|Technology For Health|
Pill camera reveals the inside story of body BBC - October 2002
The photograph of the bridge, top, was translated into the middle outline and conveyed through music to a blind subject. The subject produced the bottom image of the bridge using the musical description.
October 29, 2000 - AP
Two blind people in England were able to imagine and draw pictures of cars, buildings, landscapes - even a painting by Cezanne - that were all described to them through music.
B.K., a 52-year-old man, and M.S., a 49-year-old woman, both lost their sight over 20 years ago. And yet, by training their ear to listen for images encoded into music, they were able to "see" images in their imagination.
The technique works by using a computer to digitize images and then relay them numerically into musical form. The length of horizontal lines are conveyed by how long a single note is held. Vertical lines are made going up or down the musical scale. The subjects' ears are then trained to hear what a certain line sounded like. For instance, a horizontal line of a certain length that's rising sounds like this, and vert one sounds like that.
"So for example, I had an X, two diagonal bars crossing each other, you'd hear notes going down and up at the same time. They reach a point where they're the same note and then they diverge," said co-author Krisha Persaud said.
The subjects picked up the musical clues very quickly, said John Cronly-Dillon, a neuroscientist at England's University of Manchester and lead author of the study.
"Within five minutes they can do something simple, like a triangle," he said.
The technique wouldn't work on people blind since birth, who have no appropriate reference points in their visual vocabulary.
Distilling complex visual scenes into simple shapes via sound has its origins in artificial intelligence.
"Because you want a computer to recognize a scene, the image is fed into the computer and it creates an internal 'image,'" said neuropsychologist and artificial intelligence expert, Richard Gregory at England's University of Bristol.
"It's not unlike what we do when our brains take in and interpret an image," he said
Pernaud agrees and notes that translating rich, complex images into simple shapes doesn't necessarily limit their functional value.
"It's the same way Picasso did," he said. "Where you can draw a few lines and that could identify an object. So we're not conveying everything there is in vision to a blind person, but we're giving them enough information to actually deal with the world."
The study will be published in the Nov. 7 issue of Proceedings B from Britain's Royal Society.
"Where we're going with this is hooking it all up to video so they can visualize everything immediately," Cronly-Dillon
This would involve attaching video cameras to blind people that would continuously emit sounds corresponding to objects in their environment, allowing them to navigate without help. For example, a manhole would sound like a circle and Christmas tree like a triangle.
Right now, B.K. and M.S. are using the video systems to walk about - albeit very slowly with little shuffling steps, said co-author Krisha Persaud.
August 5, 2000 - Reuters - Jerusalem
Israeli surgeons said on Sunday they had broken medical ground by implanting an experimental device in a 64-year-old man which could enable people dying of heart failure to live normally without a transplant. Dr. Jacob Lavee, head of the transplant unit at Sheba Medical Center near Tel Aviv, said the battery-powered electric pump weighed about 350 grams and did most of the work of the left ventricle, the heart's main pumping chamber.
``It's the first time it has been planted in a human being,'' Lavee told Reuters.
He said the device, HeartMate 2, made by Massachusetts-based Thermo Cardiosystems Inc, was a smaller and more effective version of the company's original left ventricle assist device, HeartMate.
The original HeartMate was designed only as a temporary solution while a patient waited for a heart transplant, but the new device -- whose price has yet to be set -- would be permanent.
``HeartMate 2 is meant to be an alternative to human heart transplants,'' Lavee said.
``If the new technology is proven to be successful, and it will take another year, it has the potential of solving the problem of many thousands of patients waiting for heart transplants around the world,'' he added.
The device was installed in the patient, identified only as A.S, during a 14-hour operation Thursday at Sheba Medical Center. Lavee said the man, who was on the verge of dying before the operation, was in critical condition after the procedure.
Initial tests after the surgery showed that HeartMate 2 was working well, he added.
With HeartMate 2, Lavee said, the patient could look forward to a normal lifespan assuming he was able to overcome the damage done to his organs from months of heart failure.
He said that before Thermo Cardiosystems Inc sought the U.S. Food and Drug Administration's approval for HeartMate 2, it would be tested on other patients who, like A.S., were dying from heart disease and deemed unsuitable for transplants.
The FDA approved HeartMate in 1998 for dying patients waiting for transplants.
A major benefit of HeartMate 2 is that patients do not need to take anti-rejection drugs which often cause organ damage and lower the immune system, making them susceptible to illness.
However, Lavee said patients with HeartMate 2 would need to take aspirin and other anti-clotting medication.
The number of hearts available for transplants is usually a fraction of the number of people waiting for heart donations. In the United State an estimated 15,000 to 20,000 people need heart transplants each year, but there are only enough hearts for about 2,000 people.
Lavee said the problem was particularly severe in Israel, which had a very low rate of heart donations compared with other countries due to religious beliefs that made people less likely to donate organs.
August 4, 2000 - Nando - Boston
- Linda Hirsch's days of phone tag with her doctor are over.
When she wants to look at the results of her X-rays or medical tests, she uses a new program called PatientSite to download them on her home computer. If she has questions, she e-mails her doctor over a secure link. She can request prescription refills online, and even make a doctor's appointment.
