Telemedicine in rural Norway.

Trials are reported from Norway on the use of videoconference facilities to make remote diagnoses in the fields of pathology, dermatology, otorhinolaryngology, cardiology and radiology. Telemedicine is moving from the experimental stage to become a regular feature of practice.

Nordic teleradiology development.

In the Nordic countries there are several reasons why teleradiology has been an interesting topic of research during the last years. The distances in rural areas are long, and radiology expert service is not available in every health centre which is able to provide X-rays. Also, the telecommunication network is on a very advanced level in the Nordic countries. The staff is well educated and they are used to operating with computers. This all means that the infrastructure to develop and use systems like teleradiology exists. This paper describes two separate systems developed in Norway and Finland. Their development has been in many respects the same. The common hardware and software features, as well as the differences and the clinical experiences, are discussed in this paper.

The weight of the evidence among group C carcinogens.

Pesticide chemicals (more than 40) with limited evidence for carcinogenicity in animal experiments, and assigned to Group C according to the EPA Guidelines for Carcinogen Risk Assessment, were further analyzed and ranked by refining the weight of the evidence evaluation. For some of these chemicals there were considerable concern with respect to their potential as human carcinogens and for others there was minimal concern. A clear tumor response at several doses, malignancy of the tumors, the tumor type (rare versus common), the timing of the tumor, and the observance of tumors in both sexes raised the concern for potential human carcinogenicity, as did ancillary information such as the structure-activity relationship and genotoxicity. The design and quality of the studies used in the evaluation were significant factors in reaching a conclusion concerning the carcinogenic potential of the chemicals. Potency factors (Q1*) calculated for these chemicals indicated no correlation with the level of biological evidence for carcinogenicity.

Remote frozen section service: a telepathology project in northern Norway.

We discuss the organization of a remote frozen section service in northern Norway. The service is operated by remote control of a motorized video-microscope located at Kirkenes Hospital, at a distance of more than 400 km from the workstation at the University Hospital in Tromsø. The video images of the frozen section are transmitted via a two-way telephone and video telenetwork with a 2 Mbit/s capacity. The images are displayed on monitors and diagnosed by pathologists in Tromsø. To date, 17 patients have been examined by remote frozen section. Correct benign versus malignant diagnoses have been given in all 17 cases compared with final diagnoses based on formalin-fixed and paraffin-embedded material. The average time taken for examining each frozen section was 15 minutes (range, 5 to 30 minutes). In none of the cases was the interpretation of the slides difficult due to deficient quality of the video images. For small hospitals with limited availability of local pathology services and for hospitals with a deficiency of specialists, telepathology may be a worthwhile substitute.

[Use of telecommunications in pathology and anatomy services]. / Bruk av telekommunikasjon i patologisk-anatomisk service.

Telepathology comprises the transmission of microscopic images via the telecommunications network. This paper describes the first experiences from this new technology in Norway. These include teleconferences based on showing histologic slides from the Department of Pathology at the University Hospital in Tromsø to clinicians at local hospitals. A frozen section service to Kirkenes Hospital, based on remote control of a robotic microscope and transmission of high quality video images of the slide, has also been successfully established.

Evaluation of the carcinogenic potential of pesticides. 2. Methidathion.

The carcinogen potential of methidathion, a dimethoxyorganic phosphorus pesticide and cholinesterase inhibitor, was evaluated by the Health Effects Division of the Office of Pesticide Programs using a consensus peer review process and the EPA's guidelines for risk assessment. Methidathion was categorized as a Group C (possible human) carcinogen based upon evidence of an increased incidence of benign and malignant hepatocellular tumors, alone and in combination, in a single study involving male Chr-CD-1 mice. The compound was not carcinogenic in female Chr-CD-1 mice in the same study or in Sprague-Dawley rats of either sex in a second study. Methidathion was not genotoxic in a variety of in vitro or in vivo tests designed to detect DNA damage, chromosome aberrations, gene mutations, and sister chromatid exchange. Although methidathion was identified as being structurally similar to two other organophosphate insecticides, prothidathion and lythidathion, no toxicological data were available on either of these agents for comparative purposes. The biological information on methidathion was reviewed by the agency's FIFRA Scientific Advisory Panel who agreed with the category C designation for methidathion. The data were not found to be sufficient to quantify human risk to methidathion.

Metabolic reduction of benzidine azo dyes to benzidine in the rhesus monkey.

Rhesus monkeys were fed azo dyes derived from benzidine (a known human bladder carcinogen). The urinary excretion of free benzidine was assayed and compared to the amount excreted when benzidine itself was fed. A substantial amount of the dye fed was converted to free benzidine. Results indicate that the simple precaution in the use of only azo dyes manufactured from noncarcinogenic aromatic amines, e.g., aniline, for all consumer products appears prudent.