Notes From The Net - July 1996

by Stephen M. Pribut, D.P.M.

This is the first column in a series on the use and impact of the Internet on Podiatric Medicine. Over the next several months we will review both general aspects of the Internet and those specific to Podiatric practice. This month we will review some basic terminology, the use of indexes to find information while surfing the web and how to access Medline via the Internet.

The Internet is a set of tens of thousands of interconnected networks containing millions of computers joined together and able to communicate with each other. The World Wide Web, also known as the WWW or W3, is currently the most visible part of this network. The Web is essentially a hypertext linking system which allows one to traverse it by clicking on textual links. While originally designed to contain only text links, it has now become a network of multimedia links, containing graphics, sounds, and video images. A Web Browser is software that is designed to view Web documents. One of the first available browsers was Mosaic. The most widely used one is Netscape and Microsoft, not to be left out, has produced Explorer.

Use of the Internet has been growing by leaps and bounds. Its many uses include ease of communication and increased access to a wide variety of information. The World Wide Web makes access and use to the world of the Internet quite easy. In the past arcane UNIX commands and unfriendly software were needed to peruse the Internet. Now, user-friendly software gently allows one to use a graphical interface to perform most of the functions that you would desire. These functions can be accessed through "home pages" on the Web. Home pages are designed and displayed by both companies and individuals. It is a form of self-publication that is affordable and accessible to nearly all. The most frequently used functions on the Internet have been ftp (file transfer), Telnet (running a program on another computer), e-mail (sending messages), WAIS (full text search of documents) and Archie (a search for information).

Windows and Macintosh software have made accessing the Internet no more difficult than it would be to use a Windows style help menu. Two problems have developed as a result of this. The first is that the Internet is becoming more crowded and slower in general. The other problem is the time delay that occurs when downloading a graphics laden home page. As a result, some people now call the World Wide Web, the World Wide Wait.

The Web has been criticized as being an unorganized amalgamation of material. Many people feel that there is no easy way to identify and use the ever growing information available on the Web. However, a variety of indexes and searching utilities are available on the Web to help locate information. One of the most popular has been Yahoo ( Yahoo is a company that has an online selection of over 30,000 Web sites consisting of what they consider to be a "best of the net." The selections are done manually by human inspection of the sites. Point ( lists what they call the "Top 5% of The Web." Their listings also include a review of the site, a representative excerpt, and a rating of three parameters (appearance, information, experience). Both of these sites may be searched by topic or keyword. While they will lead you to information on many topics, they will also miss many sites. More compete searching is available from sites that use "bots" or automated searching. The most popular sites include: Alta Vista ( and Lycos ( Lycos purports to have 15 million pages indexed. Alta Vista, recent winner of a C|net award for best search engine, claims to have 15 billion words indexed from 30 million pages. They report examining 2.5 million pages per day. Searches may be performed by using a word, phrase or with simple Boolean combinations of words.

Our medical highlight this month is the U.S. National Library of Medicine's (NLM) "Internet Grateful Med." This is the Web version of a popular software product that performs searches on the NLM's MEDLINE database. Grateful Med has been available as a stand alone DOS program for the past several years. It allows for an automated and assisted search of MEDLINE. An index of Medical Subject Headings (MeSH) is available to help make the search more specific. The Internet version of Grateful Med works with your Web browser and requires no additional software. The cost is nominal for most searches, consisting only of a per citation fee and search time. There is no charge for setting up a search which is done by filling out a form using your Web browser. Searches are easily limited by categories such as study groups (human or animal), language, age, year of article and so on. On line help is easy to use and readily available. One of the special aids supplied by the NLM is the Unified Medical Language System (UMLS) Metathesaurus . This coordinates your keyword with a conceptual search which is linked to the MeSH. A tree like display of search headings is then presented for you to incorporate into your search. Searches will automatically try to map your keyword to a medical subject heading. A utility that will analyze a search and suggest ways to improve it is also available.

To demonstrate the ease of use of this system and the specificity possible in a search, a sample search was performed. Searching on the terms Fibromyalgia and foot diseases gave one citation between the years 1993 and 1996. Analysis of the search revealed 315 citations of Fibromyalgia and 995 citations of Foot Diseases with only one containing both search terms. Clicking on "Find Related" accessed the Metathesaurus and suggested adding the search terms Fatigue Syndrome, and Chronic Fibrosis to the term Fibromyalgia and also suggested adding Podiatry to Foot Diseases. Adding terms is done by clicking on a green "go" button and returning to the search window. The addition of the two terms suggested yielded a search configuration of fibromyalgia OR fatigue syndrome, chronic OR fibrosis combined with foot diseases. The number of hits for fibromyalgia and related terms was increased to 1,862 with 2 citations found with both terms. The second citation, however, was not relevant to what we really wanted. It involved Morton's neuroma and fibrosis of the tissue rather than fibromyalgia. Sometimes less is more. Each article is a hypertext link. Clicking on the article will change the display to reveal more information and will also allow you to view the abstract.

A set of search results may be downloaded to your hard disk for examination on your personal computer, provided you have the disk based version of Grateful Med. It is also possible to have citations e-mailed to your Internet address. In combination with a service called "Lonesome Doc", you can arrange for a copy of desired articles to be available at a nearby library. The Medline service takes up 5.8 Gigabytes of disk space. The Metathesaurus, alone, takes up over 950 Megabytes of storage space. Information on Grateful Med and how to set up an account is available on the Web at: .

Future columns will discuss online journals, list servers, Usenet, E-mail, hypertext, urls, and more on how to find people, places and things. If there are topics you would like discussed, please send e-mail to The text and hot links of this article will be available at my Home Page .

After publication in the APMA News, my columns will be available on my home page at with a complete hypertext listing of all of the sites mentioned.

Published in APMA News, July 1996

Hot Links From This Article



Alta Vista


National Library of Medicine's (NLM) Internet Grateful Med

Coming Next

August 1996 - Dissecting an URL and Medical Journal Highlights