"If I can see my lab results in front of me, and take an active role in my health care, that's what I want to do," said Hirsch, 52.
Developed by CareGroup, a network of six hospitals and hundreds of doctors in the Boston area, the PatientSite program could soon be available to 1 million patients. Other similar but so far much smaller online records systems are being developed elsewhere.
But while online record access is hailed as convenient for patients and timesaving for doctors, it also raises concerns about privacy and fears that patients could misinterpret the data.
Still, Hirsch's primary care physician, Rich Parker, is enthusiastic about PatientSite, which is being tried out by 750 patients and 40 doctors in CareGroup.
"As we are pressured more and more by the powers that be to see more and more patients in a shorter period of time, we just have to be more efficient," Parker said.
Some doctors already use the Internet to communicate with suppliers, insurance companies and each other, but patients have been mostly left out of the equation.
Some hospitals and at least one private company, MedicaLogic, which operates a site called 98point6.com, also are working to put records online, but PatientSite is believed to be the first large-scale effort.
Parker says he wants to ensure that his patients aren't confused by the medical information.
"My one concern I have is that when we give patients easy and complete access to their labs and X-rays they may see something ... and interpret that as a major problem before I get to them," he said.
John Halamka, chief medical information officer of CareGroup, says the idea is to not overwhelm patients or give them information they can't understand. For example, PatientSite will post explanatory X-ray reports, rather than the X-rays themselves.
PatientSite also lets doctors choose which options to make available to patients. And doctors have access to test results 24 hours before patients, allowing time for a telephone call if the news is bad or demands a nuanced explanation. Finally, biopsy results will not be made available over the Internet.
Thomas Sullivan, chairman of the committee on information technology at the Massachusetts Medical Society, thinks the idea is good but worries that hackers might get into private patient information.
"There isn't enough security protection right now, both from a technical and policy perspective," said Sullivan, who has lobbied the Massachusetts Legislature for tighter medical confidentiality laws.
Halamka says PatientSite uses the same technology that banks and online retailers use to protect consumers. The program uses encryption to protect information from prying eyes, and patients need a login name and password, which can only be obtained from their doctor.
But Halamka says technology is only 10 percent of the problem facing the system.
The rest, he said, is that physicians as a group have been slow to embrace the Internet. A recent survey of 257 doctors conducted by WebSurveyMD.com, a service of the health care research group Ziment, found only one-third expressed significant interest in using the Internet to communicate with patients.
Only 27 percent felt the Internet would save the health care system money in the next five years. And the survey found young doctors were no more enthusiastic about the Internet than their older counterparts.
Parker said doctors he knows who have tried PatientSite are enthusiastic, but he realizes changes could come slowly.
"In the past, for better or for worse, the doctor was the centerpiece," Halamka said. "You inconvenienced yourself to drive to the doctor, who gave you 10 minutes, and then left, and if you had another question, too bad. Now, the patient is the centerpiece."
July 12, 2000 - Nando - Va.
A woman had her gall bladder removed by a robot Wednesday in the first operation in the United States to be performed by a surgical system that doctors describe as less invasive.
The da Vinci Surgical System, approved for use at five U.S. hospitals on Tuesday by the Food and Drug Administration, enables surgeons to operate by manipulating joysticks at a computer terminal. Lenses inserted in the patient's body give the surgeon a 3-D view of the person's insides.
Dr. William E. Kelley Jr. performed the gall bladder surgery Wednesday on 35-year-old Kimberly Briggs at Henrico Doctors Hospital.
"I was very pleased. I think it went very smoothly," said Kelley, who had been trained on the da Vinci but had used it to operate only on pigs and cadavers before.
Also pleased was Briggs, who was wheeled into a news conference less than four hours after her surgery was over.
"I feel great," she said, adding that the less invasive procedure would allow her to be home in time for her son Mario's sixth birthday party on Thursday.
With wrist-like devices at the end of the robotic arms giving surgeons a full range of precise movement, the da Vinci is a significant advance on laparoscopic surgery, a decade-old breakthrough that already had made much surgery less invasive.
Dr. Marc Katz, a cardiac surgeon, said using a computer screen to view the area magnified by 10 times and having a robot do the work with precision are "incredibly exciting."
"It gives you the ability to get your instruments where they need to be," said Katz, who is trained to use da Vinci.
Over time, he said, da Vinci could make operations involving large incisions virtually obsolete, allowing patients instead to cover their incisions with "a few Band-Aids."
Surgery using the da Vinci has been approved only for abdominal operations in the United States, but the $1 million robot is being more widely used in Europe, Kelley said. FDA approval for da Vinci on cardiac surgery could come this year, Katz said.
Five hospitals are trained to use the Da Vinci now: Henrico Doctors Hospital in Richmond, Va., Baylor Medical Center in Houston; Ohio State University in Columbus; East Carolina University in Greenville, N.C.; and the San Ramon Medical Center in California.
A few other hospitals are conducting clinical trials of robot-assisted heart surgery.
