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Bhati CS, Wigmore SJ, Reddy S, Mayer DA, Buckels JAC, Derek M, Mirza DF. Web-based image transmission: a novel approach to aid communication in split liver transplantation. Clin Transplant 2009; 24:98-103. [PMID: 19878514 DOI: 10.1111/j.1399-0012.2009.01125.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Split liver transplantation (SLT) is technically demanding and requires good communication between transplant centers. The recipient surgeon receiving a shipped split liver needs detailed information on allocation of inflow and outflow vessels. We describe the first use of an image transmission system to facilitate SLT. METHODS Twenty cadaver livers undergoing ex situ splitting were studied. Fifteen were shared between the geographically separate Birmingham adult and pediatric centers and five were shared with other UK centers. RESULTS A total of six to eight images of each split graft were taken with a camera at standardized settings using the National Organ Retrieval Imaging System (NORIS), showing details of appearance, size, and anatomy of allocated inflow and outflow vessels. These were uploaded using a personal digital assistant to a secure website (http://www.noris.org.uk). The remote recipient surgeon then viewed these images by logging onto the password-protected website. Minimum time interval between division of the hilar vessels and completion of the split procedure was two h, allowing remote surgeon to view their allocated "shipped" graft in advance of commencing surgery. CONCLUSION This advanced yet simple image transmission system has the potential for routine application in transplant surgery, not only for splitting but also for reporting injuries and graft steatosis.
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Measurement of knee joint motion using digital imaging. INTERNATIONAL ORTHOPAEDICS 2008; 33:1627-31. [PMID: 19037641 DOI: 10.1007/s00264-008-0694-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2008] [Revised: 10/24/2008] [Accepted: 10/24/2008] [Indexed: 10/21/2022]
Abstract
The measurement of joint motion is common practice in many aspects of orthopaedic surgery. A number of techniques and instruments have been developed for this purpose. We describe a method of recording and measuring knee joint motion using digital imaging which demonstrated high inter-observer reliability (r > 0.948) and intra-observer repeatability (r > 0.906). This technique may offer some practical advantages over other methods of measuring joint motion.
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Marguet CG, Springhart WP, Preminger GM. New Technology for Imaging and Documenting Urologic Procedures. Urol Clin North Am 2006; 33:397-408. [PMID: 16829273 DOI: 10.1016/j.ucl.2006.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Recent advances in fiber optics and digital technology have dramatically improved the ability of the urologic surgeon to accurately image and document endoscopic and laparoscopic procedures. In addition, the development of digital endoscopes has expanded the armamentarium of the endoscopic surgeon greatly. Finally, new virtual reality technology has allowed increased visualization during surgery and provides excellent training for surgeons. This article details new imaging and documentation technology currently utilized during urologic procedures.
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Affiliation(s)
- Charles G Marguet
- The Comprehensive Kidney Stone Center, The Division of Urology, Department of Surgery, Duke University Medical Center, Box 3167, Room 1572 D, White Zone, Durham, NC 27710, USA
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Razdan S, Johannes J, Kuo RL, Bagley DH. The camera phone: A novel aid in urologic practice. Urology 2006; 67:665-9. [PMID: 16618555 DOI: 10.1016/j.urology.2005.10.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2005] [Revised: 09/12/2005] [Accepted: 10/04/2005] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To describe a novel use of the camera phone for efficient, reliable, and cost-effective collection and transmission of medical data in the urologic setting. METHODS We used camera phones (Verizon VGA and Sanyo-Sprint PCS) with a resolution of 640 x 480 pixels to capture images in the operating room, as well as in the outpatient clinic. Images were obtained directly from the monitor or the x-ray viewing box. These were then immediately transmitted to the office computer through a secure Internet connection. The images were then incorporated into operative and office notes, as needed. RESULTS The images obtained with this method were of adequate quality for demonstration purposes, with the added advantage of allowing secure transmission and storage. The best-quality images were those obtained directly from the x-ray viewing box or from a liquid crystal display monitor. In addition, the images could be edited and labels added with the aid of the software that came with the camera phone. CONCLUSIONS This method allows the acquisition of fair-quality digital images of surgical procedures and radiographic studies with simultaneous data transmission and storage for clinical documentation. The technology reduced costs and increased the efficiency of our practice considerably.
