From the echocardiography machine to the lecture room: a simple method for transferring echocardiographic frames and loops to a personal computer

The use of computers in scientific and educational presentations is rapidly increasing. As a digital presentation is ideal for showing moving images, the use of multimedia files, e.g., echocardiographic loops within these presentations, is common. Even though recent echocardiography machines store acquired data in a digital format, these data are often not readily accessible to be transferred to a personal computer. We present an easy and cost-efficient method for transferring frames and loops from any echocardiography machine into a personal computer using a digital video camera equipped with a standard analog input and flash memory. Still images and movies are stored in the camera to be subsequently transferred to a personal computer. In the computer, still images and movies are post-processed with graphical and video editing software. Finally, the still images and movies can be projected from the video camera or presented with specialized software such as PowerPoint. The images can also be used for Web-based publications and production of educational material or books on electronic media such as CD-ROM. The described method can also be used to transfer images from other proprietary devices and programs, as long as the devices are equipped with an analog video outlet. IMPLICATIONS: The transfer of frames and loops from echocardiographic machines to personal computers is often useful for publication, teaching, and educational purposes. We present an easy and cost-effective method for transferring frames and loops from any echocardiography machine into a personal computer using a digital video camera.     

膝关节镜的计算机图像处理系统

目的 介绍膝关节镜手术资料计算机采集，编辑，管理，保存的方法和经验。方法 利用视 卡实现计算机对关节镜动静态图像的采集，应用计算机各种软件完成对各种图像的编辑，管理，应用可写光盘永久保存。结果 计算机采集图像分辨率高，编辑，管理方便，打印照片清晰资料可永久保存。结论多媒体计算机的应用为关节镜图像资料的处理提供了一种快捷，简便，可靠的方法。     

Utility of digital camera-derived intraoperative images in the planning of epilepsy surgery for children.

OBJECTIVE: This study was undertaken to assess the utility of digital camera-derived intraoperative images in the planning of neurosurgery for children with epilepsy. METHODS: A hand-held digital camera was used to capture the exposed surgical field at the time of craniotomy for 11 children with medically intractable seizure disorders. Intraoperative somatosensory evoked potential recordings of phase reversals and direct cortical stimulation were used to map areas of eloquent brain tissue. Digital camera images were obtained to mark regions of functional brain tissue with respect to cortical surface landmarks and subdural grid placement. The digital camera images were then immediately downloaded, in the operating room, to a laptop computer, which was placed next to the electroencephalographic recording device. Using computer software, the epileptologist highlighted the primary and secondary zones of epileptogenesis, as well as the functional brain areas identified during the monitoring period, on the digital camera images on the computer screen. A neurosurgical map was thus created to aid the neurosurgeon and the epileptologist with the proposed cortical resections and multiple subpial transections. RESULTS: With the images obtained using the digital camera, the epilepsy team was able to observe the contacts of the grid electrodes with the brain during the procedure. Color printouts of the images served as references during the period of invasive monitoring. Zones of primary and secondary epileptogenesis, as well as areas of functional brain tissue, were identified and plotted on the digital camera images. Other benefits of the digital camera-derived images included the ability to accurately reposition the grids or letters marking eloquent brain tissue if they were inadvertently shifted during the procedure, the ease with which the images could be obtained and manipulated, the ability to assess postresection epileptiform activity of the surrounding brain tissue with images obtained while an electrocorticographic array was in place, the ability to provide the entire epilepsy team with updated information on the neurosurgical field while minimizing movement in the operating room, and facilitation, with neurosurgical maps, of discussions with the patients and their families concerning proposed cortical resections. CONCLUSION: Digital camera images have become essential components for the planning of cortical resections for children with intractable epilepsy at our institution. We envision widespread application of this technology to other neurosurgical fields.     

