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PubMed1988

A contoured anterior spinal fixation plate.

There is a need for a specifically designed plate for anterior fixation of the vertebral bodies, contoured to fit closely around the lateral aspect of the spine and wide enough to allow multiple options for placement of at least three screws in each vertebra. The large-diameter cancellous screws should penetrate the opposite cortex. Existing bone plates are inadequate, because they are too narrow and do not allow positioning of more than two screws in each vertebra. The Biomedical Engineering Department of the National Research Council of Canada designed and tested the plate described in this article, with particular attention to providing smooth surfaces to prevent vascular complications. Three lengths of plates have been developed and are used in the area from T11 to L5, with a specific tapered plate for the L5 area to prevent contact with the overlying iliac vessels. This device should be used for stabilization following corpectomy for tumor, decompression of burst fractures, severe disc degeneration, pseudarthrosis, and the multiply operated back.

Adult↗
PubMed1988

[Microsurgery and associated therapies for the treatment of lymphedema of the limbs].

Between 1967 and 1986, 170 cases of primary or secondary lymphedema of upper or lower limbs were operated upon using the indirect lymphaticovenous anastomosis technique proposed by Degni. For the lymphedema of upper limbs secondary to axillary lymphadenectomy for breast cancer, satisfactory results were obtained in 40% of cases, the figure rising to 72 and 74% for primary and secondary lymphedema of lower limbs respectively. When surgery is unsuccessful or contraindicated a new therapeutic method is proposed: thermotherapy as developed by Pr. Chang's team in Shanghai based on an ancient traditional Chinese medical method. With the collaboration of a biomedical engineer, a new microwave oven has been constructed and tested for the treatment of lymphedema, and its characteristics are described. Treatment is ambulatory, 45 minutes per day, 5 days per week over 3 weeks. It is very important that patients wear an elastic contention stocking (40 mmHg) between sessions. A total of 55 patients have been treated in this way, most (45) failing to improve after other medical or surgical treatment. All cases treated were of severe lymphedema and subjective and objective (ultrasonography) improvement was noted in 51%, the other 49% obtaining only subjective relief. According to Chinese authors results are maintained after 10 years. Follow up of the present series has been a maximum of one year and longer surveillance is necessary to assess long-term efficacy.

Bandages↗
PubMed1987

Present state and future trends in electrical heart stimulation.

Examples of electrical heart stimulation techniques are presented to illustrate for the physician and biomedical engineer the technical feasibility of realizing many therapeutic concepts by means of microelectronics. Because of the life-supporting applications, extremely high system reliabilty must be guaranteed. The usual methods of enhancing safety by providing redundancy cannot be used, and the service life requirements can be met only by appropriate adaptation of the current consumption due to the limited battery capacity. Based on the practical experience gained in the manufacture of more than 100,000 implantable devices, it can be reported that by rigid application of, and adherence to, quality assurance measures reliability values can be achieved of lambda = 10(-7)h-1 at a confidence level of 90% for the hybrid components and of lambda = 10(-9)h-1 for integrated circuits and passive components. The requirement for technical reliability of the implantable device for patient safety requires a thorough understanding of all technical and medical details of the therapeutic device. The success of future developments (e.g. the automatically-controlled systems which are meant to substitute for the multiprogrammable pacemakers) will not only require utilization of currently available technologies but also will depend to a great extent on active participation of the physicians in the development process itself.

Cardiography, Impedance↗
PubMed1986

[Hemosorb, a polymer-charcoal adsorbent for hemoperfusion].

Adsorbents used in haemoperfusion are briefly analysed. A new polymer-carbon adsorbent Hemosorb, worked out by the Biocybernetics and Biomedical Engineering Institute of the Polish Academy of Sciences and by the Central Research Centre of Cotton Industry. Physicochemical and biochemical qualities of the granulated adsorbent Hemosorb and Adsorba 300 C (Gambro, Sweden) were evaluated. It was found that Hemosorb is not inferior to the Gambro product.

Adsorption↗
PubMedDate not supplied

User views on standards for defibrillators.

User views on the need for defibrillator standards were surveyed as part of a multifaceted study of defibrillator use in Canadian hospitals. The majority of users favor standardization of performance, labeling, and use characteristics. They also prefer that all defibrillators incorporate cardioversion capability. Most users prefer that the defibrillator automatically switch to the emergency mode after delivery of a cardioversion shock, but almost one half of the physicians preferred the unit to remain in the synchronized mode as set. Most users are in favor of all equipment operating in the same fashion, but paramedics are not. Only a minority believes that cardioversion features are a cause of confusion, yet conversations with biomedical engineers indicate that this confusion is a common problem among the users. Virtually all users prefer that necessary standards for safety and efficacy should be mandatory for both manufacturers and hospitals.

Attitude of Health Personnel↗
PubMed1979

The challenge of biophysics to dynamic dermatology.

