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At least 541 records · Page 30Linked to original sources
PubMed1999

Surgical anatomy and morphometric analysis of the optico-chiasmatic apparatus, optic canal and sphenoid ridge.

An anatomical study was performed in order to obtain help for orientation regarding the cranial base approaches to the anterior cranial base. Cranial base approaches were studied in 8 adult cadaver heads, and morphometric measurements critical in these approaches were achieved in 76 dry skulls. Importance of the surgical anatomy of the opticochiasmatic apparatus, optic canal, sphenoid ridge, and anterior clinoid was emphasised in this study. Observations from the dissections and operative approaches, and measurements between various points were recorded in a specifically designed software, and these data helped both to understand the local anatomy and the relationship to the intimate structures better and to decide the head position, the degree and direction of safe bony removal, and the direction of the operative approach during the surgery. Considerations important in the selection of these structures, anatomical landmarks and distances were discussed.

Adult↗
PubMed1995

Diffuse esophageal spasm: a malfunction that involves nitric oxide?

OBJECTIVE: As recently suggested, nitric oxide (NO) may play an important role in the regulation of esophageal motility, being partly responsible for the latency period and latency gradient between the onset of a swallow and contractions of esophageal circular smooth muscles. Diffuse esophageal spasm appears to be a classical example in which the mechanisms normally responsible for the physiologic timing of the contractions occurring in the esophageal body after swallowing are disturbed. METHODS: Five patients (one male and four female; age, 18-48 years) with symptomatic esophageal spasm were give glyceryl trinitrate (GTN) intravenously in gradually increasing doses or L-arginine on two separate occasions and underwent manometric measurements of esophageal motility after wet swallows, using a multilumen perfused catheter system (Synetics Medical, Stockholm, Sweden). The amplitude, duration, and propagation of the contractions and the latency period were analyzed, using specially designed software. Additionally, during the GTN infusion period arterial blood pressure was measured every 5 min, RESULTS: GTN infusion given at a dose of 100 to 200 micrograms/kg-h intravenously caused the occurrence of and a dose-dependent elongation of the latency period after swallowing. The mean amplitude of the contractions did not show any significant alterations, whereas the mean duration of the contractions decreased significantly, from 11.2 +/- 4.8 sec to 5.4 +/- 0.8 sec. These effects were accompanied by significant alleviation of symptoms during swallowing. Interestingly, no adverse side effects such as headache or flush were observed at any dose of GTN. The blood pressure did not show any changes during the studies in any of the five patients. Administration of L-arginine (300 mg/kg-h intravenously) did not cause any significant alterations of motility pattern or alleviation of dysphagia. CONCLUSIONS: 1) NO may play an important role in the control of human esophageal motility, being involved in the mechanisms responsible for the timing of propulsive contractions in the body after swallowing; 2) GTN may to be of benefit in the treatment of diffuse esophageal spasm in symptomatic patients; and 3) patients with diffuse esophageal spasm may have a malfunction in endogenous NO synthesis and/or degradation.

Adolescent↗
PubMed1991

Visual display of tongue-palate contact: electropalatography in the assessment and remediation of speech disorders.

The technique of electropalatography (EPG) records the location and timing of tongue contacts with the hard palate during continuous speech. Recent developments in hardware and software design of the Reading electropalatograph are described and applications of the technique in assessment and remediation of a variety of speech disorders are outlined. In assessment, it is shown that EPG can provide insights into possible origins of auditorily perceived errors, and case descriptions illustrate how this information can lead to a more rationalised approach to treatment. In therapy, the provision of real-time visual feedback of tongue movement can be effective in the remediation of certain types of intractable speech problems. Finally, the importance of techniques such as EPG in the objective evaluation of treatment procedures is discussed in the light of the increasing demand for accountability within the speech therapy service.

Adolescent↗
PubMedDate not supplied

DIABNET: a qualitative model-based advisory system for therapy planning in gestational diabetes.

An intelligent decision support system for the analysis of home monitoring data and therapy planning in gestational diabetes is presented. The paper describes the integration of qualitative and quantitative reasoning modules within the DIABNET advisory system. The system kernel is a qualitative model of the physiological processes involved in the glucose metabolism of this type of diabetic patient. A causal probabilistic network (CPN) has been used to represent the qualitative model in order to manage uncertain and missing monitoring data. The DIABNET inputs are the patient's available ambulatory monitoring data, and the output is a dietary and insulin therapy adjustment that includes initiation of insulin therapy, quantitative insulin dose changes and qualitative diet and schedule modifications. Over periods of up to seven days, monitoring data are analysed by the CPN to detect any diet or insulin therapy items which may require modification. The qualitative insulin needs are translated into a quantitative proposal in line with the characteristics of the patient and the modification strategies usually used by doctors. The first evaluation of the system has been accomplished, the encouraging results of which are also presented.

