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At least 631 records · Page 35Linked to original sources

Improvement on the auxiliary total artificial heart (ATAH) left chamber design.

The auxiliary total artificial heart (ATAH) is an electromechanically driven artificial heart with reduced dimensions, which is able to be implanted in the right thoracic or abdominal cavities of an average human patient without removing the natural heart or the heart neurohumoral inherent control mechanism for the arterial pressure. This device uses a brushless direct current motor and a mechanical actuator (roller screw) to move two diaphragms. The ATAH's beating frequency is regulated through the change of the left preload, based on Frank-Starling's law, assisting the native heart in obtaining adequate blood flow. The ATAH left and right stroke volumes are 38 ml and 34 ml, respectively, giving approximately 5 L/min of cardiac output at 160 bpm. Flow visualization studies were performed in critical areas on the ATAH left chamber. A closed circuit loop was used with water and glycerin (37%) at 25 degrees C. Amberlite particles (80 mesh) were illuminated by a 1 mm planar helium-neon laser light. With left mean preload fixed at 10 mm Hg and the afterload at 100 mm Hg, the heart rate varied from 60 to 200 bpm. Two porcine valves were used on the inlet and outlet ports. The flow pattern images were obtained using a color micro-camera and a video recorder. Subsequently, these images were digitized using a PC computer. A persistent stagnant flow was detected in the left chamber inlet port. After improvement on the left chamber design, this stagnant flow disappeared.

Animals↗

Kinematic gait analysis in hemiplegic patients.

Temporal-distance variables of gait were investigated in 8 female and 23 male hemiplegic patients in order to assess the distribution of these variables according to functional ambulation category and to evaluate their validity. Video-recording technique was used for obtaining the temporal-distance values. Velocity, step-time, stride length and stride length in relation to lower extremity length proved to be valuable measures in the gait analysis, while cadence, step-time and step-time differential values seemed to be less important.

Female↗

A method for longitudinal microscopic in vivo examinations of morphology, vascularity, and motility in the ovary and the oviduct of the rat.

OBJECTIVE: We developed an in vivo model to enable observation of dynamic changes in morphology, vascularity, and motility of the rat adnexa. METHODS: Immature Sprague-Dawley rats (n = 16) were primed with equine chorionic gonadotrophin (eCG;15 IU) followed by human chorionic gonadotrophin (hCG; 15 IU) 48 hours later to induce ovulation. The experiments were performed during prolonged (up to 12 hours) thiobarbiturate anesthesia. During laparotomy the periovarian bursa was retracted, whereafter the oviductal-ovarian complex was submerged into an organ chamber. Water immersion lenses (4x-40x; final magnification up to 810x) enabled detailed observations that were recorded on Beta-SP videotape. RESULTS: Capillary flow was monitored easily. At the level of the follicle, top blood flow velocity variations (8-10 per minute) were observed in the microvasculature. Ovulations were followed in detail, and oocyte-cumulus complexes were seen later in the oviductal ampulla. Regular contractions in the oviduct were synchronous with the oocyte-cumulus complexes moving back and forth in the oviductal lumen over a distance of about 900 microm. These contractions were more frequent (13-16 per minute) in the postovulatory phase compared with the time before ovulation (9-10 per minute). The oviductal contractions were initiated alternately from either end of the ampulla and were accompanied by a denudation of the oocytes, with a stream of cumulus cells seen moving in an abovarian direction in between contractions. CONCLUSION: High-magnification video recording in vivo was useful for capturing microcirculatory events as well as structural and functional changes of the ovary and the oviduct.

Anesthesia↗

A systems perspective on clinical management.

A process-tracing descriptive approach is described which is aimed at understanding the clinical management of diabetes mellitus both from the physician's and the patient's perspective. Physician/patient pairs were interviewed about their views of diabetes management. Content analysis and statement classification were used to develop a four-stage model for clinical management which successfully classified 98% of physician statements and 97% of patient statements. Both four-stage models can be combined with a simplified systems description of clinical diabetes to form a unitary systems model for clinical management. Video recording of routine clinic visits with stimulated recall by physicians suggests this systems view of management has considerable heuristic and explanatory potential. A case analysis is presented to illustrate the explanatory value of the systems perspective on difficult management problems.

Clinical Competence↗

Pediatric electroencephalographic video monitoring.

