aerospace techniquesspace.bas.bg/att/pdf_files/medicine.pdf · 2009-03-27 · filters are set,...

AEROSPACEAEROSPACETECHNIQUESTECHNIQUES

andandTECHNOLOGIESTECHNOLOGIES

Space Research Inst.Space Research Inst.Sofia, BulgariaSofia, Bulgaria

spsbyte@space.bas.bgspsbyte@space.bas.bghttp://http://www.space.bas.bg/attwww.space.bas.bg/att

Areas of workAreas of work

ATTATT

MilitaryMilitary

SecuritySecurity systemssystemsMedicalsystemsMedicalMedicalsystemssystems

Remote senseRemote sensecontrolcontrol

MeasurementMeasurementsystemssystems

Switched modeSwitched modepower supplypower supply

MEDICAL SYSTEMSMEDICAL SYSTEMSDepartment of Aerospace Techniques and TechnologiesDepartment of Aerospace Techniques and Technologies

(space biology and medicine)(space biology and medicine)

HolterHolter МАМА--0101(sleep study)(sleep study)

1212 -- channelchannelPC based ECGPC based ECG

HolterHolter ERER--02M02M(ECG study)(ECG study)

HolterHolter ERER--0202(ECG study)(ECG study)

ZORAZORA

NEROLABNEROLAB -- BB

HolterHolter SP01SP01(SpO2 study)(SpO2 study)

1212 -- channelchannelCC--12 ECG12 ECG

TelemedicineTelemedicine

Physician

Telecommunication

line

Patient

NCCC – National centerfor control andcoordination

RCCC– Regional center forcontrol and coordination

RDC – Remote diagnosticcenter

MDC – Mobile diagnosticcenter

PDD – Personal diagnosticdevice

Mobile telephone line

Internet line

Satellite line

NATIONAL TEMEDECINE SYSTEM

REMOTE DIAGNOSTIC CENTER (RDC)REMOTE DIAGNOSTIC CENTER (RDC)

Personal diagnostic device (PDD)Personal diagnostic device (PDD)requirementsrequirements

•Convenient and easy to work

•Cheaper and accessible to everyone

•Be reliable

•To allow communication with external medical devices for home use

•To allow conversion of data for the purpose of compatibility withsimilar systems of the countries of the European Community.

•To ensure the security of personal data of patients.

•To be constructed on the basis of most advanced technologies

PDD prototypePDD prototype

Parameters measured with PDDParameters measured with PDD

1.ECG I lead.

2. Pulse wave

3.Blood pressure

4. Oxygen saturation of the blood

5. Perfusion index of the peripheral tissue

6. Peripheral temperature

7. Cardiac output intensity

8. Peripheral vascular elasticity andstiffness

9. Compatible interface with othermedical devices for home use

““ZORA”ZORA”TheThe ZoraZora system is designed for collecting andsystem is designed for collecting andprocessing of information. Using it, it is possible toprocessing of information. Using it, it is possible toperform a complete examination of theperform a complete examination of theneurophysiologicalneurophysiological status of man during a space flight.status of man during a space flight.Examined are the muscular motive function of theExamined are the muscular motive function of thehuman body, the vestibular apparatus, the visualhuman body, the vestibular apparatus, the visualanalysatoranalysator, the psycho, the psycho--physiological status, thephysiological status, thelocomotorylocomotory functions, the reactions of the human bodyfunctions, the reactions of the human bodyand a range of its specific parameters in theand a range of its specific parameters in thecircumstances of weightlessness.circumstances of weightlessness.

