Simulated learning environments in anatomy and surgery delivered via the next generation internet.

The Next Generation Internet (NGI) will provide high bandwidth, guaranteed Quality of Service, collaboration and security, features that are not available in today's Internet. Applications that take advantage of these features will need to build them into their pedagogic requirements. We present the Anatomy Workbench and the Surgery Workbench, two applications that require most of these features of the NGI. We used pedagogic need and NGI features to define a set of applications that would be difficult to operate on the current Internet, and that would require the features of the NGI. These applications require rich graphics and visualization, and extensive haptic interaction with biomechanical models that represent bony and soft tissue. We are in the process of implementing these applications, and some examples are presented here. An additional feature that we required was that the applications be scalable such that they could run on either on a low-end desktop device with minimal manipulation tools or on a fully outfitted high-end graphic computer with a realistic set of surgical tools. The Anatomy and Surgery Workbenches will be used to test the features of the NGI, and to show the importance of these new features for innovative educational applications.

G2H--graphics-to-haptic virtual environment development tool for PC's.

For surgical training and preparations, the existing surgical virtual environments have shown great improvement. However, these improvements are more in the visual aspect. The incorporation of haptics into virtual reality base surgical simulations would enhance the sense of realism greatly. To aid in the development of the haptic surgical virtual environment we have created a graphics to haptic, G2H, virtual environment developer tool. G2H transforms graphical virtual environments (created or imported) to haptic virtual environments without programming. The G2H capability has been demonstrated using the complex 3D pelvic model of Lucy 2.0, the Stanford Visible Female. The pelvis was made haptic using G2H without any further programming effort.

Virtual body structures: a 3D structure development tool from visible human data.

Understanding the visiospatial aspects of anatomic structures is one of the most important aspects of studying gross anatomy. In this paper we are describing a tool that self-constructs 3D virtual body structures (VBS) 'right in-front-of your-eyes'. Furthermore, manipulation capabilities, such as translucent visualization, interactive rotation, translation, and scaling, incorporated into VBS facilitate fundamental learning experience that leads one to 'build 3D models in the mind', providing a validation of computer-assisted individual learning. Creating 3-D virtual body structures from actual human data has long been a dream of many computer scientists and Medical doctors. Now, with the advances in computer hardware and software technologies, our Virtual Body Structure technique, and the Visible Human project, that dream is becoming a reality.

Virtual reality and women's health: a breast biopsy system.

Minimally invasive procedures are becoming much more common in surgical practice because of the many advantages for patient comfort and convenience, and improved surgical access. However some of the major problems leading to occasional surgical errors with this minimal access method are restricted vision, limited sense of touch, difficulties in identification in 3D space of the position of the instrument tips, and their handling during delicate, short-distance movements toward the surgical target area. These factors emphasize the need for computer simulated training in surgical manipulations and procedures in preparation for conducting them in patients. The key new feature of our proof-of-concept training simulator is a preventive mechanism that serves at least two functions. As the surgical target (or a critical structure) is approached, a haptically generated preventive force forewarns the surgeon, making it possible to abort those maneuvers that may lead to adverse results. By announcing a potential collision of a virtual instrument tip with a surgical target, the time used for searching for the target is shortened, and the haptic signal minimizes the potential of tissue damage. This real-time, interactive, virtual reality based, haptic breast biopsy-training simulation is a PC/NT based multitasking, multithreading system. It is based upon an advanced force feedback device. The system monitors and indirectly guides the surgeon's movements, while providing high fidelity visual and force feedback cues as the area of surgical interest is approached. Our first application is with human breast.

[Clinical value of the study of cardiac rhythm entropy in patients with myocardial infarction]. / Klinicheskoe znachenie issledovaniia éntropii serdechnogo ritma u bol'nykh infarktom miokarda.

Heart rhythm entropy was shown to decrease with age both in normal subjects and myocardial infarction patients. Yet in the latter it is smaller at all ages as compared to the former. It is also smaller in patients with severe course and unfavourable prognosis of myocardial infarction as compared to patients with favourable prognosis and uncomplicated course of the disease. In the course of infarction, heart rhythm entropy increases in cases with favourable prognosis, and remains small in those with unfavourable prognosis and severe clinical course. Rationed-exercise tests revealed a relationship between the prognosis of outcome, the severity of myocardial infarction and the magnitude of exercise-induced changes in heart rhythm entropy.

[Experience with the clinical study of cordaron]. / Opyt klinicheskogo izucheniia kordarona.

Complex examination including continuous long-term observation by means of a computer showed that because of a wide spectrum of action cordaron is among the effective agents for the treatment of ischemic heart disease. The capacity of cordaron to reduce the zone of myocardial damage makes its use expedient in the acute period of myocardial infarction. Long-term treatment of patients suffering from chronic ischemic disease of the heart with cordaron raises the tolerance to physical exercise and improves myocardial nutrition. The coronarolytic effect of cordaron is evidently associated to a definite measure with the action of the agent on adenosine metabolism, which is manifested in an increase in its production and inhibition of its inactivation.