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PubMed1988

[The PACS model plan at the Freiburg University Clinic. A first step toward a radiologic picture archiving and communication system].

In a study performed at several clinical departments of the University of Freiburg, West Germany, it was found that approximately 180,000 patient examinations based on computed tomography, magnetic resonance, nuclear medicine, ultrasound as well as digital and conventional radiography, produce over 1,000,000 pictures. It was assumed that modern technologies can greatly facilitate the handling of such a quantity of images. This applies to diagnosis and therapy planning as well as to communication and archiving of this large amount of data. The study also assumes that the technologies to be considered, e.g. fiber optical networks, optical archives and medical work stations, which represent the main components of PACS, should be introduced in a stepwise manner following a clear overall conception. As the first step the implementation of a local area network (LAN) in the departments of radiology and general surgery is planned. Important criteria for the selection of these particular departments are improvements in health care for a maximum number of patients and in the working profiles for the greatest possible number of physicians and assistant personnel. A cost reduction as compared to the present system through more efficient communication and archiving of the digital images is expected. New perspectives for medical research as well as for medico-technical developments are also expected. Examples are the 3-D representations of human anatomy and the manufacturing of custom-designed prothetic devices. Scheduling and budgetary plans for equipment and manpower are further study results for the Freiburg PACS-Project.

Germany, West↗

PubMed2001

Development and deployment of an internet-based data management system for use by the Asthma Clinical Research Network.

Data management system development for the first Asthma Clinical Research Network (ACRN) study began at the data coordinating center (DCC) in May 1995 with the requirement for delivery of a production system by November 1995. Special methods had to be used to establish an internet local area network (LAN), place clinical client systems, and achieve an accelerated software development cycle. The development of a fully integrated data management system prior to the start of the study was not possible. Therefore an early analysis focused on identifying discrete groupings of data management functions that would allow development of distinct database modules to provide specific functionality such as subject randomization, subject registration, and data entry. The modules were categorized as either being associated with clinical centers or the DCC so that the clinical center modules could be developed and delivered to meet the start date of the study. In the second phase of development during the relatively slow patient-enrollment period, the DCC functional modules were delivered discretely over time. While at the time this development model was a necessity due to limited DCC resources, it continues to be used today as it permits the DCC to implement studies more rapidly and efficiently for the ACRN. This paper describes the methodologies used to develop an internet-based LAN, establish clinical center client systems, establish DCC client and server operations, and develop a data management system. It describes the circumstances that contributed to the development of these systems and the special methodologies developed. The technical aspects of the data management system and LAN are presented as well as a description of the requirements and constraints analysis used to develop the hardware and software systems.

Asthma↗

PubMed1995

Development and implementation of an expert information system (BRITE) used in technical support of medical diagnostics customers.

We developed BRITE (Bringing Resources and Information to Employees), an expert information retrieval system, for problem solving and retrieving technical product information. Specialists in our Technical Assistance Center (TAC) use the BRITE system on a Pentium workstation to access information in < 3 s. Manuals, technical bulletins, parts lists, and administrative tools such as word processing and network fax are available electronically. The system allows consistent troubleshooting and definition of customers' problems by TAC specialists. BRITE seamlessly integrates expert system, document retrieval, and relational database technologies; the system runs on a token ring local area network, which is part of a Ciba Corning Diagnostics wide area network. Information received over the wide area network is used to develop and update BRITE daily. BRITE is kept current by input or troubleshooting and new applications from TAC specialists.

Chemistry, Clinical↗

PubMed2004

Circle quorum system-based non-stop network service model.

Rapid developments in network systems of business service have resulted in more reliance on distributed computing, typified by "subscriber/push" architectures. Unfortunately, frequent and unexpectable network failures were routine, and downtime was not in hours, but in days. High availability has become the most important factor decreasing business risk and improving Quality of Service. Cluster technology has solved the non-stop problem on Local Area Network. However, most technologies including cluster today fail to ensure the non-stop Internet service based on Routers. With good performance on high availability and fault tolerance, quorum systems are very suitable for application to distributed business service networks. In this work, we modeled and developed a non-stop Internet service system based on a new quorum system, circle quorum system, for Boston Mutual Fund Broker, US. With five protocols, it provided highly available data services for clients on Internet.

Journal Article↗

PubMedDate not supplied

Data communications within a health authority.