Dermatologic biophysics has much to offer both clinical and investigative dermatology. For the clinician, the radiation biophysicist can provide accurate measurements of ionizing and nonionizing outputs, including those for PUVA, and critical evaluation of radiation safety measures. In optics, there is a need for accurate measurements of skin color and examination of the skin at moderate magnification. The biophysicist, with the biomedical engineer, can improve all the physical modality instrumentation used in practice. In investigative dermatology, there is the cellular biophysics of radiation. Doppler techniques for skin circulation, spectroscopy of living cells, and many other applications are suggested for current and future studies.

Biophysical Phenomena↗
PubMed1979

CAGS lecture. Scientific salients in surgery.

Surgery, as a field of clinical skill and scientific knowledge, advances by Discovery, Development and Delivery. While the basic biosciences have been more productive in Discovery than have the clinical fields, surgery has participated in several important areas of Discovery. Developmental science is often called biomedical engineering. In this activity, surgery has been pre-eminent, while it is the study and perfection of Delivery that holds such promise for the future of surgery. Distribution and regionalization of operations, bidirectional referral flow, manpower norms and analysis of adverse outcomes are important horizons for study in surgical care delivery.

Canada↗
PubMed1973

Euthanasia--an overview for our time.

The Committee for the Continuing Study of Evolving Trends in Society Affecting Life was established by the CMA House of Delegates in 1971, following the consideration of a number of resolutions on the topic of abortion. The committee's charge was broadened, however, to include topics such as euthansia, biomedical engineering, medicine and religion, ecology and education. The committee's discussions, as its name indicates can cover a wide range of fields of interest to the medical profession. The following article is the first of several which the committee plans to publish, although the products of its deliberations may take the form of resolutions to future meetings of the House of Delegates.

California↗
PubMedDate not supplied

[Medical equipment at the Leipzig Fall Fair of 1977].

An analysis of the most interesting exponents of the Leipzig autumn fair of 1977 served as a groundwork for an attempt to outline the major orientation and trends in the development of the biomedical engineering. The advantages of the functional units method of designing are taken notice of on an example of some groups of devices manufactured both in the countries members of the Council for Economic Mutual Assistance and in western countries. Emphasis is placed on the good prospects offered by medical devices for ultrasonic location of the heart with the type M scanning, of the X-ray units intended for solving concrete diagnostic objectives within a narrow branch of medicine (apparatus for mammography, for use in urology, etc). Particular attention is paid to the medical equipment utilizing the elements of computer technique, in the form of built-in units and also in that of complex setups in which small computers ensure the most effective realization of the diagnosis and treatment.

Dental Equipment↗
PubMed1984

A user-oriented information system for emergency medicine.

A user-oriented Emergency Medical Services Information System ( EMSIS ) has been developed in our medical center that can readily be established by any interested medical center. This minicomputer based system provides online registration of poison center calls, access to the Poisindex (C) data base, concise patient information sheets, access to EMS treatment protocols, assistance in the differential diagnosis of acute poisoning, dosage recommendations for drugs with a narrow therapeutic margin, and kinetic analysis of drug overdoses. Video terminals access EMSIS in the Emergency Department, pharmacy, outpatient medicine clinic, pediatric clinic, medicine wards, poison control center, and biomedical engineering. A PDP 11/70 with 256 Kb core and 48 ports running under RSTS /E V7 .0 supports an average of 20 simultaneous users.

Computers↗
PubMedDate not supplied

[Standardization of methods for testing the resistance of medical equipment to mechanical stress].

The existing methods and facilities for testing biomedical equipment for vibration resistence is adopted from technical standards prepared for manufactures of radio-industry and fail to take into consideration actual operation conditions and transportation of equipment and instruments of biomedical engineering. On the ground of experience gained by testing medical equipment proposals for elaborating rules and conditions for vibration resistance testing for medical equipment are offered.

Medical Laboratory Science↗
PubMedDate not supplied

Salary trends for CEs and BMETs: the emergence of a database.

More than 700 survey responses have been analyzed to examine correlations between salary, job position, academic background, age, hospital size, and certification status for clinical engineers and biomedical equipment technicians. Compensation increases in relation to academic credentials, level of responsibility, and size of hospital.

Adult↗
PubMed1980

HCMR interview: Kenneth Wessner, Bill Pollard and Alex Balc, Jr. of ServiceMaster Industries, Inc.

While ServiceMaster is a service organization like many health care providers and provider-sponsored shared services, its range of services, hospitals served and geographic distribution of services make it the largest shared service in the nation. ServiceMaster manages laundry and houskeeping, and supplies plant and biomedical engineering and materiel management services to more than 800 hospitals throughout the United States. Some of these services are high-technology oriented. All require excellence in products, methods and people skills.

Contract Services↗
PubMed1995

[Presentation of the international, emergency medicine relevant periodical spectrum and ethics and authorship and publication].

