[THE USE OF PROGRAMMED DIGITAL COMPUTERS AND ELECTRONIC ANALOG COMPUTERS FOR SOLVING CHEMOTHERAPEUTIC PROBLEMS].
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An analog computer simulation of human pulmonary microvascular exchange was programmed and tested. This model of blood-to-lymph transport is based on a compartmental analysis of the lungs and has the capacity to describe fluid volumes, plasma protein content, flows and pressures for both normal and perturbed conditions. Normal conditions were predicted and shown to be in agreement with the literature. The trends in the response of the lungs to changes in microvascular pressure is shown also to agree with the literature both for steady state and transient predictions. The results of a sensitivity analysis, which demonstrates the response of the lungs to a variety of perturbations, is also reported. The simulation predicts reasonable results for normal, transient, and perturbed conditions in human lungs.
This paper describes an analog computer program used to predict warfarin dosages following an initial three daily doses of 10 mg. The program simulates the patient's response to warfarin and suggested dosages can be entered into the program daily to predict the dose necessary for the patient. Warfarin dosage predictions were made for 29 patients. There was a statistically significant correlation between predicted prothrombin time (PT) response and actual PT response (p less than 0.005) for all predictions made. However, when actual and predicted responses were compared with a paired t test, they were significantly different (p less than 0.05). The program described here has been useful for predicting initial warfarin requirements for the majority of patients. Continued research is necessary to identify useful computer methods for predicting warfarin dosages.
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An analog-computer method is described that provides estimates of steady-state plasma theophylline concentration nd total body clearance well before steady-state is achieved. An analog computer was programmed to simulate single compartment disposition of plasma theophylline for a constant rate infusion and an initial bolus. The two simulations were algebraically summed and the curve displayed on an oscilloscope. A series of 20 simulations was performed to define the rate of theophylline administration as applied to the analog-computer rate constant. The method was then tested using patient data previously reported in the literature. Presteady-state plasma concentration-time data points (n = 72) for the 20 simulations were compared; r2 for the analog-computer fit with calculated values as 0.99995. Using data for four patients, the estimates of total body clearance compared favorably with values generated by nonlinear least-squares regression analysis. An r2 of 0.86 was obtained for the analog-computer fit to 16 presteady-state patient data points. Use of the analog-computer method may enable clinicians to adjust aminophylline doses early in therapy to achieve optimal plasma theophylline concentrations.
A ten-compartment analog computer model is presented to determine the precise distribution and excretion of two antidepressant drugs, LM 5008 AND Imipramine. Eight patterns were simulated using experimental data and drug distribution in the two undetermined compartments were obtained by the analog model. Close agreement with existing experimental data lends confidence in the model as a valuable tool for predictions in a variety of therapeutic situations.
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Three hundred dye-dilution curves taken during our first year of clinical experience with the Waters CO-4 cardiac output computer were analyzed to estimate the errors involved in its use. Provided that calibration is accurate and 5.0 mg of dye are injected for each curve, then the percentage standard deviation of measurement using this computer is about 8.7%. Included in this are the errors inherent in the computer, errors due to baseline drift, errors in the injection of dye and acutal variation of cardiac output over a series of successive determinations. The size of this error is comparable to that involved in manual calculation. The mean value of five successive curves will be within 10% of the real value in 99 cases out of 100. Advances in methodology and equipment are discussed which make calibration simpler and more accurate, and which should also improve the quality of computer determination. A list of suggestions is given to minimize the errors involved in the clinical use of this equipment.
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