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Biomedical subjects

F Kohler

Publications and source records attributed to F Kohler.

At least 19 recordsLinked to original sources
PubMed1999

Postural control of ballet dancers: a specific use of visual input for artistic purposes.

Dance is a specific expression of human motor behaviour. This artistic physical activity depends upon an effective technical training with important postural components and necessitates the codification of sensory inputs to build mental representations of the action to be produced. Proprioception and vision being two fundamental sensory modalities in classical ballet, this study attempted to determine the importance of the visual input for postural control during the practice of this activity. First, this work compared the performances of 18 professional ballet dancers and 46 non-dancers on a platform of forces during static posturographic tests in open or closed eyes situation. Then, we studied how professional dancers achieve balance in postures specific of classical ballet: on demi-pointe and on pointe. The results indicate that visual inputs are important in classical ballet since dancers only performed better than controls in eyes open conditions. The similar results obtained on pointe with eyes open or closed conversely suggest that training in classical ballet develops specific modalities of balance which are not transferable to posture control in daily life situations.

Adolescent↗
PubMed1998

Peer-mediated social intervention for young children with autism.

In this paper, we trace the history of peer-mediated intervention for young children with autism. Special attention is paid to outcomes achieved, implementation strategies, practicality, combining peer-mediation and naturalistic teaching, and overall conclusions from 20 years of study.

Autistic Disorder↗
PubMed1998

Integration of the analytical and alphabetical ICD10 in a coding help system. Proposal of a theoretical model for the ICD representation.

UNLABELLED: In French hospitals, medical diagnosis coding with the ICD10 is commonly performed and the use of effective tools would help coders in their task. AIM OF THIS WORK: To ameliorate an existing coding help system. This system, which already consists of the ICD10 analytical index, would be increased with the terms of the alphabetical index that includes lexical variants and additional terms as well. The addition of the second volume of the ICD would allow the coding of more terms and would lessen documentary silence. METHODS: The first step of this work was a careful study of a theoretical model of the ICD content. Then the alphabetical index file was submitted to a lexical analysis, and it was automatically transformed to be integrated into the existing coding help system. RESULTS: Compromise had to be made between a theoretical model and between what could be obtained in practice by an automatic processing of the file. Finally the alphabetical index was added to the initial thesaurus, which represents 42,000 terms and 4,000 additional words. Links between words and codes were also considerably increased, which has enhanced the searching possibilities of the tool and lessen documentary silence. Conversely the research time has been increased. CONCLUSION: Difficulties have to be encountered when trying to turn a manual tool into an automatic research tool.

Abstracting and Indexing↗
PubMed1998

Differences of case-mix according to the type of hospital: methodological aspects and results.

This study has brought to the fore variations of case-mix according to the type of French hospitals taken into consideration. The GHM line-up in the French classification of the hospital stays (French DRG) have also been studied and variations linked to the type of hospitals have been noticed too. This survey has been carried out thanks to the anonymous discharge summary issued by the national and the regional databases.

Diagnosis-Related Groups↗
PubMed1998

Evaluating a computerized tool for coding patient information.

OBJECTIVE: Computerized tools may be useful in speeding up and facilitating the laborious task of coding patient information. This paper describes a method of objectively evaluating their efficiency. DESIGN: 38 study subjects were randomly assigned to a manual coding group or an automated coding group, with stratification according to two variables (used to coding yes/no, physician yes/no). Subjects then coded the same standardized set of diagnoses in a limited time. The numbers of exact codes retrieved were compared using a global analysis of variance model. RESULTS: The two groups were not significantly different with regard to the number of physicians (p = 0.74) and the number of usual coders (p = 0.52) they included. Significantly more exact codes were achieved in the group using automated coding than among the manual group (p = 0.04). Physicians were significantly more efficient at coding than non-physicians (p = 0.02). CONCLUSION: This study describes an objective means of evaluating the performance of an automated coding tool. It shows that better results were achieved with the computerised compared to the manual method, even when the superior abilities of physicians were taken into account.

Disease↗
PubMed1997

Case mix of elderly in-patients in the 29 hospitals in Lorraine in 1994 and 1995.