Pediatric EEG video monitoring is based on methodology that is similar to that used for monitoring of adults, although there are important differences. In addition, the range of clinical events suspected of being seizures in the pediatric population is quite different from those in adults and, within childhood, is age-specific. Thus, the clinical utility of monitoring in neonates, infants, and children is based on an understanding of the full range of normal and abnormal epileptic and nonepileptic events that may occur in this age group. Similarly, the findings of the EEG are age-dependent and must be considered when they are interpreted as part of the monitoring study and when they are correlated with clinical events captured on video. Monitoring can be utilized in the detection, characterization, and quantification of various types of seizure disorders in children. The most effective application of monitoring, which can ensure the greatest chance for clinically useful information, occurs when monitoring is well-planned; utilizes appropriate EEG and polygraphic-physiologic parameters; incorporates optimal video recording techniques; maintains age-appropriate recording environments within the context of medical necessity; and is conducted in a laboratory with adequate support staff. Pediatric monitoring has been effective in the clinical management of neonatal seizures, infantile spasms, other seizure types in infancy, epilepsy in late childhood, and in the evaluation of pediatric patients of all ages for epilepsy surgery.

Age Factors↗

Mechanical recycling of waste electric and electronic equipment: a review.

The production of electric and electronic equipment (EEE) is one of the fastest growing areas. This development has resulted in an increase of waste electric and electronic equipment (WEEE). In view of the environmental problems involved in the management of WEEE, many counties and organizations have drafted national legislation to improve the reuse, recycling and other forms of recovery of such wastes so as to reduce disposal. Recycling of WEEE is an important subject not only from the point of waste treatment but also from the recovery of valuable materials.WEEE is diverse and complex, in terms of materials and components makeup as well as the original equipment's manufacturing processes. Characterization of this waste stream is of paramount importance for developing a cost-effective and environmentally friendly recycling system. In this paper, the physical and particle properties of WEEE are presented. Selective disassembly, targeting on singling out hazardous and/or valuable components, is an indispensable process in the practice of recycling of WEEE. Disassembly process planning and innovation of disassembly facilities are most active research areas. Mechanical/physical processing, based on the characterization of WEEE, provides an alternative means of recovering valuable materials. Mechanical processes, such as screening, shape separation, magnetic separation, Eddy current separation, electrostatic separation, and jigging have been widely utilized in recycling industry. However, recycling of WEEE is only beginning. For maximum separation of materials, WEEE should be shredded to small, even fine particles, generally below 5 or 10mm. Therefore, a discussion of mechanical separation processes for fine particles is highlighted in this paper. Consumer electronic equipment (brown goods), such as television sets, video recorders, are most common. It is very costly to perform manual dismantling of those products, due to the fact that brown goods contain very low-grade precious metals and copper. It is expected that a mechanical recycling process will be developed for the upgrading of low metal content scraps.

Computer Terminals↗

The medicolegal implications of teleconsulting in the UK.

Broadly speaking, the medicolegal position of doctors involved in a telemedicine consultation is similar to that when telephone, fax, email or letter is used instead. All amount to the provision of advice from a distance and the normal standards of care and skill will apply. There is therefore a duty to practise to a reasonable level of skill. In a telemedicine consultation between general practitioner and hospital specialist, the referring doctor must give an accurate history (note that a video record would provide retrospective proof). For anything more than treatment purposes, the patient's permission is required before recording. There may be occasions when it is inappropriate not to use telemedicine if that is considered to be best practice in the circumstances. Time will tell whether teleconsulting is a more efficient method of practising medicine, as some people believe already. Ultimately many of the questions raised here about the medicolegal implications of such telemedicine will be determined in the courts.

Humans↗

Evaluating CPR performance in basic life support: the VIDRAP protocol.

This paper presents the second part of the validated Cardiff test for one rescuer basic life support skills, based on observation of video recording combined with the Recording Resusci Anne printout (VIDRAP). The authors believe that this is a robust evaluation tool which is capable of assessing the potential value to a casualty of a simulated resuscitation. The adoption of a widely accepted test methodology would facilitate comparison of research in different centres, which is not possible at present.

Adult↗

Evacuation behaviours of occupants with learning difficulties in residential homes.

