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This article defines and describes the process of backing up data files, which should be undertaken by anyone who routinely uses a computer. The important points to be considered when developing a backup strategy are explained and a résumé given of the backup devices currently available.
In a modern version of David and Goliath, backers of hand-held pen computers hope to make serious inroads against well-established computer workstations. A start-up company, Practice Technology Inc., wants to build information networks based on pen computing. But it's going up against well-established network vendors that are relying on PC-based systems. Meanwhile, two pen computer manufacturers have stopped producing those devices, citing lack of demand.
Common object request broker architecture (CORBA) is a method for invoking distributed objects across a network. There has been some activity in applying this software technology to Digital Imaging and Communications in Medicine (DICOM), but no documented demonstration of how this would actually work. We report a CORBA demonstration that is functionally equivalent and in some ways superior to the DICOM communication protocol. In addition, in and outside of medicine, there is great interest in the use of extensible markup language (XML) to provide interoperation between databases. An example implementation of the DICOM data structure in XML will also be demonstrated. Using Visibroker ORB from Inprise (Scotts Valley, CA), a test bed was developed to simulate the principle DICOM operations: store, query, and retrieve (SQR). SQR is the most common interaction between a modality device application entity (AE) such as a computed tomography (CT) scanner, and a storage component, as well as between a storage component and a workstation. The storage of a CT study by invoking one of several storage objects residing on a network was simulated and demonstrated. In addition, XML database descriptors were used to facilitate the transfer of DICOM header information between independent databases. CORBA is demonstrated to have great potential for the next version of DICOM. It can provide redundant protection against single points of failure. XML appears to be an excellent method of providing interaction between separate databases managing the DICOM information object model, and may therefore eliminate the common use of proprietary client-server databases in commercial implementations of picture archiving and communication systems (PACS).
This paper reports a new extension of IS & C (Image Save And Carry) project. Because IS & C is an off-line system and requires full compatibility so as to enable medical data interchange with ease among hospitals and clinics, specifications that are indispensable for compatibility have been standardized by the IS & C committee. The IS & C system is supposed to be used in medicine, so the file protection mechanism for the security of the recorded files has been also developed. The characteristics of IS & C volume and file structure and the second national project being carried out in National Cancer Center Hospital are briefly explained as well.
In this article the author explains the basic theory and practical applications of the latest advancement in imaging technology called fractal imaging. Fractal imaging is a unique way of compressing and storing images which has unlocked the door to the restrictions imposed by conventional imaging technology as regards storage and transmission of high quality images. The article outlines how this technology has been successfully applied by the creation of the first and only fractal photographic archival and retrieval system in Scotland, in the form of the George Washington Wilson collection comprising 44,000 images and associated text in only 450 megabytes (Mb) of disc space.
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BACKGROUND: The aim of this study was to assess the clinical concordance of expert cardiologists' interpretation of echocardiographic studies recorded on Super-VHS videotape or stored in magneto-optical disk, as well as the feasibility and clinical value of intelligent compression and digital storage of echocardiographic data as cine-loops and still-frames for interpretation of transthoracic echocardiographic images in clinical practice. METHODS: All clinical cardiologists experienced in echocardiography in our department (n = 10) reported on a standardized worksheet checklist the echocardiographic data of 7 consecutive patients (140 reports), and recorded them on videotape or magneto-optical disks to compare the interpretation of videotaped studies, acquired in the usual way, with clinically compressed studies stored to magneto-optical disks using a standard (Italian Society of Echocardiography) image acquisition protocol. RESULTS: The time interval between analog and digital study readings was 50 +/- 15 days. Except for tricuspid valve regurgitation grading (k = 0.28) and for left ventricular global hypokinesia (k = 0.32), the intraobserver agreement in the interpretation of the 3290 cardiovascular morphological and functional findings found on analog and digitally stored images was good (k value ranging from 0.66 to 1.00). The wall motion score index was 1.56 +/- 0.53 when interpreting analog studies, and 1.52 +/- 0.54 on digital studies (p = 0.35). Conversely, the interobserver variability of the wall motion score index (Gini index ranging from 0 to 0.80) was significantly lower when interpreting studies stored digitally than when analog ones were examined (0.48 +/- 0.021 and 0.52 +/- 0.023 respectively, p = 0.006). In comparison to videotape recordings, digital storage of echocardiographic studies significantly shortened the time to image access for study review (327 +/- 62 and 30 +/- 4 s, respectively, p < 0.0001) and the reading time (600 +/- 300 and 540 +/- 300 s respectively, p = 0.034), rendered study accessibility easier (difficult or good: 73 vs 43% of observers, fast or optimal: 27 vs 57% of observers respectively, p = 0.0011) and improved the recorded image quality perception (poor: 25 vs 10% of observers, sufficient or good: 75 vs 90% of observers respectively, p = 0.022), without loss of study completeness (insufficient: 18 vs 17% of observers, adequate or complete: 82 vs 83% of observers, respectively; p = NS). Finally, from September 1, 1999, digital storage has become routine practice for patients admitted to our Department. By December 31, 1999, 411 echo studies had been stored: 7 +/- 3 cine-loop/study, 32 +/- 18 frames/cine-loop, and 3 +/- 2 still-frames/study. The average amount of memory needed for storage was 18.6 +/- 11.9 MB/study. CONCLUSIONS: Clinical compression of echocardiographic studies seems to be an accurate summary of the complete examination recorded to videotape for the assessment of patients admitted in the coronary care unit. In addition, digitally stored studies allow a significant improvement in the interobserver reproducibility of wall motion score assessment.
