Type of image Number of images 4 4 40 50 252 1258 157 491 12 12 12 12 in .NET

Creating Denso QR Bar Code in .NET Type of image Number of images 4 4 40 50 252 1258 157 491 12 12 12 12
Type of image Number of images 4 4 40 50 252 1258 157 491 12 12 12 12
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Figure 34 The main components of a PACS system
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A relatively recent development is accessing PACS databases via the Internet Due to sophisticated image processing, medical professionals can share medical images stored in PACS, even over low-bandwidth Internet connections The iPACS technique is implemented in a web gateway [4] The main idea behind iPACS is that only relatively small areas of images are processed (compressed and transmitted), so that the bandwidth need is greatly reduced Current iPACS systems allow viewing of PACS images through a dial-up Internet connection In addition to still pictures, telemedicine applications require the transmission of a moving video from diagnostic equipment (or, a suf ciently long series of still pictures/frames taken at very short intervals so that at the observer s end, it can be reconstructed as a moving video) Ultrasound systems typically produce 512 512 pixel frames, with dynamic resolution of 8 bits, and for a 30 frame-per-second motion quality, a channel bandwidth of about 60 Mbps would be needed if a real-time reproduction was required This is usually not the case; however, taking into account that a typical duration of a record is of the order of 60 seconds, a high transmission data rate is still required to allow a reasonable transmission time of the resulting long le
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334 Videoconferencing in telemedicine
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Full motion, live video communication between persons or groups constitutes an essential part of today s telemedicine applications It includes showing the environment and the patient, as required by the speci c diagnostic session This is done by using some kind of videoconferencing system, either in a point-to-point or in a multipoint setting Multipoint videoconferencing is widely used in telemedicine for educational applications Figure 35(a) and (b) illustrate two videoconferencing systems developed for medical applications by Tandberg [5] The powerful HCS III (Health Care System III) is implemented on a lightweight, easy-to-maneuver roll-about cart The wide angle camera, a 20 inch medical grade monitor on a swing-arm with an adjustable height bar, and the unidirectional shotgun microphone allow for free movement around consultation rooms (Figure 3 5(a)) Medical and nonmedical peripheral equipment, as well as a personal computer, can be added The system supports 15 frames per second transmission when only modest data rates are available on the communication link (56 128 kbps) and 30 fps on 168 kbps 3 Mbps links Even 60 fps is possible in point-to-point con guration It works on ISDN, using up to six BRI interfaces
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Figure 35 Videoconferencing systems developed for medical applications Reproduced by permission of Tandberg (a) Health Care System III; (b) Intern II
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(768 kbps) or a PRI (2 Mbps), on a leased line with up to 2 Mbps (E1) data rate, as well as over IP through a 10/100 Mbps Ethernet interface The Intern II system, shown in Figure 35(b), is intended for applications in which a smaller, more mobile system is needed to perform remote consultations The equipment utilizes 15 inch at-screen LCD displays The stand design ensures a high level of stability and maintains a small footprint, allowing ease of mobility within a medical facility Important, but less bandwidth-demanding, information sources are measuring instruments of biometric data (such as an electronic thermometer or blood pressure meter) and the output of the electronic/digital versions of some traditional diagnostic devices, such as a stethoscope or otoscope Even for ECG telemonitoring, taking into account a 12-lead diagnostic, a typical sampling rate of 400 samples per second and a 12 bit per sample quantization, the resulting data stream can t into a single ISDN B channel In telesurgery, a surgical operation is being followed, supervised, controlled or even conducted by a remote specialist, the latter case being called telepresence surgery In military environments, it is often extremely useful to have a remote specialist to advise the local surgeon; and in eld uses, to accomplish the operation remotely by using robotic equipment in the operation room In telepresence, the key technology is the robotic arm system, however, the reproduction of the visual environment at the remote site is equally important, and this latter consumes the majority of the bandwidth of the communication link, only a fraction of it is used for transmitting the robotic control and feedback information In general surgical practice, the most frequently used scenario is telementoring, which is based on an online, two-way audiovisual communication between the operation room and a remote site, using videoconferencing systems From the remote site, specialists can follow the operation and advise on special issues or form a second opinion during the operation This set-up is also extremely useful for conducting demonstrations for educational purposes The videoconferencing equipment, as mentioned above, is capable of transmitting radiographic or other diagnostic pictures, as well as other diagnostic data, when needed during the operation A typical room installation consists of a panoramic room camera showing the operation room team and the patient, a ceiling camera showing the patient, and a document camera as an input device for any textual and pictorial diagnostic information A multipoint technique allows several remote sites to follow the operation The technical environment of minimally invasive surgery (MIS) is quite close to a telepresence operation scenario Laparoscopy is a technique by which the surgeon conducts the operation by using manipulators and a ber optic camera inserted into the abdomen of the patient through small incisions, and follows the whole process on a monitor The extension to doing it from a distance is, therefore, quite straightforward In this rapidly evolving area there is an increasing need for new specialists and, therefore, training via videoconferencing is particularly important Telemonitoring in home health care is another important and growing area Remote monitoring of vital signs and patient diagnostic data by a health care professional remotely allows improved care of patients in their homes They can be just elderly people or patients suffering from chronic diseases who live alone, or are left alone by relatives during the day The advantages are manifold and the investment needed is quite low, as there is no need for expensive high-speed communication We have already mentioned education and training in several places when discussing telemedicine systems and applications General methodology and systems of tele-education
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