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Technology and Health Care is intended to serve as a forum for the presentation of original articles and technical notes, observing rigorous scientific standards. Furthermore, upon invitation, reviews, tutorials, discussion papers and minisymposia are featured.
The following types of contributions and areas are considered:
1. Original articles:
Technology development in medicine: New concepts, procedures and devices associated with the use of technology in medical research and clinical practice are presented to a readership with a widespread background in engineering and/or medicine.
Significance of medical technology and informatics for healthcare: The appropriateness, efficacy and usefulness deriving from the application of engineering methods, devices and informatics in medicine and with respect to public health are discussed.
2. Technical notes:
Short communications on novel technical developments with relevance for clinical medicine.
3. Reviews and tutorials (upon invitation only):
Tutorial and educational articles for persons with a primarily medical background on principles of engineering with particular significance for biomedical applications and vice versa are presented.
4. Minisymposia (upon invitation only):
Under the leadership of a Special Editor, controversial issues relating to healthcare are highlighted and discussed by various authors.
Abstract: This paper provides an overview of the computerized assessment and rehabilitation of patients with cognitive disorders caused by focal brain damage. The characteristics of computer-based rehabilitation systems are discussed in general and questions as to their efficacy addressed. Diagnostic but in particular rehabilitation systems for the following areas are examined more closely: attention disorders, visual–perceptual disorders, memory and language disorders. The development of hard and software is followed back to its beginnings. Typical examples of modern systems are given. The focus is on systems evaluated in the course of a European Concerted Research Action. (Supported by the European Commission, Project…No. MR4*-0231-D).
Abstract: Patients in cardiogenic shock may benefit from treatment with mechanical circulatory support systems. These systems permit either bridging to the recovery of native heart function (bridge to weaning) or bridging to a natural cardiac graft (bridging to transplantation). The present world experience includes 965 implants for bridging to weaning and 544 implants for bridging to transplantation. From this experience it has become clear that patients about to die have the possibility for survival after or with mechanical circulatory support. The risks of the procedures have also been clearly shown. Based on current experience new orientations for clinical research and developments…in bioengineering are indicated.
Abstract: Osteoarthritis is a common disease that constitutes a considerable socioeconomic burden. So far no radiological procedure was available that allowed the disease to be detected in an early stage. Monitoring disease progression and efficacy of therapeutic procedures was also not possible. We present a measuring procedure and describe evaluation tools that are based on 3D computed tomography. The procedure provides quantitative data on pathological features known to be associated with osteoarthritis such as subchondral sclerosis, osteophytes, joint space narrowing, and bone lesions. It is fully three dimensional, the results are operator independent and describe global as well as local…parameters. Changes in these parameters are evaluated from differential images. For that purpose a 3D matching procedure based on translation and rotation-specific correlation techniques is used that allows a repositioning of the bone objects with a mismatch of less than 0.3 mm with regard to translations and 0.250 with regard to rotations. The use of the new tools for measurement, repositioning and evaluation is illustrated with the results from a clinical study. Patients with mild osteoarthritis of the knee joint, healthy controls and osteoporotic patients, all in the same age range of 60 to 75 years, were examined during three years. The cortical to trabecular bone ratio describing subchondral sclerosis proved to be especially helpful to distinguish early osteoarthritic cases from age matched controls. Disease progression is best shown by the increase in the number of detected bone lesions, a reduction of the mean distance between femur and tibia and an increase in the cortical to trabecular bone ratio. Hence the presented procedure appears to have a great potential in diagnosis and treatment monitoring of osteoarthritis.
Keywords: Osteoarthritis, Quantitative computed tomography, Bone densitometry, Knee joint, 3D image analysis
Abstract: Minimally invasive pediatric surgery (MIPS) is a new dimension in pediatric surgery. The scope of methods replacing large operations in children by smaller endo- or laparoscopic interventions is presented. Electromagnetic double-segmental elongation has achieved auto anastomosis in 16 out of 22 children with long gap esophageal atresias since 1975. A new radial laser-applicator with entirely lateral radiation has led to a method for endoscopic occlusion of esophagotracheal and other fistulas with a 100% success rate in a minipig-model. Our experience with 54 laparoscopic interventions including large bowel resections, hiatus hernia, and a new technique for pyloromyotomy documents that laparoscopy…halves hospitalisation-periods and may well become the most rapidly growing branch of pediatric surgery.