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[Bicycle ergometer for rehabilitation].

In patients that are in rehabilitation the physical ability is measured with stationary cycle ergometers. A new ergometer, that can be mounted easily to a bicycle, allows the mobile measurement independent of the location. The principle is based on the simultaneous measurement of chain force and chain velocity. One component of the chain force is measured, that is generated by the change of the chain's direction by pulleys. The velocity of the chain is measured by the rotational speed of one of the pulleys. The new ergometer is easy to attach and remove. The measured values are digitized, numerically processed and recorded. Through a GSM-Modem these data are transmitted to a remote central host computer and allow the control/evaluation of the patient's performance.

Equipment Design↗

Recording and transmission of digital wound images with the help of a mobile device.

The goal of this project is to develop a mobile device for transmitting images for the aftercare of surgical patients within the framework of the competence center TELTRA. After designing and evaluating different platforms and cameras, it was decided to develop for a compact flash camera card and an HSCSD modem which is based on and can be plugged into a pocket PC. The recorded images are sent with the help of a Java program from the pocket PC over an IrDA interface to the HSCSD mobile telephone, and then to the web server, where it is saved in a digital patient record.

Computer Communication Networks↗

Telemedicine for antenatal surveillance of high-risk pregnancies with ambulatory and home fetal heart rate monitoring--an update.

Antepartum fetal surveillance is routinely used to assess the risk of fetal death in high-risk pregnancies. Traditionally, testing is performed in the hospital or outpatient clinic by trained medical staff. New equipment is now available that is easy to operate and can be used for self-monitoring of the fetal heart rate (FHR) in the home setting. The tracings are transmitted by modem to a referral center for immediate interpretation by a health provider. The aim of this review was to assess the current data on the application of this new technology with regard to feasibility, access to care, maternal and neonatal outcome, patient and physician satisfaction, and cost-effectiveness.

Ambulatory Care↗

Role of reproductive technologies and genetic resource banks in animal conservation.

In combination with modem reproductive technologies, there is potential to use frozen and stored germplasm (genetic resource banks) to support conservation measures for the maintenance of genetic diversity in threatened species. However, turning this idea into reality is a complex process, requiring interdisciplinary collaboration and clearly defined goals. As the number of species deserving the attention of conservation scientists is overwhelmingly large, yet detailed knowledge of reproductive physiology is restricted to relatively few of them, choosing which species to conserve is one of the most difficult issues to be tackled. Besides the direct application of technologically advanced reproductive procedures, modern approaches to non-invasive endocrine monitoring play an important role in optimizing the success of natural breeding programmes. Through the analysis of urine and faecal samples, this type of technology provides invaluable management information about the reproductive status of diverse species. For example, it is possible to diagnose pregnancy and monitor oestrous cycles in elephants and rhinos without causing stress through restraint for sample collection. In this review, we identify the potential contribution of reproductive biology and genetic resource banks to animal conservation, but also highlight the complexity of issues determining the extent to which this potential can be achieved.

Animals↗

Body composition and peak aerobic power in male international level Hungarian athletes.

Body size, physique, body composition and physiological performance of elite athletes are independent aspects, have aroused the interest of exercise scientists, but studies that combine these aspects in elite athletes are scarcely available. The aim of the present study was to describe the selected anthropometric and exercise physiological characteristics of some Hungarian top athletes. The investigated subjects were qualified Hungarian water polo players (n=25), paddlers (n=24) and modem pentathlonists (n=20), all of whom had been medalists at several continental and intercontinental competitions. The athletes' body composition was estimated by the Drinkwater-Ross (45) body mass fractionation technique. Peak physiological performance was estimated by graded exhausting spiroergometric treadmill exercise. Intergroup differences in mean height, body mass and body composition characteristics were significant at the 5% level of random error. By the results of spiroergometry, all the three groups compared could be qualified as physically excellently trained. The greatest oxygen uptake relative to body mass was found in the modern pentathlonists (73.22 ml x kg(-1) x min(-1)) and the lowest one (59.79) in the water polo players. The authors do not disregard the favourable effects of regular and adequate trainings in the development of the studied characteristics, but in their opinion the process of proper selection has been the most important factor that explains the observed significant intergroup differences.

Body Composition↗

[Role of radiology in forensic dentistry].

