Yasuaki Antoku

Electromagnetic interference on medical equipment by low-power mobile telecommunication systems

There have been a number of reports of electromagnetic interference (EMI) on electronic medical equipment caused by mobile telecommunication systems. In Japan, the use of the personal handy-phone system (PHS) has greatly expanded within urban areas, PHS handsets transmit EM signals at a frequency of 1.9 GHz and have a peak radiated power of 80 mW. This power level is lower than that of other mobile telecommunication systems. Two studies were carried out. One was to determine whether or not PHS interferes with electronic medical equipment in hospitals. We observed no EMI on electronic medical equipment when the PHS handset was in either the speaking mode or on standby. The second study was to observe EMI from 1.9-GHz signals at several radiation power levels. Although EMI was not observed at the radiated peak power of the PHS handset, EMI on some of the tested equipment was observed when the radiated power was ten or more times higher than that of the PHS handset.

Emerging technologies for telemedicine.

This paper focuses on new technologies that are practically useful for telemedicine. Three representative systems are introduced: a Digital Video Transport System (DVTS), an H.323 compatible videoconferencing system, and Vidyo. Based on some of our experiences, we highlight the advantages and disadvantages of each technology, and point out technologies that are especially targeted at doctors and technicians, so that those interested in using similar technologies can make appropriate choices and achieve their own goals depending on their specific conditions.

A Practical Procedure to Prevent Electromagnetic Interference with Electronic Medical Equipment

Problems involving electromagnetic interference (EMI) with electronic medical equipment are well-documented. However, no systematic investigation of EMI has been done. We have systematically investigated the causes of EMI. The factors involved in EMI were determined as follows: 1) Electric-field intensity induced by invasive radio waves from outside a hospital. 2) Residual magnetic-flux density at welding points in a building. 3) Electric-field intensity induced by conveyance systems with a linear motor. 4) The shielding capacity of hospital walls. 5) The shielding capacity of commercial shields against a wide range frequency radio waves. 6) The immunity of electronic medical equipment. 7) EMI by cellular telephone and personal handy-phone system handsets.From the results of our investigation, we developed a following practical procedure to prevent EMI. 1) Measurement of electric-field intensity induced by invasive radio waves from outside the hospital and industrial systems in the hospital. 2) Measurement of residual magnetic-flux density at electric welding points of hospital buildings with steel frame structures. 3) Control of the electromagnetic environment by utilizing the shielding capacity of walls. 4) Measurement of the immunity of electronic medical equipment. And 5) Installation of electronic gate equipment at the building entrance to screen for handsets.

High-Quality Telemedicine Using Digital Video Transport System over Global Research and Education Network

Shuji Shimizu1, Koji Okamura2, Naoki Nakashima3, Yasuichi Kitamura4, Nobuhiro Torata5, Yasuaki Antoku6, Takanori Yamashita7, Toshitaka Yamanokuchi8, Shinya Kuwahara9 and Masao Tanaka10 1,2,3,5,6,7,8,9,10Telemedicine Development Center of Asia, Kyushu University Hospital, 1Department of Endoscopic Diagnostics and Therapeutics, Kyushu University Hospital 2Research Institute for Information Technology, Kyushu University 3,6,7,8Department of Medical Informatics, Kyushu University Hospital 4National Institute of Information and Communications Technology 9Kyushu Electric Power Company 10Department of Surgery and Oncology, Kyushu University Graduate School of Medical Sciences Japan

Advantages of Low Output Mobile Communication Systems in Hospitals

Mobile telephone systems using radio waves with very low power outputs rarely interfere with electronic medical equipment, which allows them to be safely installed in hospitals. The Personal Handy-phone System, PHS, which was developed and is widely used in Japan, is one such system. It has many useful functions including voice communication, string message transfer, e-mail, an answering system limited to selected persons or groups, paging, automatic call transfer, and handset positioning. In this paper we discuss the benefits of these functions confer to hospital communication systems.

