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Acquisition and display of radiation dose distributions using microcomputer technology.

In the commissioning or quality assurance of a medical linear accelerator or a computerized radiotherapy planning system, the traditional approach usually consists of acquiring and comparing one-dimensional dose profiles. This methodology is tedious and incomplete since only a portion of the radiation field can realistically be sampled. We have developed an automated measurement system which allows efficient measurement and display of complete two-dimensional dose distributions. The general purpose microcomputer used (IBM PC/XT compatible) can be interfaced economically to any water phantom dosimetry system equipped with a three axis scan controller, and can also communicate data to the treatment planning system. This allows for direct comparison of measured with computed dose distributions, thus revealing discrepancies in the dose computation algorithms used. In this paper, we describe the interface between the microcomputer, a conventional water dosimetry system (Therados RFA-3), and a treatment planning computer. We report our early experience with acquiring dose distributions and show sample comparisons with computed results for megavoltage electron beams incident on homogeneous and heterogeneous systems.

Humans

Allergy screening using a microcomputer.

Data are presented to show that a microcomputer can be programmed to: (1) analyse a standard allergy questionnaire, (2) reliably predict the ranked order probabilities with which IgE antibody tests will produce positive results, (3) store the IgE test results, and (4) print a comprehensive report that summarises and integrates the clinical and laboratory data. Consequently, the practitioner who refers a blood sample and a questionnaire completed by the patient to a centre where both can be analysed will obtain enough practical information to decide whether to treat or refer that patient to a specialist. The microcomputer is therefore potentially of great value in any preliminary allergy investigation.

Computers

Audit of a surgical firm by microcomputer: five years' experience.

From 1982 to 1986 inclusive work of one surgical firm was audited with a microcomputer. Data were recorded on 4336 patients having 3355 operations, who were under the care of one consultant in a general surgical unit; fifty items of information were recorded on each patient, allowing a wide range of analyses to be performed--for example, the number of admissions and operations, grades of operation, diagnostic grouping, complications, and complication rates associated with individual surgeons. Data collected for the audit provided a valuable baseline for the unit, defining aspects of practice that could be reviewed and improved. During the audit the overall rate of complications as a percentage of admissions fell significantly from 13% to 9% and the rate of postoperative complications decreased significantly from 16% in 1982 to 11% in 1986. The incidence of chest and wound infections also decreased significantly. The system was improved by using the data to produce discharge summaries as well as audit; the microcomputer thus became an integral part of the office work of the unit.

Computers

TOXBASE: a microcomputer database for post mortem toxicology.

A cheap microcomputer program for the storage, retrieval, and analysis of the results of toxicological investigations on samples obtained at necropsy was devised. The program was written using FoxBASE+, a dBase III clone, which is both cheaper and faster than other comparable software. The hardware requirements are an IBM PC compatible microcomputer, preferably with both hard and floppy disc drives, and a suitable printer. The system was found to be particularly useful when preparing reports for coroners and in retrieving data for administrators concerned with aspects of work in the laboratory. The system is flexible and can be readily adapted to other uses.

Autopsy

Microcomputer monitor and blood sampler for free-diving Weddell seals.

The equipment used for the first sampling of arterial blood at depth on free-diving Weddell seals Leptonychotes weddelli is described. Blood was withdrawn through an aortic catheter by a submersible, peristaltic roller pump and stored in a single- or multiple-sample collection device. The multiple sampler allowed up to eight individual blood samples to be collected during a single dive. The blood pump was controlled by a dedicated microcomputer that allowed initiation of blood sampling at flexible combinations of depth and/or time during either the descending or ascending phase of the dive. The dedicated microcomputer also recorded swimming depth, velocity, heart rate, and body temperature at selectable time intervals. These data were transmitted to a laboratory computer, and blood samples were retrieved, when the seal surfaced to breathe.

Animals

A new comprehensive microcomputer software programme for the urodynamics clinic.

Urodynamic investigation has undoubtedly been greatly refined and facilitated with the use of the modern generation of microcomputers. Manual techniques of data storage, analysis and interpretation are tedious, time consuming and lead to significant observer-dependent transcription errors. The logical solution to this problem is to develop a specifically designed software programme which would operate in conjunction with the microcomputer system integrated in most modern urodynamic apparatus. We describe here our experiences with the development of just such a system.

Computer Systems

Factor analysis and predictive validity of microcomputer-based tests.

11 tests were selected from two microcomputer-based performance test batteries because previously these tests exhibited rapid stability (less than 10 min, of practice) and high retest reliability efficiencies (r greater than 0.707 for each 3 min. of testing). The battery was administered three times to each of 108 college students (48 men and 60 women) and a factor analysis was performed. Two of the three identified factors appear to be related to information processing ("encoding" and "throughput/decoding"), and the third named an "output/speed" factor. The spatial, memory, and verbal tests loaded on the "encoding" factor and included Grammatical Reasoning, Pattern Comparison, Continuous Recall, and Matrix Rotation. The "throughput/decoding" tests included perceptual/numerical tests like Math Processing, Code Substitution, and Pattern Comparison. The output speed factor was identified by Tapping and Reaction Time tests. The Wonderlic Personnel Test was group administered before the first and after the last administration of the performance tests. The multiple Rs in the total sample between combined Wonderlic as a criterion and less than 5 min. of microcomputer testing on Grammatical Reasoning and Math Processing as predictors ranged between 0.41 and 0.52 on the three test administrations. Based on these results, the authors recommend a core battery which, if time permits, would consist of two tests from each factor. Such a battery is now known to permit stable, reliable, and efficient assessment.