This paper describes the data communication network installed in four hospitals in the Hammersmith and Queeen Charlotte's Special Health Authority to support several hundred microcomputers, terminals and printers and several host systems, including the integrated computerized hospital information system which is currently under development. Broadband local area network and wide area network technologies have been employed to provide a flexible system, which is capable of being expanded to meet the increasing demand for data communications within the authority. The broadband networks are the first such installations in a health authority in Britain.

Computer Communication Networks↗

PubMed1995

Asynchronous transfer mode technology for radiologic image communication.

Image communication is an important component in picture archiving and communication systems (PACS) and teleradiology applications. Currently, local area networks (LANs) and wide area networks (WANs) use different technologies for image communication. Asynchronous transfer mode (ATM) is an emerging technology that can be used for both LANs and WANs. This article describes experimental results using an ATM network to transmit CT scans and digitized radiographs between the University of California, San Francisco (UCSF) and Mount Zion Hospital, an affiliated community hospital in the San Francisco Bay area. The WAN connection between the two hospitals is via an ATM main switch at Pacific Bell, a local communication carrier located in Oakland, CA, which uses single-mode optical fibers. Preliminary results show that, using the ATM Optical Carrier Level 3 (OC3) (155 Mbits/sec) specification, it takes 1.3 sec and 2.7 sec to transmit a 10-Mbyte digitized radiograph and a 20-Mbyte CT scan, respectively, between the two locations. Encouraged by these results, we have designed and implemented an ATM WAN and LAN between UCSF and Mount Zion Hospital. This is the first of a three-phase project of installing a WAN serving four hospitals and one clinic in the San Francisco Bay area.

Computer Communication Networks↗

PubMed2002

Practical applications of hand-held computers in dermatology.

For physicians, hand-held computers are gaining popularity as point of care reference tools. The convergence of hand-held computers, the Internet, and wireless networks will enable these devices to assume more essential roles as mobile transmitters and receivers of digital medical Information. In addition to serving as portable medical reference sources, these devices can be Internet-enabled, allowing them to communicate over wireless wide and local area networks. With enhanced wireless connectivity, hand-held computers can be used at the point of patient care for charge capture, electronic prescribing, laboratory test ordering, laboratory result retrieval, web access, e-mail communication, and other clinical and administrative tasks. Physicians In virtually every medical specialty have begun using these devices in various ways. This review of hand-held computer use in dermatology illustrates practical examples of the many different ways hand-held computers can be effectively used by the practicing dermatologist.

Computers, Handheld↗

PubMed1994

A pathologist-designed imaging system for anatomic pathology signout, teaching, and research.

Pathology images are derived from gross surgical specimens, light microscopy, immunofluorescence, electron microscopy, molecular diagnostic gels, flow cytometry, image analysis data, and clinical laboratory data in graphic form. We have implemented a network of desktop personal computers (PCs) that allow us to easily capture, store, and retrieve gross and microscopic, anatomic, and research pathology images. System architecture involves multiple image acquisition and retrieval sites and a central file server for storage. The digitized images are conveyed via a local area network to and from image capture or display stations. Acquisition sites consist of a high-resolution camera connected to a frame grabber card in a 486-type personal computer, equipped with 16 MB (Table 1) RAM, a 1.05-gigabyte hard drive, and a 32-bit ethernet card for access to our anatomic pathology reporting system. We have designed a push-button workstation for acquiring and indexing images that does not significantly interfere with surgical pathology sign-out. Advantages of the system include the following: (1) Improving patient care: the availability of gross images at time of microscopic sign-out, verification of recurrence of malignancy from archived images, monitoring of bone marrow engraftment and immunosuppressive intervention after bone marrow/solid organ transplantation on repeat biopsies, and ability to seek instantaneous consultation with any pathologist on the network; (2) enhancing the teaching environment: building a digital surgical pathology atlas, improving the availability of images for conference support, and sharing cases across the network; (3) enhancing research: case study compilation, metastudy analysis, and availability of digitized images for quantitative analysis and permanent/reusable image records for archival study; and (4) other practical and economic considerations: storing case requisition images and hand-drawn diagrams deters the spread of gross room contaminants and results in considerable cost savings in photographic media for conferences, improved quality assurance by porting control stains across the network, and a multiplicity of other advantages that enhance image and information management in pathology.

Computer Systems↗

PubMed2006

The sensitivity and specificity of nonmydriatic digital stereoscopic retinal imaging in detecting diabetic retinopathy.

