December 1998

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Special issue
Update on results from European R&D projects
November 30, 1998

Each year hundreds of European R&D projects produce important results. In this special issue, co-published by the magazines Primeur and VMW, we give an update from a number of projects in the HPCN and medical sectors that were supported within the Esprit or Telematics programmes from the European Commission.

This issue is published in conjunction with the large IST 1998 event (the former Esprit/Telematics conference) in Vienna.

Technology transfer

Medical Media Engineering and simulation Design and traffic Next issues are planned in April during ITIS99 (at HPCN Europe) in April and in November during IST 99 in Helsinki. When you want your project results in one of those issues, please contact the editors of Primeur magazine or Virtual Medical Worlds magazine.

ITIS98logo Visit the UPDATED website of the first International Conference on the Telemedical Information Society.
Newly available from 01-07-98: coverage of the three forum discussions held at ITIS'98 !

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Charter and official launch of the Virtual Medical Worlds Community
January 1st 1999 will be the official starting date for the Virtual Medical Worlds Community (VMWC) initiative. The major objective of this newly founded working group is to create a dynamic synergy between users operating in the telemedical sector and technology suppliers to advance the European industry in both areas. VMWC will try to stimulate exchange of information and expertise to generate awareness in the medical sector via the organization of workshops, technical meetings, participation in major telemedical events, and a virtual community environment on the Internet for active brainstorming and discussion among the members.

Launch of a new Web-based publication: The Journal of ITIS Letters
Regular visitors of the Virtual Medical Worlds Web site undoubtedly have noticed the birth of an innovative concept for scientific papers. Articles appearing in The Journal of International Telemedical Information Society (ITIS) Letters are refereed and published via the World Wide Web. In tight collaboration with Elsevier science publishers and the renowned Journal of Future Generation Computer Systems , the new publication aims at playing a capital role as a catalyst to promote dissemination and uptake of leading edge research activities in the field of telemedicine. The rapid publishing within a 4 week review period of papers will turn The Journal of ITIS Letters into an efficient exponent of creative ideas for the building of a telemedical information society.

Catalonian hospital trust develops Java visualizer to display medical images on the Web
Dr. Josep Fernández is responsible for the Laboratory of Medical Imaging of the SDI-UDIAT. This research centre, which is hosted by the Corporation of Health Facilities Parc Tauli, is one of the 49 institutions connected to the Catalonian scientific network. Since Dr. Fernández recently developed a visualizer in Java to show medical images on the Web, the Laboratory has become a pioneer in medical image visualization through the use of Internet technologies.

Modern alchemists discover Philosophers' Stone with promise of eternal youth
Geron Corporation has sponsored and licensed the scientific experiments, independently undertaken by competent researchers at two academic institutions, to derive and maintain in culture human pluripotent stem cells for the very first time. This achievement will open unsuspected perspectives for tissue transplantation, drug screening and toxicology testing, as well as for cell and gene therapy. Can newly created immortal cells replace affected cells in the human body to offer us eternal youth?

Markets grow more accustomed to speech recognition technology
The Speech Processing Division of the Philips Company recently developed FreeSpeech 98, a new system that recognizes natural speech for conversion into text. The software package can be applied to generate and format text, while simultaneously controlling the Windows interface without using the keyboard. Philips has implemented the so-called "software only" method, which means that the programme performs the entire recognition procedure. It is now possible to have the calculations executed by a fast but simple PC processor. Currently, speech technology software has become very user-friendly. Several providers, such as IBM, Lernout & Hauspie, and Nortel are introducing their innovative products on the market.

NEC scientists awarded patent for design of "DNA Turing Machine"
A computer which simultaneously can solve a series of any given problems through the use of DNA molecules is truly universal. In fact, the invention was revolutionary enough for awarding a US patent to Dr. Warren Smith and Dr. Allan Schweitzer, two scientists at the NEC Research Institute in Princeton. Their concept has been baptized the DNA Turing Machine in analogy with the original computer out of 1937, and according to the name of its designer, Alan Turing, a British computer scientist. Today's digital computers are all inspired on this model.

"Citius, altius, fortius" with Blue Pacific and the Next Generation Internet
A memory of over 2.6 trillion bytes and a performance of 3.9 trillion calculations per second, these astonishing assets constitute the precious dowry of Blue Pacific, the world's fastest computer. United States Vice President Gore and Energy Secretary Bill Richardson unveiled the new and powerful machine, developed by a team of computer experts from IBM and the Energy Department's Lawrence Livermore National Laboratory in California, to break the speed barrier for computing. On the same occasion, the Vice President announced the birth of the Next Generation Internet. President Clinton has signed a bill to establish a high speed connection between more than 100 universities for advanced network applications, such as telemedicine and distance learning.

