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Factors influencing distant tele-evaluation in cytology, pathology, conventional radiology and mammography.

The present paper summarizes our 1 year's experience with the use of static high resolution videophones (9600 bauds transmission rate, lossless compression, 512 x 512 spatial resolution). The images (n = 610) belong to regular videoconsultation in cytology (160 images), (160 images), pathology (226 images), conventional radiology (50 images) and mammographies (174 images). The results showed an exponential relationship between agreement with 'gold standards' (true diagnosis of the case based on pathology, surgery and follow-up) and the time of training on screen diagnosis (r = 0.9726, P < 0.01) that increases (r = 0.983, P < 0.004) when the screen diagnosis training within the specific topic is examined. Conversely, no significant correlation is found when medical experience itself is considered (r = 0.31, P nonsignificant). Sufficient diagnostic response has been achieved after 1 year of training on screen diagnosis within a specific topic.

Cell Biology↗

Networking pathology services: adjusting to managed care.

Health care reform is creating the need for pathologists to find new approaches to providing traditional pathology services in an increasingly competitive environment. This article reviews changes impacting pathology practices and describes a "messenger network" model as a solution for pathology practices desiring to retain and increase market share.

Community Networks↗

The pathologist's workstation.

To leverage the time and expertise of the pathologist, a comprehensive workstation is a useful tool. Because the practice of pathology is so diverse, however, there is no one standard for what constitutes a workstation. The author reviews the several elements and components which must be included (access to your LIS, word processing, electronic mail, Web browser, literature search), and also reviewed are the many more which may be included, depending on the specialized needs of the practitioner (statistical analysis, ROC curves, image analysis, voice synthesis). It is, however, up to the pathologist to determine which of these components are required and to assemble them in as seamless a manner as possible.

Computers↗

[Computerization and robotics in medical practice].

The article gives the outlines of all principles used in computing included the non-electrical and analog computers and the artifical intelligence followed by citing examples as well. The principles and medical utilization of virtual reality are also mentioned. There are discussed: surgical planning, image guided surgery, robotic surgery, telepresence and telesurgery, and telemedicine implemented partially via Internet.

Computer Communication Networks↗

[Computer-assisted microtelephotometric study of dysplasia and adenocarcinoma of the large intestine in patients with chronic nonspecific colitis].

Computer-aided microtelephotometry showed that the mean size of the nuclei gradually increases and their shape changes, and the total content of Feulgen DNA increases in patients with nonspecific ulcerative colitis in proportion to the severity of dysplasia and malignant degeneration of the mucosal epithelium of the large intestine. In first-degree dysplasia the value os 2.8, in second degree 5.0, in third degree 6.9; in cribriform structures of adenocarcinoma 8.6, in poorly differentiated cancer cells 10.9, and in highly polymorphous sites of adenocarcinoma as high as 20. Mathematical expression of different degree of dysplasia and of adenocarcinoma of the large intestine will no doubt facilitate the differential diagnosis of these processes and help universally assess them. A new technology of histocytological investigations - computer-aided microtelephotometry - permits the use of all types of telecommunications for consultations to be carried out all over the country.

Adenocarcinoma↗

Joslin Vision Network Validation Study: pilot image stabilization phase.

PURPOSE: This preliminary study is designed to evaluate the quality of initial images obtained using the Joslin Vision Network (JVN) image capture and retrieval system. METHODS: Digitized images of 18 patients (36 eyes) were obtained using Topcon Non-mydriatic Fundus Camera and various imaging protocols as described for each series of images. Level of retinopathy ranged from no diabetic retinopathy to proliferative diabetic retinopathy. Images were reviewed and evaluated in comparison to medical record notes and Early Treatment Diabetic Retinopathy Study (ETDRS) seven-standard field stereoscopic 35-mm retinal fundus photographs--when available--to determine the ability of JVN digitized images to allow appropriate diagnosis and clinical management. JVN images were also evaluated for presence of photographic artifacts and stereoscopic presentation. The various displays and relative value of each JVN display were also evaluated. RESULTS: Using combinations of JVN image displays, JVN images were shown to match diagnosed level of diabetic retinopathy as determined from record notes and/or ETDRS seven-standard field stereoscopic 35-mm retinal fundus photography. Viewing images with various combinations of JVN image displays delineates possible sources of artifacts in JVN images. Areas to guide future image capture and image reading are identified. CONCLUSIONS: The JVN image capture system and reading of images by certified readers should allow appropriate photodiagnostic information to support the JVN, the diabetes mellitus disease management telemedicine initiative of the Joslin Diabetes Center. A rigid, full-scale, masked study to compare the Joslin Vision Network to seven-standard field stereoscopic 35-mm retinal fundus photography should be pursued to validate the image-gathering and image-reading strategy to support the Joslin Vision Network.

Adult↗