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Affiliation(s)
- Sanjay Razdan
- Department of Urology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
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Eze N, Lo S, Bray D, Toma AG. The use of camera mobile phone to assess emergency ENT radiological investigations. Clin Otolaryngol 2005; 30:230-3; discussion 233. [PMID: 16111418 DOI: 10.1111/j.1365-2273.2005.00982.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To determine the accuracy of assessment of common ENT emergency radiological investigations using mobile phone digital images. DESIGN Prospective case controlled series. SETTING Tertiary referral otolaryngology centre. PARTICIPANTS Fourteen randomly selected patients who underwent emergency ENT radiological investigations over a 1-month period. MAIN OUTCOME MEASURES The accuracy and confidence of six ENT consultants and five specialist registrars in making diagnoses based on a brief history and assessment of CT scans and X-ray images taken from and transmitted via a mobile phone, compared with examination of the same films on a conventional X-ray box. RESULTS With 14 films, a total of 154 cases were assessed by the 11 subjects. All doctors made the correct diagnosis for every case examined. Overall, the relative confidence of diagnosis was ranked highly for both image media, although the overall confidence of diagnosis using the X-ray box was significantly greater than the mobile phone (95% CI upper bound = 1.6 lower bound = 0.9; paired t-test P < 0.0001). The seniority of the clinician did not predict a difference in the confidence of diagnosis (P = 0.3). There is no statistical relationship between confidence of diagnosis of the original films and degradation of film quality on the mobile phone (P = 0.7). CONCLUSIONS The accuracy and confidence of diagnosis of common ENT emergency radiological investigations using mobile phone digital images seem compatible with X-ray box. Financially it is a much cheaper than conventional telemedicine technology. It may be used to augment information sent to non-resident specialists in the management of emergency ENT cases.
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Affiliation(s)
- N Eze
- Department of Otolaryngology-Head and Neck Surgery, St George's Hospital Medical School, University of London, London, UK.
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Abstract
Advances in image processing and display technologies, such as digital imaging, HDTV, and virtual reality, will ultimately allow integration of endoscopic imaging with diagnosis and therapy during ureteroscopic procedures. Further improvements in simulation technology and telemedicine should improve surgical training and greatly benefit patient care.
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Affiliation(s)
- Yeh Hong Tan
- Division of Urology, Department of Surgery, Duke University Medical Center, Box 3167, Room 1572D, White Zone, Durham, NC 27710, USA
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Truzzi JC, Bruschini H, Simonetti R, Andreoni C, Ortiz V, Srougi M. A Simple Way to Take Pictures During Endoscopic Procedures. J Urol 2004; 171:327-8. [PMID: 14665907 DOI: 10.1097/01.ju.0000100387.98674.bd] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE We describe a new method of taking pictures from endoscopic images using a digital photo camera coupled to the endoscopic lens without an adapter. MATERIALS AND METHODS We used a digital camera with 3.3 megapixel resolution and 6 x optical zoom. The camera was coupled to the endoscopic lens with no special adapter. The image was accompanied through the LCD (liquid crystal display) visor, and the picture was taken with the flash button on and with no macro resource. The image was then enlarged by optical and digital zoom before being easily stored in photo files at the personal computer. RESULTS The quality of the photos obtained by this method was at least similar to that of traditional photos, and the data were promptly stored. CONCLUSIONS We describe a simple method of taking pictures from endoscopic images with the additional advantage of a facility to edit and store the photographs.
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Abstract
The benefits of digital photography are certainly numerous and include rapid image production, easy and quick deletion of poor images, no need for film or its associated expenses, decreased costs for enlargements, ease of editing and image storage, effortless placement in presentations or publications. Many physicians believe that the benefits of digital images clearly outweigh any limitations that future technologic advances will minimize. Digital imaging allows for the seamless integration of all patient images (e.g., clinical, radiographic, pathologic) into the medical record. Additionally, manipulating these images with lighting, filters, of other processing techniques may encourage diagnostic advances (e.g., distinguishing between benign and malignant surface lesions). Some drawbacks, however, continue to exist, including cost of the hardware and software, continuously evolving technology, power consumption and battery usage, lower image resolution compared with 35-mm photography, and the need to have backup image files. With decreasing costs, improving resolutions, and enhanced capabilities, digital cameras will overcome these limitations rapidly.
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Affiliation(s)
- Richard V Smith
- Department of Otolaryngology, Albert Einstein College of Medicine, Montefiore Medical Center, 3400 Bainbridge Road, Bronx, NY 10467, USA.
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Abstract
One of the most significant developments in imaging technology has been the process of digitalization. By incorporating currently available digital imaging equipment into surgical practice, urologists can be assured of obtaining real-time video images with optimal clarity and detail. In addition, one can efficiently capture and store still images that are crisper and sharper than their analog counterparts. These factors greatly improve the diagnostic capabilities and organization of today's endourologist.
