October 1998

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VMW's live coverage of the IST'98 Conference in Vienna offers unique advertising opportunity
The Virtual Medical Worlds Magazine offers interested industrial partners a fantastic opportunity to highlight their company in the VMW Live! edition from the Information Society Technologies Conference & Exhibition in Vienna, to be held from November 30th till December 2nd 1998. Sponsors of this live coverage are invited to present their products and services in striking advertisements for a well targeted public of potential customers.

Human electric potentials manipulated on the Web
In clinical practice, there is a growing tendency to use multiple imaging modalities for a detailed examination of the same anatomical structure over again, in order to acquire as much information as possible to make a correct diagnosis. At the NTUA, the National Technical University of Athens, a pilot system has been developed to combine images of human electric potentials inside the patient's body with computed tomography (CT) data from the same person so as to prepare the information for visualization and manipulation via the World Wide Web (WWW). The researchers hope to contribute to an improved method for diagnosis by taking a first but decisive step towards virtual reality as a useful technique in current Medical Imaging Systems.

VR based simulation model to assess tumour growth in vitro
In medical science, models of tumour growth are developed to achieve a deeper insight into the molecular origin of cancer and to improve therapeutic approaches in oncology. The complex process of uncontrolled cell proliferation has recently been captured in a simplified 3D cytokinetic simulation model of a small cell lung cancer (SCLC) tumour in vitro by a scientific team of the National University of Athens (NTUA). The experiment is innovative in the sense that a special visualization method is used to allow real time surface and volume rendering on affordable computer hardware for application in daily medical practice. The idea is to set up a client-server architecture for this purpose. Future extension of the system will imply the introduction of various therapeutic schemes as well as a suitable procedure to animate volumes or triangulated surfaces.

CAREN helps patients to overcome balance disorders with Virtual Reality
In Europe, there currently exist no standard rehabilitation and exercise methods for diagnostic and corrective treatment of balance disorder. Some 40 European clinics have a specialized therapeutic programme, based on cause related classification of balance disorders, but there is no network communicative protocol available to exchange medical experiences on used equipment and procedures. In addition, progress assessment is performed visually, since generic tools are lacking to accurately measure the patient's balance behaviour. This has inspired the Dutch TTN (Technology Transfer Nodes) to develop CAREN, an interactive Computer Assisted Rehabilitation Environment. This real time virtual reality applied tool-platform will allow the medical expert to monitor actual patient's behaviour side by side with the perceived successful behaviour after rehabilitation, and to correct all deviations from optimum.

CAREN platform performs balancing act
The Motek Motion Technology team has demonstrated the first results of the Computer Assisted Rehabilitation Environment (CAREN) before an audience of medical specialists and orthopaedists who are partnering in the project. The invited physicians were offered a chance to test the motion platform's flexibility in a range of virtual tasks, designed for patients with balance disorder problems to help them regain their sense of coordination. As a result, the medical experts will be able to steer and advise the Motek team to adapt the virtual environments to the exact clinical needs of both doctors and patients. The system will be optimized by the end of the year and tests with real patients will follow in the course of 1999.

Gigabit Testbed South to focus on surgery simulation
Last August 13th, the Gigabit Testbed South as well as the Siemens Nixdorf (SNI)/Fujitsu VPP700 with 52 processors, 115 Gflop/s and 104 GByte aggregated memory, were inaugurated at the Leibniz Computing Centre. The Gigabit Testbed South constitutes a high speed communication network infrastructure between the cities of Munich and Erlangen for a broad range of high performance computer networking (HPCN) initiatives. One of the medical applications relates to computer aided 3D planning and simulation of operations at the facial skull and was demonstrated by Dr. Hans-Florian Zeilhofer, who is responsible for this project at the Clinic and Polyclinic for Oral and Maxillofacial Surgery of the Technical University of Munich.

Parallel PET reconstruction methods give accurate diagnostic analysis
Medical and computer specialists face a tough job generating high quality images out of positron emission tomography (PET) data. The Parapet project is trying to meet the challenge through the development of a PARAllel PETscan system. Both clinical partners and algorithm designers are united in this Esprit funded initiative to create and apply new advanced parallel algorithms, which have to run on high performance hardware, in order to reduce costs. The enhanced processing rates will produce a superior volume reconstruction quality, very suitable for accurate diagnostics and improved clinical procedures.

