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This paper investigates the use of Christian references and computer metaphors in the novel Die Stunde zwischen Frau und Gitarre by Clemens J. Setz. It argues that the novel is structured by the principle of substitution, which is also the main principle of the metaphor. The accumulation of computer metaphors makes the fictional universe resemble a computer game, thereby creating a ludum mundi metaphor rather than the well-known theatrum mundi metaphor. This accentuates the power relations among the characters within the novel and at the same time draws attention to the position of the author. In depicting personal relations and the fictional world as a stalking game, Setz thus questions the relation between author, reader and character. [ABSTRACT FROM AUTHOR]

For a variety of reasons, hospitals are developing a growing interest in changing their information systems to support patient processes in a more direct way. This means to actively deliver the tasks to be performed to the right persons at the right point in time with the necessary information and the application functions needed for performing these tasks. Process-oriented workflow technology is a very interesting candidate to achieve this goal. It offers components for the computer-based analysis, modeling, animation, coordination and monitoring of (hospital) processes. In this paper we discuss the perspectives offered by workflow-based, clinical information systems. We survey key features of today's business process modeling tools and of workflow management systems, and we show how they can be applied in the clinical domain. To illustrate the huge potential offered by workflow technology, we present results from the project "Using Workflow Management Systems for Clinical Applications". Within this project we thoroughly analyzed and redesigned core processes from the University's Women hospital and we proto-typically implemented a workflow-based application system for the support of processes from the division day clinic. Although our work shows that current workflow technology is still lacking some important features, in the long run, it may strongly influence information processing within hospitals.

The development of a portable electronic gestation calculator enables the obstetrician for the first time to recall all relevant data for his daily routine work from an electronic memory. This is useful not only for the calculation of the duration of pregnancies or the determination of delivery data, but also includes all relevant information from ultrasound biometry of the fetus. This paper presents the experience with this new electronic device, 'Babycomp', and comments on its design, technical features, functions and performance. The device has been thoroughly tested especially with respect to its suitability for practical purposes. Compared with the widely used disk for pregnancy calculations, the 'Babycomp' has a wide range of advantages for all users working in the field of obstetrics and reproductive medicine.

Described in this paper is a physical method by which to determine virus concentrations, including ultracentrifugation of a sample through a saccharose gradient and subsequent analysis of tubule content by means of a flow photometer. Here before, the curves thus obtained used to be graphically evaluated by means of stencil plates. Direct recording and processing of the extinction-time curve by means of a KC 85/1 minicomputer have substantially improved accuracy of results. Time consumption has been reduced, and reading as well as calculating errors have been entirely ruled out. Repetition of determinations confirmed that virus concentrations could be determined at an accuracy of four to seven percent.

In modern ultramicrotomes the thermic advance system has been replaced by a mechanical one. Earlier, conventional DC-voltage motors were used, but recently the step motor has become popular. In connection with such motors, the application of digital control elements is facilitated, thus increasing precision significantly. A further step towards improving the precision of the advance system is the application of microprocessors as intelligent and interacting control elements. The microprocessor can not only take over the function sensors, the function of regulation. This paper describes a working concept whereby the advance system does not, as usual, work freely, but in connection with a sensor which measures the advance, and first after a positive data comparison over the microprocessor, allows the cutting movement. The concept is not limited to ultramicrotomes but can also be applied to mechanical rotation microtomes.

By demonstrating three actual cases of disputed paternity the validity of the computer program described in the first part of this paper is shown, namely: the information with respect to possible unrecognized exclusions pointing to chances of extended family studies; the standard deviation and distribution curve giving an actual survey of statistical parameters of a given case of disputed paternity.