OBJECTIVE: The objective of this study was to determine the sensitivity and specificity of Joslin Vision Network nonmydriatic digital stereoscopic retinal imaging (NMDSRI) as a screening tool in detecting diabetic retinopathy. RESEARCH DESIGN AND METHODS: We reviewed the records of 244 patients with diabetes who had a dilated funduscopic examination (DFE) and NMDSRI done within 1 year of each other at four locations in the metropolitan Washington, DC, area. The images were transmitted through a local area network to a central reading location where they were graded by a single retinal specialist. RESULTS: Images of 482 eyes from 243 patients were included in the study. Four images did not transmit, and 35% of the images were not gradable. Of the remaining 311 eyes, there was 86% agreement in the grading between NMDSRI and DFE: 227 eyes with no diabetic retinopathy and 40 eyes with diabetic retinopathy. In 46 eyes (15%) there was a disagreement between gradings made by the two techniques. NMDSRI detected diabetic retinopathy in 35 eyes reported as normal by DFE, and in the remaining 11 eyes, the DFE grade was one grade higher than the NMDSRI grade. Adjudicated nonconcordant examinations were within one grade. In the 76 eyes with diabetic retinopathy, retinal thickness could not be assessed in 17 (21%) eyes. When the NMDSRI result was gradable, the overall sensitivity of NMDSRI was 98% and the specificity was 100% for retinopathy within one grade of the DFE. In the limited number of eyes that had diabetic retinopathy with macular edema (six), agreement with the clinical examination was 100%. CONCLUSIONS: NMDSRI is a sensitive and specific method for the screening and diagnosis of diabetic retinopathy, which may help improve compliance with the standards of eye care for patients with diabetes.

Aged↗

PubMed1985

Techniques of networking in the computer world.

Networks can play an important role for nurses in user-to-user communication because they can be used both within and outside the health care delivery system. The choices include an information exchange, which can be an effective strategy for sharing personal concerns, problems, and achievements about the computer; commercial data bases with their vast sources of information and research data; or local area networks, effective in an office or campus setting. All of these networks can put worlds of information and services just a few words or keyboard strokes away, because they offer, outside of your own computer, a whole new dimension of retrieval, storage, reference, and communication capabilities. These networks can significantly enhance computing potential by providing an overall expansion of information.

Commerce↗

PubMed1997

Information retrieval in digital libraries: bringing search to the net.

A digital library enables users to interact effectively with information distributed across a network. These network information systems support search and display of items from organized collections. In the historical evolution of digital libraries, the mechanisms for retrieval of scientific literature have been particularly important. Grand visions in 1960 led first to the development of text search, from bibliographic databases to full-text retrieval. Next, research prototypes catalyzed the rise of document search, from multimedia browsing across local-area networks to distributed search on the Internet. By 2010, the visions will be realized, with concept search enabling semantic retrieval across large collections.

Abstracting and Indexing↗

PubMed1985

Use of a microcomputer network for history taking in a prenatal clinic.

A stand-alone microcomputer was installed at St. Bartholomew's Hospital to obtain the booking (first prenatal) history. This system has many well-documented advantages over the manual method, particularly with respect to the completeness and quality of the history produced. However, a single microcomputer system is unable to deal with the load of a busy clinic, and initially, several independent terminals were required. We now describe the installation of a local area network to link several microcomputers with a single database in the Antenatal Clinic at Queen Charlotte's Maternity Hospital.

Computers↗

PubMed1995

1995 Joseph E. Whitley, MD, Award. A World Wide Web gateway to the radiologic learning file.

RATIONALE AND OBJECTIVES: Computer networks in general, and the Internet specifically, are changing the way information is manipulated in the world at large and in radiology. The goal of this project was to develop a computer system in which images from the Radiologic Learning File, available previously only via a single-user laser disc, are made available over a generic, high-availability computer network to many potential users simultaneously. METHODS: Using a networked workstation in our laboratory and freely available distributed hypertext software, we established a World Wide Web (WWW) information server for radiology. Images from the Radiologic Learning File are requested through the WWW client software, digitized from a single laser disc containing the entire teaching file and then transmitted over the network to the client. The text accompanying each image is incorporated into the transmitted document. RESULTS: The Radiologic Learning File is now on-line, and requests to view the cases result in the delivery of the text and images. Image digitization via a frame grabber takes 1/30th of a second. Conversion of the image to a standard computer graphic format takes 45-60 sec. Text and image transmission speed on a local area network varies between 200 and 400 kilobytes (KB) per second depending on the network load. CONCLUSION: We have made images from a laser disc of the Radiologic Learning File available through an Internet-based hypertext server. The images previously available through a single-user system located in a remote section of our department are now ubiquitously available throughout our department via the department's computer network. We have thus converted a single-user, limited functionality system into a multiuser, widely available resource.