"In My Steps" simulates cancer patient's fatigue to create physician's awareness
"If only the doctor could feel what I'm going through", must be the heart's desire of many a cancer patient. It seems that virtual reality has made this dream come true. Medical Consumer Media has developed a fully immersive virtual environment to simulate the patient's experience when faced with the challenge to perform everyday tasks and to manipulate simple objects in his home. The system has been designed in a way to complicate every single movement of the user in the virtual house so that he actually can live through the daily trials and the extreme fatigue of a patient under cancer treatment. "In My Steps" is offering health providers a unique chance to gain a deeper insight in the effects of fatigue due to the disease and to reconsider their treatment programmes.

Pet project's collector to head for Healtheon and Hyperion
The true pioneering spirit is never afraid of letting go to seek new adventure in an inspiring challenge. Healtheon saw the light in 1996 as a provider of advanced Internet-based solutions for the health care industry. Founder of this company which develops and manages virtual health care networks is Jim Clark, the paragon of unconventional entrepreneurship. Before going telemedicine, this talented Texan rebel launched two ventures which proved to be extremely successful. Names like Silicon Graphics and Netscape indeed ring a whole carillon of bells...

Internet matches cancer patients with clinical trials via SecureNet
In close collaboration with Microsoft and TVisions, the American Oncology Resources (AOR) Company has created SecureNet, a set of easy-to-use but very sophisticated applications and databases to adequately identify cancer patients for perfect matches with exactly those clinical trials they are in need of. In time, SecureNet will replace the current paper-based method which unfortunately has proven to deliver ineffective results in an ad hoc manner at the cost of too much effort. SecureNet constitutes a promising alternative to save precious lives and may offer original answers to cure cancer as well as other life-threatening diseases in the long run.

Five year funding will significantly extend Protein Data Bank's capabilities
The Protein Data Bank (PDB) has received a fresh management. Three American institutions have formed a consortium, called the Research Collaboratory for Structural Bioinformatics (RCSB), and handed in a vast proposal to operate and extend the PDB as a scientific tool, in order to unveil the enigma of biological systems in pharmaceutical and medical research. The triumvirate consisting of Rutgers, the State University of New Jersey; the University of California at San Diego (UCSD); and the National Institute of Standards and Technology (NIST), have obtained a $10 million grant for five years to explore new mechanisms for fast sequence and molecular structure investigation.

Virtual centre without walls allows AIDS researchers to join forces
Although geographically far apart from each other, partners of the Great Lakes group for AIDS Research from now on can "meet" in a virtual centre, created by investigators at the Michigan Collaboratory for Research on Electronic Work (CREW). A suite of innovative voice, video and data communication tools will establish a real frontier-crossing virtual work environment that will connect four Midwestern universities. The scientists, who recently were awarded a joint National Institutes of Health (NIH) grant for their ongoing efforts to beat the AIDS virus, thus are able to interact with each other as if they were operating at the same location.

Single network ATM backbone to put Health First on the road to telemedicine
Since a few months, health care delivery is travelling via high speed asynchronous transfer mode (ATM) networking in Brevard County, Florida. Health First, a not-for-profit health care organization which was founded in 1995, has selected FORE Systems to replace the outdated local area network (LAN) with a new wide area network (WAN) based on a strong ATM backbone solution. Headquartered in Melbourne, Health First is now able to propagate its original concept of a seamless, integrated health care system of physicians, hospitals, health plans and insurance products in a streamlined fashion to all of its facilities. One single network backbone is transmitting all the medical information between the various locations of the health care organization. Health First already dreams a future bright with video conferencing and distance learning, telemedicine, security monitoring, and surveillance.

SynaPoint software identifies occurrences of epilepsy in children
Worldwide, some one to two percent of the children and a half to one percent of the adults are suffering from epilepsy. The final origin of the disease is difficult to detect but in general, medical experts believe that it is caused by the abnormal electrical activity of neurons in the patient's brain. Since April 1996, NEC Corporation is marketing the SynaPoint software to provide high resolution observation of electrical sources within the brain. In September 1997, the Hospital for Sick Children in Toronto decided to start a partnership with the company, in order to turn the SynaPoint package into a brain function analysis tool to localize occurrences of epilepsy in the brain of its young patients.