Blood Glucose Self-Monitoring↗
PubMed1992

A method of analysis of the electrical activity of the proximal gastrointestinal tract of the chicken.

The present paper describes a method of recording and analyzing electromyographical (EMG) signals from the digestive tract of the chicken. The EMG signals from the proventriculus, gizzard, and duodenum were recorded after implantation of Ni and Cr electrodes. The amplified EMG signals were digitized using a sampling frequency of 50 samples per second, and numerical data was stored immediately on the hard disk (1 datum = 1 byte). The software designed allowed: 1) detection of spike-bursts with a high accuracy; 2) analysis of maximum amplitude (with a maximum error of 6.7%), mean amplitude, duration, and frequency of the spike-bursts; the time of interval between spike-bursts, and the percentage of activity; 3) integration of the recorded data with a variable time set; and 4) a wave analysis by means of the Fourier algorithm. These methods, already used in EMG studies in mammals, are assembled and adapted for its application in birds.

Animals↗
PubMedDate not supplied

Laser intrastromal keratoplasty--case report.

PURPOSE: To evaluate the feasibility of correcting high hyperopia by means of intrastromal implantation of a laser shaped corneal lenticule prepared from a human donor eye. METHODS: A female patient with high hyperopia and irregular astigmatism resulting from multiple laser in situ keratomileusis procedures and lamellar keratoplasty underwent laser intrastromal keratoplasty. Her preoperative uncorrected visual acuity (UCVA) was 20/300 and best spectacle-corrected visual acuity (BSCVA) was 20/100 with a refraction of +8.00 -1.00 x 130 degrees. Corneal topography showed a highly irregular corneal surface. Central corneal thickness was 398 microm. Lenticule preparation included mechanical de-epithelialization of a human donor eye, keratectomy with a microkeratome, user-designed software combining a photorefractive keratectomy (PRK) treatment for +8.00 D sphere, an ablation zone of 7.0 mm, and a circumferential cut (internal diameter of 6.5 mm) for tissue ablation. Implantation involved re-lifting the flap, positioning the lenticule onto the corneal bed, and repositioning of the flap. RESULTS: The operation was uneventful as was the early postoperative follow-up. BSCVA improved to 20/50 with +1.00 -2.25 x 120 degrees at 2 months postoperatively. Corneal topography showed a more regular cornea with increased curvature in all meridians. Central corneal thickness increased to 600 microm. CONCLUSION: Laser intrastroma keratoplasty may be an option for correcting high hyperopa and irregular astigmatism in eyes with a thin corneal bed.

Adult↗
PubMedDate not supplied

First clinical experience with the Alcon LADAR 6000 excimer laser.

PURPOSE: To evaluate the reliability and ergonomics and to assess the first clinical results provided by the new LADAR 6000 excimer laser used to correct myopia and astigmatism, both by conventional and wavefront-guided ablation. METHODS: Seventy-four consecutive eyes from 37 patients underwent LASIK as the first field evaluation protocol of the Alcon LADAR 6000 excimer laser. Forty-six eyes were treated by wavefront-guided ablation to correct a manifest spheroequivalent refractive error (MSRE) of -0.50 to -9.75 diopters (D) (mean: -4.19 D, cylinder range: 0.0 to -3.50 D). Twenty-eight eyes were treated by conventional ablation to correct MSRE of -1.00 to -7.00 D (mean: -3.11 D, cylinder range: 0.0 to -1.75 D). Uncorrected (UCVA) and best spectacle-corrected visual acuity (BSCVA), MSRE, and wavefront measurements were assessed. Follow-up was 3 months for all eyes. RESULTS: Three months after surgery, all eyes were within +/- 1.00 D of intended correction. Forty-three (93.5%) eyes treated with wavefront-guided ablation and 25 (89.3%) eyes treated with conventional ablation were within +/- 0.50 D. All eyes reached > or = 20/25 UCVA. UCVA > or = 20/20 was reached in 45 (97.8%) wavefront-guided eyes and 26 (92.9%) conventional eyes; 37 (80.4%) wavefront-guided eyes and 17 (60.7%) conventional eyes had 20/16 UCVA. None of the eyes treated lost > or = 2 lines of BSCVA. CONCLUSIONS: The LADAR 6000 excimer laser results proved to be at least as accurate, predictable, and safe as the results currently achieved with the LADARVision4000 excimer laser. The improved microscope illumination enhances visibility for better consistency and ease of use. The better ergonomics and software design of this platform improved patient flow.

Adult↗
PubMed2002

[Development and evaluation of QA software for the monitor chamber of an accelerator].

