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The paper presents a concept of a computer system designed to assist a surgeon's work both before and during a surgical operation. The aim of multimedia in the system is to ensure comfort in communication between an operating surgeon and his assistants. The elements of artificial intelligence, on the other hand, are to assist the surgeon in taking optimal decisions in difficult and untypical situations.
The paper presents a concept of an educational system for medical students designed to help them learn taking case history and diagnosing oncological patients. The system is a modification of the SYMULPA system worked out by the authors and implemented and tested at the Chemotherapy Clinic of the Medical Academy of Lódź. The main changes lie in the introduction of multimedia to the system, which improves communication capabilities of the system and enables a wider range of results to be considered and examined during case history taking.
Presentation of content in hyperlinked multimedia formats for teaching has failed using the computer's power of navigation through rich visual and auditory information. We have developed "Information Frames", an authoring tool in hypertext markup language (html) format, that allows easy utilization by technology-challenged teachers and professors, and attracts students because of interactive, design-based learning. An Information Frame contains a definition, explanation and illustration of a single concept. Topics are provided with hyperlinks to other Information Frames having related concepts that may provide prerequisite knowledge, or may raise the concept to a more integrative level. A graphical view of the linked-Information Frames presents a Concept Map of the overall topic.
The necessity of home telecare system is growing due to increase in desire for health promotion owing to increase in chronic diseases, aged population and medical expenses. Already, we computerized patient's data and offer periodic health reminder to patients for health promotion by using Life-time Health Monitoring Program (LHMP). Our study connected LHMP to the Web on internet by CGI as an electronic medical record; enabling reference to patient's medical records anywhere. The study also made possible video teleconsultation and constructed multimedia database to provide health-related information to the patients. On these bases, a flow chart was developed using the home telecare to practice manage patients with chronic diseases, old patients, and the handicapped. Further standardization in data, establishment of law bases for home telecare system, development of rules for medical fees and active utilization of biomedical telemetry will be needed to extend home telecare system.
We propose an approach for collaborative workspace management in medical conferencing. A collaborative workspace is a virtual data space shared between medical experts for working out solutions collaboratively while conferencing. Our approach provides medical users with an integrated view of various kinds of multimedia patient data and a unified control over the workspace. For data navigation and conferencing, a tree-like navigation tool, which we named the patient record tree, is provided. And we classify patient data, which is the object of medical collaborative works, into six basic types, and provide a view template for displaying each of these types.
To improve communicative competence during physicians' consultations, we developed a computer-assisted multimedia learning programme. This programme can be used in medical education as well as in continuing education for physicians. Dependent on individual skills and needs, the system, based on hypertext links, can be tailored to expand and improve communicative competence in a series of steps. The programme is based on a manual of medical interviewing and breaking bad news. The user gains information about theory and techniques of verbal intervention. He is trained to be able to reflectively observe and interactively intervene in video-taped and transcribed physician-patient dialogues. In a contrast-typological approach to model learning, in which negative and positive cases can be compared in a problem-based concept, alternative types of interventions can be recognised and evaluated. Finally, the learning goals in verbal intervention techniques should be subject of self-evaluation which can be objectified by further evaluations.
Seamless integration of all types of patient data is a critical feature for clinical workstation software. The Dept. of Veterans Affairs has developed a multimedia online patient record that includes traditional medical chart information as well as a wide variety of medical images from specialties such as cardiology, pulmonary and gastrointestinal medicine, pathology, radiology, hematology, and nuclear medicine. This online patient record can present data in ways not possible with a paper chart or other physical media. Obtaining a critical mass of information online is essential to achieve the maximum benefits from an integrated patient record system.
A distributed multimedia electronic patient record (EPR) is a central component of a medicine-telematics application that supports physicians working in rural areas of South America, and offers medical services to scientists in Antarctica. A Hyperwave server is used to maintain the patient record. As opposed to common web servers--and as a second generation web server--Hyperwave provides the capability of holding documents in a distributed web space without the problem of broken links. This enables physicians to browse through a patient's record by using a standard browser even if the patient's record is distributed over several servers. The patient record is basically implemented on the "Good European Health Record" (GEHR) architecture.