MRI helps track surgical instruments inside patient's body
At the beginning of this year, a new project called IRVIT has been set up by the Finnish liaison of the Technology Transfer Nodes (TTN) within the organization's Machine Vision department. A group of researchers from the Information Processing Laboratory at the University of Oulu investigates the possibility of integrating Magnetic Resonance Imaging (MRI) techniques during surgical interventions for intra-operative real time visualization and instrument tracking (IRVIT). The scientists are working together with two manufacturers of MRI scanners and MRI compatible instruments to design a functional and cost-effective system for the Department of Diagnostic Radiology at the Oulu University Hospital.

Big Apple telesurgery on patients in Baltimore
The AT&T communications company recently offered a telesurgery link to a group of doctors, present at the World Congress of Endourology in New York City, to interconnect with surgeons at the Johns Hopkins Bayview Medical Center in Baltimore, Maryland. Over the high speed Global ISDN (GISDN) network installed by AT&T, the doctors in New York City performed a successful medical intervention on a patient in Baltimore, thus bridging a distance of nearly 200 miles. The conference attendees witnessed the unique live procedure, consisting in the remote manoeuvring of surgical instruments inside the patient's body.

Philips Medical Systems acquires ultrasound applications
Philips Medical Systems (PMS), the Dutch manufacturer of medical imaging devices and software for hospital radiology departments and laboratories, has paid about 800 million dollars to acquire the Seattle based company ATL Ultrasound. This surprising business transaction will turn PMS into an international top player, particularly in the field of ultrasound applications, according to the Automatisering Gids . Ultrasound indeed constitutes a huge market potential. In the United States, a yearly amount of nearly 100 million dollars is spent on ultrasound techniques for female patients alone, whereas the market annually increases with 12 to 15 percent.

US Army's Special Forces get high tech radiology services
IQ Holdings Incorporated, headquartered in Washington D.C., constitutes a newly traded public company. By means of its fully owned subsidiary, IQ Management, the company provides professional health care services and management support to commercial as well as government customers. As such, the United States Army has awarded IQ Management a multi-million dollar competitive contract with a supplementary option of four years. The health care support equally extends to telemedicine applications.

Highest rated US hospitals use Digital Visual Communications
The annual U.S. News & World Report issued a list of "America's Best Hospitals" on July 27th 1998. The highest rated medical facilities all appear to be customers of VTEL Corporation, a developer and manufacturer of Digital Visual Communications technology. The top three is formed by the Duke University Medical Center, Massachusetts General Hospital and Cleveland Clinic. These three hospitals all use telemedicine applications to offer the patient a better quality of care.

Broadcast Server used for prescription "reminder" service and E-commerce
MicroStrategy Incorporated is a Virginia based company, which is specialized in enterprise decision support systems (DSS). The NDC Health Information Services provider has decided to implement MicroStrategy's recently issued DSS Broadcaster for both consumer and industry support in the pharmaceutical marketplace. DSS Broadcaster is designed to send highly personalized messages to many thousands of recipients via e-mail, fax, pager, and mobile phone. NDC plans to use the innovative tool in two different products. The first one constitutes the Intellect Care Alert for automated drug refill and compliance reminders towards patients and the second relates to the Intellect Rx Alert for Internet based critical market reporting for the benefit of industrial partners.

Fraud and Abuse Management System cleans up medical billing
Medaphis Corporation is the first commercial company, without any relation to the insurance business, to issue an innovative software solution that will detect and prevent errors in medical billing claims. The Atlanta based provider of software and billing services has partnered with IBM to offer a specialized tool to the health care market for claims data mining, reporting and analysis tasks. The Fraud and Abuse Management System (FAMS) forms part of a comprehensive Physicians Billing Compliance Risk Management programme.

Monitors can check cardiac emergencies worldwide
Physio-Control Corporation and Micromedical Industries Ltd. have signed an exclusive agreement for the distribution of the latter company's Biolog 3000 electrocardiograph monitor to the emergency medical services (EMS) industry all over the world by Physio-Control Corporation. This Redmond based manufacturer of portable defibrillation devices will combine the Biolog 3000 monitor with its own LIFEPAK 500 automated external defibrillator (AED) to accurately assess the condition of patients suffering from acute cardiac problems. Last April, both companies already signed a first agreement for the exclusive distribution of the Biolog 3000 monitor to the commercial aviation industry.

European regions take health care services on the CHIN
Within the Fourth Framework Programme of the European Commission, a group of ten contractors from the Information Technology (IT), telecommunications industry as well as from several health care administrations have set up a three year project in 1996 to establish a range of Co-operative Health Information Networks (CHINs) in eight European regions. The partners cherish the great ambition to reach hospitals, clinics, doctors and private individuals in both urban and rural areas with a varied set of Health Care Telematic (HCT) services, which may be standardized or region specific. The available tools for inter-regional connectivity range from desk-top video-conferencing over file transfer and e-mail to application sharing. The CHIN concept will be validated through regular feedback from representative user groups.

