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

A novel laser Doppler flowmetry scheme is reported that adjusts the processing bandwidth adaptively to optimise the estimation of flow. To obtain an adequate processing bandwidth, the Doppler spectra is first fitted to the Lorentzian function, and the bandwidth at half the maximum of the Lorentzian function is used as an indicator of the major frequency range of the signal. The processing bandwidth is then tuned accordingly, and a frequency-weighted algorithm is applied to compute the fluid velocity. To investigate the influence of the processing bandwidth, an in vitro experiment was performed. In the experiment, the flow rate was controlled at constant velocity in the range from 0 to 18.52 mm s−1, and the fluid velocity indices were calculated using adaptive and fixed processing bandwidths, respectively. The results showed that the adaptive processing bandwidth adjustment, not only significantly reduced the biological zero (9.6% of the case using 100 kHz bandwidth), but also enhanced the sensitivity of the laser Doppler measurement (over 20%) and linearly responded to a wider velocity range (R2=0.979 for velocity from 0 to 18.52 mms−1).

Adaptive processing bandwidth adjustment for laser Doppler flowmetry.

IT ;S of considerable importance to develop a portable real-time display and high-performance physiological data monitoring and recording system for ambulatory patients. There are many different systems that have been designed to monitor various signals obtained from ambulatory patients and even to be used as a means of early diagnosis of some diseases. The most popular data-recording medium in the biomedical field is the magnetic tape and/or the electronic memory, Several singleand multichannel portable biological signal recording systems have been developed to record physiological signals. Some of them use magnetic tape as the recording medium to record blood pressure (t~WARADA et al., 1991) and blood flow (DAHNOUN et al., 1990). Other researchers use electronic memory as the recording medium to record the EMG (TEPAVAC et al., 1992), pressure, s between the foot and shoe (ZHU et al., 1991), body movements (EvANs et al., 1991), oesophageal pressure (BREEDIJK et al., 1989), pH (PHSTER et al., 1989) and other variables. There ate two disadvantages with magnetic tape: bandwidth limitation due to the need for slow tape motion, and the number of I/O channels available for recording and analysing the data. Magnetic tape also lacks a real-time display for use as a monitoring function. Electronic memory, such as SRAM, has two primary limitations. First, storage of vast amounts of data is not practical owing to PCB space availability. Secondly, power consumption would be excessive as this is a portable system. Although DRAM has the advantage of high density and low cost, it does, however, require complicated timing that renders it difficult to employ in a portable data storage system. In recent years, engineering and technological growth has greatly improved the development of small-size, large-capacity, shock-protected and low-power consumption disk drives. Disk device recording, in contrast with magnetic tape, has the advantages of speed, case of dam transfer and evaluation without requiting an expensive piece of equipment, as does the Holter monitor. Disk devic~ recording, in contrast with RAM recording, has the advantage of being non-volatile, and a removable disk drive (RDD) can be directly inserted into the host computer for post-processing. Currently, there are three

Microprocessor-based physiological signal monitoring and recording system for ambulatory subjects.

Continuous arterial blood pressure monitoring is essential in monitoring patients during surgical operation or in intensive care units In this study, we propose a new method to estimate beat-to-beat systolic blood pressure by combining the pulse arrive time and normalized pulse width measurement The method was examined in nine patients who were in ICU Results shows the new method has higher linearity (08218) and better precision (30775) than the methods using either pulse arrive time or pulse width only

Estimation of Beat-to-Beat Systolic Blood Pressure Using Pulse Arrive Time and Pulse Width Derived from the Photoplethysmogram

The Taita No. 1 ventricular assist device (T-VAD) is a totally implantable pulsatile impeller centrifugal pump driven by a magnetically suspended motor. The flow can achieve 2.01 +/- 0.17 L/min against a pressure of 100 mm Hg under 0.266 +/- 0.017 amp and 13.55 +/- 0.41 voltage. The speed was around 3,500 rpm. It consumed less than 6 W of power, resulting in less heat production and mechanical bearing complications. The impeller vane was designed to have both radial and axial curves according to the stream surface and stream lines to reduce thrombosis and hemolysis. Eight calves weighing 80 to 100 kg (mean 87 +/- 12 kg) were used for experiments. With the calves under general anesthesia, left posterolateral thoracotomy was performed to connect the inflow tube with the atrial appendage and to anastomose the outflow tube with the descending aorta. The calves usually awoke and stood up within hours after discontinuation of anesthetics. The mean survival of the calves was 75 +/- 42 days (range 33-148 days). The terminations of experiments were mainly due to infection. During the course of pumping, no significant deterioration of liver or renal function was noted. The evaluation of serum samples from the implanted calves indicated that hemolysis was not associated with use of the T-VAD. The average daily free hemoglobin level was 8.08 +/- 3.05 mg/dl, which was less than the set limit of 20 mg/dl. The red blood cell and platelet count and hemoglobin of implanted animals were within the normal range. In our results, the T-VAD provided competent pulsatile function without severe blood damage or organ dysfunction.

Development of a totally implantable pulsatile centrifugal pump as a ventricular assist device.

Optical coherence tomography (OCT) is analogous to ultrasound imaging except that it uses infrared light instead of sound. Polarization-sensitive optical coherence tomography (PS-OCT) combines the advantages of OCT and provides additional image contrast of the tested sample. We demonstrate this technique for imaging of back-reflected light, birefringence, and fast-axis orientation simultaneously in different kinds of atherosclerosis plaque. This in vitro study suggests birefringence changes in plaque are due to the prominent deposition of collagen or cholesterol by correlating PS-OCT images with histology. Thus the combination of high resolution structural imaging and birefringence detection make PS-OCT a potentially powerful tool for early assessment of atherosclerosis appearance and prediction of plaque rupture.

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Gwo-Jen Jan

Papers

Adaptive processing bandwidth adjustment for laser Doppler flowmetry.

Microprocessor-based physiological signal monitoring and recording system for ambulatory subjects.

Estimation of Beat-to-Beat Systolic Blood Pressure Using Pulse Arrive Time and Pulse Width Derived from the Photoplethysmogram

Development of a totally implantable pulsatile centrifugal pump as a ventricular assist device.

Imaging of human aortic atherosclerotic plaques by polarization-sensitive optical coherence tomography