contains a number of heuristic rules that are used by physicians in
the identification of certain infections. The second major contribution
of MYCIN was the later development of EMYCIN (Empty MYCIN).
EMYCIN was the first expert/knowledge-based system shell. It took
approximately 20 man-years to develop the MYCIN program. The
researchers realized that if expert systems were to become a viable
problem solving technique this development time must be cut. In an
effort to do reduce the time to develop an expert system the
researchers developed EMYCIN by taking all of the rules out of the
system and leaving just an empty “shell” in which other developers in
other domains could then just “plug-in” their new knowledge base.
One of the best known expert systems is MYCIN (Shortliffe 1976;
Davis, Buchanan and Shortliffe 1977), a program for advising
physicians on treating bacterial infections of the blood and meningitis.
It does reasonably well without common sense, provided the user has
common sense and understands the program's limitations.

MYCIN conducts a question and answer dialog. After asking basic
facts about the patient such as name, sex and age, MYCIN asks
about suspected bacterial organisms, suspected sites of infection, the
presence of specific symptoms (e.g. fever, headache) relevant to
diagnosis, the outcome of laboratory tests, and some others. It then
recommends a certain course of antibiotics. While the dialog is in
English, MYCIN avoids having to understand freely written English by
controlling the dialog. It outputs sentences, but the user types only
single words or standard phrases. Its major innovations over many
previous expert systems were that it uses measures of uncertainty
(not probabilities) for its diagnoses and the fact that it is prepared to
explain its reasoning to the physician, so he can decide whether to
accept it.

MYCIN begins with its ontology. The ontology of a program is the set
of entities that its variables range over. Essentially this is what it can
have information about.

MYCIN's ontology includes bacteria, symptoms, tests, possible sites
of infection, antibiotics and treatments. Doctors, hospitals, illness and
death are absent. Even patients are not really part of the ontology,
although MYCIN asks for many facts about the specific patient. This
is because patients aren't values of variables, and MYCIN never
compares the infections of two different patients. It would therefore be
difficult to modify MYCIN to learn from its experience.

The production formalism turned out to be suitable for representing a
large amount of information about the diagnosis and treatment of
bacterial infections. When MYCIN is used in its intended manner it
scores better than medical students or interns or practicing
physicians and on a par with experts in bacterial diseases when the
latter are asked to perform in the same way. However, MYCIN has
not been put into production use, and the reasons given by experts in
the area varied Some said it would be ok if there were a means of
keeping MYCIN's database current with new discoveries in the field,
i.e. with new tests, new theories, new diagnoses and new antibiotics.
For example, MYCIN would have to be told about Legionnaire's
disease and the associated Legionnella bacteria which became
understood only after MYCIN was finished. (MYCIN is very stubborn
about new bacteria, and simply replies ``unrecognized response''.)

Others say that MYCIN is not even close to usable except
experimentally, because it doesn't know its own limitations. I suppose
this is partly a question of whether the doctor using MYCIN is trusted
to understand the documentation about its limitations. Programmers
always develop the idea that the users of their programs are idiots, so
the opinion that doctors aren't smart enough not to be misled by
MYCIN's limitations may be at least partly a consequence of this
ideology.

An example of MYCIN not knowing its limitations can be excited by
telling MYCIN that the patient has Cholerae Vibrio in his intestines.
MYCIN will cheerfully recommend two weeks of tetracycline and
nothing else. Presumably this would indeed kill the bacteria, but most
likely the patient will be dead of cholera long before that. However,
the physician will presumably know that the diarrhea has to be
treated and look elsewhere for how to do it.

On the other hand it may be really true that some measure of common sense is
required for usefulness even in this narrow domain. We'll list some areas of
common sense knowledge and reasoning ability and also apply the criteria to
MYCIN and other hypothetical programs operating in MYCIN's domain.

CASE STUDY OF E-MYCIN
GENERIC NAME: erythromycin

BRAND NAMES: E-Mycin, Eryc, Ery-Tab, PCE, Pediazole, Ilosone

DRUG CLASS AND MECHANISM: Most infections are caused by
bacteria that invade and grow in the human body. Medications that
control or eradicate these bacteria are called antibiotics. Erythromycin
is an antibiotic that prevents bacteria from producing proteins, which
interferes with bacterial growth and multiplication, while not affecting
human

Erythromycin is an antibiotic used to treat many kinds of infections,
including:

Acute pelvic inflammatory disease

Gonorrhea

Intestinal parasitic infections

Legionnaires' disease
Listeriosis
Pinkeye
Rectal infections
Reproductive tract infections
Skin infections
Syphilis
Upper and lower respiratory tract infections
Urinary tract infections
Whooping cough

Erythromycin is also prescribed to prevent rheumatic fever in people
who are allergic to penicillin and sulfa drugs. It is prescribed before
colorectal surgery to prevent infection.