Chip implants allow paralysed patients to communicate via the computer
Speech-impaired patients can learn to interact with the outside world thanks to a newly developed, revolutionary method. At the Emory University, neurosurgeon Roy E. Bakay and neuroscientist Phillip R. Kennedy successfully have implanted a neurotrophic electrode into the brains of a woman, suffering from Amyotrophic Lateral Sclerosis (ALS) and a man with brainstem stroke. The computer chip is directly connected with the cortical nerve cells and permits the patient to "talk" by moving a cursor on the computer screen with his mere thoughts. The neural signals are transmitted to a receiver and connected to the computer in order to drive the cursor. Is this the first step to a generation of bionic people who are able to control devices with the brain and whose cerebral functions are influenced by chip implants?

New Web service launches "Michelin" guide for cardiac surgery in hospitals
Since a short while, American health care consumers can consult a new service on the Internet which evaluates the mortality data with regard to the various cardiology treatment programmes and different methods of cardiac surgery within hospitals throughout the United States. A five-star system is being applied to rate the hospital's performance in cardiology and offer candidate heart patients an insight in the quality of the health care service. The rate system will soon be extended to other medical specialities, such as respiratory illness, oncology, and neurosurgery.

Computer simulation to test electronic stimulation of auditory system in cochlear implants
At the University of Iowa, Dr. Jay Rubinstein, a computational scientist and assistant professor of otolaryngology, over the past ten years has been developing a computer model to investigate the biophysics of cochlear implants. The simulation runs on the CRAY C90 at the San Diego Supercomputer Center (SDSC) and represents the primary auditory neurons of both a cat and guinea pig. The auditory performance in both intact and deafened animals with a cochlear implant is being compared via electrical stimulation of the auditory system. The ultimate goal has been focused on the major improvement of information transfer for human patients with all types of auditory prostheses implants.

KPN Telecom invites Medical Centre Apeldoorn to dance in Dutch Telecare project
KPN is the largest provider of telecommunications and related products and services in the Netherlands. Since a few years, the company is trying hard to enter the health care sector. Recently, the Medical Centre Apeldoorn has been selected as the ideal partner for setting up a regional network based on Internet. The initiative constitutes a first test to generate an Electronic Patients Record (EPR) for all of the Dutch health care takers, who are working in or outside the hospital environment. In the long run, KPN therefore aims at introducing this technology also in other regions of the country. The project still leaves a lot of thought about infrastructure and practical organization but KPN Telecom seems very determined to play a leading role as major future supplier of EPR technology.

Talking Web browser allows blind people to interact with the World Wide Web
Chieko Asakawa, a blind researcher at IBM's Research Laboratory in Tokyo, could imagine no reason whatsoever why visually impaired people should be devoid of the enormous source of information the World Wide Web provides to computer users. This logical reasoning meant the start for the design of Home Page Reader for Windows, a new software tool to access the Internet through speech technology. The talking Web browser is able to read aloud the information, located at any selected Web site. The first version has been developed in the Japanese language but Home Page Reader will become available in English at the beginning of January 1999.

PictureTel launches interactive and mobile telemedicine workstation MedLink
For the first time, the renowned videoconferencing system expert, PictureTel, has designed a mobile telemedicine workstation for interactive use in operating theatres, emergency room environments, and critical care units. The MedLink device has been equipped with innovative audio and video technology of the highest quality, allowing to support a wide variety of health care applications. MedLink enables the medical specialist to remotely examine and treat patients, who can be reached at any imaginable location in the world, no matter how isolated it may be.

StrengthErgo gives bedridden patients new taste for a bicycle ride through the virtual forest
The new vision towards rehabilitation programmes focuses on how to keep disabled patients from becoming completely bedridden and on how to let elderly people remain independent by encouraging them to regain their physical strength. Mitsubishi Electric Corporation recently has decided to try and double its sales in medical equipment to 20 billion yen by the end of 2003. As a result, the company will concentrate its efforts on the market for home rehabilitation devices. To this purpose, the Mitsubishi developers have designed a therapeutic exercise system, called StrengthErgo, which consists of bicycle training for patients with functional impairment of the legs. Video software stimulates the patient by offering him a beautiful virtual scenery to derive deeper enjoyment from his bicycle ride.

PV-WAVE signal processing software empowers cardiac diagnostic systems design
Marquette Medical Systems is a manufacturer of non-invasive cardiac diagnostic equipment, clinical information systems, as well as sophisticated electrocardiogram (ECG) monitoring technology. One of the core products is the Multi-parameter Arrhythmia Review Station 8000 that records the heartbeat signals of a patient during 24 to 48 hours in order to detect possible irregularities. The MARS 8000 unit collects the cardiac data for rapid scanning and analysis of relevant indications, allowing the ECG technicians to draw an accurate ECG report for the patient's physician to interpret. The analysis procedure requires powerful signal processing and visualization tools. Only the PV-WAVE software package, as developed by Visual Numerics, included all the essential features to succeed in performing the job.

