ABSTRRACTMolar pregnancy is a gestation in which the ovum is transformed into a fleshy tumor mass or mole. Of all gynecologic tumors, it is one of the most feared. It is characterized by first trimester bleeding, hyperemesis, and toxemia and can be diagnosed using pelvic ultrasound. Suction curettage is the treatment of choice for molar pregnancy when a patient desires to have more children; however, hysterectomy may be necessary. Abdominal hysterectomy reduces the risk of malignant sequelae. Complications associated with molar pregnancy usually are a result of suction curettage and include pulmonary insufficiency syndrome, choriocarcinoma, hyperthyroidism, theca lutein cysts, and disseminated intravascular coagulation. The perioperative nurse can be instrumental in assessing, planning, organizing, and directing intervention for potential complications associated with the management of a molar pregnancy crisis. The perioperative nurse is encouraged to review all aspects of molar pregnancy to understand the ramifications of the surgical procedures. AORN J 60 (August 1994) 193–201.

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A codec is the mechanism by which video and audio signals are compressed to conserve bandwidth before transmission across a telecommunication network. It may be implemented either in hardware or software. In the past, manufacturers sometimes used proprietary codecs that were incompatible with those from other manufacturers. As network usage became more widespread, however, it became clear that standards were needed to permit interoperability between equipment from different manufacturers. Regardless of the coding standards employed, the primary concerns for the user of a codec system are the quality of the audio and video transmitted. How does one decide what kind of codec to use? For telehealth applications, good quality is important, so it is best to look at products from established manufacturers. Ultimately, the choice of a codec for telehealth depends primarily on the trade-offs between quality, cost, bandwidth requirements and interoperability required by the application(s) for the system, and the environment in which it will be used.

The Wyoming Network for Telehealth (WyNETTE) is a statewide network providing the infrastructure to support the delivery of health care to rural/frontier, underserved communities in the US state of Wyoming. The network connects 40 sites in the state through an ATM cloud to a collection point that connects the network to Internet 2. The primary focus of the network development is the delivery of behavioral health, although other applications are supported.