Terminal circulation can be studied in vivo using capillaroscopy. This paper presents the results of systematic investigations of capillary permeability (KPU) in the nailfold. In addition to the morphology of capillary loops, we investigated the transcapillary passage and interstitial distribution of sodium fluorescein (Na-flu) in healthy persons (42) and in patients suffering from functional microangiopathies (17) or organic vascular disease (58). The effects of various therapeutic measures on the microcirculation were also studied. First, dynamic processes at the capillary loops were recorded on a video system. The second step consisted of quantification of the pericapillary light intensities (FLI) at predetermined times using a computerized video-densitometer. The measured variables, i.e. maximal interstitial FLI, diameter of the juxtacapillary halo (IK-H) and distance between the intracapillary column of red cells and the interstitial peak of FLI, provided information about the permeability of the capillaries and the interstitial diffusion of Na-flu. In healthy subjects, the interstitial FLI reached its highest values 10 sec after the appearance of Na-flu in the capillary loop, the distance between the peak of FLI and the intracapillary column of erythrocytes increased continuously over a period of 2 min, whereas the diameter of the IK-H reached a constant value after 20 sec. In patients suffering from functional microangiopathy, an increased pericapillary FLI as well as an enlarged juxtacapillary zone with elevated Na-flu concentrations could be established as objective criteria in addition to the already known alterations of the morphology of the capillary loops. Similar observations, but of much greater extent, were made in patients suffering from microvessels disease associated with collagen disease. The regional variation in the pericapillary FLI supports the assumption that morphological changes are present in these patients. KPU in patients suffering from organic macroangiopathy revealed no changes in comparison to healthy persons. The effects of conventional therapy in patients with reduced peripheral arterial perfusion on the parameters measured by KPU were of variable magnitude. The increase in trans-capillary leakage and interstitial dispersion of Na-flu was significant during systemic fibrinolysis and during the intra-arterial application of PGE1. The changes in the measured parameters were considerably smaller during therapy with phenprocoumarol and heparin, whereas treatment with inhibitors of platelet aggregation left the results of KPU unchanged.(ABSTRACT TRUNCATED AT 400 WORDS)

In this paper is described a calculating disk for the percental deviation from the Broca-weight. By exact references to the mathematical derivation and to the construction a practical use is striven for.

The recent advent of microcomputers offers a possibility and challenge to use them for data acquisition, storage and analysis. The paper describes a simple program which allows to analyze and storage the spirometric data. The program was written in BASIC-80 so that it could be easily modified and extended. A microcomputer MC 80 was used.

This paper begins with a discussion of a number of strabologic terms, such as the definition of squint and orthotropia, and criteria of cure. Congenital strabismus and dynamic and static angles of squint are also discussed. Finally, some problems of computer coding in strabismus are considered.

There are two ways to introduce electronic data processing in anesthesia recording, which should be combined in the future: (1) computer-aided data collection (during anesthesia) and (2) data analysis. Both procedures have their own advantages and disadvantages. The first step in data collection is a system whereby the on-line registered data are automatically plotted and the discrete data are noted by hand (semi-automatic recording). The second step is to keep the minutes on a display screen instead of on paper, thus producing a protocol in digital form (automatic recording). We discuss the problems of these computer-aided recording systems and future trends, in particular the problems caused by the "human-computer interface" and by uncertainty with respect to the validity of the stored data. For computer-aided data analysis of anesthesia records, one has to select appropriate data in order to build up data bases. This selection is necessary whether the protocol is in analogical or in digital form, and we attempt to develop some general rules, the concrete selection depends, of course, on the aim of the evaluation. As an example we discuss evaluations for administrative purposes. Evaluations for scientific questions are even more affected by the quality of data definitions, and the efforts involved in data management are considerably higher. At the end of this paper we sketch a hybrid information system for computer-aided anesthesia recording that combines data collection and data analysis.

