[Monitoring system of local cortical blood flow during operation. Evaluation of measurement by using a plate type probe].
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Adolescent↗
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[Newly designed skin temperature monitoring system for microvascular anastomosis--an experimental and clinical study (author's transl)].
Blood circulation must be carefully evaluated following the microvascular anastomosis, such replantation of the digits and hands, free toe-to-hand transfer, and free flaps. From May 173, we have performed replantation of forty-five digits, seven wrists or forearm in thirty-four patients and one leg in one patient. The overall survival rate was 92.5%, including near total amputation. Also, from May 1974, we have performed eleven free flaps or free musculocutaneous flaps in ten patients. Seven out of eleven free flaps survived without any problems. The clinical inspections such as skin color and capillary refill are of subjective nature, and not always reliable. Therefore, from 1974, we have been measuring the skin temperature in the revascularized parts by means of a thermister. We usually use an electric blanket to warm the proximal part of the operated limb to maintain the peripheral circulation. Under normal ward environment, we analyzed the patterns of temperature fluctuations, and compared them against the revascularized parts and control sites. On our animal experiments, with the rats' hind limbs, a drastic temperature drop by about 2.0 degrees C was observed in 30 min, compared against the control group, when either artery or vein or both were obstructed. In the cases of the replantations, the skin temperature of control digits ranged from 30.4 to 37.1 degrees C. It usually remained above 32.0 degrees, fluctuating within 3 degrees. Also the skin temperatures of the successfully replanted parts and free flaps usually indicated the level above 32.0 degrees C, which corresponds to more than 80% of the axillary temperature in replanted cases and 90% in free flaps. In one failure case of replantation, the skin temperature fluctuated fom 27.2 to 32.1 degrees. On the fifth post operative day, the temperature suddenly dropped by 5 degrees in two hours. Arteriography was performed, and the arterial obstruction was confirmed. For the four flap operations, the skin temperatures had dropped below 32.0 degrees C, of which two had recovered by an auto-vein graft and the removal of haematoma respectively. We have concluded from these results, that the critical skin temperature in replantation and free flap cases was apparently above 32.0 degrees C in the normal ward environment. Based on our experiences, we have designed a continuous skin temperature monitoring device which consists of a resistance bridge and a thermister. The power source is a D.C. 12V. A high accuracy is maintained at the range of 32.1 +/- 0.3 degrees C when the system is set at 32.0 degrees C in the ward. The circuit is designed to flash a blue lamp when the temperature of the operated site is maintained above the pre-established temperature, while a red lamp and buzz signal give a warning when the temperature drops below the pre-established temperature. This equipment and skin thermometer have been simultaneously used following the various operations of microvascular anastomoses...
Adolescent↗
[Development of a long-term dynamic ECG monitoring system (Holter system)].
The development of a Holter system is introduced here with the emphasis on some key problems such as low power consumption hardware design, high efficient real-time algorithm, high speed reliable playback interface and full function interactive software.
Algorithms↗
[Monitoring system of cerebral blood flow and cerebral metabolism. Part I. Measurement of cerebral blood flow and cerebral oxygen consumption by use of argon and mass spectrometry in clinical cases (author's transl)].
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Adolescent↗
Prevention of sudden infant death syndrome (SIDS) due to an active health monitoring system 20 years prior to the public "Back to Sleep" campaigns.
BACKGROUND: Before reunification, the post-neonatal mortality rate was lower in East Germany than in West Germany. Moreover, the incidence of SIDS (sudden infant death syndrome) was much lower in the East. METHODS: Mortality data on sudden infant death syndrome (SIDS) from West and East Germany since 1980 as well as post-neonatal mortality data for both states since 1970 were examined. 95% Confidence intervals were calculated for the rates. Witnesses from the former East Germany who were involved at the time were also interviewed and archives were searched. RESULTS: We found that as early as 1972 active monitoring of infant and child mortality rates in East Germany had shown that the prone sleeping position was dangerous for infants: the post-neonatal mortality rate was approximately 1 per 1000 live births lower in East than in West Germany during the 20 years before reunification. In contrast, in the West, prone sleeping was only discovered to be a risk factor for SIDS in the early 1990s. CONCLUSIONS: Active monitoring is an effective tool in the early detection of risk factors and serves to prevent unnecessary deaths.
Autopsy↗
Comparison of the Bravo wireless and Digitrapper catheter-based pH monitoring systems for measuring esophageal acid exposure.
