The PACS system built and used in hospitals nowadays has quite significant overload on the central server of it because of both treatment of very large data and full management of medical images. We suggest a distributed communication and management methodology using Peer to Peer multicasting strategy for efficient management of medical images produced by DICOM modalities. It is absolutely necessary for reducing strict degradation of PACS system due to large size of medical images and its very high transport rates. DICOM Peer to Peer component is composed a service manager to execute requested queries, a communication manager to take charge of file transmission, and a DICOM manager to manage stored data and system behavior. Each manager itself is a component to search for requested file by interaction or transmit the file to other Peers. Distributed management and transformation of medical information based on Peer to Peer multicasting methodology will enhance performance of central server and network capacity reducing overload on them.

Recently, the trends of medical information technologies are capturing digital image from medical analog information, medical image aquisition, transmission, storage and query as well as integration with hospital information system. Analog medical visual information from ultrasonic, MRI can be changed into digital medical information, and to connect with medical video information system which need frame editing, 3D modeling and rendering. The purpose of this study is to design multi graphic image authoring tool and development of digital video editing functionalities, which can be used usefully for medical visual editing tool as well as vector image production system. The implementation methodology is based on Object-Oriented Modeling with primitive, media and composition object with reusability and inheritance characteristics, which can be useful for interleaving various type of media into video stream. The system assesment is based on international recommendation ISO 15504 81W process capability determination. We select 6 processes from Engineering process of system requirement analysis and design category, and determine capability for selected SIW process for system assesment.
Equidae ; Hospital Information Systems ; Information Systems ; Magnetic Resonance Imaging ; Rivers ; Ultrasonics ; Wills

For the minimally invasive surgery, endoscopic surgery has been being a useful technique in diagnosis and treatment of many kind of human diseases and injuries. But, performing endoscopic operations demand expert skills which allow surgeon to learn navigating complex organs in the body through limited view of endoscope as well as manipulating surgical instruments. So the virtual reality based endoscopic surgery simulator has been great increasingly developed with improvements in computing power, graphic hardware, and haptic device in the recent few years. A good balance between surgical realism and real-time interactive rates of simulation is one of most challenging problems in surgical simulation. And when coupled with precise computations of the forces and deformation of organs, it may be possible for the surgeon to feel haptic sensations close to reality. We describe the virtual laparoscopic cholecystectomy simulator using force-feedback device. A goal of this paper is to improve the realism of simulator through real-time interaction between force-feedback and visual-feedback. To calculate deformation of virtual objects separately from the force-feedback, because the latter must be updated much more frequently, the two feedbacks are implemented in each processor. And pre-calculated data set which used for reducing amount of calculation about deformation results in improvement of the real-time interactive rates between the two feedbacks. When virtual surgical tool, manipulated by the user, was collided with isosurface based organ, the surface was deformed in real-time and the graphics, including tissue deformation, performed at 20~30 frames per second. Simultaneously, force-feedback was transmitted to the user at about 500 times per second, therefore we could implement real-time interactive virtual laparoscopic surgery simulator.
Cholecystectomy, Laparoscopic* ; Dataset ; Diagnosis ; Endoscopes ; Humans ; Laparoscopy ; Sensation ; Surgical Instruments ; Surgical Procedures, Minimally Invasive

This paper is about the system using a wireless stethoscope to analysis the FFT and the time-frequency for a heart sound and to manage the collected data for a web-based system. We reformed a wireless stethoscope, connected to PC interface and added the analysis function. In result, we combined merits of an existed wireless system to be convenient for measuring the heart sound and to be available for many listener to ausculate the heart sound simultaneously, and an existed wired system to supply the various analysis functions. The heart sounds data was made into the database to search or refer to the patient data. It is possible to search and refer by the web-browser to the recorded heart sound file, the analyzed file by FFT and the STFT time-frequency method.
Heart Sounds* ; Heart* ; Humans ; Statistics as Topic* ; Stethoscopes*

This study is intended to the diagnostic accuracy and reproducibility rate according to the input devices and the video signals, potential technical problems of the telepathology system and possible physical and psychological impacts. Web based in telepathology system had been developed and in use, but their functional capability and diagnostic accuracy are considered to be inferior to those of conventional optical microscope. We devised a telepathology system using our existing microscope equipped with CCD camera unit that has no restriction of network speed. Total 55 histopathologic cases from various organs were selected. Three pathologists are involved in making diagnoses. The resulting diagnostic accuracies were 1CCD camera with composite video signal was 86.2%, 3CCD camera with composite video signal was 93.1% and 3CCD camera with component video signal was 95.0%. The 3CCD camera with component video signal resulted 95.0% diagnostic accuracy and was superior to 1CCD and 3CCD camera with composite video signal. At this time of problems were not noted in the monitor quality.
Diagnosis ; Telepathology*