TheseThese examinations are included in the following medical and biologicaexaminations are included in the following medical and biological experiments:l experiments:‘‘StatokineticsStatokinetics’, ‘Labyrinth’, ‘’, ‘Labyrinth’, ‘Potential’,‘OprosPotential’,‘Opros’, ‘’, ‘DosugDosug’ which could be divided in’ which could be divided insub experiments with the aim the examinations to be more detailesub experiments with the aim the examinations to be more detailed and precise. Thed and precise. TheZoraZora system functioned in the space on the board of the Mir stationsystem functioned in the space on the board of the Mir station for five yearsfor five years(1988(1988 --1993). The newest concepts for performing of space medical exami1993). The newest concepts for performing of space medical examinations arenations areconnected with simultaneous registration, processing and expressconnected with simultaneous registration, processing and express analyze ofanalyze ofbiosignalsbiosignals different in their nature, in real time. This ensures the possidifferent in their nature, in real time. This ensures the possibility forbility forexamination of the correlations between differentexamination of the correlations between different biosystemsbiosystems in man when workingin man when workingon board of the space apparatuson board of the space apparatus

NEUROLABNEUROLAB -- BB

NEUROLAB-B is a new generation ofmedical measurement devices designed forexamination of the neuro-regulating changesin human organism on earth and in spacecircumstances.

NEUROLAB-B is a system for intellectual digital processing of bio signalsfor performing of express analyze and evaluation in real time, correlated withdifferent functional systems of the human organism.The scientific object of the examinations performed with this system is theresearch of the neuro-regulating processes in human organism by dividedrecording of the influence weightlessness factors and of the vegetativeemotional reactions

NEUROLABNEUROLAB -- BBWith the system following parameters aremeasured:• Electroencephalogram EEG• Electrooculogram EOG• Evocated potentials on the basis of EEG and EOG• Electrocardiogram ECG• Electromiogram EMG• Skin temperature• Arterial blood pressure• Frequency of the breathing

• Frequency of the basic tone of the speech• Spreading of the attention by following the pupil of the eye• Skin resistance• Mechanical power - dynamometer.During the different examination phases audiovisual and somatosensor stimulations areperformed. The flight configuration of the system includes 48 channels combined onmodule principle (4 specialized channels in each module).

NEUROLABNEUROLAB -- BBThe system is having an unique internal analog-digital interface for communication,supporting the management and the registration of information from the analogamplifiers modules.The module structure allows the exchangeability of the modules and assemblies andtheir combination as well by the solving of different problems connected with ameasurement of the psycho physiological parameters of man. In order to secure theenough channels for registration of physiological information the devices are designedso that their number can increase up to 128.The software of the signal processor for proceeding of physiological signals DSP-TMS320C50 allows a fast and flexible configuration of the system. During theexperiment a variation of the number and the parameters of the channels (sample rate,amplification and filter type) is possible. Significant important for the improvement ofthe leaded signals is that digital filtration is possible. Up to 64 different types of digitalfilters are set, which can be individually chosen for every channel.Proceeding of speech is developed on TMS 320C25. With the help of this module aprocess of identification of fixed number of speech commands (which are used by themanagement of the system) is possible. In this way the introduced bio feedback issecuring a high effectiveness of the functions and high information value of the datareceived from the experiment. NEUROLAB-B functioned on the board of the MIRstation in the space for 5 years (1996 -2001) when station splash down in Pacific ocean.

Sleep apnea analyzeSleep apnea analyze holterholter МАМА--0101The device MAThe device MA--1 is designed for1 is designed forregistration and discovering ofregistration and discovering ofdifferent kinds of apnea during adifferent kinds of apnea during asleep. Its working capacity wassleep. Its working capacity wasproven in cases of monitoring ofproven in cases of monitoring ofthe physiological parametersthe physiological parametersduring operative intervention underduring operative intervention underanesthesia and duringanesthesia and duringpostoperative recovery of patients.postoperative recovery of patients.

Important function of the supporting software of MAImportant function of the supporting software of MA--1 is the possibility for1 is the possibility forperforming of manually measurements of pulse frequency, SO2, artperforming of manually measurements of pulse frequency, SO2, arterialerialblood pressure and results are shown on the liquid crystals dispblood pressure and results are shown on the liquid crystals display build inlay build inthe system. Build in there is a watch showing the year, month, dthe system. Build in there is a watch showing the year, month, day, hour anday, hour andminutes which are recorded in every data file, recorded as wellminutes which are recorded in every data file, recorded as well are theare thefrequency of discretion and the kind of data.frequency of discretion and the kind of data.