Consortium creates embedded microprocessor environment for CT imaging systems
Just before the Summer of 1998, a new two year project has been launched under the European Union Esprit Programme which aims at reconciling the complex worlds of high performance computing (HPC) and computerized tomography (CT). The New Roentgen consortium will try to develop an embedded microprocessor based system for high performance medical CT imaging. The involved partners rely on a lively and interactive feedback relationship with hospital end-users and CT manufacturers to meet the exact requirements for a successful implementation of both the hardware and software platform by the end of May 2000.

New image processing techniques to improve quality of digital X-ray image sequences
The Image Sciences Institute (ISI) at the University of Utrecht and the Department of X-Ray Diagnostics and Pre-development at Philips Medical Systems (PMS) are partnering in a project, called Optimization of Information Extraction from Digital X-Ray Image Sequences. The scientific work fits into the extensive Innovation Targeted Research Programme (IOP), launched by the Dutch Ministry of Economic Affairs in 1996. One of the areas of interest constitutes Image Processing, a topic under which eleven additional projects reside. Last June, Dr. Wiro Niessen presented some of the aspects related to multiscale medical image analysis at ASCI'98, the annual conference of the Advanced School for Computing and Imaging, held at the Vossemeren in Lommel.

CauchyPar detects electrical activity in the brain
The ESPRIT funded European project CauchyPar is a co-operative effort between five industrial and academic partners, to integrate Cauchy software, developed by the Rheinisch-Westfälische Technische Hochschule (RWTH), into a scalable parallel system. This high performance combination localizes and visualizes electrical discharges within the human brain. From this it is possible to derive mutual dependencies between the various discharges, and both normal and pathological functional regions in the brain. The more processors involved in the procedure, the less calculation time is needed to locate the electrical activity.

RISE project rescues elderly from isolation
State-of-the-art Information Technology applications tend to cut like a double-edged sword in modern society. On the one hand, IT solutions substantially improve the quality of life and of health care for different population classes. On the other hand, people who are not familiar with current computer technology incur the risk to be completely cut off from social life and health care facilities. In order to break this shell of isolation which specifically threatens the elderly, who feel uncomfortable with technology, RISE has been set up under the European Union Telematics Programme for the Disabled and Elderly (TIDE) as a three year project with a funding of 5 million ECU to care for the elderly in the Information Society.

International TeleHealth service network boosts training and information
Within the European Health Telematics Programme, the two year HealthLine project has been set up at the beginning of 1998 as an overall initiative to increase the positive results of TeleHealth implementation within other specific projects, such as RISE and NIVEMES. Funding of 1,8 Mecu has been allocated to provide expert training and information dissemination services to health professionals, beneficiaries and the general public through the use of telehealth systems and infrastructure already applied by existing RISE and NIVEMES projects. HealthLine is planned to run in two phases. First, users will be extensively informed and trained in the application of innovative tools, services and health care provision methods. Second, a help desk facility will be set up in each country which participates in the network, to offer on-line and off-line information and advice to both citizens and health professionals.

Broadband wireless and satellite technology shows promise in niche markets
An extensive report has been issued on the growing popularity of broadband satellite and wireless communication technologies. The Virginia based market research and consulting firm, Communications Industry Researchers (CIR) Inc., presents a detailed analysis of the expected future evolution with regard to wireless broadband applications in this study, which has been entitled "Broadband Unwired: New Opportunities in LMDS, High-Speed Fixed Wireless and Broadband Satellites." Both satellite and wireless technologies are most suitable to fill in the gaps, left uncovered by the conventional broadband wireline technology, according to the CIR report.

European research network hits the new TEN-155 highway
In the past months, Quantum project partners have made tremendous progress with their efforts to install the new TEN-155 network for European research and development purposes. For DANTE, the company which organizes international network services for the European research community, the work related to the TEN-155 initiative, has turned into a major activity. The supply contract for the main part of the network capacity was signed at the end of August.

Smartcard monitors medication for Parkinson patients
In the spring of 1999, the Dutch managed care organization Zorg en Zekerheid (Care and Security) will make a smartcard available to about 600 to 800 of its patient-members, who are suffering from Parkinson's disease. The combined chip/memory card has to enable an improved control and monitoring with regard to the medication behaviour within this specific patient's group, according to the Automatisering Gids .