June 6, 2000 - Reuters
Surgeons at a French hospital said Monday they had given a patient an electronic heart in an operation that was only the second of its kind.
The artificial heart, whose battery is implanted in the body and can be recharged without the risk of infection accompanying previous techniques, was given to a 70-year-old diabetic with a history of heart disease.
Professor Iradj Gandjbakhch, who headed the surgical team during the operation at Paris's La Pitie-Salpetriere hospital, said the battery implanted behind the abdomen could be re-charged through the skin from a coil outside the body.
Technology had previously allowed only for re-charging artificial hearts through a cable running through a catheter to an external battery, leading to the risk of infection and the need for patients to carry the battery with them.
The same operation as the one in Paris was carried out for the first time in October when an American patient received a similar heart in Germany.
``We waited several months until after the patient operated in Germany recovered and returned home,'' Gandjbakhch said.
He added that the apparatus, made by the Arrow firm in the United States, had been tested on animals for seven years before a human was involved.
The patient who received a new heart in Paris was not named.
It takes 24 hours to travel through the body
May 25, 2000 - BBC
A camera in a pill that can be swallowed to show pictures inside the gut has been developed by UK scientists.
It takes 24 hours to travel through the body A camera in a pill that can be swallowed to show pictures inside the gut has been developed by UK scientists.
The researchers believe patients will find the capsule hugely preferable to the current endoscope technology which requires a fibre optic cable to be put up the back passage.
The new "capsule endoscope" measures 11mm by 30mm and contains a tiny video camera, light source and transmitter.
The pill's view of the stomach and intestine
It radios the images from inside the body to a portable recorder strapped to the patient's waist.
The compactness of the new system means that the patient can avoid the inconvenience of a hospital stay.
"The main advantage is that it is very small and completely painless for the patients," Professor Paul Swain, from the Royal London Hospital, Whitechapel, told BBC News Online. "Once they have swallowed the pill, they don't feel it - and they can go home or go to work.
"The belt and the receiver is then sent into the hospital where it is plugged into a computer. A doctor can then examine the images to see if there are any problems."
The team would like to get more control over the movement of the capsule
The capsule is forced through the intestinal tract by natural contractions (peristalsis) and eventually expelled.
In the day it takes to go through a patient's system, the capsule will provide up to six hours of high quality images from the stomach, small bowel and mouth of the large intestine.
The journal Nature reports that the capsule has been tested on 10 volunteers but it must complete clinical trials before being made available commercially. Professor Swain said he hoped this would happen within the next 12 months.
Eventually, further refinements and add-on technologies would make the capsule a "core device" in diagnostic medicine, he said.
"Maybe we could make it move around like a little robot and travel up and down the gut. Maybe we could make it sample tissues or send out signals that imply what is going on inside the body - and perhaps in the future we could even treat people from the inside."
It is more comfortable than standard endoscopes
May 5, 2000 - Reuters
A 52-year-old Texas woman has been implanted with an experimental heart pump that could provide an alternative to heart transplants, surgeons said on Wednesday.
``I think this is may be, as Neil Armstrong said, one small step for man, one giant leap for mankind,'' pioneering heart surgeon Denton Cooley said, quoting the astronaut on his moonwalk.
Cooley is the founder and chief surgeon of the Texas Heart Institute at St. Luke's Episcopal Hospital, where doctors performed the implant surgery on Lois Spiller of Houston.
Spiller, a retired financial planner, had terminal heart disease caused by a virus and was nearing death when she received the device on April 10, said heart surgeon O.H. Frazier, who performed the operation.
The Jarvik 2000 pump, about the size of a flashlight battery, was slipped inside the left ventricle of Spiller's heart where it pushes through a steady flow of oxygenated blood that she can increase or decrease.
The pump, which is linked by wires to an external battery on the waist, will be used temporarily until Spiller can receive a heart transplant. But Frazier and Cooley said the pump could be installed permanently in other patients after further refinements are made to the device and additional research is complete.
The Texas Heart Institute is the first hospital to test the pump on humans in a trial authorized by the Food and Drug Administration.
Other heart assisting devices already in use are larger, more intrusive and difficult to install, Frazier said. They are also too big for most women and children, he said.
The new pump was designed by Robert Jarvik, best known for creating the Jarvik-7 artificial heart that was implanted in several patients in the 1980s, all of whom died. Jarvik said the pump would likely cost between $50,000 and $75,000.
In recent months, two other patients not included in the FDA study received the Jarvik 2000 pump, Frazier said, but only as last-ditch measures. In both cases, the patients died because they were they were too far gone to save when they received the pump, he said.
Spiller was in bad shape, but had fewer complications when she underwent the surgery, Frazier said.
Now, just three weeks after the successful operation, Spiller told reporters she is ready to hit the shopping malls.
``I like to be on the go. I am not a 'sit still' type of person. Since I had the pump put in, I feel 100 percent better,'' Spiller said.
Unfortunately, Frazier said, FDA research protocol requires that Spiller stay in the hospital until she undergoes a transplant operation. That will happen whenever a donor heart becomes available.
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