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Affiliation(s)
- R L Kuo
- The Comprehensive Kidney Stone Center, Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA
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Kuo RL, Delvecchio FC, Babayan RK, Preminger GM. Telemedicine: recent developments and future applications. J Endourol 2001; 15:63-6. [PMID: 11248922 DOI: 10.1089/08927790150500971] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Telemedicine, or the delivery of health care from a distance, is an exciting field that has undergone rapid advancements over the past three decades. Previous studies have demonstrated that telemedicine can effectively assist in patient care. However, cost issues and the lack of resources to sustain telemedicine systems have previously limited the use of this technology. Herein, we explore the development, current applications, and future of telemedicine.
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Affiliation(s)
- R L Kuo
- The Comprehensive Kidney Stone Center, Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA
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Abstract
Digital photography has become a practical alternative to film photography for documentation, communication, and education about orthopaedic problems and treatment. Digital cameras may be used to document preoperative and postoperative condition, intraoperative findings, and imaging studies. Digital photographs are captured on the charged coupler device (CCD) of the camera, and processed as digital data. Images may be immediately viewed on the liquid crystal display (LCD) screen of the camera and reshot if necessary. Photographic image files may be stored in the camera in a floppy diskette, CompactFlash card, or SmartMedia card, and transferred to a computer. The images may be manipulated using photo-editing software programs, stored on media such as Zip disks or CD-R discs, printed, and incorporated into digital presentations. The digital photographs may be transmitted to others using electronic mail (e-mail) and Internet web sites. Transparency film slides may be converted to digital format and used in digital presentations. Despite the initial expense to obtain the required hardware, major cost savings in film and processing charges may be realized over time compared with film photography.
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Affiliation(s)
- B Elbeshbeshy
- Department of Orthopaedic Surgery, NYU-Hospital for Joint Diseases, New York, NY, USA
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Bruno D, Delvecchio FC, Preminger GM. Digital still image recording during video endoscopy. J Endourol 1999; 13:353-6; discussion 356-7. [PMID: 10446795 DOI: 10.1089/end.1999.13.353] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
With the advances in telemedicine and virtual consultation services comes the need for state-of-the-art endoscopic imaging techniques and equipment. Concomitant with current day concerns of cost containment, the ability to utilize the aforementioned tools in a cost-effective fashion that lowers operating expenses, accurately depicts procedures, and expedites chart documentation is paramount. We report on a fast and efficient way to obtain and store images during endoscopic procedures, which can be stored on standard 3.5-inch floppy disks using an innovative digital image recorder. These images are stored as high-resolution (640x480x24) JPEG files, which can be placed in electronic medical records, imported into Internet Web pages, incorporated into slide presentations, and, most importantly, stored in easily accessed archives.
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Affiliation(s)
- D Bruno
- The Comprehensive Kidney Stone Center, Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA
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Kuo RL, Aslan P, Dinlenc CZ, Lee BR, Screnci D, Babayan RK, Kavoussi LR, Preminger GM. Secure transmission of urologic images and records over the Internet. J Endourol 1999; 13:141-6. [PMID: 10360490 DOI: 10.1089/end.1999.13.141] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Telemedicine has become a common method for the transmission of images and patient data across long distances. Our goal was to assess the efficiency and accuracy of Photomailer MD software, a store-and-forward telemedicine system, in the urologic setting. METHODS Photomailer MD software was loaded on two computers in the host institution, one with a T1 connection to the Internet and the other with a dial-up modem connection (24,000 bits/second), and computers at three remote sites. A total of 14 clinical cases, comprised of digitized histories and radiographic images, were sent to the remote institutions four separate times using the four transmission modes available: nonencrypted, 56-bit encryption, 128-bit encryption, and 128-bit encryption with password. The following data points were recorded: file size before and after encryption, file transmission times, and diagnostic accuracy of the remote urologists. One-way ANOVA was used to compare mean values statistically, while the z-test was used to compare diagnostic accuracies. RESULTS Encryption increased the file size by a mean of 37.8%, with the three encryption modes increasing file sizes by the same number of kilobytes. When a dial-up modem was used, encrypted files required a significantly longer transmission time (P < 0.05) than the unencrypted files. The same trend was seen with the T1 connection, although the differences often were not significant. When T1 transmission times were compared with modem times with other variables held constant, modem times were significantly longer (P < 0.05). Diagnostic accuracies for each of the three remote centers ranged from 85.7% to 100%. Differences in accuracy rates between attending physicians and residents were not significant. CONCLUSIONS Photomailer MD provides a secure, convenient, and affordable method of transmitting patient images and records via the Internet. Transmission speed was significantly greater when using a T1 line and also tended to be faster when files were not encrypted. There was no significant difference in transmission time among the three encryption modes; therefore, 128-bit encryption with a password should be used to maximize security. Diagnostic accuracies were comparable to those in the literature. In general, 640 x 480-pixel resolution was adequate for urologic diagnoses, although higher-resolution images may improve accuracy.
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Affiliation(s)
- R L Kuo
- Comprehensive Kidney Stone Center, Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA
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