This paper describes preliminary work evaluating automated semantic indexing of radiology imaging reports to represent images stored in the Image Engine multimedia medical record system at the University of Pittsburgh Medical Center. The authors used the SAPHIRE indexing system to automatically identify important biomedical concepts within radiology reports and represent these concepts with terms from the 1998 edition of the U.S. National Library of Medicine's Unified Medical Language System (UMLS) Metathesaurus. This automated UMLS indexing was then compared with manual UMLS indexing of the same reports. Human indexing identified appropriate UMLS Metathesaurus descriptors for 81% of the important biomedical concepts contained in the report set. SAPHIRE automatically identified UMLS Metathesaurus descriptors for 64% of the important biomedical concepts contained in the report set. The overall conclusions of this pilot study were that the UMLS metathesaurus provided adequate coverage of the majority of the important concepts contained within the radiology report test set and that SAPHIRE could automatically identify and translate almost two thirds of these concepts into appropriate UMLS descriptors. Further work is required to improve both the recall and precision of this automated concept extraction process.
At present, personal computers (PC) are most available multimedia devices and used in the design of medical complexes. A problem occurs while choosing a device PC interface. The paper considers a USB interface and the use of its based computer medical complexes. A lot of advantages provided by the new interface, low cost and high efficiency make it possible to design up-to-date devices having high consumer qualities.
The development of the Multimedia Electronic Medical Record System (MEMRS) offers new opportunities for integrating medical imaging data with text-based clinical data. The effective integration of pathology images into the patient's medical record poses some significant technical and organizational challenges. Before these challenges can be met, it is imperative that we investigate the value and utility of providing these images to clinicians. In this study we examined attitudes towards use of pathology images in Image Engine, a MEMRS under development at the University of Pittsburgh Cancer Institute (UPCI). We conducted semi-structured standardized interviews with a cohort of practicing oncologists, all of whom had significant experience with Image Engine. This study is a first step towards elucidating the potential barriers, uses, and value of anatomic pathology images in the MEMRS.
The ENN sleep atlas and database was set up on a dedicated server connected to the internet thus providing all services such as WWW, ftp and telnet access. The database serves as a platform to promote the goals of the European Neurological Network, to exchange patient cases for second opinion between experts and to create a case-oriented multimedia sleep atlas with descriptive text, images and video-clips of all known sleep disorders. The sleep atlas consists of a small public and a large private part for members of the consortium. 20 patient cases were collected and presented with educational information similar to published case reports. Case reports are complemented with images, video-clips and biosignal recordings. A Java based viewer for biosignals provided in EDF format was installed in order to move free within the sleep recordings without the need to download the full recording on the client.
With the use of computer image processing technology and molecular biological technology, we have developed a new multimedia molecular biological information processing system to detect the characteristic parameter of molecular biological electrophoresis image. The system can determine the macromolecules densities and molecular weight of the DNA amplified fragment or restriction endonuclease hydrolytic fragment protein and other macromolecules. The clinical use and biological application indicate that the system is useful to gene diagnosis and molecular biological researches.
The computer-based textbook is a new educational tool that promises to play a prominent role in the coming years. Classical instructional technologies, such as video, stills, audio files and computer programs with a textbook orientation, have been merged into one multimedia computer system and have created additional opportunities for learning in medical, dental and nursing education. The authors developed a hypermedia textbook of â San-Yin-Jiao pressure for reducing the labor pain and shortening the labor time' using a personal computer with hypermedia software that contains texts, images, videos, audios and literature citations. The target population of this educational CD-ROM would be nurse-midwives, clinical nurses working for the obstetric units, and faculty members who teach the Maternity and Women's Health Nursing. Valuable and practical experiences were obtained and shared.