The computer-system for the on-line-analysis of hemodynamic data developed in Aachen enables the clinical user to perform the immediate on-line analysis of ECG, pressure-curves and thermo- or dye-dilution-curves in a dialog mode. The procedure of pressure analysis as well as the calculations by the computer for the individual haemodynamic parameters are described. The comparison of the medical-manual evaluation of the pressure curves on paper-registration and the computer results of the same measurement shows a very good correlation for wave-recognitions and wave-measurements for this system, integrated in the daily routine since 24 months. As well in the application of various fluid-filled catheters used in praxis as in tip-manometers it could be proved for the pressure-analysis in the different positions of the heart, that the computer-system produced reliable evaluations for all catheter materials used. The flexible conception of the computer program with its fast adaption to new problems allows its use not only in the clinical routine, but also and especially in the handling of scientific questions in the frame-work of haemodynamic analysis.

On the basis of preliminary investigations completed in 1978 dealing with computer-assisted analysis of infrared photographs of the ocular fundus, multispectral photograph analysis methods were tested as to their usefulness in improving differential diagnosis. The computer used in this case was a process control computer with special peripheral equipment. Computer programs were developed to solve problems relating to photograph analysis and classification. Information obtained by computer processing should prove helpful in the differential diagnosis of pigmented changes in the fundus. Since melanomas cannot always be clearly differentiated by purely visual examination, and since the "extra-visual" spectra are often more easily interpreted with the aid of computerized photograph analysis, this paper presents examples illustrating the anticipated practical value of our investigations.

The routinely performed data-aquisition and its analysis by means of a computerized patient-monitoring-system will reduce the repetitive and often monotonous task of data collection accompanied by accuracy and objectivity as much as possible. Another and equally important point for the anesthesiologists is to remove some of the pencil-and-paper burden, reduce the possibilities of human errors in reading instruments and note-taking and the rapid retrieval of monitored and stored data for the purpose of trend analysis. In detail this paper deals with two major systems (department of anesthesia, Latter-Day-Saints Hospital, Salt-Lake City, Utah, and the department of anesthesia, Center of System Research, Stanford University, Palo Alto, Calif., U.S.A.) where the computer is used to extend present monitoring capabilities and frees the staff of those tasks which can be done more efficiently by a machine. It is shown that the more experienced the computer center and the less complex the programming will be, the more liable the anesthesiologist trapped in the routine work will profit from this device. The System in Salt-Lake City proved to be a reliable tool while the system in Stanford so far has shown only to be valid in the remote surveillance of nurse anesthetists in the OR.

This paper deals with the possibility of coding synthetic textile fibers. Using a small data bank the efficiency of a computer aided data search is demonstrated. It is intended to build up a large collection of textile fibers and to determine at least approximately the frequency of a certain fiber type. If this can be achieved the forensic scientist who has to examine textile fibers in case work will be able for the first time to answer the question about the frequency of an incriminating fiber, a question which is often asked in court.

This paper gives a survey on the principles, methodology, and clinical applications of the signal-averaging technique. Bioelectric signals of the heart at the microvolt level are overwhelmed by basal noise in high-gain amplified EKG registrations. By summation and averaging of several hundreds of cardiac cycles, basal noise can be minimized and the signal of interest accumulates. This improvement of the signal-noise ratio primarily depends on the number of cycles averaged, e.g., by 10:1 when 100 cycles are averaged (approximately, the square root of the number of averaged cycles). At present, signal-averaging computers in use are rather variable with respect to data acquisition, filter settings, trigger mechanism/stability, and data processing. These properties have to be taken into account when the results of different groups using different types of averaging computers have to be compared. At present, several applications of the signal-averaging technique in clinical cardiology have been proposed: (1) Surface EKG--registrations of pre-P potentials, of His bundle potentials, and of ventricular late potentials, as well as analysis of the frequency spectrum of the QRS complex in patients with myocardial infarction; (2) intracardiac EKG--recordings of pre-P potentials and of A-V nodal potentials; (3) surface phonocardiogram--detection of low-amplitude, late diastolic signals; (4) Intracardiac pressure analysis--recording of average phasic pressure changes. The most promising and clinically proven application of the signal-averaging technique, at present, seems to be the registration of His bundle potentials as well as of ventricular late potentials from the body surface. Future efforts will need to be made to record cardiac microvolt potentials beat by beat from the body surface by means of specially designed EKG recorders.

