Telepsychiatry: addressing mental health needs in Georgia.

Creation of a comprehensive mental health telecommunications system to serve isolated persons in Georgia, resulting in a more equitable distribution of mental health resources, is the goal of the telepsychiatry program at the Medical College of Georgia. Although telepsychiatric consultation is not a new idea, the "distribution" of telepsychiatry through additional integrated telecommunications channels such as the World Wide Web is a distinctive approach. This report describes the history of the development of the MCG Telepsychiatry Program. Through the use of a multichanneled telecommunications system, a more equitable distribution of mental health resources is underway in Georgia.

Use of telemedicine for children with special health care needs.

OBJECTIVE: In 1995, the Children's Medical Services (CMS) of the State of Georgia contracted with the Department of Pediatrics of the Medical College of Georgia (MCG) and the MCG Telemedicine Center to develop telemedicine programs to provide subspecialty care for children with special health care needs. This article presents project statistics and results of client evaluation of services, as well as physician faculty attitudes toward telemedicine. DESIGN: A demonstration project using telemedicine between a tertiary center and a rural clinic serving children with special health care needs was established. Data were collected and analyzed for December 12, 1995 to May 31, 1997, during which 333 CMS telemedicine consultations were performed. RESULTS: Most CMS telemedicine consultations (35%) involved pediatric allergy/immunology. Other subspecialties included pulmonology (29%), neurology (19%), and genetics (16%). Overall, patients were satisfied with the services received. Initially, physician faculty members were generally positive but conservative in their attitudes toward using telemedicine for delivering clinical consultation. After a year's exposure and/or experience with telemedicine, 28% were more positive, 66% were the same, and only 4% were more negative about telemedicine. The more physicians used telemedicine, the more positive they were about it (r =.30). CONCLUSIONS: In terms of family attitudes and individual care, telemedicine is an acceptable means of delivering specific pediatric subspecialty consultation services to children with special health care needs, living in rural areas distant to tertiary centers. Telemedicine is more likely to be successful as part of an integrated health services delivery than when it is the sole mode used for delivery of care.

The Georgia State Telemedicine Program: initiation, design, and plans.

This paper describes the genesis, implementation, and operation of the Georgia Statewide Telemedicine Program, a full-service system that provides a comprehensive range of clinical and consultative services to all residents of the state through a hub-and-spoke network. When completed, it will consist of several tertiary-care centers and a set of secondary hubs at medical centers throughout the state. Each hub will, in turn, serve several remote sites. The system enables connectivity throughout the network, and the overall coordination, implementation, and oversight is provided by the Center for Telemedicine at the Medical College of Georgia. The evolution of the system is described, together with lessons learned from the experience.

Histologic localization of surgically transplanted syngeneic seminiferous tubule segments into testis with Fast Blue as tracer.

Spermatogenesis is a complex differentiative process influenced by the testicular extratubular and intratubular tissue environments. One method of determining the relative importance of intratubular versus extratubular factors in cases of deficient spermatogenesis has been syngeneic seminiferous tubule transplantation. Generally in such a scheme, tubule segments from a testis deficient in spermatogenesis are transplanted into an intact recipient testis, and the progression of spermatogenesis in transplanted tubules is examined histologically. However, this experimental approach has been complicated by the tedious histologic serial sectioning required to locate these transplanted tubules and the need to distinguish them from recipient testis solely by structural differences. A method is described for the surgical transplantation of seminiferous tubule segments into rat testes that uses prelabeling donor tubules in vitro with the fluorescent tracer Fast Blue to facilitate their localization. The technique was evaluated by transplanting cut segments of Fast Blue-labeled seminiferous tubules from 15-day-old rat testis into normal adult rat testis (recipient), then localizing and histologically examining the progression of spermatogenesis in the transplanted tubules for up to 28 days. Transplanted tubules were easily identified in sections of recipient testis by fluorescent microscopy; intense Fast Blue staining with low background was seen up to 28 days after transplantation. Histologically, transplanted tubules had limited germ cell differentiation in recipient testis for the Fischer rat strain. At 10 days after transplantation, tubules had characteristics qualitatively similar to tubules from 25-day-old rat testis, with increased tubular diameter and abundant germ cells at the pachytene spermatocyte stage.(ABSTRACT TRUNCATED AT 250 WORDS)