Computer diagnosis of electrocardiograms. 3. A computer program for arrhythmia diagnosis.
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Extensive research is being conducted to study the mechanism of blood flow during cardiopulmonary resuscitation (CPR). Recently, work has been published using a simple electrical model of the circulation to simulate the hemodynamics of CPR. This analog was a hard-wired circuit consisting of the heart and great vessels modeled as a resistive-capacitive network, pressure as voltage, blood flow as current, blood inertia as inductance and vascular valves as diodes. Such a model is useful for examining the physiology of various methods and techniques of CPR administration. In this investigation, a general purpose circuit simulation program, SPICE Version 2G.6, was used to analyze previously published CPR models. With minor modifications, the program was fully able to simulate the hard-wired circuits. The program is very flexible, allowing for easy model modification and a wide range of parameter values. In addition, the program offers the advantages of increased accuracy and low cost. Suggested future applications are for rapid evaluation of new CPR concepts.
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This paper proposes a fuzzy methodology to translate the natural language descriptions of the TW3 method for bone age assessment into an automatic classifier. The classifier is built upon a modified version of a fuzzy ID3 decision tree. No large data records are needed to train the classifier, i.e., to find out the classification rules, since the classifier is built upon rules given by the TW3 method. Only small data records are needed to fine-tune the fuzzy sets used to implement the rulebase.
Although Hanger Orthopedic Group, Inc., has been developing clinical protocols for its INSIGNIA scanner for more than 2 years, there are many applications that are currently in development and will be released over the next 2-year period after this publication. It is the goal of Hanger Orthopedic Group, Inc., to replace all plaster casting procedures with the laser scan and move toward a paperless environment where all images and documents are passed through its virtual network. INSIGNIA currently has five major production centers throughout the United States, which support more than 600 INSIGNIA certified clinicians. These clinicians staff more than 600 clinics in North America, all under the Hanger company name. The central fabrication service and the central design center processes hundreds of shapes per day (Fig. 27). So that any clinician in the field can use the expertise of the central designers and central fabricators to help with overflow or problems they might be having, the network that exists within Hanger is tied together and enhanced by INSIGNIA. Through virtual modification and centralization of these services, each patient receives the virtual collaboration of several clinicians with a total of years of experience. INSIGNIA has enhanced the patient experience. The enhancement is not only in removing the plaster from the process, but also in exposing each patient to the team of prosthetic experts working collaboratively behind the scenes. The rehabilitation industry continues to be bombarded with compliance paperwork and justifications. The INSIGNIA scan and resulting measurement reports give inherent strength to justifications based on volume change, surgical revisions, or tissue change. The files are kept in a data warehouse where they are vaulted and preserved presumably forever. Also, any of the shape graphics or measurement instruments can be printed into a discrete report that can become part of the patient's permanent record. Many physicians receive update letters from their orthotic and prosthetic clinician with a status update before and after treatment of their patient. This update includes a descriptive narrative, a printout of the pertinent metrics, a printout of the scan graphic, and often a digital image of the patient wearing the device (Fig. 28). The network is HIPAA compliant, and all private health information is held in tight security. If a practitioner does not have a HIPAA agreement in place with Hanger Orthopedic Group, Inc., and would like one, or ifa practitioner would like to have an INSIGNIA representative call or visit with more information, the practitioner is encouraged to call 1-800-4-HANGER and request an INSIGNIA in-service or visit INSIGNIA on the web at www.hanger.com.
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Recent reports suggest that physicians in non-ambulatory settings can use indirect CT venography (CTV) of the lower extremities immediately following spiral CT angiography (CTA) of the chest to identify patients with a negative CTA who have thromboembolic disease identified on CTV. We sought to determine the frequency of isolated deep venous thrombosis (DVT) discovered on CTV in emergency department (ED) patients with complaints suggestive of pulmonary embolism (PE) yet having a negative CTA. This study was conducted in a suburban and urban ED where patients with symptoms suspicious for PE were primarily evaluated with CTA and CTV. A total of 800 patients were studied, including 360 from the suburban ED and 440 from the urban ED. 88 (11%) patients were diagnosed with thromboembolic disease by CTA, or CTV, or both. Seventy-three patients had a CTA of the chest that was positive for PE, 42 (5.2%) of whom had evidence of both PE on CTA and DVT on CTV. Fifteen patients (2%, 95% CI = 1-3%) had a negative CTA and were subsequently found to have isolated DVT on CTV, all of whom received anticoagulation therapy. These data suggest that indirect CT venography of immediately following CT angiography of the chest significantly increased the frequency of diagnosed thromboembolic disease requiring anticoagulation in ED patients with suspected PE.
Between March, 1980 and January, 1984, computerized tomography (CT) was performed on 110 patients with proven esophageal carcinoma. In 26 patients, information obtained preoperatively by CT was compared with results of intraoperative exploration or histologic examination of resection specimen. Correlation analysis showed that accuracy of CT in assessing actual tumor size and mediastinal or abdominal lymph node involvement is rather limited, while correct results were obtained in between 84 and 100 per cent of patients as far as identification of invasion of adjacent organs is concerned. We thus advocate routine use of CT in the process of preoperative assessment of operability and staging.
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