CD-ROM↗

PubMedDate not supplied

Client-server, distributed database strategies in a health-care record system for a homeless population.

OBJECTIVE: To design and develop a computer-based health-care record system to address the needs of the patients and providers of a homeless population. DESIGN: A computer-based health-care record system being developed for Boston's Healthcare for the Homeless Program (BHCHP) uses client-server technology and distributed database strategies to provide a common medical record for this transient population. The differing information requirements of physicians, nurses, and social workers are specifically addressed in the graphic application interface to facilitate an integrated approach to health care. This computer-based record system is designed for remote and portable use to integrate smoothly into the daily practice of providers of care to the homeless. The system uses remote networking technology and regular phone lines to support multiple concurrent users at remote sites of care. RESULTS: A stand-alone, pilot system is in operation at the BHCHP medical respite unit. Information on 129 patient encounters from 37 unique sites has been entered. A full client-server system has been designed. Benchmarks show that while the relative performance of a communication link based upon a phone line is 0.07 to 0.15 that of a local area network, optimization permits adequate response. CONCLUSION: Medical records access in a transient population poses special problems. Use of client-server and distributed database strategies can provide a technical foundation that provides a secure, reliable, and accessible computer-based medical record in this environment.

Boston↗

PubMed2002

A method to convert HDTV videos of broadcast satellite to RealSystem multimedia contents.

Recently, the Internet is widely used in the field of medicine. Daily use of e-mail for medical communication is very common. Also various information regarding hospitals can be accessed via the network. Apart from this practical use of the computer network, the mediums of telemedicine, tele-education, and telecare are also available. The Medical Information Network via Communications Satellite for University Hospital (MINCS-UH; http://www.umin.ac.jp/mincs/) was constructed by the Ministry of Education, Culture, Sports, Science and Technology. These programs feature high quality images viewed on High Definition Television (HDTV) through the Broadcast Satellite (BS). We have compiled a video library of MINCS-UH program contents with W-VHS tapes for HDTV and VHS or S-VHS tapesfor NTSC, available to medical staff in our university hospital through the Hospital local area network (Hospital intranet). We have also constructed a web-based streaming system that is a low cost, user-friendly multimedia delivery system capable of providing medical lectures. This system was constructed using the RealSystem package with the Internet Protocol (IP) network. Although the image quality of RealSystem is inferior to that of the original video, users can review lectures and medical congress presentations with video and audio through Hospital intranet, at any time that is convenient to them. This system can also be an efficient tool for distance learning and supports the diffusion of up-to-date information and technology to busy physicians via the Internet.

Education, Distance↗

PubMed2000

[A visual displayer for publishing radiologic images on the World Wide Web].

PURPOSE: To present a software suitable for publication of medical images on the World Wide Web and compatible with both the DICOM and other popular formats like GIF and JPEG. MATERIALS AND METHODS: DICOM viewer is a Java applet, written in Java 1.0. The tool offers the capability to publish medical images, to modify brightness and contrast (windowing) and to magnify the picture (magnification lens). Information related to the image is available for consultation only for DICOM images. RESULTS: The viewer was tested with many DICOM files, generated by our PACS or downloaded from Internet. It works well with the DICOM 3.0 file format, but correct functioning is not granted for previous releases. The software was compatible with all the most popular Web browsers (MS Internet Explorer 3.0 or newer, Netscape Navigator 4.5 or newer, Sun and HotJava) and it works well in Windows, Sun Solaris. Macintosh, Windows CE. A 512 kb image (a standard MR image) requires about 5 seconds to be shown on an Intel Pentium II PC with 32 Mbyte RAM connected on a 10 Mbit/s Ethernet network. About 3 seconds are needed to download the file and about 2 seconds to display the image. Windowing and zooming are quick enough. CONCLUSIONS: The applet allows to publish DICOM medical images directly on the World Wide Web, without converting them into another graphical format. Moreover, it supplies some image processing tools common in the radiological environment. The viewer characteristics make it suitable for preparing teaching radiology sites or clinical files on the Web. The viewer's performance is somewhat poor, particularly on the Internet. Better performances are achieved on local area network (intranet). To improve performance, we will introduce file compression and rewrite the software in Java 1.1. The software is available from the author free of charge.