In March 1999, we have inaugurated the first academic Department Of Medical Jnformatics (DOMI) at Kyungpook National University School of Medicine in Korea. The initial intent of DOMI is to cover the basics of information science for medical students in order to cope with future medical environment. The purpose of this study is to analyze student response from the medical informatics class to settle in as a regular course of medical education curriculum. The informatics lecture consists of series of 18 lectures to introduce computer and information sciences, basics of internet, laboratory, radiology, telemedicine, patient administration, clinical and management information systems. We conducted a survey before and after the lecture for 150 first year medical students. Both evaluation results were compared to observe any significant changes were acquired. Before the lecture, respondents were reluctant to have computer-related lecture due to resistance of curriculum changes. After the lecture, it is surprising to note that student attitude toward informatics lecture was dramatically changed. Positive views of medical informatics were dominant, and respondents strongly recommended medical informatics lecture to be continued. In addition, a new graduate study program of medical informatics is in operational beginning 2000. The graduate study is designed to offer master s degree for training information specialists in hospital, and doctoral degree for developing faculty and researchers to prepare for the progress of medical informatics in the future.
Curriculum ; Surveys and Questionnaires ; Education ; Education, Medical ; Gyeongsangbuk-do ; Humans ; Informatics ; Information Science ; Information Services ; Internet ; Korea ; Lectures ; Management Information Systems ; Medical Informatics* ; Students, Medical ; Telemedicine

Problem-based Learning challenges students to be more actively involved in defining what they learn and solving the problem. When it proceeds with the Internet, the Internet program will provide learning materials and guide the clinical reasoning process. We developed the PBL casebank database on the web to facilitate development and maintenance of PBL case modules. The database has the 3-tier structure according to the form of the preexistent Internet program, and possible record forms are text, sound files, and image files. This database system is connected with web using ODBC(Qpen DataBase Connectivity) and ASP(Active Server Pages) technology on the Microsoft Windows NT server. With this PBL casebank system, we are hoping for owning medical education materials in common between universities and distance learning in medicine.
Education, Distance ; Education, Medical* ; Hope ; Humans ; Internet* ; Learning ; Problem-Based Learning*

In 2000, Korea Health Industry Development Institute(KHIDI) made a plan for sharing electronic patient records between health care institutions which reflects the advance of information technology. The implementation of the plan is believed to have a number of desirable effects such as direct and indirect medical cost savings, the increase in patient satisfaction, the rationalization of health care institution management, and the improvement of health care delivery system. At the same time, however, it requires a great amount of resources for building the system at first and maintaining it since then nationwide. Therefore, the economic evaluation is required for the plan to be undertaken. This paper assessed the plan from economic perspective. In particular, cost-benefit analysis was performed and the result showed that the present value of net benefit, or the social profit is 3,046.3 billion won over the period of 2000-2030. Also, the benefit-cost ratio turned out to be 1.25. The results of cost-benefit analysis confirmed that the benefits of the plan justify the costs.
Cost Savings ; Cost-Benefit Analysis* ; Delivery of Health Care* ; Humans ; Information Dissemination ; Korea ; Patient Satisfaction ; Rationalization

This study provides an application of data mining approach to Health Promotion Program on Public Health Center. We analyed the survey data in health practice. The main results of this study is as follows; 1) the smoking rate of overweight man was higher than normalweight man. 2) the lower group of 39 age in alchol offerer was very high possibility of alcholism. We found that the technology of data mining was very efficient tool to find the group of Health Promotion Program on Public Health Center. In the base of results, we offered the efficient ways of Health Promotion Program using Data Mining. The contents of efficient ways as follows; 1) The target group of Health Promotion Program is necessary to find using Data Mining Technology 2) The ways of Health Promotion Program is necessary to find using Data Mining Technology.
Data Mining* ; Health Promotion* ; Overweight ; Public Health* ; Smoke ; Smoking

The objective of this study is to present a new approach to the development of national health insurance rate-setting system using data mining technique. In particular, this paper examines the feasibility of applying the rate-setting system for the regional insurance program to the insureds of the workman' s insurance program, so that the unified rate-setting system can be developed. The subjects of the study were the beneficiaries(sample size = 234,224) of the workman' s insurance program(excluding government officials and teachers) residing in Goyang City. 1998 data from Korean Medical Insurance Corporation were analyzed through various data mining techniques such as Decision Tree, Regression, Assessment and SCORE. Major results and conclusions are as follows: 1) On average, the insured' s property element of insurance fee, automobile element of insurance fee, property score of income assessment, and automobile score of income assessment together accounted for only 16% of the actual income, which implies that we need more precise data in order to develop an equitable rate-setting system. 2) To do so, it is necessary to gather all the income-related data(property income, financial income, earnings, ...) in a timely manner. Since current computer and information system would not allow efficient maintenance and utilization of such data, it would also be necessary to establish data warehouse for this purpose. 3) In developing the rate-setting system on the basis of data warehouse, various data mining techniques should be employed to ensure the equity of insurance rates among different classes of insureds.
Automobiles ; Data Mining* ; Decision Trees ; Fees and Charges ; Humans ; Information Systems ; Insurance ; Insurance, Health* ; National Health Programs ; Occupational Groups