The monitor chamber of a radiotherapy system needs to be calibrated once a week. Because the calibration procedure requires a large variety of complicated calculations, we have developed software that facilitates calculation and enables comparison and storage of data. According to the standard measurement of absorbed dose, we used Visual Basic 6.0 (Microsoft Corp.) to establish the calibration method. This new technique has simplified the conventional intricate calculation required for calibration of the monitor chamber and enabled automatic processing of calculated results. We have confirmed the usefulness of this software in calibrating the monitor chamber. In the routine inspection, we can compare the current data with former results. Because of this advantage, it is possible to eliminate serious accidents such as overdosing and underdosing.

Calibration↗
PubMed1997

C.A.S.M. and C.A.S.T.--phase two.

This paper outlines the second phase of a research project currently being conducted at the University of Central Lancashire. The aim of this second phase is to construct a computer based toolset for clinical audit, based on the structured method (C.A.S.M.) developed during the first phase of the project. A discussion of the validation of the C.A.S.M. and an outline of the toolset is portrayed.

England↗
PubMed1997

An example of usability measurement in clinical software procedures.

As a consequence of the dramatic improvements achieved in information technology standards in terms of single hardware and software components, efforts in the evaluation processes have been focused on the assessment of critical human factors, such as work-flow organisation, man-machine interaction and, in general, quality of use, or usability. This trend is particularly valid when applied to medical informatics, since the human component is the basis of the information processing system in health care context. With the aim to establish an action-research project on the evaluation and assessment of clinical software procedures which constitute an integrated Hospital Information System, the authors adopted this strategy and considered the measurement of perceived usability as one of the main goals of the project itself: the paper reports the results of this experience.

Attitude of Health Personnel↗
PubMed1997

Software quality assessment for health care systems.

The problem of defining a quality model to be used in the evaluation of the software components of a Health Care System (HCS) is addressed. The model, based on the ISO/IEC 9126 standard, has been interpreted to fit the requirements of some classes of applications representative of Health Care Systems, on the basis of the experience gained both in the field of medical Informatics and assessment of software products. The values resulting from weighing the quality characteristics according to their criticality outline a set of quality profiles that can be used both for evaluation and certification.

Delivery of Health Care↗
PubMed1998

University medical information network--past, present, and future.

The University Medical Information Network (UMIN), established in 1989, is a network service organization for national university hospitals in Japan. It has provided various medical information services to medical professionals, including database, electronic mail, and news services. Although its initial network was constructed as a closed network using N1 protocol, it now adopts TCP/IP protocol and is open to other medical professionals via the Internet. The next UMIN network system is planned to be constructed as a secure virtual closed network on the Internet, using cipher technology, and to provide secure information services to national university hospitals via the closed network, and to other medical professional via the Internet. User friendly interface and flexible system development were made possible by adopting TCP/IP, and the number of users dramatically increased accordingly. However, the database, software design, and human organizations developed in the N1 era have now proven to be of great value, and contribute to todayís flourishing state of the UMIN.

Computer Communication Networks↗
PubMed1999

[3-D model analysis of the maxilla of infants with lip-jaw-palate clefts].

For the investigation of three-dimensional morphological changes in the maxilla of children with cleft lip and palate, the use of two-dimensional test analysis is inadequate. Since no standardised three-dimensional method has so far been available, a three-dimensional digital, computer-aided procedure was developed to visualize and metrically analyse the growth of the edentulous maxilla of infants with cleft lip and palate. Chronologically consecutive casts of the maxillas (obtained at the ages of one week, and three, six and twelve months) of five children with complete unilateral CLP were measured optically with the instrument Micromeasure 70. Following digitation, the casts were reconstructed in the computer, aligned and superimposed using the Orthosurf program. The distances between the surfaces were then measured; in addition, the surfaces were segmented perpendicular to the alveolar crest at reference points C1, C1', C2, C2' and I. The volumes of the resulting segments were determined and compare with one another. Specially designed software automated the following steps: 1. identification of reference points; 2. alignment of the cloud of points in a system of coordinates, and 3. identification of the alveolar crest. Our initial results show that (1) the new method enables visualization of the extent and direction of morphological changes of the mucosal surface, and (2) reproducible quantification of these changes via the determination of changes in the volume of defined alveolar segments. The three-dimensional analysis presented here permits a comprehensive three-dimensional measurement of the models of the edentulous maxilla of infants with cleft lip and palate.

Cephalometry↗
PubMed2000

Human endothelial cell cultures from progenitor cells obtained by leukapheresis.