PURPOSE: This paper reports the results of unannounced evacuation of two residential care premises providing accommodation for people with learning disabilities. METHOD: Awareness of disability has in relation to fire safety focussed generally on mobility. With the advent of performance-based fire safety engineering codes which require the characterization of buildings and their occupants it is necessary to obtain knowledge of the likely behaviours of people with learning difficulties in an emergency. The unannounced evacuations which were conducted at 11.30 pm were video recorded to enable observation and an analysis of the residents' behaviours. RESULTS AND CONCLUSION: The results and observations obtained raise many issues; including transferable training skills, predictability of evacuation behaviours, and the need in performance code evaluation to consider the characterization of buildings and their occupants as mutually inclusive processes.

Facility Design and Construction↗

Babbling of an infant with a repaired cleft lip: a case study.

The infant born with a cleft lip is faced with risk factors that threaten the development of speech-language skills. The earlier the age of identification and management of the developmental delay, the better the outcome. The attainment of the mature syllable is considered to be a critical measure of babbling competency. This single case study aimed to determine whether the formedness of the syllable in babbling would be affected by the cleft lip repaired prior to the onset of meaningful speech. Three samples of babbling in a naturalistic environment were video-recorded. Data was analysed following the principles of infraphonology, employing a perceptually-based method. A profile of infraphonological features was obtained. Results showed that the development of the mature syllable was attained. The results support the theories that babbling is a robust phenomenon. Clinical and research implications are discussed.

Child Language↗

A video-based method for evaluation of low-back load in long-cycle jobs.

A method for evaluation of the physical load on the lumbar spine in industrial work is presented. It is suitable for identification of high spinal loads and their time duration. The method is based on biomechanical analysis of video-recordings. It takes into account the posture of the body as such, as well as the possible occurrence of external load and support. Compression of the L5-S1 intervertebral disc and strain on the lumbodorsal fascia is determined at 5-s intervals in each work task.

Biomechanical Phenomena↗

[Prevalence of autistic states in a cohort of very young children followed up in home care].

It is hypothesized that infantile autism could represent a defensive position with variable clinical characteristics whose expressions are notably influenced by the environment. We examined a group of ten children under the age of three who were followed up on home care. Our research focused on a double-blind correlation test between two types of data: the diagnostic on the one hand and the child video recording observation on the other hand. Certain objectivable autistic states were found in two children for which the initial diagnosis of autism were in a first time ruled out (according to DSM-III-R and French Classification). This confirms the polymorphism of children autistic states.

Autistic Disorder↗

[Video fiber endoscopy during induced sleep].

Video-fiberoscopy is the exploration of upper respiratory airways used in our diagnostic protocol in patients with chronic snoring and obstructive sleep apnea syndrome (OSAS). We perform a fibroscopy during propofol induced sleep without tracheal intubation; video recording and monitoring of level of sleep, pulse oximetry, blood pressure, ECG, etc. is used. This exploration allows us to asses upper respiratory airways when the patient is asleep as well as the areas of collepse and vibration both from a functional and anatomical points of view.

Anesthetics, Intravenous↗

Blinking is controlled primarily by ocular surface conditions.

PURPOSE: To investigate the relation between blinking and ocular surface conditions and to introduce and examine a new index, the maximum blink interval. METHODS: In a prospective study, the blink rate of subjects under relaxed conditions was determined from a video recording taken by a hidden observer. The maximum blink interval was defined as the longest time subjects can avoid blinking without feeling uncomfortable. RESULTS: Significant changes in the blink rate and maximum blink interval were induced by factors that directly or indirectly affect the ocular surface: topical anesthesia, changing exposed ocular surface area, and wind. Moreover, the blink rate and maximum blink interval were significantly different in dry eye patients compared with healthy volunteers, with the values of the former approaching the values of the latter after use of artificial tears. The maximum blink interval was decreased by the same factors that increased the blink rate, and there was a significant inverse correlation between blink rate and maximum blink interval. Use of video display terminals was associated with decreased maximum blink interval and, hence, the development of dry eye symptoms. CONCLUSIONS: There was an important association among blink rate, maximum blink interval, and ocular surface conditions. The blink rate and our newly introduced measurement, the maximum blink interval, should prove useful in assessing factors that cause dry eye. This prospective study should contribute to the understanding and treatment of dry eyes.

Administration, Topical↗

Cavitation threshold with respect to dP/dt: evaluation in 29 mm bileaflet, pyrolitic carbon heart valves.