Digital recording in neurosurgery

The purpose of this study is to examine the image quality of multi-media for digital recording of surgical procedure using an operating microscope in neurosurgery. For video recording, high vision recording, digital video recording and analogue VHS recording were used. For still pictures, an analogue camera with 35 mm silver halide film and a micro-digital camera were used. The quality of photographs taken with a microdigital camera was superior to the quality of those taken with the conventional 35 mm film camera. The micro-digital camera system is superior to the conventional 35 mm camera in neurosurgery in its quality and success rate. In video recording, high vision analogue recording was superior to any other media as far as its image quality is concerned although its practical convenience is limited and cost performance is not always good. On the other hand, digital video can record high quality images, including still pictures, with satisfactory quality to the neurosurgeon. These digital recording media are also space saving for storing the huge amount of data obtained during surgery and the cost-performance is superior to that of the conventional method. In the near future, most of surgical procedures are supposed to be expected using digital media.     

Digital recording in microsurgery. Technical note

The authors examine the quality of intraoperative photography in which digital recording technology, including a microdigital camera and digital video paired with an operating microscope, is used during neurosurgery. A microdigital camera developed for this purpose (1.4 million pixels) was attached to an operating microscope and used during surgery. The same surgical views with precisely the same optical conditions were taken through the microscope by using both a conventional 35-mm camera and the microdigital camera, and the quality of the final output was compared. In addition, the quality of the digital camera photographs was compared with the still photograph clipped from the digital video recording. The quality of the photographs taken with a microdigital camera was superior to the quality of those obtained with the conventional 35-mm camera. The success rate of recording (what you see is what you get) was almost 100%. The quality of the still photographs clipped from the digital video was nearly equal to those taken with the digital camera. The microdigital camera system is superior to the conventional 35-mm camera in neurosurgery in terms of its success rate and the quality of the photography. It is also a space-saving system for storing the huge amount of data generated in the recording of surgical procedures, and the cost/performance ratio is superior to that of the conventional method. Digital technology including digital cameras and videos is very useful for clear recording of microsurgical procedures.     

Intraoperative ?Augmented-reality-Visualisierung“

The intraoperative application of augmented reality (AR) has so far mainly taken place in the field of endoscopy. Here, the camera image of the endoscope was augmented by computer graphics derived mostly from preoperative imaging. Due to the complex setup and operation of the devices, they have not yet become part of routine clinical practice. The Camera Augmented Mobile C-arm (CamC) that extends a classic C-arm by a video camera and mirror construction is characterized by its uncomplicated handling. It combines its video live stream geometrically correct with the acquired X-ray. The clinical application of the device in 43 cases showed the strengths of the device in positioning for X-ray acquisition, incision placement, K-wire placement, and instrument guidance. With its new function and the easy integration into the OR workflow of any procedure that requires X-ray imaging, the CamC has the potential to become the first widely used AR technology for orthopedic and trauma surgery.     

Computer-based desktop system for surgical videotape editing

Background: The educational role of surgical video presentations should be optimized by linking surgical images to graphic evaluation of indications, techniques, and results. We describe a PC-based video production system for personal editing of surgical tapes, according to the objectives of each presentation. Methods: The hardware requirement is a personal computer (100 MHz processor, 1-Gb hard disk, 16 Mb RAM) with a PC-to-TV/video transfer card plugged into a slot. Computer-generated numerical data, texts, and graphics are transformed into analog signals displayed on TV/video. A Genlock interface (a special interface card) synchronizes digital and analog signals, to overlay surgical images to electronic illustrations. The presentation is stored as digital information or recorded on a tape. Results: The proliferation of multimedia tools is leading us to adapt presentations to the objectives of lectures and to integrate conceptual analyses with dynamic image-based information. We describe a system that handles both digital and analog signals, production being recorded on a tape. Movies may be managed in a digital environment, with either an ``on-line' or ``off-line' approach. System requirements are high, but handling a single device optimizes editing without incurring such complexity that management becomes impractical to surgeons. Conclusions: Our experience suggests that computerized editing allows linking surgical scientific and didactic messages on a single communication medium, either a videotape or a CD-ROM. Received: 20 August 1996/Accepted: 30 September 1996     

