[Neurological symptomatology of manganism. Project of disability graph].
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The authors describe the installation and application of a computerized management system for clinical information in an intensive care-resuscitation unit. The authors analyze the installation of the hardware and software as well as the professional preparation provided to personnel. They review the different sections which comprise this program, describing the use(s) of each. They conclude by analyzing the advantages and disadvantages detected over the two years during which they have employed this program, highlighting the qualities derived from its daily use which make it a tool that facilitates daily nursing tasks. This report was presented at "Inforenf 2000", "Inforenf 2001" and "Seeiuc 2000".
Volume-selective 31P-MR spectra were obtained from 37 patients using a whole-body MR scanner in combination with surface coils and a modified ISIS sequence. The quantitative evaluation took place by line fitting to the signal in the time domain using a non-linear procedure. The following signal intensities were determined: PME, PDE, Pi, gamma-, alpha-, beta-ATP and pH. 1024 excitations were averaged to achieve an adequate signal-to-noise ratio (10.0 +/- 3.3), measurements lasting 34 minutes on average. The mean measured volume was 174 +/- 52.4 ml. Contamination by muscle tissue could be excluded based on the absence of phosphocreatinine signal in the spectra. Contamination by fatty tissue was excluded by visualisation. A reduction in the value of the Pi/alpha-ATP ratio as a function of time was observed due to the regeneration process following reperfusion injury. In transplant rejection (n = 7) a significant rise in Pi/alpha-ATP ratio was seen compared to the control group (n = 20) (0.4 +/- 0.16 vs. 0.22 +/- 0.11, p < 0.01), the calculated difference in pH was significant as well. In cases of acute tubular necrosis a reduced value fore the PME/PDE ratio was observed (0.65 +/- 0.1 vs. 0.96 +/- 0.5, p < 0.04). Acute tubular necrosis could be differentiated from rejection by difference in pH (6.93 +/- 0.1 vs. 7.14 +/- 0.19, p < 0.04).
OBJECTIVES: Not only architects but also information managers need models and modeling tools for their subject of work. Especially for supporting strategic information management in hospitals, the meta model 3LGM2 is presented as an ontological basis for modeling the comprehensive information system of a hospital (HIS). METHODS: In a case study, requirements for modeling HIS have been deduced. Accordingly 3LGM2 has been designed to describe HIS by concepts on three layers. The domain layer consists of enterprise functions and entity types, the logical tool layer focuses on application components and the physical tool layer describes physical data processing components. In contrast to other approaches a lot of inter-layer-relationships exist. 3LGM2 is defined using the Unified Modeling Language (UML). RESULTS: Models of HIS can be created which comprise not only technical and semantic aspects but also computer-based and paper-based information processing. A software tool supporting the creation of 3LGM2 compliant models in a graphical way has been developed. The tool supports in detecting those shortcomings at the logical or the physical tool layers which make it impossible to satisfy the information needs at the domain layer. 3LGM2 can also be used as an ontology for describing HIS in natural language. CONCLUSIONS: Strategic information management even in large hospitals should be and can be supported by dedicated methods and tools. Although there have been good experiences with 3LGM2 concerning digital document archiving at the Leipzig University Hospital, which are presented in part 2, the benefit of the proposed method and tool has to be further evaluated.
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