There are various methods for the identification of human remains; most of them are based on comparisons between available ante- and post-mortem data. Although fingerprinting is the most accurate and precise method, in many cases, such as in mutilated, decomposed, burned or fragmented bodies, it cannot be used, and the dental methods become of the utmost importance, since teeth and dental restorations are very resistant to destruction by fire--they keep numerous characteristics, which are quite unique, and offer the possibility of accurate and legally acceptable identification of remains. This brief review describes the progress of forensic dentistry during the last 25 years, regarding the procedures and techniques that use ante-mortem and post-mortem radiographs. Among the discussed progresses one can point out: a specially designed self-supporting film holder that retains intra-oral films in the mouths of deceased persons whose mandibular musculature has been fixed in rigor mortis; positioning devices suitable for reproducing the geometry of ante-mortem radiographic images; methods involving digital radiographs, which can be easily stored in a central archive, retrieved and transmitted, via modem, to mass casualty sites; age estimation procedures; identification of edentulous individuals comparing radiographs of the maxilla; and studies of validation of dental radiographs taken with ante-mortem and post-mortem intervals of up to 30 years.

Age Determination by Teeth↗

The role of the pineal gland in magnetobiological effects.

The problem of pineal mognetosensitivity is considered in light of modem magnetobiology publications and the authors' own findings. It has been shown that electromagnetic exposure of different parameters affects pineal activity. Changes in the temporal organization of biological systems are suggested to be the main effect of electromagnetic exposure. Modern data evidence that there are magnetoreceptive structures aside from the pineal gland.

Animals↗

Nocturnal hemodialysis: three-year experience.

There is evidence that high frequency, as well as long duration, hemodialysis provides better clinical outcomes. We developed nocturnal hemodialysis, a new innovative form of renal replacement therapy, which is performed six to seven nights per week for 8 to 10 h during sleep at home. Blood flow was set at 300 ml/min and dialysate flow at 100 ml/min. An internal jugular catheter was used as the vascular access. Special precautions were taken to prevent accidental disconnection during sleep, as well as air embolization. Dialysis functions from the patient's home were monitored continuously via a modem at the nocturnal hemodialysis center. Twelve patients have completed training and have been successfully performing nocturnal hemodialysis for up to 34 mo. This study represents 170 patient months of experience accumulated over 3 yr. There was hemodynamic stability and significant subjective improvement in patient well being. Nightly Kt/V was 0.99. Weekly removal of phosphate was twice as high and beta2 microglobulin 4 times as high as conventional hemodialysis. All patients have discontinued their phosphate binders and have increased dietary phosphate and protein intake. BP control was achieved with fewer medications. Dialyzer reuse has decreased the operating costs to the level of the other form of home dialysis. Complications were infrequent and were related primarily to the dialysis access. Nocturnal hemodialysis represents the most efficient form of dialysis at low cost and should be considered as an option for patients who can be trained for home hemodialysis.

Adult↗

The rapid implementation of a statewide emergency health information system during the 1993 Iowa flood.

In the face of disastrous flooding, the Iowa Department of Public Health established the statewide Emergency Computer Communications Network to establish rapid electronic reporting of disaster-related health data, provide e-mail communications among all county health departments, monitor the long-range public health effects of the disaster, and institute a general purpose public health information system in Iowa. Based on software (CDC WONDER/PC) provided by the Centers for Disease Control and Prevention and using standard personal computers and modems, this system has resulted in a 10- to 20-fold increase in surveillance efficiency at the health department, not including time saved by county network participants. It provides a critical disaster assessment capability to the health department but also facilitates the general practice of public health.

Computer Communication Networks↗

Operational aspects of Quality-of-Life Assessment. Choosing the right instrument.

In assessing quality of life, the most important goal is to develop a strategy that produces useable and useful information for decision making. Assessment design is complex, and whether an assessment is developed from scratch, or 1 or more portions of existing instruments are adapted, the focus must be on the quality of the theoretical and operational elements of the particular line of inquiry and its environment. The necessary and most often discussed focus on the theoretical dimensions of validity, reliability and responsiveness is not sufficient to insure that the data are of the requisite high quality. There is also a need, almost universally given little attention in the literature, to look at operational aspects, such as design, format, flow, appearance, and response-stimulus, of each assessment instrument. Searching for guidance in the quality-of-life (QOL) literature remains a challenge even with computers, modems, keywords, static guidebooks and bibliographic systems. The On-Line Guide to Quality-of-Life Assessments (OLGA) is presented as a personal computer-based system that is updated 3 times a year to provide QOL researchers and assessment developers with 2 databases: assessments providing full descriptions and contact information; and references providing fully keyed citations to the assessment use literature. These databases are made more useful by decision-logical programs that identify relevant assessments and supporting research literature. OLGA can thus save time and other resources by helping investigators concentrate on the most relevant elements of the existing literature. This focus will assist them in avoiding the problems of ending up with the right answers to the wrong questions.