INTRODUCTION: We compared esophageal acid exposure data obtained during simultaneous esophageal pH studies using the Bravo wireless and the Slimline catheter-Mark III Digitrapper pH systems. METHODS: Twenty-five asymptomatic subjects underwent endoscopy with endoclip placement at the squamocolumnar junction (SCJ) and manometry to localize the lower esophageal sphincter (LES). A Bravo capsule was placed 6 cm above the SCJ and a Slimline catheter 5 cm above the LES. Relative positions were checked fluoroscopically. Synchronized pH data were compared by manual extraction into Excel spreadsheets. An in vivo pH reference was established with swallows of orange juice (pH 3.88). RESULTS: Median acid exposure time was greater with the Slimline compared to the Bravo system (Slimline, 3.4%; Bravo, 1.76%, p < 0.05) but electrode positions were similar. The dominant source of discrepancy between systems was an offset in recorded pH values around pH 4 as evidenced by the recorded values of the swallowed orange juice. Bench-top testing suggested that this offset was mainly attributable to the software designed to compensate for the difference in electrode recording characteristics between room and body temperature. After adjusting the pH data sets to accurately reflect actual orange juice pH, acid exposure between systems was similar (Slimline, 0.90%; Bravo, 1.15%). CONCLUSION: The Slimline system on average over-recorded esophageal acid exposure compared to the Bravo system largely because of a flawed software scheme for electrode thermal calibration. Accuracy of pH data sets from both systems can be improved by scrutiny for artifacts and use of an in vivo pH reference.
Acids↗
A European scale monitoring system to assess water quality of multi-national river basins in the accession countries.
In the middle of the 1990s the European Environment Agency (EEA) started to develop a data collecting system for surface and subsurface water resources for assessing pressures, states and impacts on European water resources. The main objective of this system was to provide reliable, comparable, homogenous information, and support integrated environmental assessments at European level. The data collecting system for water is called Eurowaternet. The extent and information content of the network makes not only pan-European, but also regional or thematic environmental assessments possible. An extensive programme started in 1997 to support the Phare countries in their accession to the EU with implementation of this data collecting system in their countries. The paper briefly introduces the methodology of the system, but it focuses more on the application of the system in the accession countries, highlighting, through examples, the usefulness of the implemented network and assembled database. The examples present--among several other possible ones--trends of average nutrient concentrations; relationships between catchment size and annual average nutrient concentrations; relationships between catchment size and agricultural usage.
Databases, Factual↗
[The new ambulatory non-invasive 24-hour blood pressure monitoring system, Takeda Medical TM 2420. Reliability and practical experiences].
Takeda TM 2420 is an automatic ambulant device for measuring blood pressure which functions by auscultation of the Korokoff sounds. During static conditions, the apparatus was investigated by means of a double stetoscope and a connecting branch with the Hawksley random zero manometer. Where 69 persons were concerned (ages 13-89 years, systolic blood pressures 85-212 mmHg, diastolic blood pressure 44-110 mmHg) a difference in the systolic blood pressure of 1.5 +/- 9.2 mm Hg were found (average +/- standard deviation) and where the diastolic blood pressure was concerned 2.8 +/- 6.3 mm Hg. Statistical comparison with the Hawksley manometer on the contralateral arm in 51 volunteers produced corresponding results. In 24-hour monitoring of 80 persons, useful results were obtained in 74. The proportion of erroneous measurements was acceptable but the apparatus was unsuitable for exercise testing on an ergometer bicycle. The quality of the cuff, the connecting tubing, the carrying strap and computer programmel should be improved but the apparatus was otherwise found to be useful for daily clinical use.
Adolescent↗
Multiple mouse biological loading and monitoring system for MRI.
The use of mice to study models of human disease has resulted in a surge of interest in developing mouse MRI. The ability to take 3D, high-resolution images of live mice allows significant insight into anatomy and function. However, with imaging times on the order of hours, high throughput of specimens has been problematic. To facilitate high throughput, concurrent imaging of multiple mice has been developed; however, this poses further complexities regarding the ease and rapidity of loading several animals. In this study, custom-built equipment was developed to streamline the preparation process and to safely maintain seven mice during a multiple-mouse imaging session. Total preparation time for seven mice was approximately 24 min. ECG and temperature were monitored throughout the scan and maintained by regulating anesthetic and heating. Proof of principle was demonstrated in a 3-h imaging session of seven mice.
Animals↗
Magnetic field exposure and behavioral monitoring system.
