1)Osaka University Hospital, Osaka, 2)Kyoto University Hospital, Kyoto, 3)Nara Research Center, Nara, 4)BBCC, Kyoto, Japan
Purpose: In telemedicine, the cardiovascular field is deemed the most difficult to deal with because high definition animated pictures are necessary for diagnosis. In order to demonstrate that the specification of super high definition system and B-ISDN is enough to conduct telemedicine in the cardiovascular field, we constructed a teleconference system which deals with various medical pictures including animated ones of a patient with ischemic heart disease.
Methods: The teleconference system is constructed on the super high definition system which consists of a monitor with resolution of 2048pixel x 2048line x 60frame/sec and non-interlace-scan, frame memory of 2048(pixel) x 2048(line) x 3(RGB) x 8(bit) x 256(frame), and a control unit. Two sets of the system are connected via B-ISDN. The pictures filed in one system are transferred to the other beforehand and can be controlled from remote point. An electronic television system (ShowMe) is also installed in the control unit. This patient underwent PTCA twice because of restenosis, thus her clinical history can be divided into 4 phases (before and after the first and second PTCA) . In this filing system, we stored pictures of electronic cardiogram, ultrasonic cardiogram (animated), myocardial scintigram, coronary angiogram (animated) and left ventriculogram (animated) in each phase. The total number of stored pictures amounted to 243 frames. It took 2 hours to transfer all the pictures (about 3Gb) beforehand.
Results: System resolution is enough to identify the fine collateral vessels in coronary angiogram and animation is also clear in left ventriculogram. Pictures can be quickly selected by using a user friendly interface program which also simultaneously controls the remote system. The system also shows the pointer not only in static but animated pictures as well. When the animated pictures are stopped, the same frame can be seen on both sides. Using this system, we held a teleconference between Osaka University and Kyoto University. The conference was carried out without any failure as if it had been held in the same room.
Conclusion: This success demonstrates that specification of super high definition system and B-ISDN based system has enough sufficiency to realize telemedicine in the cardiovascular field.