Although improved prosthetic graft patency with endothelial cell (EC) seeding has been shown in animal models, the clinical application of this technique requires a convenient source of ECs. We have evaluated EC cultures derived from the mononuclear cell (MNC) fraction obtained during large-volume leukapheresis and compared this with cultures grown from peripheral blood cells obtained by phlebotomy. Leukapheresis was performed in healthy adult volunteers (n = 7) using software designed to increase the percentage of MNCs harvested. Blood (40-293 mL) was drawn from a peripheral vein in healthy adult volunteers (n = 13), and the MNCs were obtained by differential centrifugation using a Lymphoprep gradient. Significantly more MNCs were obtained by leukapheresis than by phlebotomy. Each leukapheresis procedure yielded 12.5 to 23 mL, which contained 2.29 +/- 0.35 x 10(9) MNCs, compared with 2.16 +/- 0.50 x 10(8) MNCs, for each phlebotomy (P < 0.001). EC colonies developed in significantly more cultures from leukapheresis-derived MNCs (6 of 7) than phlebotomy-derived MNCs (4 of 13; P = 0.008). Leukapheresis-derived cells developed EC morphology at 15.5 +/- 2 days compared with 21 +/- 3.4 days for cells obtained by phlebotomy (P = not significant). EC were identified by positive factor VIII and vascular endothelial growth factor receptor immunostaining. Leukapheresis significantly increases the number of progenitor cells available for differentiation into EC compared with phlebotomy and avoids the need for any surgical procedure to harvest a peripheral vein as a direct source of ECs.

Adult↗
PubMed2000

PSG-EXPERT. An expert system for the diagnosis of sleep disorders.

This paper describes PSG-EXPERT, an expert system in the domain of sleep disorders exploring polysomnographic data. The developed software tool is addressed from two points of view: (1)--as an integrated environment for the development of diagnosis-oriented expert systems; (2)--as an auxiliary diagnosis tool in the particular domain of sleep disorders. Developed over a Windows platform, this software tool extends one of the most popular shells--CLIPS (C Language Integrated Production System) with the following features: backward chaining engine; graph-based explanation facilities; knowledge editor including a fuzzy fact editor and a rules editor, with facts-rules integrity checking; belief revision mechanism; built-in case generator and validation module. It therefore provides graphical support for knowledge acquisition, edition, explanation and validation. From an application domain point of view, PSG-Expert is an auxiliary diagnosis system for sleep disorders based on polysomnographic data, that aims at assisting the medical expert in his diagnosis task by providing automatic analysis of polysomnographic data, summarising the results of this analysis in terms of a report of major findings and possible diagnosis consistent with the polysomnographic data. Sleep disorders classification follows the International Classification of Sleep Disorders. Major features of the system include: browsing on patients data records; structured navigation on Sleep Disorders descriptions according to ASDA definitions; internet links to related pages; diagnosis consistent with polysomnographic data; graphical user-interface including graph-based explanatory facilities; uncertainty modelling and belief revision; production of reports; connection to remote databases.

Computer Systems↗
PubMedDate not supplied

[Epidemiologic analysis of patients afferent to the ICU].

BACKGROUND: To understand in- and out-patients flow to and from an ICU during a year (1998). The setting of the study was an 8-beds Intensive Care Unit of a 480-beds General Hospital with an Emergency Department. METHODS: Retrospective analysis by a specific designed software of all patient data extrapolated from the hospital database, in order to: 1) Divide all ICU patients in four groups, according to the first admission Department; 2) Classify all ICU patients into 3 subgroups: a) medical; b) surgical; c) trauma; 3) Evaluate the different needs of ICU resources in these different patient populations. RESULTS: Two hundred and fifty-four patients were admitted to our ICU during the study period (1.2% of all admissions). The mean duration of ICU stay was 10.4 days. Thirty-five per cent of ICU admissions came from the Emergency Department, 61% of ICU patients were discharged to another hospital ward, while the remaining 7% had to be transferred to a different hospital; 2.8% of our patients had ICU re-admissions. The overall mortality rate was 32%. CONCLUSIONS: Compared with previously reported data, a lower re-admission rate (3%), a longer mean stay in the ICU (>10 days) and a higher occupancy rate (91.4%) were observed. These data suggest that a large part of the available resources for the intensive care in our hospital are devoted to the in-hospital patient care. The hypothesis is suggested that this could be mainly due to the lack of sub-critical care areas.

Critical Care↗
PubMed2001

[Diagnosis of right ventricular function by transesophageal echocardiography].

Transesophageal echocardiography allows the complex structure of the right ventricle to be adequately visualized. Image analysis with specially designed software provides qualitative and quantitative information on right ventricular function, whether during surgery or in the intensive care unit, where the technique has proven particularly useful for early diagnosis of right ventricular insufficiency in patients receiving assisted ventilation. Loading conditions and degree of dysfunction of the right ventricle can be monitored in real time under various clinical conditions, significantly facilitation management.

Cardiac Output↗