Arches II aims for cheap connectivity, higher bandwidth
December 1997 was the start of the second phase of an Esprit funded project with ambitious aims for the support of dynamically changing network configurations. The 18 month project Arches II will try to expand the potential range of market applications through continuous refinement and consolidation of Heterogeneous InterConnect (HIC) technologies, and exploit standards, based on the IEEE 1355 international standard network technology. Partners from six different European countries participate in the initiative to ensure a broad take-up of the HIC knowhow. The Lübeck Medical University is one of the involved parties as an end-user for medical image and simulation applications.

Scottish government invests millions in health care technology programme
The Minister for Health at The Scottish Office, Sam Galbraith, has allocated 45 million of funding to the National Health Service (NHS) in order to develop a system by 2002 which will give general practitioners (GPs) the power to book hospital appointments instantly. The initiative forms part of an overall project to provide all GP surgeries with modern communications equipment, as to offer direct links to hospital laboratories and radiology departments to enable quicker receipt of test results. Developments are underway to automatically implement facilities for copying discharge letters, referral letters and booking of hospital tests directly from the GP's personal computer into the Electronic Patient Information System.

DownEast Telemedicine Network to overcome patient travel fears
In the region of Washington County and Bangor in the state of Maine, health care and mental agencies have decided to unite forces and set up a telemedicine initiative which is bound to create a huge impact on the rest of the United States. The three-year project has received a grant of 1,1 million dollars to offer urgently needed health care services to patients who are physically unable or unwilling to travel long distances. The medical sessions will be held by means of a powerful, innovative videoconferencing network. Since the plan has been operable in the Down East area of Maine, the project is referred to as the DownEast Telemedicine Network or DETNET.

DISA delivers up to the minute information over the network
The Defense Information Systems Agency (DISA) organization is responsible for all voice and data communications with regard to the United States Department of Defense (DoD). The transmission of timely data out to staff members and the provision of technical support to experts located at remote sites all over the world, constitutes a big challenge for this type of institution. That is the reason why the DISA people selected the VSTOR VS-150 MPEG video recorder and player, as well as the leading-edge mpegStudio Pro management software, designed by Optivision. This comprehensive digital video solution enables flexible communications traffic and offers a great ease of integration in the existing DISA network.

Continuum model goes deeper into the mammalian heart
Within many computational models, the mammalian heart tends to be represented as a mechanical device instead of a physiological organ. The Cardiac Mechanics Research Group (CMRG), hosted at UCSD, the University of California in San Diego, is developing a biophysically based continuum model to enhance the geometric and structural images with anatomic and morphologic characteristics. As a result, the researchers are offered a more realistic tool to approach and examine the tissue properties and chemical interactions, next to the merely electro-mechanical changes within the heart. The detailed model will enable scientists to relate experimental observations on the biological and biophysical behaviour of the heart cells to clinically relevant aspects of the organ as a whole under both normal and deviating circumstances, due to disease.

Supercomputer database reveals hidden relationship of proteins with entirely different functions
In the September 1998 issue of Protein Engineering , two biology scientists give an account on the database they created on the 256-processor CRAY T3E of the San Diego Supercomputer Center (SDSC). Researchers are now able to access the new database via the Web in order to compare the 3D structure of over 8000 proteins. Recent experiments have shown that proteins with very different functions and sequences can share a surprising structure similarity. The discovery of such structure neighbours might indicate important clues to an energetically favourable arrangement as often observed in nature or prove the existence of some distant evolutionary relationship between the concerned proteins.

Computational power reduces time to discovery in protein-fold research at UCLA
By the year 2050, scientists will have unveiled the complete DNA genome as well as the 3D structure of each identifiable protein. Diseases caused by mistakes in proteins will be tracked down to observe how the mutations occur. Drugs and therapies will be developed to repair the initial deviation in the errant protein molecules. This is the picture offered by Dr. Duilio Cascio, Research Faculty Member of the Molecular Biology Institute at UCLA, the University of California in Los Angeles. Here, the biologists use custom-designed software to perform compute intensive simulations and molecular modelling on Digital Unix based Alpha workstations. The cost-effective but powerful computer infrastructure enables the scientific team to produce solutions in the shortest time possible.

Fears and doubts of Windows NT for Automated Patient Records
In the past, physicians and caretakers were rather reluctant to use computer based patient records systems because first generation records software involved a great deal of typing and code memorizing to have the programme actually up and running. Currently, health care people are getting pretty familiar with the user-friendly point-and-click facilities of the Windows technology on their home computer. As a result, doctors tend to rely more often on clinical information systems developed on a Windows platform. Vendors are closely following this evolution in order to meet the new user's requirements. Still, some experts have expressed doubts on the scalability and network integration capacity Windows NT environments in health care practices and hospitals.