Digital photography in orthopaedic surgery

Digital photography has become a practical alternative to film photography for documentation, communication, and education about orthopaedic problems and treatment. Digital cameras may be used to document preoperative and postoperative condition, intraoperative findings, and imaging studies. Digital photographs are captured on the charged coupler device (CCD) of the camera, and processed as digital data. Images may be immediately viewed on the liquid crystal display (LCD) screen of the camera and reshot if necessary. Photographic image files may be stored in the camera in a floppy diskette, CompactFlash card, or SmartMedia card, and transferred to a computer. The images may be manipulated using photo-editing software programs, stored on media such as Zip disks or CD-R discs, printed, and incorporated into digital presentations. The digital photographs may be transmitted to others using electronic mail (e-mail) and Internet web sites. Transparency film slides may be converted to digital format and used in digital presentations. Despite the initial expense to obtain the required hardware, major cost savings in film and processing charges may be realized over time compared with film photography.     

Thirty-five millimeter versus digital photography: comparison of photographic quality and clinical evaluation

The objective of this article is to assess the quality of digital images versus standard 35-mm photodocumentation and to undertake a comparative assessment of 35-mm and digital photography in a clinical setting in facial plastic surgery. For evaluation of image quality, 10 subjects had images captured via a conventional 35-mm single lens reflex (SLR) camera and a digital camera under identical lighting conditions. The digital images were transferred to computer hard drive and processed for production of slides. Direct side-by-side comparison of projected images was performed by the authors. The standard photographic slides were of slightly finer detail and crispness than the computer-generated images. In a clinical setting, the quality of both the 35-mm and digital photographs enables complete preoperative evaluation and assessment of postsurgical outcome.     

Advances in computer imaging/applications in facial plastic surgery

Rapidly progressing computer technology, ever-increasing expectations of patients, and a confusing medicolegal environment requires a clarification of the role of computer imaging/applications. Advances in computer technology and its applications are reviewed. A brief historical discussion is included for perspective. Improvements in both hardware and software with the advent of digital imaging have allowed great increases in speed and accuracy in patient imaging. This facilitates doctor-patient communication and possibly realistic patient expectations. Patients seeking cosmetic surgery now often expect preoperative imaging. Although society in general has become more litigious, a literature search up to 1998 reveals no lawsuits directly involving computer imaging. It appears that conservative utilization of computer imaging by the facial plastic surgeon may actually reduce liability and promote communication. Recent advances have significantly enhanced the value of computer imaging in the practice of facial plastic surgery. These technological advances in computer imaging appear to contribute a useful technique for the practice of facial plastic surgery. Inclusion of computer imaging should be given serious consideration as an adjunct to clinical practice.     

Computing support for information-rich laparoscopy

Developments in the architecture and organization of high-performance general-purpose computer systems are largely ignored by the technology infrastructure of the modern laparoscopic surgical suite. The current state of technology for laparoscopy is a camera and monitor linked via a controller that distributes analog or digital video signals without regard to their content. This article discusses the opportunities that will be created by inserting general-purpose high-performance computing into the information stream between camera and display. We envision that the use of this technology will radically transform laparoscopy from its current state as ;;surgery by pictures' into an entirely new, information-rich surgical environment.     

The Universal Serial Bus Endoscope: Design and Initial Clinical Experience

Endoscopic forehead lift is a well-established procedure in aesthetic plastic surgery. Many agree that currently available video-endoscopic equipment is bulky, multipieced and sometimes cumbersome in the operating theater. A novel system, the Universal Serial Bus Endoscope (USBE) was designed to simplify and reduce the number of necessary equipment pieces in the endoscopic setup. The USBE is attached by a single cable to a Universal Serial Bus (USB) port of a laptop computer. A built-in miniaturized cold light source provides illumination. A built-in digital camera chip enables procedure recording. The real-time images and movies obtained with USBE are displayed on the computers screen and recorded on the laptops hard disk drive. In this study, 25 patients underwent endoscopic browlift using the USBE system to test its clinical usefulness, all with good results and without complications or need for revision. The USBE was found to be reliable and easier to use than current video-endoscope equipment. The operative time needed to complete the procedure by the authors was reduced approximately 50%. The design and main technical characteristics of the USBE are presented.Presented in part at the Annual International Aesthetic Plastic Surgery Symposium, Guadalajara, Jalisco, Mexico, November 2001.     