Most important fact about this drug
Erythromycin, like any other antibiotic, works best when there is a
constant amount of drug in the blood. To help keep the drug amount
constant, it is important not to miss any doses. Also, it is advisable to
take the doses at evenly spaced times around the clock.

Medication
Some forms of erythromycin are most effective when taken on an
empty stomach. Your doctor may advise you to take each dose at
least 1/2 hour and preferably 2 hours before meals. Delayed release
formulations may be taken with or without food.

Chewable forms of erythromycin should be crushed or chewed before
being swallowed.

Delayed-release brands and tablets and capsules that are coated to
slow their breakdown should be swallowed whole. Do not crush or
break. If you are not sure about the form of erythromycin you are
taking, ask your pharmacist.

The liquid should be shaken well before each use.
• If you miss a dose...
Take it as soon as you remember. If it is almost time for your
next dose, and you take 2 doses a day, space the missed dose
and the next dose 5 to 6 hours apart; if you take 3 or more
doses a day, space the missed dose and the next one 2 to 4
hours apart. Never take 2 doses at the same time.

• Storage instructions...
The liquid form of erythromycin should be kept in the
refrigerator; use E.E.S. within 10 days. Do not freeze. Store
tablets and capsules at room temperature in a tightly closed
container.

side effects
Side effects cannot be anticipated. If any develop or change in
intensity, inform your doctor as soon as possible. Only your doctor
can determine whether it is safe to continue taking this medication.

• Side effects may include:
Abdominal pain, diarrhea, loss of appetite, nausea, vomiting

Case study of neomycin

Generic Name: neomycin (nee oh MY sin)
Brand Names: Mycifradin, Neo-Fradin, Neo-Tab

Neomycin is an antibiotic.
Neomycin is used to reduce the risk of infection during surgery of the
bowel. Neomycin is also used to reduce the symptoms of hepatic
coma. Neomycin may also be used for purposes other than those
listed here.

Neomycin may cause damage to the kidneys and/or nerves. Kidney
function and drug levels in the blood may be monitored with blood
tests during treatment. Tell your doctor if you experience decreased
urination, hearing loss, ringing in the ears, feeling of fullness in the
ears, dizziness, numbness, skin tingling, muscle twitching, or
seizures which may be signs of kidney or nerve damage.

Do not take neomycin without first talking to your doctor if you have

• kidney disease;
• a blockage in the intestines;
• bowel disease such as Crohn's disease or ulcerative colitis;
• a neuromuscular disorder such as Parkinson's disease or
myasthenia gravis;
• hearing loss or loss of balance due to ear problems; or
• other medical problems or if you take other medications.
You may not be able to take neomycin, or you may require a dosage
adjustment or special monitoring during treatment if you have any of
the conditions listed above.

Neomycin side effects
If you experience any of the following serious side effects, stop taking
neomycin and seek emergency medical attention:
• an allergic reaction (shortness of breath; closing of the throat;
hives; swelling of the lips, face, or tongue; rash; or fainting);
• little or no urine;
• decreased hearing, ringing in the ears, or a feeling of fullness in
the ears;
• dizziness, clumsiness, or unsteadiness;
• numbness, skin tingling, muscle twitching, or seizures; or
• severe watery diarrhea and abdominal cramps.
Other, less serious side effects may be more likely to occur. Continue
to take neomycin and talk to your doctor if you experience
• nausea or vomiting; or
• diarrhea.
DIFFERENCE BETWEEN Artificial intelligence & Expert
system
S.NO ARTIFICIAL EXPERT SYSTEM
INTELLIGENCE
1. The branch of computer A computer application that
science concerned with performs a task that would
making computers behave otherwise be performed by a
like humans. human expert.
Artificial intelligence
includes: For example, there are expert
games playing systems that can diagnose
expert systems human illnesses, make financial
natural language forecasts, and schedule routes
neural networks for delivery vehicles. Some
robotics expert systems are designed to
take the place of human experts,
while others are designed to aid
them.

2. Currently, no computers Expert systems are part of a
exhibit full artificial general category of computer
intelligence (that is, are applications known as artificial
able to simulate human intelligence
behavior

3. Computer-based system Ability of a machine to perform
designed to respond like a tasks thought to require human
human expert in a given intelligence
field.

4. Expert systems are built AI, or at least the semblance of
on knowledge gathered intelligence, has developed in
from human experts, parallel with computer
analogous to a database processing power, which
but containing rules that appears to be the main limiting
may be applied to solving a factor. Early AI projects, such as
specific problem. An playing chess and solving
interface allows the user to mathematical problems, are now
specify symptoms and to seen as trivial compared to
clarify a problem by visual pattern recognition,
responding to questions complex decision making, and
posed by the system. the use of natural language.
Software tools exist to help
designers build a special-
purpose expert system
with minimal effort. An
outgrowth of work in
artificial intelligence,
expert systems show
promise for an ever-
.