The creation of regional standardized medical information databases in relation with the French anonymous discharge dataset allows the study of the geriatric case mix processed in the Lorraine region for patients over 69. The age histogram (69 to 107 years) presents a two mode distribution with an important dip centered on 79 years probably in connection with the demography of Lorraine and the consequences of the First World War. These geriatric patients represent 17% of hospitalisations in public and private hospitals participating in the public sector. The case mix is related to the size of the hospital and to its juridical status. The bigger the size of an hospital, the less its activity is concentrated on a small number of disorders. Lung and heart diseases represent the first cause of hospitalisation in all hospitals. It is necessary to underline the limitation of an approach which uses the patients' individual hospitalisations, and which does not allow different stays of a given patient on the same hospital or between different hospitals to be linked. This approach prevents from appreciating the care network for this elderly population suffering from chronic diseases.

Aged↗
PubMed1996

Methodology for using the UMLS as a background knowledge for the description of surgical procedures.

The Unified Medical Language System (UMLS) contains and organizes a large number of terms from a variety of biomedical terminology systems. This study examines the relevance of the UMLS content and structures to the specific purpose of the conceptual representation of medical procedures. The MAOUSSC modelling is a compositional formalism with a description of elementary procedures in terms of elementary concept entities and combinations of such descriptions into more complex ones. The UMLS knowledge base is expected to provide semantically categorized medical concepts and interconcept relations. A method to reuse the UMLS has been developed. Quantitative and qualitative results are presented. Some difficulties in reusing the UMLS as a background knowledge are related to the preeminence of some terminology sources and to the instanciation of interconcept links. Other ones suggest that purpose-independence in categorization cannot be achieved.

Artificial Intelligence↗
PubMed1995

Knowledge acquisition from the UMLS sources: application to the description of surgical procedures.

The re-usability of lexicons and knowledge in medicine is a crucial challenge. The Unified Medical Language System (UMLS) project has attempted to provide a repository of concepts, semantically categorized for biomedical domain. This paper describes some results about the relevance of UMLS structures for specific purposes. We have focused on the description of surgical procedures. Discussion concerns synonymy of terms, granularity of concepts, and ontology. A preliminary work on the exploitation of interconcept links by a computerized application reveals a heterogeneous implementation of those relationships. However, the UMLS provides a powerful knowledge base for developers.

General Surgery↗
PubMed1994

Factors associated with low cognitive performance in general practice.

In the preparatory phase of a randomised controlled trial data were collected to assess the magnitude of changes on cognitive functions in 1628 volunteers (age range 45-75 years) that were recruited from general practitioners' patient population. Subjects were administered a short neuropsychological battery of tests including three paper-and-pencil tests, which assessed immediate recall, delayed memory, and attention. Being on antihypertensive medication was associated with low results for all three tests in every age group, and in all strata according to blood pressure levels. Psychotropic drug use was correlated with low results for all three tests. Differences between psychotropic drug users and nonusers increased with age. Antihypertensive treatment and psychotropic drug use seem to be important to consider in longitudinal studies of cognitive decline in aging.

Aged↗
PubMed1994

Designing a sub-set of the UMLS knowledge base applied to a clinical domain: methods and evaluation.

The UMLS is a complex collection of interconnected biomedical concepts derived from standard nomenclatures. Designing a specific subset of the UMLS knowledge base relevant to a medical domain is a prerequisite for the development of specialized applications based on UMLS. We have developed a method based on the selection of the appropriate terms in original nomenclatures and the capture of a set of UMLS terms that are linked to them in the network to a certain degree. We have experimented it as the foundation for a concept base applied to urology. Results depend on the exhaustiveness of the relationships between the Metal concepts. A preliminary analysis of the sub-base reveals that some adaptations of vocabulary and ontology are required for clinical applications.

Algorithms↗
PubMed1994

Inpatient quality assurance by local analysis of uniform data set data.