Adult

Measuring children's social skills using microcomputer-based videodisc assessment.

This article describes the development of a microcomputer-based videodisc assessment prototype for measuring children's social skills. The theoretical and empirical foundations for the content are described, and the contributions of interactive microcomputer-based video technology to assessment of children with handicaps are detailed. An application of Goldfried and D'Zurilla's "behavior-analytic" approach to development of the content of assessments is presented, and the related video and computer technology development is detailed. The article describes the conceptual foundations of the psychometrics of the assessment prototype as well as the psychometric methodology that was employed throughout the development process. Finally, a discussion of the potential applications and implications of the social skills assessment prototype is included.

Child

Aminoglycoside pharmacokinetics on a microcomputer.

The authors describe the use of a microcomputer to evaluate an existing dosage regimen and to determine a new regimen and steady-state peak and trough levels for four aminoglycoside antibiotics--amikacin, gentamicin, kanamycin, and tobramycin. The microcomputer program is based on a one-compartment open pharmacokinetic model for the aminoglycosides. It accounts for patients' sex, age, height, obesity, and ascitic compartment. The program is divided into seven subprograms for each of the four aminoglycosides: (1) steady-state peak and trough levels are predicted, based on serum creatinine for a given dosage regimen; (2) a dosage regimen that conforms to 6, 8, 12, 16, or 24 hours is ascertained, based on serum creatinine; (3) a dosage regimen is determined, on the basis of serum creatinine, for desired steady-state peak and trough levels; (4) a dosage regimen that conforms to 6, 8, 12, 16, or 24 hours is ascertained for given aminoglycoside serum levels; (5) a dosage regimen for desired peak and trough levels is ascertained for given aminoglycoside serum levels; (6) a dosage regimen that conforms to 6, 8, 12, 16, or 24 hours is ascertained from data collected using Sawchuk's and Zaske's method; and (7) a dosage regimen, estimated for desired peak and trough levels, is estimated from data collected using Sawchuk's and Zaske's method.

Adult

[Serodiagnosis of microbiosis in mice with a quantitative assay of immunoglobulins by a microcomputer-introduced ELISA system. 1. Anti-Sendai virus antibodies in naturally infected mouse sera].

An enzyme-linked immunosorbent assay system combined with microcomputer data analysis was established as a quantitative assay method of immunoglobulins. The assay system was applied to measure IgG and IgM levels of anti-microbe antibodies in animals, especially mouse and rat. And now the measurement of IgG and IgM levels (ng/ml) of anti-Sendai virus (HVJ) antibodies in naturally infected mice is available. The assay system could improve serodiagnosis in the specificity and sensitivity and in the rapid treatment of many serum samples. The operation of this system was performed by a microcomputer, FM 8 connected Titertek Multiskan MC. The limited sensitivity of this assay for IgG and IgM was 10 ng/ml and 30 ng/ml, respectively. Ninety-one of serum samples were positive for IgG and/or IgM (45 samples for IgG and IgM, 44 samples for IgG, 2 samples for IgM) to Sendai virus in the tested 279 mouse sera, and serum titers were ranged from 1: 10 to 1: 12,800 in the IgG, and from 1: 20 to 1: 160 in the IgM. In these titers, serum IgG and IgM amounts were estimated to be 0.1 to 154 micrograms/ml and 0.5 to 4.8 micrograms/ml, respectively. Relationships of serum titers and antibody amounts were almost consisted, being judged like that approximately 10 micrograms/ml is 1: 400, 30 micrograms/ml is 1: 1,600 in IgG, and 2.4 micrograms/ml is 1: 80, 4 micrograms/ml is 1: 160 in IgM.

Animals

[Sexual differences in functional hemispheric asymmetry: verbal tachistoscopic evaluation using microcomputers].

Study of sexual differences for the hemispheric prevalence on visual verbal stimuli using a microcomputer-based tachistoscope technic. Seventeen right-handed individuals, 10 males and 7 females (mean age 32 years old), without neurological or visual abnormalities were studied. The subjects performed a verbal trigram tachistoscope test, using a IBM PC microcomputer compatible. The trigram consists of 80 consonant-vowel-consonant pairs of stimuli presented randomly to right and left visual fields. The evaluation was made through two conditions: T1 and T2. In T1 Experiment stimuli exposition time was 260 ms, and in T2 Experiment the stimuli exposition time was 160 ms. In T1 Experiment 80% of females showed a Right Hemispherical Preference while 100% of males showed a Left Hemispherical Preference. In T2 Experiment, both sexes showed Left Hemispheric Preference. A close relationship between sexual difference and hemispheric preference was found. We point out the importance of stimuli exposition time in determination of sexual differences in lateral hemispherical asymmetry.