Genomic analysis refined through high performance GeneMatcher
Celera Genomics Corporation and Paracel Inc. have decided to form a team in the design of advanced gene discovery tools to assist the bioinformatics community in its data sequence and molecular structure research activities. The Pasadena based Paracel Company will install a GeneMatcher parallel genomic data analysis engine at Celera, headquartered in Rockville, to perform sensitive and selective genetic search algorithms at unequalled speeds. Celera anticipates that with the help of the GeneMatcher technology, the entire sequencing of the human genome will be completed in three years.

Mobile Sonoline Sienna platform offers crisp ultrasound images
Small tears in the Achilles tendon can be accurately diagnosed with an incredible level of precision via ultrasound images provided by a lower-priced mobile system. It sounds hard to believe but Dr. Tom Winter, who is involved in research as M.D. in the Department of Radiology at the University of Washington, has put the Siemens Sonoline Sienna platform clinically to the test, together with lots of other colleagues. The participating physicians achieved some outstanding results. The innovative and versatile device integrates colour flow and high-frequency imaging technology at an affordable cost, ranging from $60.000 to $80.000. Siemens has made the system available for immediate delivery.

Distributed PHASE server for drug target discovery at supercomputing speed
Metacomputing environments constitute a vital service which is much sought after in the pharmaceutical industry to enhance both the scope and speed of the drug target discovery process. The Paderborn Center for Parallel Computing co-ordinates a team of scientific researchers and industrial end-users in PHASE, a two-year Esprit funded project which started in February 1997, to develop a distributed high-performance application server for the execution of compute-intensive bio-informatic codes through Inter- and/or Intranet connections. The identification of new proteins requires much less time when integrated in a job load balancing scheme in which the available computational resources are assigned to the various partitions of the task. The server architecture is also very suitable for other than pharmaceutical implementations and supports a multi-level built-in security to protect the user's privacy.

European Telemedicine 1998/99 reference book to be launched in December 1998
The European Health Telematics Observatory (EHTO) has joined forces with Kensington Publications Ltd. and the Royal Society of Medicine (RSM) to publish a unique and authoritative 400 pages study on the various aspects of the European telematics scene with regard to qualitative health care delivery to isolated patients. Major aim of the initiative is to promote the development of telemedicine throughout Europe. The comprehensive reference book will also contribute to the European Commission (EC) plans for continuous support of the health care telematics projects. The targeted public for this publication consists of senior procurement executives and managers in hospitals, clinics and health care organizations.

Emerald system keeps teleradiological watch in the Trento region
In co-operation with the Health Imaging Division of the Kodak company, the Department of Radiology in the Trento region has developed a radiological emergency service for digital diagnosis of patients, located in remote areas. The new system, referred to as Emerald, enables real time medical treatment via the transmission of X-ray images over the Internet by means of a telematic network. The telemedicine service very soon will be extended to the fields of teleoncology and telecardiology.

Medical students get clean online practice with "The Virtual Autopsy"
As a preclinical medical student, you don't necessarily have to manipulate the scalpel anymore in somewhat "messy" sessions to cut up corpses and learn about the secrets of diagnostics or to find out the typical symptoms of mortal disease. Tim Taylor, a student at Leicester Medical School, has introduced an instructive medical quiz on the World Wide Web to offer his fellow-students at the University of Leicester an online teaching resource to expand their knowledge on the human body in all its different aspects. "The Virtual Autopsy" site presents twelve autopsy cases with the intention to determine the cause of death for each of them.

HEALTH one meets the standard of a Good Electronic Health care Record
During the Conference on Electronic Patient Records in Medical Practice (EPRiMP), held in Rotterdam last October, the HEALTH one system was presented by the Health Data Management Partners, an international company based in Evere, near Brussels. Since 1986, HDMP is specialized in the research, development, distribution and service of an Electronic Medical Record, featuring all the elements required by the European project's Good Electronic Health care Record (GEHR). Flexibility, portability, security and a solid clinical content constitute the major characteristics of the HEALTH one record which equally incorporates all of the European Standard concepts on Electronic Health care Record Architecture.

Intelligent search engine CIPRESS to retrieve medical information through association
Frequent users of large databases and retrieval systems know that the search for relevant information can be very time-consuming, not only because enormous quantities of data are stored everyday but also because the maintenance of logic and hierarchical relationships between the data is a far from evident task. In March 1998, five partners have started a two year Esprit funded project to tackle the problem of effective information retrieval from medical databases by parallelizing the process through the use of a scalable High Performance Architecture (HPA). The team has the strong ambition to develop a metacomputing search machine, described in clear terms as CIPRESS, a Complex Information Patterns Retrieval with a parallel distributed processing knowledge Engine Search System.