The clinical evaluation of cardiac function by non-invasive means with the help of radioactive isotopes registering minimal cardiac transit times (MTTs) is increasingly employed in routine diagnosis. In order to economise on work load and time expenditure and for the purpose of an objective and complete evaluation of data, automatic data processing is desirable. This paper describes a program that consists of 4 sections: 1. examination 2. generation of data 3. processing of data 4. evaluation of data. The program permits a nearly total automated data generation, analysis, calculation, classification, final clinical evaluation and the automated production of a medical report. This greatly reduces the time spent per examination to approximately 5 minutes. The automated evaluation of the data is based on clinical experience with approximately 3.500 measurements in patients with the most frequent cardiac diseases. The result is an objective statement of causes of MTT changes and is highly useful for medical routine application. The control and the final inclusion of the findings into the spectrum of other clinical results remains the subject of the physician's judgement. The advantage of the method is the evaluation of all cardiac segments. This pertains to the evaluation of both atria and both ventricles, as well as of the entire central circulation with and without participation of the lung.

The present paper describes the microcomputer-based allergy data storage and retrieval system, realized with the relational database system INFORMIX on a Siemens MX2 computer. The main features of the kind and structure of data stored are discussed, as well as some general aspects of data storage. Additionally, the activities of the German Contact Dermatitis Group with regard to computer-based documentation are mentioned.

The combination of microphotometer systems with different types of computers allows various possibilities of automatisation in fluorescence photometry. This paper presents several examples of automated fluorometry as testing of preparation and staining, determination of fluorescence intensity with instantanous background correction, controlling a scanning system for detection of immunofluorescence on microplates, rapid microspectroscopy of fluorescence emission, quantification of fading phenomena, help for chromosome analysis and also facilities of data correction and statistical data evaluation.

It is the object of this paper to familiarize the ophthalmologist with some modern epidemiological techniques and to present examples of their application to a consideration of the influence of the level of intraocular pressure on the development of the type of visual field loss characteristic of primary open angle glaucoma. Epidemiological methods are particularly required in chronic multifactorial diseases such as primary open angle glaucoma and arterial hypertension to obtain reliable guidance on practical measures for their treatment or control. Two basic requirements are reliable uniform data suitable for computer manipulation and epidemiological methods to exploit the data and yield conclusions as free of bias and confounding as possible. An example of a glaucoma data base is described and types of enquiry and the importance of standardising prevalence estimations are discussed. Analyses by the four-fold table, risk ratios, the effect of stratification, sensitivity, specifity and the decision curve are described. Attributable risk (potential for prevention) is indicated as yielding information suitable for public health programmes. The life table method is described when relating initial observations to subsequent progressive visual field loss. The factors to be considered in epidemiological work generally and the inferences concerning the early diagnosis of primary open angle glaucoma are discussed.

As a dedicated solution for professional classification, the COMRAD (COMputer in RADiology) system makes available a "dialog system" that enables the fully integrated processing of operational layouts or word processing and administration of medical practice. The dialog system is based on data files which enable direct access to all stored data as well as the storage of new data, thus avoiding a multiple input and storage. The operational layout of text processing which is to be introduced by this paper, permits radiological findings to be prepared in a flow text, strictly observing a division of the analysis into a descriptive and a evaluative report. The synthesis of the findings is reached through a dialed description of a pathological condition, which is automatically supplemented for assessment by the pertinent evaluation text including its variables. In contrary of assembling text modules the texts of all not directly dialed findings without pathological changes are automatically incorporated both into the description and into the assessment. The variables may be standard attributes, free attributes and pairing attributes.