Humans↗

PubMed2005

Windows .NET Network Distributed Basic Local Alignment Search Toolkit (W.ND-BLAST).

BACKGROUND: BLAST is one of the most common and useful tools for Genetic Research. This paper describes a software application we have termed Windows .NET Distributed Basic Local Alignment Search Toolkit (W.ND-BLAST), which enhances the BLAST utility by improving usability, fault recovery, and scalability in a Windows desktop environment. Our goal was to develop an easy to use, fault tolerant, high-throughput BLAST solution that incorporates a comprehensive BLAST result viewer with curation and annotation functionality. RESULTS: W.ND-BLAST is a comprehensive Windows-based software toolkit that targets researchers, including those with minimal computer skills, and provides the ability increase the performance of BLAST by distributing BLAST queries to any number of Windows based machines across local area networks (LAN). W.ND-BLAST provides intuitive Graphic User Interfaces (GUI) for BLAST database creation, BLAST execution, BLAST output evaluation and BLAST result exportation. This software also provides several layers of fault tolerance and fault recovery to prevent loss of data if nodes or master machines fail. This paper lays out the functionality of W.ND-BLAST. W.ND-BLAST displays close to 100% performance efficiency when distributing tasks to 12 remote computers of the same performance class. A high throughput BLAST job which took 662.68 minutes (11 hours) on one average machine was completed in 44.97 minutes when distributed to 17 nodes, which included lower performance class machines. Finally, there is a comprehensive high-throughput BLAST Output Viewer (BOV) and Annotation Engine components, which provides comprehensive exportation of BLAST hits to text files, annotated fasta files, tables, or association files. CONCLUSION: W.ND-BLAST provides an interactive tool that allows scientists to easily utilizing their available computing resources for high throughput and comprehensive sequence analyses. The install package for W.ND-BLAST is freely downloadable from http://liru.ars.usda.gov/mainbioinformatics.html. With registration the software is free, installation, networking, and usage instructions are provided as well as a support forum.

Algorithms↗

PubMed2006

A novel system for environmental monitoring through a cooperative/synergistic scheme between bioindicators and biosensors.

This paper addresses environmental monitoring through a robust dynamic integration between biomonitor and biosensor systems, a strategy that has not been attempted before. The two systems are conceptually interrelated and methodologically correlated to a cooperative/synergistic scheme (CSS) with a view to minimise uncertainty and monitoring costs and increase reliability of pollution control and abatement. The structures and operations of the biosensor component (in terms of sensitivity, device and method versatility, nature-mimicking physicochemical mechanisms, prospects and technological input) are such that they reinforce or promote the structures and operations of the natural component (in terms of bio-surveillance, impact assessment, environmental quality indexing, stress responses, metabolic pathways, etc.) and vice versa. The bioindicator ontology presented herein, including concepts, relations and controlled vocabulary aiming at establishing an integrated methodology for mapping/assessing negative environmental externalities, provides a useful tool for the design/development/implementation of an environmental network for the monitoring of a variety of pollutants over time and space and the assessment of environmental quality; the collection of the available information and its classification into taxonomic and partonomic relations allows the construction of a database that links pollutants with organisms' response, at a phenomenological and in-depth level, considering ecological parameters, relations and geomorphologic characteristics. As a result, a computer program has been designed/developed as a decision support system and has been successfully tested on a representative population of species indigenous to southern Greece. Significantly, a novel system in the form of a rational framework at the conceptual design level has been developed, that actually contributes towards achieving a cost-effective long-term monitoring program, with the flexibility to counter on-course any (anticipated or not) variations/modifications of the surveillance environment. This novel and pioneering approach will further offer a dynamic system utilised in (a) environmental impact studies and risk assessment (positive/analytic approach), (b) decision-making in the short-run (normative/tactic approach), and (c) policy-making in the long-run (normative/strategic approach). The proposed CSS, based on the integration of multiple data sources, can establish a local area network, incorporated into/expanding to a wide area network, thus offering the potential of better predictive ability and greater lead-time warning at alarm conditions than that provided by separate, stand-alone surveillance modalities.

Biosensing Techniques↗