To maximize the availability and usefulness of a small magnetic field exposure laboratory, we designed a magnetic field exposure system that has been used to test human subjects, caged or confined animals, and cell cultures. The magnetic field exposure system consists of three orthogonal pairs of coils 2 m square x 1 m separation, 1.751 m x 0.875 m separation, and 1.5 m x 0.75 m separation. Each coil consisted of ten turns of insulated 8 gauge stranded copper conductor. Each of the pairs were driven by a constant-current amplifier via digital to analog (D/A) converter. A 9 pole zero-gain active Bessel low-pass filter (1 kHz corner frequency) before the amplifier input attenuated the expected high frequencies generated by the D/A conversion. The magnetic field was monitored with a 3D fluxgate magnetometer (0-3 kHz, +/- 1 mT) through an analog to digital converter. Behavioral monitoring utilized two monochrome video cameras (viewing the coil center vertically and horizontally), both of which could be video recorded and real-time digitally Moving Picture Experts Group (MPEG) encoded to CD-ROM. Human postural sway (standing balance) was monitored with a 3D forceplate mounted on the floor, connected to an analog to digital converter. Lighting was provided by 12 offset overhead dimmable fluorescent track lights and monitored using a digitally connected spectroradiometer. The dc resistance, inductance of each coil pair connected in series were 1.5 m coil (0.27 Omega, 1.2 mH), 1.75 m coil (0.32 Omega, 1.4 mH), and 2 m coil (0.38 Omega, 1.6 mH). The frequency response of the 1.5 m coil set was 500 Hz at +/- 463 microT, 1 kHz at +/- 232 microT, 150 micros rise time from -200 microT(pk) to + 200 microT(pk) (square wave) and is limited by the maximum voltage ( +/- 146 V) of the amplifier (Bessel filter bypassed).
Animals↗
Sodium arsanilate-induced vestibular dysfunction in rats: effects on open-field behavior and spontaneous activity in the automated digiscan monitoring system.
Vestibular dysfunction was chemically induced in Long-Evans rats by intratympanic injections (30 mg per side) of sodium arsanilate (atoxyl). Following a one-week recovery period the rats were behaviorally assayed for integrity of the labyrinthine systems. All subjects were tested for presence of the air-righting reflex, the contact-righting reflex (by lightly holding a sheet of Plexiglas against the soles of the rat's feet), and body rotation-induced nystagmus. All animals were then tested for their ability to remain on a small (15 x 15 cm) platform. Next, the subjects were given two 10-min open-field tests during which ambulation, rearing, grooming, and defecation responses were recorded. Four to five weeks later all rats were tested twice (60 min per session) in the automated Digiscan Activity Monitor which provides a multivariate assessment of spontaneous motor activity. The rats with vestibular dysfunction (Group VNX) took significantly less time to fall off the platform (p less than 0.01). They also exhibited significantly more open-field ambulation but fewer rearing responses (ps less than 0.01). An examination of group correlation coefficients for open-field variables and the platform test scores revealed some interesting group differences (ps less than 0.05). In the Digiscan tests the atoxyl-treated rats exhibited fewer number of horizontal movements, but increased speed for these movements (ps less than 0.05). Vertical movements did not differ significantly in incidence, but these movements were greatly reduced in duration (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
Clinical testing of contrast thresholds using a commercial television monitor system.
Background: The Medmont AT-20 has incorporated a contrast threshold test using a predetermined letter size that can be applied in clinical settings. This paper describes a pilot study that evaluates this technology and the effects of certain parameters on test outcomes. Methods: A photometric calibration of the test was performed to define the relationship between the AT-20 scale and Weber contrast (W%). We determined the effects of repeated measures (precision), target size (6/6 to 6/96), viewing duration (50 to 1,000 msec), defocus (+0.50 to +1.50 DS) and a macula scotoma on thresholds. The accuracy of the staircase (PEST) procedure was evaluated with and without false-negative responses. Results: The AT-20 scale has an almost linear relationship to a logarithmic transformation of W% and provides a suitable measure of contrast threshold. In the absence of monitor calibration, threshold uncertainty could be as great as 0.22 log units (W%) compared with published norms. We found that threshold variability averaged +/- 7.1 AT-20 scale units (95 per cent limits of agreement) and was proportional to threshold magnitude. One dioptre of defocus decreased thresholds by about one log unit (W%) for a 6/24 target. We propose that a 6/24 letter shown for 500 msec should provide a useful target for most clinical settings. The PEST procedure can yield endpoints in 47 (+/-12) seconds, is robust to false negative (FN) responses and gives abnormal thresholds in the presence of a macula scotoma. Conclusions: The Medmont AT-20 contrast test provides a useful clinical measure of contrast threshold. With calibration, the test could also be applied to research projects.
Journal Article↗
A new ambulatory monitoring system for tremor.
We have described a fully portable tremor recording system which allows a patient to carry out his normal day's activities with minimal hindrance. Computer analysis of the recording has enabled the extent of the tremor over prolonged periods to be presented in a format which is easily understandable and which should be useful for the objective assessment of therapy.