This paper presents techniques for computer-aided analysis of medical ultrasonic images. Methods of image processing, feature extraction and a classification algorithm for tissue characterization are described. Based on these techniques a pattern recognition system for semi-automatic analysis of ultrasonic images has been developed and proved within three clinical studies, which aimed to improve the ultrasound diagnosis of the prostate, the thyroid and the female breast. The results show that computer analysis of ultrasonic images is capable of providing a quantitative diagnosis as well as of differentiating tumor lesions by sonography.

Continuing an earlier publication in which the growth of spontaneous mammary carcinomas in female mice of a C3H inbred strain was described, in the present paper the growth rate is expressed by a mathematical function, and is adapted by electronic data processing to the experimental values of 60 tumors classified into seven "growth types". For mathematical description the tumors were conveniently assumed to have a spherical shape, and the main reason for the reduction in volume increase with increasing tumor size was thought to be insufficient supply with oxygen and the essential nutrients S. Including the experimental data of all carcinomas investigated, the minimum concentration of S necessary for mitotic activity of the tumor cells was calculated to be 65% of the normal level. As the average for all the tumors investigated, a time of at least 33 hrs is required for the tumor volume to double.

After a general introduction into the area of medical expert and consultation systems, a survey about different types of medical expert systems is given. The different objectives and modes of application of medical expert systems are presented and explained in detail. In the second part of this paper, the applicability of computer systems for fully automated interpretation of hepatitis serology findings in the clinical laboratory and for aiding differential diagnosis in internal medicine is described. With the examples given, it is demonstrated that expert systems for clinical decision aid can be of great benefit for the physician in the hospital or the doctor's office.

In clinical electroencephalography, hyperventilation is the most used method of activation. However, knowledge of the conditions of hyperventilation with regard to their effects on the EEG is so far rather undifferentiated. For this reason the effects of hyperventilation in 1109 children are examined in this paper based on clinical and electroencephalographic parameters of a data configuration with a large number of criteria and the results obtained are calculated with the aid of electronic data processing. The statistical methods of examination were frequency and significance investigations by chi 2 tests, multifactorial analysis of variance, multiple regression analysis of influencing quantities, and determination of the reliability of the quantitative method of evaluation. New knowledge on group-statistical validity was obtained with this multivariant analysis and it was thus possible to extend the value of hyperventilation as a method of provocation in clinical electroencephalography. The increase in knowledge is based in particular on the facts that the hyperventilation effects are practically independent of sex, they do not require the consideration of certain age related development modalities of the EEG, they are diagnostically significant as regards unspecific changes of the bioelectrical activity, and they make a differentiated consideration with reference to their strength necessary, which results in 4 types of forms of changing the EEG spectrum. In addition to this, a recurrence of EEG changes was observed after the HV effect proper had faded, and the term "Reprise" is suggested for this and its clinico-encephalographic importance discussed. It was also found that occipital maxima dominate and that changes in frequency and amplitude require separate consideration. The influence of respiratory rate, tidal volume minute volume, alveolar CO2 tension, blood sugar and body weight on the strength of the effect of hyperventilation is not very significant. Mean controlled hyperventilation has proved useful to standardise arbitrary hyperventilation; an improvement could be achieved at the most by norming the respiratory rate. It was possible to prove that the applied method of non-mechanical quantitative EEG analyses had a high degree of accuracy and is consequently suitable for scientific investigations.

Many people think that the development of mathematics is independent from social influences. One simple argument undermines this view: the more money a society has, the more mathematicians could be paid for mathematical work. A second argument is interesting: nowadays computers are a more and more important technological basis for mathematics, too. But arguments like these may have an influence only on the quantity of mathematics and not on its quality. Is this restriction correct? Is the quality, the methodology of mathematics independent from social influences? I do not think so. My main thesis in this paper is that the "foundation-crisis" of mathematics at the beginning of this century has not been solved by a philosophical discourse (platonism vs. intuitionism). The decision for the formal-axiomatic methodology was the decision for a more functional communication code. [ABSTRACT FROM AUTHOR]

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Copyright of Wiener Klinische Wochenschrift is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)