A video endoscope system includes a reusable control cabinet and an endoscope that is connectable thereto. The endoscope may be used with a single patient and then disposed. The endoscope includes an illumination mechanism, an image sensor, and an elongate shaft having one or more lumens located therein. An articulation joint at the distal end of the endoscope allows the distal end to be oriented by the actuators in the control cabinet or actuators in a control handle of the endoscope. Fluidics, electrical, navigation, image, display and data entry controls are integrated into the system along with other accessories.

Articulation joint for video endoscope

M-Health can be defined as “mobile computing, medical sensor, and communications technologies for health-care.” This emerging concept represents the evolution of e-health systems from traditional desktop “telemedicine” platforms to wireless and mobile configurations. Current and emerging developments in wireless communications integrated with developments in pervasive and wearable technologies will have a radical impact on future health-care delivery systems. This editorial paper presents a snapshot of recent developments in these areas and addresses some of the challenges and future implementation issues from the m-Health perspective. The contributions presented in this special section represent some of these recent developments and illustrate the multidisciplinary nature of this important and emerging concept.

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Guest Editorial Introduction to the Special Section on M-Health: Beyond Seamless Mobility and Global Wireless Health-Care Connectivity

With an increasingly mobile society and the worldwide deployment of mobile and wireless networks, the wireless infrastructure can support many current and emerging healthcare applications. This could fulfill the vision of "Pervasive Healthcare" or healthcare to anyone, anytime, and anywhere by removing locational, time and other restraints while increasing both the coverage and the quality. In this paper, we present applications and requirements of pervasive healthcare, wireless networking solutions and several important research problems. The pervasive healthcare applications include pervasive health monitoring, intelligent emergency management system, pervasive health-care data access, and ubiquitous mobile telemedicine. One major application in pervasive healthcare, termed comprehensive health monitoring is presented in significant details using wireless networking solutions of wireless LANs, ad hoc wireless networks, and, cellular/GSM/3G infrastructure-oriented networks. Many interesting challenges of comprehensive wireless health monitoring, including context-awareness, reliability, and, autonomous and adaptable operation are also presented along with several high-level solutions. Several interesting research problems have been identified and presented for future research.

Pervasive healthcare and wireless health monitoring

The aim of this paper is twofold. First, we present a thorough experimental study to show the superiority of the generalization capability of the support vector machine (SVM) approach in the automatic classification of electrocardiogram (ECG) beats. Second, we propose a novel classification system based on particle swarm optimization (PSO) to improve the generalization performance of the SVM classifier. For this purpose, we have optimized the SVM classifier design by searching for the best value of the parameters that tune its discriminant function, and upstream by looking for the best subset of features that feed the classifier. The experiments were conducted on the basis of ECG data from the Massachusetts Institute of Technology-Beth Israel Hospital (MIT-BIH) arrhythmia database to classify five kinds of abnormal waveforms and normal beats. In particular, they were organized so as to test the sensitivity of the SVM classifier and that of two reference classifiers used for comparison, i.e., the k-nearest neighbor (kNN) classifier and the radial basis function (RBF) neural network classifier, with respect to the curse of dimensionality and the number of available training beats. The obtained results clearly confirm the superiority of the SVM approach as compared to traditional classifiers, and suggest that further substantial improvements in terms of classification accuracy can be achieved by the proposed PSO-SVM classification system. On an average, over three experiments making use of a different total number of training beats (250, 500, and 750, respectively), the PSO-SVM yielded an overall accuracy of 89.72% on 40438 test beats selected from 20 patient records against 85.98%, 83.70%, and 82.34% for the SVM, the kNN, and the RBF classifiers, respectively.

Classification of Electrocardiogram Signals With Support Vector Machines and Particle Swarm Optimization

Wireless telemedicine using GSM and GPRS technologies can only provide low bandwidth connections, which makes it difficult to transmit images and video. Satellite or 3G wireless transmission provides greater bandwidth, but the running costs are high. Wireless networks (WLANs) appear promising, since they can supply high bandwidth at low cost. However, the WLAN technology has limitations, such as coverage. A new wireless networking technology named the wireless mesh network (WMN) overcomes some of the limitations of the WLAN. A WMN combines the characteristics of both a WLAN and ad hoc networks, thus forming an intelligent, large scale and broadband wireless network. These features are attractive for telemedicine and telecare because of the ability to provide data, voice and video communications over a large area. One successful wireless telemedicine project which uses wireless mesh technology is the Emergency Room Link (ER-LINK) in Tucson, Arizona, USA. There are three key characteristics of a WMN: self-organization, including self-management and self-healing; dynamic changes in network topology; and scalability. What we may now see is a shift from mobile communication and satellite systems for wireless telemedicine to the use of wireless networks based on mesh technology, since the latter are very attractive in terms of cost, reliability and speed.