Ambulatory Care↗
Myocardial ischemia during cardiovascular surgery as detected by an ST segment trend monitoring system.
The incidence of intraoperative myocardial ischemia was determined in 312 patients undergoing cardiovascular surgery using ECG recordings obtained from a prototype system that trends ST segment changes. Prior to cardiopulmonary bypass, ischemic ECG changes were observed in 11.9% of patients, the incidence being lower during coronary artery bypass grafting (CABG) procedures (8.1%) than in patients undergoing repeated CABG (23.5%), valve replacement (25.9%), or concomitant valve replacement and CABG (35.3%). The occurrence of intraoperative myocardial ischemia was statistically greater in patients with a history of hypertension, two or more previous myocardial infarctions, or kidney disease. The incidence of ischemia was also significantly greater in patients with left ventricular end-diastolic pressures of 15 mm Hg or higher at cardiac catheterization. The incidence during induction was significantly reduced by the addition of hypnotics to narcotics, and, during maintenance, by the addition of an inhalational agent. The majority of ischemic events were temporally related to some hemodynamic disturbance, and many coincided with surgical manipulation. The incidence of intraoperative myocardial ischemia was substantially less than that reported in comparable studies. Since the incidence decreased significantly following clinical acceptance of the prototype system, the authors conclude that such capability increases sensitivity to small ST segment changes. This heightened awareness and prompt remedial action reduced the incidence of ischemia during CABG to 6% during the final 2 years of the study.
Aged↗
Assessment of elderly mobility using a remote multisensor monitoring system.
This study was designed to estimate the changes of different activities (going to bed, getting up, visiting washroom) of elderly as an index of mobility. The different values in time and number of the different activities were obtained from 16 elderly suffering from Alzheimer's disease in a hospital for short period observation adding up 4 months of observation data. Significant agreement in different activities (going to bed, getting up, visiting washroom, wandering) among the two measurements by multisensor system and by nursing staff notation was found. As interesting results, the follow up of a patient is shown for 13 consecutive nights. These studies show the potential usefulness of assessment of night activities as an index of mobility, mirror of motor behaviour. Due to minor error, the precise mobility index could not be observed, motor behaviour could simply be evaluated.
Aged↗
Chemotherapeutic-bacteriological interdependences observed by use of a clinical anti-infective drug monitoring system.
The relationships between the extent and type of clinical antibacterial chemotherapy and bacteriological findings were investigated, both retrospectively and contemporaneously, by study of pharmacy deliveries and analysis of patient records and the results of bacteriological examination of urine. Initially, with a high proportion of tetracycline use and relatively little of ampicillin, co-trimoxazole and cephalosporins, E. coli was frequently found and seldom Klebsiella/Enterobacter; the in-vitro efficacy of tetracyclines was low against all bacteria tested. Deliberate restraint in the use of tetracyclines and promotion of co-trimoxazole as well as a spontaneous rise in ampicillin use, were correlated with a decrease in E. coli and increase in Klebsiella/Enterobacter. The in vitro susceptibility of Klebsiella to all the chemotherapeutics tested was relatively low, but it improved markedly after use of cefuroxime was begun. This resulted in a decrease in the incidence of Klebsiella/Enterobacter in urine specimens. Restraint in tetracycline usage was accompanied by an increase in its in vitro efficacy against E. coli. The study shows that continuous monitoring of antibacterial chemotherapy under routine conditions enables the clinical pharmacologist to recognize transient and locally specific circumstances and to define guidelines or corrective recommendations as a basis for and to aid control of real therapeutic decisions.
Anti-Bacterial Agents↗
A transportable, remote sensing, infrared air-monitoring system.
A transportable, remote sensing instrument has been built that is capable of performing real-time quantitative analysis of gas and vapor contaminants of workplace air. The emphasis in this system is on simplicity and sensitivity for use over pathlengths of up to 40 m. A method was developed to overcome the effect of nonanalyte species present in the background spectrum on the quantitation of analytes in the sample spectrum. In addition, results demonstrated that instrument response was proportional to the beam pathlength under homogeneous concentration conditions. The application of software capable of qualitative analysis was also demonstrated.
Air Pollutants, Occupational↗
[Monitoring of blood glucose. Biosensors, a new monitoring system].
The education on the diabetic field, carried by nurses most of the time, is the most important therapeutic measure for the reduction of acute and chronic complications of the diabetic patient. One of the most important parts of the educational contribution consist on self-control; in order to reach said self-control, it is necessary to practise the self analysis, being the best one the control of the capillary blood glucose. In this article, we are presenting a meter for glucose control of the latest generation; the meter has a biosensor technology and it extend its benefits when connected to a personal computer.
Blood Glucose Self-Monitoring↗