Telemedicine equipment was installed at a rural site in Drumheller and at Calgary, 85 miles (136 km) away. It allowed consultation between health-care providers at Drumheller and specialists and subspecialists at the Faculty of Medicine in Calgary. The efficacy of the system in providing more equitable access to health care for persons living in geographically remote sites was evaluated during a 12-month pilot project. Seventy-five encounters were attempted during the study. A total of 55 encounters (42 clinical and 13 non-clinical) were completed. The completed clinical encounters were distributed across a wide spectrum of medical specialties. Users of the system reported favourably on the impact of the telemedicine system on access to health services for rural patients, on diagnostic, investigative and management decisions, on patient and physician travel times, on feelings of professional isolation and educational opportunities and on overall patient health status. The study provides new knowledge and demonstrates the success of the technology in this project. As expected, other problems were raised and addressed in a preliminary manner including: the potential for health-provider education; acquisition and retention of rural physicians; ethical, legal and patient confidentiality issues; minimum acceptable technology; and network management issues.
Autoradiographic studies were conducted to identify and characterize target cells for 1,25(OH)2 vitamin D3 in the pyloric region of rats and mice. After injection of 3H 1,25(OH)2 vitamin D3, nuclear concentration of radioactivity was observed in nuclei of duodenal epithelium and certain cells of pyloric glands, while most of the epithelial cells in the pyloric and gastric glands did not show nuclear labeling. In combined immunohistochemical studies, cells in the pyloric glands that showed nuclear concentration of radioactivity, were stained in their cytoplasm with antibodies to gastrin. Also, cells of the pyloric sphincter muscle showed nuclear labeling, in contrast to cells of the duodenal muscularis, which remained unlabeled under the conditions of the experiments. The results indicate that the cells with nuclear radioactivity contain receptors for 1,25(OH)2 vitamin D3 and suggest that gastrin secretion and pyloric muscle functions are regulated by a direct action of 1,25(OH)2 vitamin D3 on these cells.
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