The PAR IS 2000: a new system for retinal digital image analysis

We describe the PAR IS 2000, a new system of digital image analysis of the optic disc. The system uses a simultaneous stereoscopic camera and a video camera to acquire images directly from the optic disc and from optic disc photographs, respectively. The image data are stored on an optical laser disk capable of handling large amounts of data (4000 monochrome images/disk). These images can be analyzed using a modified digital interactive mapping program to generate stereometric parameters, contour maps, section profiles, pallor maps, depth maps, and three-dimensional topographic plots of the retina. A skeletonizing program permits determination and measurement of shifts in the position of retinal vessels. The system's wide range of capabilities may be helpful in improving patient care and ophthalmic research.     

正颌外科电脑模拟手术系统的研究

我们利用电脑数字图像处理技术，建立了一个服务于正颌外科的电脑辅助设计系统──正颌外科电脑模拟手术系统，对患者的头颅Ｘ线定位片进行测量，为正位片提供７１项点线距离、角度值和比例值，为侧位片提供６８项测量值，并作出诊断；对患者的侧面彩色像进行模拟手术，预测疗效，并将手术移动的数据，量化地提出手术方案，提供临床使用。结果可通过激光打印机和视频打印机进行打印，所有操作可在２０ｍｉｎ内完成。     

Image catalogs

The advent of digital photography and radiography allows documentation of interesting clinical findings with unprecedented ease, and many orthopaedic surgeons have taken extensive advantage of this opportunity to create large digital libraries of clinical results. However, this leaves surgeons with a rapidly increasing volume of data to store and organize; therefore, a system for archiving, locating, and managing images, radiographs, and digital slide presentations has become a crucial need in most orthopaedic groups and practices. However, many surgical groups and practices are not familiar with the computer technology available to initiate such systems. In this review, we discuss several software solutions currently on the market to address the specific needs of orthopaedic surgeons, and as a practical example, discuss a system that is in place in the Department of Orthopaedic Surgery at our institution. Overall, depending on the individual circumstances of each institution, there are various options that meet different technologic and financial requirements.     

Elektronische Bilddatenspeicherung und-verarbeitung mittels PC in der Unfallchirurgie—ein Anachronismus?

Acquisition, storage and processing of any images relevant in trauma surgery together or in combination with (alpha) numeric data nowadays are possible employing a personal computer. The computing speed that is achieved with 486 cpu's “inside” is sufficient to process images in motion as well as single images to be filtered. The display and process-resolutions required for processing of X-ray-images can be achieved with the PC's hardware as well as with the software available. That is why there is no need any longer for special configurations for X-ray-departments. Calculating the price of the process-environment proposed, about 25.000 DM should be enough including the video tape recorders and the CD-ROM-recorder that are required.     

正颌外科电脑模拟手术系统的研究

我们利用电脑数字图像处理技术,建立了一个服务于正颌外科的电脑辅助设计系统——正颌外科电脑模拟手术系统,对患者的头颅 X 线定位片进行测量,为正位片提供71项点线距离、角度值和比例值,为侧位片提供68项测量值,并作出诊断;对患者的侧面彩色像进行模拟手术,预测疗效,并将手术移动的数据,量化地提出手术方案,提供临床使用。结果可通过激光打印机和视频打印机进行打印,所有操作可在20 min 内完成。     

Editorial Commentary: We Need to Customize Surgical Treatment When Treating Patients With Recurrent Anterior Shoulder Instability

Surgical repair of shoulder instability is challenging, and multiple procedures have been proposed. In an attempt to reduce risk of recurrence following surgical reconstruction, some surgeons have added steps to prior arthroscopic procedures, and other surgeons have selected a bone reinforcement procedure. These additional augmented repair techniques have reduced the risk of postoperative recurrence, but introduced additional risk of complications related to hardware, fixation, and possible need for additional surgery. Surgeons should become familiar with multiple surgical procedures to treat patients with recurrent shoulder instability, and select the appropriate procedure that addresses the demands of the athlete's shoulder and minimize the risk of complication.