We constructed a data base in order to examine the profile of patients admitted to a 24 bed inpatient rehabilitation unit at Fairfield Hospital. Data were collected according to the Uniform Data Set for Medical Rehabilitation, and collated and analysed using the Clinical Reporting System database software and the Statistical Package for Interactive Data Analysis statistical software. Outcome data collected included the patients domicile before and after admission, the duration of stay, medical diagnoses before admission to and during the stay in the Rehabilitation Unit, as well as the Functional Independence Measure item scores at admission and discharge. Analysis of the first 100 patients in the data base indicated a duration of stay of 43 +/- 34 days with a right skew distribution. Scatter plots of age and duration of stay, and age and functional improvement showed no bias in the Unit concerning these parameters. The Wilcoxon rank sum test indicated a highly significant difference (P = 0) between entry and exit Functional Independence Measure scores, indicating that patients improved functionally in the unit. Eighty three patients returned home on discharge and only five required admission to a nursing home. With the data base, the course of patients whose performance lies outside the range of normal for the unit can be examined and factors identified which produce a prolonged stay or failure to progress.

Age Factors↗
PubMed1991

Fumonisin, a toxin from the fungus Fusarium moniliforme sheld, blocks both the calcium current and the mechanical activity in frog atrial muscle.

The effects of fumonisin, a toxin isolated from the fungus Fusarium moniliforme sheld were studied on transmembrane potentials and currents of the frog heart muscle using the double sucrose gap technique. Fumonisin (280 microM) shortened the plateau duration of the action potential. Under voltage clamp conditions, fumonisin inhibited the Ca current. The block occurred without alteration of either the kinetic parameters or the apparent reversal potential of the current suggesting that the toxin blocked the maximal Ca conductance. Fumonisin reduced mainly the phasic component of the peak tension. The time to peak tension was unchanged whereas its relaxation phase was accelerated at positive membrane potentials suggesting that Na-Ca exchange was accelerated by fumonisin. Dose-response curves for the Ca current and the peak tension indicated half inhibition at about 100 microM fumonisin and a stoichiometric parameter of 1.7, suggesting that more than one toxin molecule interacted with the Ca channel. The data suggested that the effect of fumonisin on the Ca current and the tension might account for cardiac failure reported in animal intoxication by Fusarium moniliforme.

Action Potentials↗
PubMed1991

[Coding problems in medical information in the framework of the medicalization of the hospital information system].

The authors review the difficulties presented by the description of medical data, on the basis of the french experience with the programme to medicalize the hospital information system. They explain the different steps in preparing a hospital discharge abstract, and the difficulties presented by each one. They particularly stress the phase of hierarchization in choosing the principal diagnosis. They propose some solutions to improve data quality and an approach based on medical practice patterns.

Data Collection↗
PubMed1989

Prognostic significance of peripheral blood S + G2/M phase size in adult acute non-lymphoblastic leukaemia.

Flow cytometric analysis of peripheral blood (PB) S + G2/M phase size was performed in 73 adult patients with untreated acute non-lymphoblastic leukaemia, to assess whether the results may correlate to response rate and patient prognosis. All patients were treated with the same induction chemotherapy regimen: ARA-C alone or in combination with an anthracycline antibiotic. Pretreatment PB S + G2/M phase size is significantly correlated to induction response rate (p less than 0.02), duration of response (p less than 0.02) and duration of survival. Patients with low PB S + G2/M phase size experience a longer survival, in patients over and below 50 yr (p less than 0.001). Lastly, early deaths tend to be more frequent in the high median age and high PB S + G2/M phase size group. Our study suggests that PB S + G2/M phase size has prognostic significance in obtaining response and duration of survival.

Adult↗
PubMed1988

[Endothelial morphometry and perforating keratoplasties].

50 corneal grafts were studied by specular microscopy. The endothelial cell morphology of the grafts was analysed by using a computerised image analysis system. The endothelial cell density decreased rapidly during the first three post-operative months (17%). It continued to decrease for the first year (52%, after which cell loss occurred at a slower rate (3% of the sample cell count per year). The coefficient of variation in cell area remained constant (27%). The percentage of endothelial cell loss might be closely associated with the reestablishment of the hexagonal cellular pattern. These results suggest that the endothelium of the graft is in a state of transition during the first year after surgery.

Adult↗