Health Status↗

[Microbes on the edge of global biosphere].

The search for life on the edge of global biosphere is a frontier to bridge conventional bio/ecology and exo/astrobiology. This communication reviews the foci of microbiological studies on the inhabitants of the selected "edges", i.e., deep-sea, deep subsurface and Antarctic habitats. The deep-sea is characterized as the no-light (non-photosynthetic) habitat, and the primary production is mostly due to the chemosynthetic autotrophy at the hydrothermal vents and methane-rich seeps. Formation of the chemosynthesis-dependent animal communities in the deep leads to the idea that such communities may be found in "ocean" of the Jovian satellite, Europa. The oxygen minimal layer (OML) in mid-water provides another field of deep-sea research. Modern OML is a relatively thin layer, found between the water depth of 200 and 1000 m, but was much thicker during the periods of oceanic anoxia events (OAEs) in the past. The history of oceanic biosphere is regarded as the cycle of OAE and non-OAE periods, and the remnants of the past OAEs may be seen in the modem OML. Anoxic (no-O2) condition is also characteristic of deep subsurface biosphere. Microorganisms in deep subsurface biosphere exploit every available oxidant, or terminal electron acceptor (TEA), for anaerobic respiration. Sulfate, nitrate, iron (III) and CO2 are the representative TEAs in the deep subsurface. Subsurface of hydrothermal vents, or sub-vent biosphere, may house brine (high salt) habitats and halophilic microorganisms. Some sub-vent halophiles were phylogenetically closely similar to the ones found in the Antarctic habitats which are extremely dry by the liophilizing climate. Below the 3000-4000 m-thick glacier on Antarctica, there have been >70 lakes with liquid water located. One of such sub-glacial lakes, Lake Vostok, has been a target of "life in extreme environments" and is about to be drill-penetrated for microbiological studies. These 'microbiological platforms' will provide new knowledge about the diversity and potential of the Earth's life and facilitate the capability of astrobiologial exploration.

Antarctic Regions↗

Solo practice management: value of a computerized reporting system.

OBJECTIVE. A computerized reporting system based on keyed entry of acronyms and eponyms was developed to reduce transcription delays and speed report output for a solo radiology practice that covers several community hospitals in a large region. The purpose was to improve practice outcomes, quality assessments, continuing medical education, and billing efficiency. SYSTEM AND APPLICATIONS. Over a 10-year period, problems in accurate reporting, transcription delays, slowed report deliveries, and incomplete or lost billings were described to computer programmers. These programmers composed 31,000 lines of computer code designed to address the problems. The resultant program was applied to 100,000 imaging procedures. Entry of commonly used clinical acronyms, eponyms, and other symbol strings chosen by the interpreting radiologist triggered the immediate printing of a report's text at the radiologist's desk. After the reports were proofread, electronically authenticated, and/or hand signed, they were sent to distant locales by facsimile transmission. During new case interpretations, potentially erroneous statements of fact or judgement were prevented by enabling the interpreter to instantly review old reports, informative elements of a patient's history, and pertinent medical literature, all of which was placed in various caches of the computer's memory. Billing labor was reduced by automatically providing the number identifying each procedure and the diagnoses made during image interpretation. OPERATION. The acronym/eponym-based reporting system was time- and cost-effective. The new system reduced typing strokes by 84%, and reports were generated in 1 min, while the studies were being interpreted. With the retrieval and monitoring techniques operating on old, stored information, new reporting errors, as well as some diagnostic oversights, were reduced by 50%. Counting the acronyms and symbols representing imaging quality and technical problems showed an 11% mistake rate. Modem transmission of automatically included current procedural terms and disease classification numbers reduced billing labor by 50% and reduced lost charges to zero. The same messaging mechanism of the program sent the text of interpretations to remote clinics and hospitals a few minutes after the radiologist's interpretation was made. CONCLUSION. My experience suggests that a computerized reporting and messaging system based on acronyms and eponyms is a time- and cost-effective technique for managing a solo radiology practice. By using a programmable relational data base, one can modify the system to include educational, quality improvement, and billing functions.