Wireless Mesh Networks

This paper proposes a mobile patient monitoring system, which integrates current personal digital assistant (PDA) technology and wireless local area network (WLAN) technology. At the patient's location, a wireless PDA-based monitor is used to acquire continuously the patient's vital signs, including heart rate, three-lead electrocardiography, and SpO/sub 2/. Through the WLAN, the patient's biosignals can be transmitted in real-time to a remote central management unit, and authorized medical staffs can access the data and the case history of the patient, either by the central management unit or the wireless devices. A prototype of this system has been developed and implemented. The system has been evaluated by technical verification, clinical test, and user survey. The evaluation of performance yields a high degree of satisfaction (mean=4.64, standard deviation-SD=0.53 in a five-point Likert scale) of users who used the PDA-based system for intrahospital transport. The results also show that the wireless PDA model is superior to the currently used monitors both in mobility and in usability, and is, therefore, better suited to patient transport.

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A wireless PDA-based physiological monitoring system for patient transport

The method of truncated singular value decomposition (SVD) is proposed for electrocardiogram (ECG) data compression. The signal decomposition capability of SVD is exploited to extract the significant feature components of the ECG by decomposing the ECG into a set of basic patterns with associated scaling factors. The signal information is mostly concentrated within a certain number of singular values with related singular vectors due to the strong interbeat correlation among ECG cycles. Therefore, only the relevant parts of the singular triplets need to be retained as the compressed data for retrieving the original signals. The insignificant overhead can be truncated to eliminate the redundancy of ECG data compression. The Massachusetts Institute of Technology-Beth Israel Hospital arrhythmia database was applied to evaluate the compression performance and recoverability in the retrieved ECG signals. The approximate achievement was presented with an average data rate of 143.2 b/s with a relatively low reconstructed error. These results showed that the truncated SVD method can provide efficient coding with high-compression ratios. The computational efficiency of the SVD method in comparing with other techniques demonstrated the method as an effective technique for ECG data storage or signals transmission.

ECG data compression using truncated singular value decomposition

The present invention is a method for exploring the viewpoint and focal length of a fisheye lens camera (FELC). It employs the characteristic of the central symmetry of the distortion of the fisheye lens (FEL) to set its optic axis by means of a calibration target with a plurality of symmetrically homocentric figures. Once the optic axis is fixed, further disclose the viewpoint (VP) of the FELC along the optic axis through a trail-and-error procedure and calculate its effective focal length and classify it to the primitive projection mode. Because the invention is capable of finding out both the internal and external parameters of the FELC and the calibration method is easy, low-cost, suitable to any projection model, and has greater sensitivity corresponding to an increasing in image distortion, the distortive images can be transformed easily to normal ones which fit in with a central perspective mechanism. Furthermore, the invention is also practicable and excellent in its applications in the fields of quality identification of the FEL and wide-view 3-D metering.

Method for exploring viewpoint and focal length of camera

Adult respiratory distress syndrome (ARDS) has been the major cause of mortality in burn injury. The authors reported the experience of using extracorporeal membrane oxygenation (ECMO) to treat adult burn patient with ARDS. Three patients with burn or electric injury, around 48.9% of body surface area over second-degree burns, developed ARDS after resuscitation. All had positive blood culture and depended on a ventilator more than 5 days before ECMO. Venovenous (VV) ECMO was started at the beginning of severe respiratory failure with an oxygen index of 61.6 ± 15.5 cm H2O/mm Hg (≧40 cm H2O/mm Hg), partial arterial oxygen tension to inspired oxygen fraction (Pao2/Fio2) of 46.1 ± 7.0 mm Hg (≤200 mm Hg), positive end expiratory pressure (PEEP) of 15.7 ± 1.6 cm H2O (≧10 cm H2O), alveolar-arterial difference in oxygen concentration (A-a Do2) of 618.9 ± 19.3 mm Hg (≧300 mm Hg), and lung compliance of 17.3 ± 4.6 ml/cm H2O (≤30 ml/cm H2O). The VV type had to be converted to the newly designed veno-venoarterial (V-VA) ECMO due to the myocardial dysfunction. Two of three patients survived. The duration of ECMO was 160.2 ± 51.1 h. Two patients received debridement of escar during ECMO support and desmopressin infusion, and no increased bleeding or coagulopathy was found. The respiratory parameters were significantly improved after ECMO, especially in the survivors. ECMO is also suitable for ARDS in adult burn injury.

Application of extracorporeal membrane oxygenation in adult burn patients.

The present invention is a method for presenting the fisheye-camera images. A calibration target with a concentric-and-symmetric pattern (PCT) is utilized to assist in parameterizing a fisheye camera (FIS) in order to ascertain the optical parameters comprising the principal point, the focal length constant and the projection function of the FIS. Hence, the position of an imaged point referring to the principal point on the image plane directly reflects its corresponding zenithal distance α and azimuthal distance β of the sight ray in space so as to normalize the imaged point onto a small sphere. Further according to the map projections in cartography capable of transforming the global geometry into flap maps, the interesting area in a field of view can be accordingly transformed by a proper projection method. The image transforming method disclosed in the invention is simple, low-cost, suitable to various FISs with different projection mechanisms and capable of transforming the fisheye-camera images for particular functions, such as the approach of normal human visual perception, video data encryption, and image compression/transformation with a high fidelity.

Gwo-Jen Jan

Papers

A wireless PDA-based physiological monitoring system for patient transport

ECG data compression using truncated singular value decomposition

Method for exploring viewpoint and focal length of camera

Application of extracorporeal membrane oxygenation in adult burn patients.

Method for presenting fisheye-camera images