HolterHolter МАМА--0101 -- configurationsconfigurations

Breath efforts recorderBreath efforts recorder

PulsoximeterPulsoximeter holterholter Blood pressureBlood pressure holterholter

Sleep apnea recorderSleep apnea recorder

MAMA--01 sleep apnea analyze01 sleep apnea analyze

MAMA--01 sleep apnea analyze01 sleep apnea analyze

HR histogram

Oxygen saturation

Successive interval analyze

Breath frequency

Blood pressure analyzeBlood pressure analyze

2424 –– hourshoursfull disclosurefull disclosureholterholter systemsystem

ERER--02M02M

ER-02

ERER--0202ММ

Main features of ERMain features of ER--02 system02 systemll Full disclosure, 24 hours continuous recordingFull disclosure, 24 hours continuous recordingll Two independent ECG channels (total of 5Two independent ECG channels (total of 5

electrodes)electrodes)ll Online ECG signal controlOnline ECG signal controlll Fast data transfer to PC (24 hours record for 20Fast data transfer to PC (24 hours record for 20

sec.)sec.)ll Data storage on nonvolatile SD cardData storage on nonvolatile SD cardll Power supply: 2Power supply: 2 NiMHNiMH 1.2V rechargeable or 21.2V rechargeable or 2

alkaline 1.5V batteriesalkaline 1.5V batteriesll Optical connection between patient and PCOptical connection between patient and PCll Powerful software for data analysisPowerful software for data analysisll Dimensions: 95x63x28 mmDimensions: 95x63x28 mmll Weight with batteries: 160 gWeight with batteries: 160 g

““HLAB” data analysis programHLAB” data analysis programll Automatic and manual modes availableAutomatic and manual modes availablell Data processing time in automatic modeData processing time in automatic mode –– up to 6 minup to 6 minll “Program education” functions enabled“Program education” functions enabledll Creates and maintains patients databaseCreates and maintains patients databasell Online registration of pulse frequency, QRS complexOnline registration of pulse frequency, QRS complex

and ST segment characteristicsand ST segment characteristicsll AnalysisAnalysis andand chart presentation of pathological rhythmchart presentation of pathological rhythm

eventsevents inin aa tabletable oror aa graphicgraphic wayway:: bradycardiabradycardia,,tachycardiatachycardia,, pausespauses inin thethe ECGECG signalsignal,, chamberchamberextrasystolsextrasystols,, coupletscouplets andand tripletstriplets asas wellwell asas bigeminiabigeminia,,trigeminiatrigeminia,, quadraminiaquadraminia,, tachicardiatachicardia,, RonTRonT variations ofvariations ofthe chamberthe chamber extrasystolsextrasystols,, STST segmentsegment andand STST elevationelevation..

ll Detection of artifacts andDetection of artifacts and myographicmyographic signals causedsignals causedby muscle contractionsby muscle contractions..

ll Exclusion of artifacts from the ECG data analysisExclusion of artifacts from the ECG data analysisll Automatic formatting and print out the report withAutomatic formatting and print out the report with

results after data analysis.results after data analysis.ll Heart rate variabilityHeart rate variability –– frequency and wave analysisfrequency and wave analysisll Interactive communication with the userInteractive communication with the user –– allowsallows

manual corrections of the automatic analysis results asmanual corrections of the automatic analysis results aswell as adding manually detected pathological eventswell as adding manually detected pathological events

““HLAB” data analysis program cont…HLAB” data analysis program cont…

Advantages of ERAdvantages of ER--0202 HolterHolter SystemSystemll Full recording of all patient’s ECG data on the twoFull recording of all patient’s ECG data on the two

channels (full disclosure)channels (full disclosure)ll Very stable recording qualityVery stable recording qualityll Full control given to the physician:Full control given to the physician:

–– Fast access to patents’ dataFast access to patents’ data–– Detailed and unlimited report volumeDetailed and unlimited report volume–– Full interactivityFull interactivity–– “Program education” function“Program education” function

ll Easy to use and safe device operation:Easy to use and safe device operation:–– Fast data analysisFast data analysis–– Recorder operated with a single buttonRecorder operated with a single button–– Patient’s safety guaranteedPatient’s safety guaranteed–– Cheap and widely available power supply unitsCheap and widely available power supply units

ll Quick and effective patient processingQuick and effective patient processingll Affordable price. Specialized unit replacementAffordable price. Specialized unit replacement

warranty service availablewarranty service available

OnOn--line signal monitoringline signal monitoring

Events histogramsEvents histograms

Manual and automatic mode of measuringManual and automatic mode of measuringthe ST segmentthe ST segment

ST episode analyzeST episode analyze

Graphic presentation of RR characteristicsGraphic presentation of RR characteristics

Average heart rate graphics

Page by page overviewPage by page overview

Full summary of eventsFull summary of events

BuildBuild--in and user defined libraries within and user defined libraries withimages of ventricular extra systolesimages of ventricular extra systoles

Review of sample zonesReview of sample zones

Grouping the VES by patternGrouping the VES by pattern

422

Exploration the VES similar to one pattern andExploration the VES similar to one pattern andborn from the same place in chamberborn from the same place in chamber

Heart rate variabilityHeart rate variability

Heart rateHeart ratevariabilityvariability

PrintPrint resultsresults

Heart rateHeart ratevariabilityvariability

PrintPrint resultsresults

Heart rate variabilityHeart rate variability –– wavelet analysiswavelet analysis 22--DD

Heart rate variabilityHeart rate variability –– wavelet analysis 3wavelet analysis 3--DD

Heart rateHeart ratevariabilityvariability

22--D waveD waveanalysisanalysis

PrintPrint resultsresults

Heart rateHeart ratevariabilityvariability

33--D waveD waveanalysisanalysis

PrintPrint resultsresults

ERER--02 print results02 print results

ResultsResults

ResultsResults

ResultsResults

ResultsResults

ResultsResults

ResultsResults

ResultsResults

ResultsResults

ResultsResults

ResultsResults

ResultsResults

ResultsResults

ResultsResults

ResultsResults

Continues record

Print an area withrecord length from 1 upto 30 minutes per page

ResultsResults

Continues record

Print an area withrecord length from 1 upto 30 minutes per page

ResultsResults

Continues record

Print an area withrecord length from 1 upto 30 minutes per page

ER02 record during flight mission onER02 record during flight mission onjetjet--fighter (overload 2gfighter (overload 2g –– 5.5g)5.5g)

NyNy=4.5 g=4.5 g

1212-- channelschannelselectrocardiographelectrocardiograph

CC--1212

CC--1212

CPCCPC--1212

Data transfer to PC via IR line orData transfer to PC via IR line orcablecable

Operating modesOperating modes

Touch panel

Screen configurationsScreen configurations

MAIN FEATURES OF THE CMAIN FEATURES OF THE C--1212llC12 supports 12 independent channelsC12 supports 12 independent channels..

llOnOn--line manual gain controlline manual gain control..

ll Wide range of values concerning signal sensibility andWide range of values concerning signal sensibility andrecord speed.record speed.

ll Computing the average QRS complex for every channelComputing the average QRS complex for every channelincludingincluding all RR interval parameters (all RR interval parameters (PQ, QRS, QT, STPQ, QRS, QT, STlevellevel andand STST slopeslope,, RR duration).RR duration).

ll Manual measurements of time intervalsManual measurements of time intervals..

llComputing the slope of the heart electrical vectorComputing the slope of the heart electrical vector..

llVector electrocardiographyVector electrocardiography from the frontal planefrom the frontal plane..

llUnlimited print pages in the final reportUnlimited print pages in the final report..