A total of 15 bileaflet mechanical heart valves were studied in a pulse duplicator at the Helmholtz Institute (Aachen, Germany) under conditions approximating first, a physiological pressure curve and subsequently, a sinusoidal pressure curve. In this study Edwards-Duromedics valves of the modified specification were compared with the earlier version of the Edwards-Duromedics valve as well as with St. Jude Medical valves. Each valve was tested at a series of nine (9) conditions. At each condition, without altering the valve installation or the systemic conditions, each valve was filmed by two separate video systems: the Helmholtz Institute strobe light system and a high speed video recording system. All data, as recorded by each system, was then independently analyzed by both of the two contributing groups and subsequently compared. In this manner, it was possible to objectively verify not only the consistency of the data obtained, but to also determine the relative reliability of the methods for cavitation threshold detection.

Carbon↗

[The Video Tearscope: a new method for evaluating lacrimal film in vivo].

PURPOSE: The lacrimal film has trophic, immunological, antimicrobial, and anti-inflammatory roles. The lipidic phase of the tear film reduces surface stresses and limits tear evaporation. We present a reproducible and noninvasive investigation of the lacrimal film, the Video Tearscope (Vi-Te), which analyzes the after-blinking tear stabilization time and the different types of blinking. Vi-Te consists of a numerical video recording of the specular reflexion produced by the Tearscope Plus adapted to a biomicroscope. MATERIALS AND METHODS: Twenty-four normal subjects and ten patients with dry eye syndrome were included. We studied the blinking types and LFST using the Vi-Te technique. The analysis was carried out at 25 images/s, corresponding to an in-between image interval of 40 ms. RESULTS: Four types of spontaneous blinking were observed: complete, subtotal (99%-70% occlusion), partial (69%-20%), and abortive (less than 20%). We obtained a LFST value of 0.65+/-0.12s for the control group versus 2.34+/-1.28 s for the dry eye syndrome group. The difference was significant between the two groups for the LFST (p<0.001) for complete blinking. CONCLUSIONS: The Video Tearscope is a promising technique that provides new insights into tear film stability and physiology. The main weakness of this technique, however, is the time required for video analysis (20-45 min per case). Despite this drawback, additional studies should be undertaken in order to establish standards for evaluating ocular surface disorders in a completely noninvasive way.

Adult↗

The effects of different viewing conditions on performance in simulated minimal access surgery.

This study aimed to assess performance in simulated minimal access surgery (MAS) tasks under a range of viewing conditions. MAS conventionally uses 2d viewing systems which produce a flat image. However, 3d viewing systems which produce stereoscopic depth information should in principle lead to better depth perception, and improve performance on tasks which require appropriate spatial representation of layout and depth. The study compared a novel 3d viewing system with a state of the art 2d viewing system and a direct viewing condition ('open surgery') as a point of reference. Tasks included pulling and cutting of threads using standard surgical instruments. Medical students (n = 16) were allocated to viewing conditions according to a Latin square and carried out 120 tasks each. Assessment was by means of a 3d movement tracking device providing a number of performance parameters (time on task, velocity, number of movements, distance travelled). In addition instrument movement was video-recorded and analysed by four observers to validate the tracking device. Results from tracking data and observer data were highly correlated (r > 0.85). While open surgery naturally scored highest, the key finding was the clearly superior performance in the 3d condition compared to 2d. Thus modern 3d viewing systems can improve performance in a realistic task.

Adult↗

An examination of the knee function during gait in children with myelomeningocele.

In this retrospective study, 37 patients with myelomeningocele who had undergone gait analysis were examined. Patients were divided into groups based on the level of involvement (29 sides: L4; 26 sides: L5; 19 sides: S1-2). Results showed increased knee flexion and associated knee extensor moments with increasing level of neurologic involvement. The mean coronal plane knee position in stance was normal in all groups and not related to coronal plane knee moment. However, there was an increased incidence of a net knee adductor moment in stance with increasing involvement (mean, 0.02 +/-0.18 N.m/kg for the L4 group). The presence of a visual valgus thrust based on video records was not reliable in predicting an abnormal knee coronal plane moment. An abnormal knee adductor moment in stance was most highly related to coronal plane trunk motion (r = -0.62) and not tibial torsion (r = -0.340). Increased transverse plane range of motion of the knee was most highly related to transverse plane trunk motion (r = 0.67).

Adolescent↗