Evaluation of two Japanese regulatory actions using medical information databases: a 'Dear Doctor' letter to restrict oseltamivir use in teenagers, and label change caution against co-administration of omeprazole with clopidogrel.

The implementation of appropriate epidemiological methodology using medical information databases (MIDs) to evaluate the effects of regulatory actions has been highly anticipated. To assess scientific methods for active pharmacovigilance using MIDs, we conducted a quantitative assessment of the impact of two regulatory actions by the Japanese government: (i) restriction of use of oseltamivir in teenagers in March 2007 and (ii) caution against the co‐administration of omeprazole (OPZ) with clopidogrel (CPG) in April 2010.

Remote Connection to the Kyushu University Medical Center LAN Using Digital and Analog Telephone Lines

SOHO (Small Office/Home Office) has recently become popular, as it makes working at home possible. Computers or Local Area Networks(LAN) connected to the office network from home are necessary for the implementation of this concept. Kyushu University has begun a service connecting home computers to the campus LAN for researchers, staff and students of the Faculty of Medicine. We have two different telephone connection methods. One connects the campus LAN and the home computer LAN using routers through the Integrated Services Digital Network (ISDN). The other connects computers at home to the workstation in the university, using modems and the PPP (Point to Point Protocol) through a public telephone analog line. This paper outlines our university SOHO connection system and discusses the merits and demerits of using telephone line connections.

Ten-year experience of remote medical education in Asia.

BACKGROUND Moving images are often essential in medical education, to learn new procedures and advanced skills, but, in the past, high-quality movie transmission was technically much more challenging than transmitting still pictures because of technological limitations and cost. MATERIALS AND METHODS We established a new system, taking advantage of two advanced technologies, the digital video transport system (DVTS) and the research and education network (REN), which enabled satisfactory telemedicine on a routine basis. RESULTS Between 2003 and 2013, we organized 360 programs connecting 221 hospitals or facilities in 34 countries in Asia and beyond. The two main areas were endoscopy and surgery, with 113 (31%) and 106 (29%) events, respectively. Teleconferences made up 76% of the total events, with the remaining 24% being live demonstrations. Multiple connections were more popular (63%) than one-to-one connections (37%). With continuous technological development, new high-definition H.323 and Vidyo(®) (Hackensack, NJ) systems were used in 47% and 39% of events in 2011 and 2012, respectively. The evaluation by questionnaires was favorable on image and sound quality as well as programs. CONCLUSIONS Remote medical education with moving images was well accepted in Asia with changing needs and developing technologies.

A Tool for Improving the Web Accessibility of Visually Handicapped Persons

Much has been written concerning the difficulties faced by visually handicapped persons when they access the internet. To solve some of the problems and to make web pages more accessible, we developed a tool we call the “Easy Bar,” which works as a toolbar on the web browser. The functions of the Easy Bar are to change the size of web texts and images, to adjust the color, and to clear cached data that is automatically saved by the web browser. These functions are executed with ease by clicking buttons and operating a pull-down list. Since the icons built into Easy Bar are quite large, it is not necessary for the user to deal with delicate operations. The functions of Easy Bar run on any web page without increasing the processing time. For the visually handicapped, Easy Bar would contribute greatly to improved web accessibility to medical information.

A simple computerized program for the calculation of the required sample size necessary to ensure statistical accuracy in medical experiments

We developed a sample size estimation program (SSEP) with which medical researchers can easily estimate the appropriate sample size for a specific significance level and statistical power using their favorite WWW browsers. SSEP can estimate the sample sizes for six statistical methods by Monte-Carlo simulation: Students t-test, Welchs t-test, Analysis of variance, Wilcoxons rank sum test, Kruskal-Wallis test, and the Cochran-Armitage test for linear trends. The SSEP simulation programs were created using the SAS software macro language. Medical researchers can interactively use this program and determine reliable sample sizes when planning new prospective clinical studies and animal experiments.