1122 –– CHANNELS ELECTROCARDIOGRAPHCHANNELS ELECTROCARDIOGRAPHCC--12 ADVANTAGES12 ADVANTAGES

ll Makes five hours continues recordMakes five hours continues recordll Digital filters of 30 Hz and 50 HzDigital filters of 30 Hz and 50 Hzll ECG signal control, onECG signal control, on--line heart rate detecting, online heart rate detecting, on--lineline

vector diagram.vector diagram.ll BuildBuild--in test generatorin test generator..ll FileFile--saved record and patient data base supporting.saved record and patient data base supporting.ll Cheap power sourcesCheap power sources -- twotwo NiMhNiMh accumulatorsaccumulators 1.2V or1.2V or

twotwo batteriesbatteries 1.51.5V typeV type R6.R6.ll Optical interface C12 to PC.Optical interface C12 to PC.ll Pocket sizePocket size -- 8585x65x32mm / weightx65x32mm / weight 165165gg..ll Easy to useEasy to use..

OnOn--line controlline control

Analyze modeAnalyze mode

Analyze modeAnalyze mode

RR--R interval parametersR interval parameters

Vector electrocardiography from frontal planeVector electrocardiography from frontal plane

Vector electrocardiography from frontal planeVector electrocardiography from frontal plane

Patients data basePatients data base

CC--1212

PrintPrint reportreport

ResultsResultsLandscape

ResultsResultsLandscape

Number of pages depends on the record length ormarked print areas!

ResultsResultsPortrait

ResultsResultsPortrait

Number of pages depends on the record length ormarked print areas!

ResultsResults

PulseoximeterPulseoximeterSPSP--0101

SPSP--0101

PULSE OXIMETER SP1PULSE OXIMETER SP1

ll Up to 24 hours continuous recordingUp to 24 hours continuous recordingll Measured parametersMeasured parameters –– Oxygen saturation [%],Oxygen saturation [%],

Heart rate [Heart rate [bpmbpm], Perfusion index[%]], Perfusion index[%]ll Manual backlight screen controlManual backlight screen controlll Data storage on nonvolatile flash memoryData storage on nonvolatile flash memoryll Selectable period of measurement (2 minSelectable period of measurement (2 min –– 1 hour)1 hour)ll Power supply: 2Power supply: 2 NiMHNiMH 1.2V rechargeable or 21.2V rechargeable or 2

alkaline 1.5V batteriesalkaline 1.5V batteriesll RS 232 connection with PCRS 232 connection with PCll Software for data analysisSoftware for data analysisll Dimensions: 110x79x27 mmDimensions: 110x79x27 mm

Record viewRecord view SPSP--0101

Test results ofTest results of SPSP--01 during high01 during highmountain claming in Everest regionmountain claming in Everest region

6065707580859095

100105

0 1000 2000 3000 4000 5000 6000 7000

[m]

[%]

STAT V1 V2 V3

The high altitude medicine handbook, Pollard, A. J., Murdoch, D. R. Wellington Square, Oxford

SpO2

Clinical test withClinical test with ColinColin--Next monitorNext monitor

SpO2

50556065707580859095

100

1 3 5 7 9 11 13 15

Colin-Next BP88 SP01

99.26530611.31933554

99.367346941.253227127

44 Number of patients

Average SpO2value with etalon

Average dispersionof etalon

Average SpO2value with SP-01

Average dispersionof SP-01

Clinical test withClinical test with Hewlett PackardHewlett Packardmonitormonitor

SpO2

50556065707580859095

100

1 2 3 4 5 6 7 8

%

Hewlett Packard M3046A SP0155

97.806451.600403

97.258061.825153

Average SpO2value with etalon

Average dispersionof etalon

Average SpO2value with SP-01

Average dispersionof SP-01

Number of patients

Clinical test withClinical test with DatexDatex EngstromEngstrommonitormonitor

SpO2

50

60

70

80

90

100

1 2 3 4 5 6 7

Datex Enstrom SP-01

97.961.67770494

98.51.669046

66

Average SpO2value with etalon

Average dispersionof etalon

Average SpO2value with SP-01

Average dispersionof SP-01

Number of patients

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