Abbreviations as Topic↗

The virtual lecture: delivery of live and recorded presentations over the Internet.

OBJECTIVE: Our objective was to deliver live and recorded lectures, with images, over the Internet using streaming media. CONCLUSION: Streaming media are an emerging technology that can deliver live lectures over the Internet using standard PCs and modems. These lectures are also simultaneously recorded and can be played back at any time by individuals with access to the Web.

Education, Distance↗

The virtual course: delivery of live and recorded continuing medical education material over the Internet.

OBJECTIVE: Our objective was to deliver live and recorded lectures from a continuing medical education course, including the representations of original slides, over the Internet, using streaming audio media. CONCLUSION: The streaming audio media, an emerging technology, not only delivers large lectures over the Internet using commercially available PCs and modems, but also allows review at any time by individuals with access to the Web. An interactive conference of continuing medical education curriculum can thus be delivered and continuing medical education credit earned without leaving home.

Education, Distance↗

[Computer communication between an ambulatory centre and its hospital of reference].

BACKGROUND: To analyse the demand for medical information requested by a primary care team from its hospital of reference over an 18 month period. MATERIAL AND METHODS: Patients assigned to 5 surgeries of a primary care team, which had computerised clinical records available in its hospital of reference. In 1995 computerised communication via modem was set up between this team and the "Local Area Network" of its hospital of reference. This connection allows members of the team to carry out real time consultations of the hospital clinical records of their patients (reports, complementary explorations...) and the laboratory and radiology reports requested by the primary care team. Consultations made over an 18 month period (March 96 - August 97) were analysed. RESULTS: Five hundred and twenty three consultations were made (29.06 per month). Ninety three point seven per cent of the patients concerning whom consultations were made had a computerised clinical record available. The most consulted services were: Radiology (28.7%), Laboratory (25.2%) and Internal Medicine (16.3%). The most consulted parts of the clinical record were those corresponding to the results of complementary tests: simple radiology (27.3%), haematology and biochemistry (24.7%), other explorations (23.7%). Some 67.5% of the searches were considered "resolutive" by the consulting doctor. An average of 4 minutes 13 seconds were employed per consultation. CONCLUSIONS: The information principally required by the family doctor was the results of complementary tests and, in particular, from the laboratory and radiology. Computerised communication between primary care and specialised care is going to be an effective, and probably efficient, system for improving communication between the two levels.

English Abstract↗

Transmitting deaf sign language over the telecommunications network.

An experimental investigation is reported into the use of moving cartoon images for two-way communication by the deaf. The images are derived by special signal-processing operations on the output of a conventional television camera, according to a new theory of perceptually important human features. Calculations show that, using facsimile-type coding and digital modems, the images are capable of transmission over the Public Switched Telephone Network; in enhanced form (with more resolution and optional voice accompaniment) they could be carried on the emerging Integrated Services Digital Network or transmitted over teletext.

Communication Devices for People with Disabilities↗

A fast communication aid for non-verbal subjects with severe motor handicaps.

A computer-based communication system for non-verbal persons with severely deficient coordination of the upper extremities is described. The device doubles as an environmental control unit. Modular design is chosen throughout. Commercially available subunits are used to reduce cost. Input is by a 3 x 3 keyboard, when the user has some command over his hands. Otherwise a binary 'autoscan' access mode is used, which is controlled by repeated closures of a single binary switch. Output is in written form on a display or acoustical by synthesized speech. Hard-copy output can also be provided. Remote communication is possible by modem or by synthesized speech. Speed of message generation is increased by establishing a vocabulary, which contains, in addition to signs and letters of the alphabet, whole words and stereotyped phrases. The data blocks of the latter are accessed by a single input cycle similar to that used for the selection of isolated letters, symbols, etc.

Communication Devices for People with Disabilities↗

Intraocular gas tamponades.

Intraocular gas tamponades are an important part of vitreoretinal surgery and have become a standard of care. The use of intraocular gas began in 1911. Modem use of intraocular gases as a surgical adjunct is continuously broadening. Today, sulfur hexafluoride and perfluoropropane are increasingly being used as intraocular gas tamponades for a wide range of complicated vitreoretinal diseases. This article reviews the types and function of commonly used gases, their indications and efficacy in certain types of vitreoretinal diseases, and their complications.

Air↗