International scientific journals dealing with the broad subject of emergency medicine are listed. The following standards were applied: only journals from Europe or North America published in English or German were selected; whenever possible, the actual number of copies printed is mentioned; listing in the "Index Medicus" is stated; and, finally, the time course of the so-called "impact factor" from 1984 to 1992 is shown. The impact factor is a measure of how often the "average article" in a journal has been cited in a particular year. Basically it describes a ratio between actual citations and citable items published. It permits some qualification of quantitative data since it discounts the advantage of large journals over small journals and that of frequently published journals over less frequently issued ones. Journals from 12 different medical specialties have been selected for analysis: Emergency Medicine; Anesthesiology and Critical Care Medicine; Biomedical Engineering; Neurosciences; General Internal Medicine; Internal Medicine: Cardiology, Pulmonary Medicine, Infectious Diseases, and Public Health; Surgery; Pediatrics; Pharmacology; Physiology; Experimental Medicine. In addition, a few remarks are made dealing with ethics of publication and the increasing number of medical authors per article published. The terms "irresponsible authorship", "author inflation", "wasteful publication", and "abstract creep" are introduced and explained. Furthermore, strategies adopted from the literature to restrain those developments are introduced.

Authorship↗
PubMed1995

Surgical video systems used in laparoscopy.

A significant amount of minimally invasive surgery (MIS) is now being performed using surgical video systems (SVSs), and with the increased application and sales of SVS equipment, many new SVS manufacturers and products have entered the medical device market. Consequently, the challenge of selecting an appropriate SVS has increased significantly, in part because of the complexity of the latest generation of equipment, which has evolved from solely optical endoscopes to mostly video electronics used with various types of endoscopes. When describing their products, manufacturers often present technical characteristics of their systems that can be complex and, many times, confusing. Although purchasers often rely on technical specifications when selecting an SVS, they actually need information that will illustrate the system's applicability in their clinical setting, which can be assessed only through clinical evaluation at the hospital. Also, the lack of standardized methods of specifying SVS performance and the difficulties in relating technical characteristics to clinical performance should diminish the emphasis that is often placed on specifications when selecting a system. In this article, we review and explain many common specifications of SVSs, focusing on their use with laparoscopes, and provide guidance on the limitations of each specification and the extent to which it may be useful. This information will help clinical engineers, biomedical technicians, and other readers participate in the technical aspects of selecting and managing an SVS for use with many types of endoscopes.

Humans↗
PubMed1993

Finite element analysis of the mitral valve.

A finite element model was developed to examine deformation and stress patterns in the mitral valve under systolic loading conditions. This is the first three-dimensional finite element model of the mitral valve, incorporating all essential anatomic components, regional tissue thickness, collagen fiber orientation and related anisotropic material properties. A non-linear, transient, dynamic analysis was performed which included time-dependent loading, leaflet and chordal mass inertial effects and chordal element bi-linearity. The model was first analyzed without either annular or papillary muscle contraction and then with either or both. The hypothesis was that the combination of annular and papillary muscle contraction would have a beneficial effect on valve function. In all models, the computed anterior leaflet principal stresses were tensile and of greater magnitude than those in the posterior leaflet. The principal stress directions were observed to correlate well with collagen fiber orientation. Earlier leaflet coaptation was demonstrated with annular contraction, promoting valve closure, while papillary muscle contraction increased the stress on the chordae tendineae and both leaflets, tending to pull the latter apart. The combination of the two combined these effects, and showed the most even stress distribution. The effects of annular and papillary muscle contraction on valve function were shown to be beneficial by this model, and they can be further elucidated by varying the extent and timing of the individual contractions. This model can be used to examine the effects of pathologic changes, surgical manipulations and proposed material replacements. It can thus aid both the surgeon and the biomedical engineer in improving the materials and techniques available for the repair and/or replacement of mitral valve system components.

Animals↗
PubMed1993

[Stimulators of the central nervous system].

Progress in biomedical engineering has provided implantable and programmable stimulators which allowed application of neurophysiological knowledge to therapeutic attempts on human neurological diseases. Chronic electrodes can be implanted accurately and safely into the brain, against the spinal cord and around the nerves. Therapeutic applications, mainly on pain, dyskinesias and epilepsy are therefore available, which call for careful clinical evaluation, basic and technological research to improve indications and diminish the cost of these methods.

Central Nervous System↗
PubMed1993

Medical-care systems for long-duration space missions.

As in the opening of frontiers on Earth, human physiological maladaptation, illness, and injury--rather than defective transportation systems--are likely to be the pace-limiting variables in efforts to expand the presence of humans into the solar system. Because of the inability of individuals to return to Earth rapidly and conveniently, the capability of delivering medical care on site will be key to the success of a manned space station, lunar base, and Mars mission. Spaceflight medical care equipment must meet stringent constraints of size, weight, and power requirements, and then must function accurately in remote, self-contained, microgravity settings after extended intervals of storage, with neither expert operators nor repair technicians on site. Satisfying these unusually rigorous requirements will require sustained direct involvement of clinically up-to-date health-care providers, medical scientists, and biomedical engineers, as well as astronauts and aerospace engineers and managers. Solutions will require validation in clinical settings with real patients, as well as in simulated operational settings.

Aerospace Medicine↗