The central equipment pool, an opportunity for improved technology management.

A model for a central equipment pool managed by a clinical engineering department has been presented. The advantages to patient care and to the clinical engineering department are many. The distribution of portable technology that has been traditionally managed by the materials management function is a logical match to the expanding role of clinical engineering departments in technology management. Accurate asset management tools have allowed us to provide reliable measures of infusion pump utilization, permitting us to predict future needs as programs expand. Thus we are more actively involved in strategic technology planning. The central equipment pool is an excellent opportunity for the clinical engineering department to increase its technology management activities.

Equipment maintenance: moving beyond insurance to self-managed programs.

Equipment maintenance insurance is a recent development that has achieved some cost savings for hospitals. However, greater cost savings can be achieved by a centrally managed self-insurance program that crosses departmental lines. The benefits of such programs are further enhanced when they are run by a technical rather than a financial person.

Orbitotonography, the dynamic assessment of orbital tension: 2. Results in patients with orbital disease.

Dynamic orbitotonography was done in 17 patients with Graves' disease, 25 patients with orbital tumours and 15 healthy subjects. The mean orbital pressure for both patient groups was significantly different from that for the healthy subjects at each time interval (p less than 0.001). Healthy patients may be differentiated from those with orbital disease with a good degree of reliability with this technique. As well, the technique may provide information about the location of disease within the orbit.

Effect of alternating current stimulation of the spinal cord on recovery from acute spinal cord injury in rats.

The therapeutic value of electrical stimulation of the spinal cord was studied in rats injured by acute compression of the spinal cord. Twenty adult Wistar rats underwent cord compression at T6-7 by the extradural clip compression technique at a force of 125 g for 1 minute. After injury and group randomization, stimulating electrodes were placed extradurally, proximal and distal to the injury site, and attached to a small, implantable receiver-stimulator. The receiver was secured to the paraspinal muscles and implanted subcutaneously, overlying the thoracic spine. The animals were maintained in specially designed cages with encircling antennae attached to radio frequency transmitters. The 10 treatment animals were subjected to a 460-kHz electromagnetic field, pulsed at a frequency of 10 Hz. The receivers converted the pulsed radio frequency into square-wave pulses at the cord electrodes (width 1 ms, frequency 10 Hz). The 10 control animals were exposed to a similar field but with a frequency below the range of the tuned receiver, and therefore they did not receive the square-wave pulse. Clinical recovery was assessed by the inclined plane technique which measures the maximum angle of inclination attained without falling. After 15 weeks of continuous spinal cord stimulation, the inclined plane performance was not significantly different between the two groups (treatment group mean, 44.4 +/- 5.4; control group mean, 41.7 +/- 7.9). This is the first experimental study of the effect of long-term continuous electrical stimulation on spinal cord recovery in mammals. The methods required and the technical aspects involved in achieving continuous stimulation, and the guidelines for future study of this modality are discussed.

A microcomputer system for on-line collection of blood flow and related physiological data.

A multi-disciplinary approach is described for the development of a microcomputer based on-line data collection system for blood flow experiments. Well designed software provides a flexible approach to data collection, which is particularly suited to blood flow research laboratories. The choice of well supported hardware ensures ease of development with minimum time and cost.

Miniprobe for lacrimal sac temperature measurement.

The hypodermic probe is presented as a portable and easily used instrument for assessing the temperature within the lacrimal drainage system. Its size makes it practical for clinic or office use. It is also acceptable to the patient and may be performed immediately prior to lacrimal syringings. We suggest that lacrimal sac temperatures may be readily measured and are helpful in assessing the degree of inflammation or the presence of mucus in the lacrimal sac.

Orbitotonography, the dynamic assessment of orbital tension: 1. Results in subjects without known orbital disease.

This paper describes a new orbitotonometer and method of dynamically assessing the orbital tissue resistance ("orbital tension"). In 20 healthy volunteers without known orbital disease the inexpensive instrument proved to be safe and accurate, providing useful, reproducible clinical information. The full diagnostic work-up of patients with orbital disease should include the accurate measurement of orbital tension, as this may provide the ophthalmologist with earlier objective evidence of the disease process as well as a method of following its course.

A spectacle device to treat facial nerve paralysis.

We describe a new method to prevent ocular complications in facial nerve palsy. A device mounted on a spectacle frame senses the blink of the normal eye and closes the lids of the paretic eye by levers which rest on the upper and lower lids. It provides a physiologic replacement of function and prevents corneal exposure.