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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: An initiative for the design of an automatic safety-alarm system is proposed. The alarm system will be designed for elderly people, who are living independently and need some assistive care. It has to detect an emergency at home, and in that case, it has to send an alarm signal to an alarm centre. The detection is done with remote sensors. The emergencies are detected by monitoring and analysing the “Activities of Daily Living” (ADL) of the elderly person at home. In this article, the product demands are worked out and a description is given how the automatic safety-alarm system can…be built up, and which technologies and components could be used.
Abstract: Background: Small retinal and choroidal tumors situated near the optic nerve or macula, such as retinoblastomas and malignant melanomas, as well as various other anomalies, in particular vascular malformations, may successfully be treated by photocoagulation. Model assumptions geared towards maximizing efficiency and minimizing undesirable side effects are forwarded, and the most important parameters subserving photothermal destruction, such as radiation field and thermal energy, analyzed. The influence exerted by physical traits of various tissues involved are also considered. Methods: The model approximations presented are based on classical radiation and absorption laws, as well as on the scattering properties of…the various tissues implicated, these being considered as a function of wavelength and their relevance to the photodestructive task at hand. Particular attention is paid to the rate processes and reaction kinetics of irradiated proteins. Conclusions: Radiation sources emitting in the near-infrared range of the electromagnetic spectrum, such as the diode (810 nm) and the cw Nd:YAG (1064 nm) lasers, are optimal for the treatment of tumors and large, voluminous entities (such as Hippel-Lindau angiomas), owing to the good tissue penetration properties of their light. Those emitting in the shorter wavelength range, such as the argon ion (488 and 514 nm) and first harmonic – mode Nd:YAG (532 nm) lasers, are not suitable for such tasks, but they are ideal for the destruction of fine sanguinous structures, within which their light is strongly absorbed but through which it penetrates poorly. For the treatment of large anomalous structures, a combinded short/long wavelength – strategy should also be considered as a viable alternative. Such a “wavelength mixture” is emitted by the xenon high pressure lamp of the once renowned Meyer-Schwickerath light coagulator. The precision and safety of photothermal destruction methods depend, in the first approximation, upon the details of the pulse energy deposition (wavelength, pulse hight and duration, pulse dynamics, mode composition, focussing), the choice of which is determined by the optical and thermal constants of the irradiated tissues. Higher pulse energies will, of course, be more effective in destroying neoplastic cells, but the risk of producing undesired collateral heat damage will also increase concomitantly. Until we can ascertain the physical properties of the pathological tissues treated with certainty, we will hardly be able to achieve more than an approximation of an ideal treatment strategy. But with increasing developments in in vivo-diagnostic techniques, we expect that this goal will be attainable in the not too distant future.
Keywords: Laser, tumor, argon laser, diode laser, frequency doubled Nd:YAG laser, physical constants, model approach
Abstract: This paper surveys the state of the art in telemedicine applications of virtual environments (VEs) and related technologies for health care. The possible use of VEs as telemedicine tool has attracted much interest in medicine. Actually this technology is commonly used in remote or augmented surgery, and surgical training, which are critically dependent upon eye-hand coordination. Recently, however, different researchers have tried to use VEs in anatomic learning and for the assessment and rehabilitation in neuro-psychology. To date, such applications have improved the quality of health care, and later they will lead to substantial cost savings. Tools that respond to…the needs of present VE systems are being refined or developed. However, the possible use of VEs in telemedicine is not linked to the solution of technical problems only. In fact telemedicine is not simply a technology but a complex process whose successful exploitation needs significant attention to ergonomics, human factors and organizational changes in the structure of the relevant health service.
Abstract: The response of human femoral cortical bone to lateral impact were investigated both analytically and experimentally. In the analytical part of this investigation the Timoshenko beam theory was used for predicting the propagation of flexural stress waves along the specimens. The final solution was given in integral form and the results were obtained with the aid of a digital computer. In the experimental part of this investigation the employed specimens were obtained by cutting a human femur shaft along its length and the specimens were machined to have a uniform rectangular cross-section. Flexural stress waves in cortical bone were generated…by impacting transversely 4.8 mm diameter spherical projectiles, fired from an air gun with the appropriate velocities. Stress waves were detected at two stations (positions) on the beam specimens by means of foil strain gages. These gages were suitably connected with a digital storage oscilloscope to detect the flexural stress waves produced by the lateral impact. Force history was recorded also on a storage oscilloscope by means of a sandwiched quartz crystal arrangement, of high frequency response, placed at the impact point of the specimen. A comparison was made between the corresponding analytical results and experimental data. Significant agreement was observed between them, as shown in the figures of this article.
Abstract: The objective of this study is to develop cervical spine models that predict the stresses in each vertebra by taking account of the biodynamic characteristics of the neck. The loads and the moments at the head point (Occipital Condyle) used for the models were determined by the rigid body dynamic response of the head due to G-z acceleration. The experimental data used were collected from the biodynamic responses of human volunteers during an acceleration in the z direction on the drop tower facility at Armstrong Laboratory at Wright Patterson Air Force Base (WPAFB). Three finite element models were…developed: an elastic local model, viscoelastic local model and complete viscoelastic model. I-DEAS software was used to create the solid models, the loadings and the boundary conditions. Then, ABAQUS finite element software was employed to solve the models, and thus the stresses on each vertebral level were determined. Beam elements with different properties were employed to simulate the ligaments, articular facets and muscles. The complete viscoelastic model was subjected to 11 cases of loadings ranging from 8 G-z to 20 G-z accelerations. The von Mises and Maximum Principal stress fields, which are good indicators of bone failure, were calculated for all the cases. The results indicated that the maximum stress in all cases increased as the magnitude of the acceleration increased. The stresses in the 10 to 12 G-z cases were comfortably below the injury threshold level. The majority of the maximum stresses occurred in C6 and C4 regions.
Abstract: This paper presents the results obtained using radiochromic (MD-55 GafChromicTM ) film for the 2D and 3D dosimetric reconstruction of the dose delivered by a proton beam under the real conditions of a programme of radiotherapy treatment for ocular tumours. Standard microdensitometric measurements were used to determine the variation in film optical density (O.D.) vs dose. Calibration curves were obtained by least-square fitting of the experimental OD values using a second order polynomial. This allows conversion of O.D. to dose. With this procedure it was possible to determine the distribution of the dose delivered by the proton beam in a…phantom composed of layers of GafChromicTM film, with high surface spatial resolution and, through sections, the complete mapping of the dose delivered to a volume subjected to irradiation, as in a course of radiotherapy treatment.
Keywords: GafChromicTM, radiotherapy, treatment planning, proton dosimetry, dose distribution