This work evaluates the benefits and applications of computers and multimedia systems in post-mortem examination practice and, more in particular, in the definition of data collection protocols. We examined issues concerning the different aims of autopsy (e.g. diagnostic, scientific, educational, legal), and found that the pathologist's main duty is to acquire a large amount of data in the best possible way. However, despite the will to carry out detailed post-mortem examinations, many pathologic anatomy services face objective difficulties in doing so, especially due to understaffing, lack of time and high costs. The Institute for Pathologic Anatomy of the University of Genoa has developed software for data handling and for outcome reporting, a particularly important aspect in fetal-perinatal diagnosis. The system consists of a relational database in a client-server environment (Fourth Dimension) with two integrated parts. The first part, with unrestricted access, contains patients' personal data, including gender, age, time and date of death, hospital department of origin, person and department requiring the post-mortem examination, hour and time of autopsy, pathologist's name, and clinical diagnosis of death. Using a scanner, a copy of the autopsy application is also field, together with the patient's medical file and any diagnostic images useful to document the case history. The second part of the information system is accessible by pathologists only, and contains the autopsy report. This part is organized to balance two different needs: it allows sufficient space and freedom for autopsy description while providing guidelines for presentation of the report. The structure of the conventional autopsy protocol has been maintained, with subdivisions for all the organs and apparatuses according to topographic criteria. Before this part, a section is dedicated to external cadaver examination and anthropometric data; weight, shape, volume and texture are described for each organ, together with external and cut-surface features. A third section allows the examiner to report other observations not requested previously, while a final section is also provided for the epicrisis and for the formulation of the final diagnosis, the same as that reported in the first form. The database is coupled with an interactive system for collecting voice comments, thereby replacing the need for tape-recorders in the autopsy room. The user can recall a dictation window, dictate a text, check spelling and insert additional text. The database is also coupled to an image acquisition system, on the assumption that moving images allow a more faithful documentation of reality. Therefore, all rooms in which autopsies are carried out on fetuses or neonates have been equipped with a fixed camera linked to a monitor and a video-recorder. A PCB, used for image digitalization, recognizes up to 16,000,000 different colors. Guided by dedicated software, image files are transferred to a computer and then saved with the autoptic report. The database can be consulted and queried in two principle ways: by key words in the contents or main disease descriptions, or by individual words or phrases contained within the complete text of the reports. The present database system for autopsy reporting has proved itself useful in a pathological anatomy service. The combined presence of images and texts renders the system useful also as a research tool. By linking to a Web site dedicated to pathologic anatomy, it will be possible to display online rare cases involving diagnostic difficulties. The system offers great advantages for present and retrospective diagnostics, as well as for research and education purposes.
Methods of computer technology (intelligent technology, IT), such as multimedia and virtual reality, are utilized more and more in all medical fields including child neurology. Advances in the digitalization of individual medical data and multi-media technology have enabled patients to be able to obtain their own medical data by small media and to receive medical treatment at any hospitals even if they are located in distance place. Changes from a doctor oriented to patients oriented medicine is anticipated. It is necessary to store medical data from birth to adulthood and to accumulate epidemiological data of rare diseases such as metabolic diseases or degenerative diseases especially in child neurology, which highly require tele medicine and telecare at home. Moreover, IT may improve in the QOL of patients with neurological diseases and of their families. Cooperation of medicine and engineering is therefore necessary. Results of our experiments on telemedicine, telecare and virtual reality are described.
Pharmacology is by definition a subject of integration. Students take on a passive role during the learning process and do not count with image aids that could foster understanding, fixation and evocation. Therefore, a hypermedia pharmacology CD ROM program was developed. Such a program includes the following features: hypertext format set up as a network of nodes and arcs, multimedia technology, highly interactive and customized navigation. The prototype thoroughly develops cholinergic neurotransmission pharmacology in its historical, anatomic, physiological, biochemical, pharmacological and therapeutic aspects. The program is divided into three modules; namely, information, exercises and evaluation. Each network node may contain a text, hypertext, images, 3D animation and experimental videos. Information resources include the navigation conceptual map for the chosen node, a track record to go back or forward immediately, the possibility of adding text or images, a text search function, images, animation and videos to find such objects in the different nodes together with the possibility of printing any of the contents. Apart from the information framework, the model has manifold useful integration exercises to assess the learning improvement and prompt the student accordingly to review the topic whenever mistakes exceed a certain amount. This program promotes knowledge integration and building through association of contents. To access to the program's demo, consult the following page.
A dynamic or level IV multimedia model is described and illustrated by application to the fate of three polychlorinated biphenyl (PCB) congeners in the United Kingdom over a 60-year period from their introduction into commerce until the present. Models of this type are shown to be valuable for elucidating the time response of environmental systems to increasing, decreasing, or pulse inputs. The suggestion is made that in addition to the outputs of time-dependent concentrations (which can be compared with monitoring data for validation purposes), it is useful to examine masses, fugacities, and fugacity ratios between media? The relative importance of processes is best evaluated by compiling cumulative intermedia fluxes and quantities lost by reaction and advection and examining the corresponding process rate constants or their reciprocals, the characteristic times. The suggestion is made that uncertainty and sensitivity analyses are desirable, but it must be appreciated that relative sensitivities of input parameters may change during the simulation period, so a single sensitivity analysis conducted at one point in time can be misleading. The use of the model for forecasting future trends in concentration is illustrated. Given the uncertainties in emission and advective inflow rates, the simulation of PCB fate in the United Kingdom is regarded as showing time trends that are in satisfactory agreement with monitoring data.