The rapid improvements in microcomputer systems have contributed to ease of performance of epidemiological research in occupational health. Computers now available can aid in all stages of research- from the early stages of literature review to data collection, analysis and presentation. Optical storage devices now allow large occupational health data bases to be stored on a single compact disc, with the information accessible by microcomputer. Hand-held computers and optical scanners allow paperless collection of field data. Epidemiological analysis and data presentation is easily done with software packages, some of which are in the public domain. However, there are limitations in the use of computers for any epidemiological research. Investment of time is required to learn the use of a computer. Care needs to be taken to ensure accurate data entry, and correct choice has to be made of methods for subsequent statistical analysis. Microcomputers are valuable as labour saving devices, but cannot replace proper planning, execution and appropriate data analysis in epidemiological research in occupational health.
A pilot PACS project, named KIDS, has been running in Kyoto University Hospital. The purpose of the system is to establish a small PACS that includes all digital imaging modalities and to evaluate it. The project has been continued from the first phase (KIDS-1) to the second phase (KIDS-2). In the first phase, a small-scale PACS was developed. In the second phase, the expansion of coverage of modalities and completion of the image database was intended. At present, the database contains image data of 16264 patients amounting to 150 Gbytes. Simulation of the retrieval process to the database shows that 154.3 s per patient is required for retrieving his/her entire image data. This calculated value is close to the actual time.
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Automated methods of monitoring stored grain for insect pests will contribute to early detection and aid in management of pest problems. An insect population infesting stored oats at a seed processing plant in north-central Florida was studied to test a device for counting insects electronically (Electronic Grain Probe Insect Counter, EGPIC), and to characterize the storage environment. The device counts insects as they fall through an infrared beam incorporated into a modified grain probe (pitfall) trap and transmits the counts to a computer for accumulation and storage. Eight traps were inserted into the surface of the grain bulk, and the insects trapped were identified and counted manually at weekly intervals. Grain temperature and moisture content also were recorded for each trap location. Manual and automatic counts were compared to estimate error in the EGPIC system. Both over- and undercounting occurred, and errors ranged from -79.4 to 82.4%. The mean absolute value of error (+/- SE) was 31.7% (+/- 4.3). At least 31 species, or higher taxa, were detected, but the psocid Liposcelis entomophila (Enderlein) and the foreign grain beetle, Ahasverus advena (Waltl), accounted for 88% of the captured insects. Species diversity, phenology, and spatial distribution are presented, as well as temporal and spatial distribution of grain temperature and moisture content. The data sets generated will find application in population modeling and development of integrated pest management systems for stored grain.
A new technique for the three-dimensional recording of a person's mandibular movement is described. A small and harmless radioactive source is fixed on the patient's skin at the point of interest or sealed in a tooth cavity. Using the proper collimation, the motion of the point source is recorded via a gamma camera and minicomputer. Long-term storage on a magnetic device offers playback, slow motion facilities, and data analysis through the use of sophisticated computer languages. Simultaneous recordings using two cameras, or postsynchronization of two different views of an experiment, enable the three-dimensional restitution of mandibular movements. Superimposition of a grid of radioactive spots spaced at measured intervals during the recording permits a straightforward calibration of the patient's motion. Multiple sources in a single experiment may be recorded to describe the displacement of several points of interest. This method, derived from nuclear medicine techniques, offers a powerful tool of general interest for the tracking of dynamic events in many fields of dentistry such as temporomandibular joint dysfunction and prosthetic restorative techniques. Further considerations on our experimental settings and results will be published in part II.