Adult

Teaching memorized spelling with a microcomputer: time delay and computer-assisted instruction.

A computer-assisted instruction program was evaluated that used a constant time-delay procedure to teach 5 students 18 spelling words. In addition to delivering the instructional procedure, the program managed the presentation of training content based on individual student responding and collected instructional data on individual student performance. The procedure was effective at teaching 4 of the 5 students the words, and generalization occurred from the computer-delivered keyboard response format to a teacher-delivered hand-written response format. Maintenance data varied among the students. The study demonstrated the feasibility of using microcomputers to deliver time-delay instruction in special education classrooms and suggested several research questions related to specific features of microcomputer-delivered time-delay instruction.

Achievement

A microcomputer-assisted study of nabumetone and slow release diclofenac in osteoarthritis.

20 UK general-practice centres entered 243 patients into a 6-week double-blind, double-dummy, randomised, parallel-group trial designed to compare nabumetone 1 g at night with slow release diclofenac 100mg at night in the treatment of osteoarthritis. Seven efficacy parameters were measured, adverse events were recorded and laboratory monitoring was performed. The study monitor entered trial data into a portable laptop microcomputer at the participating centres. Both treatment groups showed highly significant clinical improvements at the end of the 6-week study period and there were no significant inter-group differences. Overall, the incidence of adverse events was similar in the 2 groups, but significantly fewer patients in the nabumetone group (n = 21) than in the diclofenac group (n = 35) complained of gastrointestinal adverse events (p = 0.03). On-site use of the microcomputer contributed to increased monitoring efficiency and trialist motivation, resulting in rapid recruitment of patients, collection of high quality data and speedy analysis at the end of the study.

Adult

Microcomputer patient database management system for an MRI facility.

A management system for a magnetic resonance imaging facility was developed to store pertinent patient data and to maintain a teaching file. The system was developed on a Digital PRO-350 microcomputer using a commercially available database software package. The cost of the system was about $7000. The patient data are entered at a terminal by a clerk typist. Input data are condensed or abbreviated to accommodate the limited data storage on the microcomputer. Cases can be rapidly retrieved and sorted on the basis of any of the 42 data fields available or any combination of these fields. The system has been successfully used for 18 months to create directories for a teaching file, for presentations, and for clinical research. Census-type data can be compiled, and the system can be used for word processing.

Computers

Profiling self-monitored blood glucose results with the personal microcomputer.

Personal microcomputers are becoming available to millions of individuals. Inevitably this new technology will be applied in a variety of ways to the routine management of diabetes. In this article we present the results of a pilot effort which shows that large cumbersome sets of blood glucose data, obtained by conventional self-monitoring techniques, can be stored, analyzed, and displayed conveniently with a home microcomputer. This technique has potential value for the identification of long-term trends in blood glucose regulation.

Adult

A comprehensive microcomputer network program for histopathology.

For a small hospital with a limited budget, a stand-alone histopathology microcomputer network may be more valuable to the pathologist than one running off the hospital's main computer. In return for sacrificing the limited benefit of screen reading of pathology reports in the wards, one receives the great advantage of more rapid retrieval of disease data. Commercial relational database programs for microcomputers can now achieve nearly all the power of a minicomputer program, with more versatility. Using an application developed on such software, we now have 30,000 pathology reports entered, from which we can retrieve a list of pathology numbers, with patients' names, age, sex, disease, and site, for any diagnosis in 3-5 seconds. The application includes full biopsy reports for doctors and wards, autopsy final diagnoses, computer-assisted Snomed coding, outside consultations, literature abstracts, daybook printing, workload statistics and billing codes and charges, and a cytology module has been added for another hospital. Moreover, the interested pathologist can easily make his own alterations to menus, entry screens, fields, and screen listing or printout formats.

Computer Communication Networks

Microcomputer-based cardiac pacemaker-control system through blood temperature.

A microcomputer-based temperature-sensitive cardiac pacemaker system and some preliminary experiments are described. The system consists of a microcomputer, a twin 5 in floppy disk unit, expansion and interface units, a visual display unit and a printer. It senses the blood temperature in the right atrium, determines the pacing rate and supplies the heart with stimulating pulses. System-heart interfacing is performed by the separate pacing and sensing units which communicate with the computer via a peripheral interface IC in an expansion unit. The pacing rate is determined by software, rather than a combination of hardware elements. The temperature response time of the system, from 25 degrees C to 40 degrees C is about 26 s, and this would seem to be satisfactory given that smaller and slower changes in blood temperature are normal.

Animals

Telemetry system for heart-rate and blood temperature using a microcomputer.

A radio-telemetry system using a microcomputer has been constructed to measure both the heart-rate (HR) and right atrial blood-temperature in dogs. The telemeter incorporates a thermistor temperature probe, which allows blood-temperature measurements in the range of 35 degrees-42 degrees C with an available resolution of +/- 0.02 degree C. The output of the receiver is connected to active filters, a frequency counter and an HR meter, and finally to a microcomputer, through an appropriate interface circuit, for data linearization and storage.

Animals