Given current assumptions about the biology of neural organization, some connectionists believe that it may not be possible to accurately model the brain's neural architecture. We have identified five restrictive neurobiological dogmas that we believe have limited the exploration of more fundamental correlations between computational and biological neural networks. We postulate that: 1) the dendritic tree serves as a synapse storage device rather than a simple summation device; 2) connection strength between neurons depends on the number and location of synapses of similar weight, not on synapses of variable weights; 3) axonal sprouting occurs regularly in adult organisms; 4) the postsynaptic genome directly controls the presynaptic cell via mRNA, rather than indirectly by the expression of NCAMs, reverse neurotransmitters, etc.; 5) dendritic spines serve a trophic function by controlling development of new sprouts via a process we term retroduction. We entertain an alternative formulation of a computational neural element that is fully consistent with modern neuroscience research. We then show how our model neuron can learn under Hebbian conditions, and extend the model to explain non-Hebbian, one-trial learning. This work is significant because by stretching the theoretical boundaries of modern neuroscience, we show how connectionists can potentially create new, more biologically-based neural elements which, when, interconnected into networks, exhibit not only properties of existing backpropagation networks, but other physiological properties as well.
Computers and the tasks they perform are becoming increasingly important in medicine. It behooves medical personnel to become familiar with some computer functions so that they may be in a better position to demand and evaluate a given implementation. One very basic computer task is sorting information. Some general principles of computing efficiency are discussed, as well as the standard "O" notation. A simple sort, bubblesort, is discussed and analyzed. A second elementary sort, insertionsort, is considered in relation to its more sophisticated descendant, shellsort. The most efficient in-memory sort, quicksort (and its various descendants), is likewise examined, and the advantages and disadvantages of each variant are discussed in some detail, as well as methods that may enhance speed and resource utilization. Finally, mergesort, which is used in sorting large files resident in mass-storage devices, is discussed, along with its particular advantages.
Digital images are the ever-growing basis of modern medical imaging and treatment. Despite the advent of the DICOM 3.0 standard for medical image communication it still requires cumbersome efforts to export images from imaging modalities to other computer systems. This is true especially for smaller institutions, which often have limited resources for standardized image transfer. To gain access even to these data we developed an exchange interface on the basis of magneto-optical discs (MO-discs), as they are usually available in most of the imaging modalities in use today. Unfortunately images on MO-discs are usually stored in formats specific for each manufacturer. Therefore special routines to access the data on MO-discs had to be developed for each company or even each scanner. Over 10,000 CT and MRI images including their header information from different General Electric and Siemens scanners were extracted successfully from MO-discs. The interface proved to be reliable and easy to handle by technicians. Support of additional manufacturers and of the DICOM 3.0 standard are work in progress.
Experimental workstations for oral reporting and synchronized image filing have been developed and evaluated by radiologists and referring physicians. The file media is a 5.25-inch rewritable magneto-optical disk of 600-Mb capacity whose file format is in accordance with the IS&C specification. The results of evaluation tell that this system is superior to other existing methods of the same kind such as transcribing, dictating, handwriting, typewriting and key selections. The most significant advantage of the system is that images and their interpretation are never separated. The first practical application to the teaching file and the teaching conference is contemplated in the Osaka University Hospital. This system is a complete digital system in terms of images, voices and demographic data, so that on-line transmission, off-line communication or filing to any database will be easily realized in a PACS environment. We are developing an integrated system of a speech recognizer connected to this digitized oral system.
Problems with picture archiving and communication systems (PACS) are focused and an off-line PACS of practical value is proposed in this paper. This system is based on the personal database where each patient has his/her own recording medium. This medium files all medical information as well as images of value, and is carried with a patient through hospital. Advantages over the conventional or on-line PACS communicating through a network are discussed and a possibility of practical use is analysed showing a prototype system. The biggest advantage of this system is quick and easy access to the images of concern and a small amount of cost for initial investment. It is also pointed out that the format of the data recording on the disk has to be standardized so that this system could be used for a medical care system over a wide area.
The rising number of implementations of PACS (Picture Archiving and Communications Systems) subsystems, specialized information systems (radiology, laboratory, pharmacy, and other ancillary departments), and increased interest in the role of optical storage systems hospitalwide, creates an environment that demands the integration of each of these systems if the hospital is to operate at maximum profitability levels. This has been recognized by several groups who have proposed standards for communication between vendors and systems, and their efforts, combined with the support of the hospitals, will hopefully allow the promise of a fully electronic hospital to become a reality. While the concept of a totally integrated fully electronic hospital has been with us for over a decade, only recently have medical vendors attempted to evolve from a conceptual phase to one of workable, cost-effective systems. Few will debate the fact that the fully integrated information and image management system is still several years away, yet many hospitals have recognized the importance of planning for use of the component technology available today. This planning stage is critical and, combined with the phased implementation of the existing technologies, it can provide significant advantages in the overall acceptance of this future technology. This paper addresses the role of the standards organizations in making this integration a reality, how conceptually a fully integrated information and image management system will work, new technologies and their potential uses in the hospital, and both the advantages the technology can bring in solving existing problems and hurdles that still need to be overcome.