Activity Report of Asia-Pacific Medical Network Project in Kyushu University Hospital Vol.2

Transcription

1 Activity Report of Asia-Pacific Medical Network Project in Kyushu University Hospital Vol.2 April 2006 Edited by Shuji Shimizu MD and Naoki Nakashima MD Supported by Core University Program of JSPS and KOSEF Kyushu University (Interdisciplinary Programs in Education and Projects in Research Development) Kyushu University Hospital, Division of Asian Medical Cooperation Asia-Pacific Advanced Medical Network Hyeonhae/Genkai Project Kyushu GigaPOP Kyushu Electric Power Company Kyuden Infocom Company Johnson Johnson K.K.

2 Index 1. Preface (Shimizu) 1 2. Achievements of this fiscal year (Shimizu) 2 3. Network news (Okamura) 7 4. New instruments and technical tips (Ishii) Event list (Torata) Event report Programs (Shimizu/Nakashima) 19 Configuration maps (Ishii) 43 Snaps (Shimizu/Nakashima) 51 Questionnaires (Imamura) Meeting and lecture list (Shimizu) Paper list (Shimizu) Press list (Shimizu) Collaborating institutes (Nakashima) Closing (Nakashima) 95 References 1. Published papers Press release, reported newspapers and magazines Asia-Pacific Advanced Network Medical Working Group homepage Others 162

3 1. Preface 1. Preface We are pleased to release the 2 nd volume activity report of the Asia-Pacific Medical Network Project in Kyushu University amidst a period of significant technological and collaborative advances. The number of international teleconferences is increasing at a good pace, by approximately twice per month, having reached 58 times by the end of March Through close collaboration with APAN (Asia-Pacific Advanced Network), we have established new lines to Shanghai Jiaotong First People s Hospital, Taiwan National University Hospital, Taichung General Veterans Hospital, National University of Singapore, Mahidol University Siriraj Hospital in Bangkok, and Flinder s University Hospital in Adelaide, Australia. In technical aspect, we are proud to announce that we successfully established an internationally compatible security system, using IPsec among multiple stations, to protect patient privacy by abolishing the problems of import limitation in some countries. More excitingly, we succeeded in simultaneously connecting as many as 10 stations by DVTS (digital video transfer system) to meet the increasing demands of connecting more than 4 stations with conventional system. Please refer to our newly released homepage for detailed information regarding these activities Although we have made commendable advances in the past year, we must continue to work together to address further concerns. One primary issue is to establish an appropriate team or official group in each medical institution to work on our activities. Although the situation may differ, it is essential that the system should be well organized where medical staff and engineers can efficiently cooperate. At the same time, with APAN as a core organization, it is important to organize a task force to build up an association with Asia-Pacific Medical Network and to assign a definite role and responsibility for each country. Technically, NTSC and PAL, which are both utilized within the Asia-Pacific region need to communicate freely with their quality preserved, while transmission of high-definition images should be continuously improved to obtain even better quality. Appropriate care on sound or monitors and simplicity of the total system are always primary usage considerations. Based on the success of the Kyushu area, we hope to accelerate our activity in Asia and further extend our medical network to the whole world, in harmony with domestic expansion. It is our great pleasure to share our experience with you. March 2006 Kyushu University Hospital Shuji Shimizu, MD. PhD -1-

4 2. Achievements of this fiscal year 2. Achievements of this fiscal year Here is a list of major achievements in this fiscal year. Medical Working Group was formally approved at APAN-Taipei in August

5 2. Achievements of this fiscal year The first members of APAN Medical Working Group. This summarizes the goals of APAN Medical Working Group. -3-

6 2. Achievements of this fiscal year This illustration shows the future style of medical telecommunication network. Undergoing medical network in Asia-Pacific regions. -4-

7 2. Achievements of this fiscal year Increasing numbers of our activities. The snap of 10-station connection for laparoscopic surgical teleconference. -5-

8 2. Achievements of this fiscal year The team flag for AQUA was designed by Torata in August The homepage for AQUA became open in June

9 3. Network news 3. Network news This chapter discusses the network route from QGPOP to each organization via Research and Development (R & D) High-Speed Internet. Fig-1 shows the network topology, with QGPOP as the center as of December At this time, we had already connected with Korea, China, Taiwan, Singapore, Thailand and Australia by R& D High-Speed Internet and performed several experiments. Abilene Abilene (US) (US) AARNET (AU) (AU) AU CH CERNET (CH) (CH) TW ASnet ASnet (TW) (TW) KOREN (KR) (KR) KR APAN-JP SINET SINET (JP) (JP) JP JGN2 JGN2 SingAREN (SG) (SG) SG QGPOP as2523 ThaiSARN (TH) (TH) TH Fig-1: Network Topology around December Japan: Major Japanese Universities can be connected for DVTS using SINET. If the university, institute or organization is not connected by SINET, JGN2 can be used. But generally, the access line from JGN2 to the organization is necessary, plus expenses to establish the link. -7-

10 3. Network news Korea: If the Universities or Institutes are member of KOREN, they can be connected using APII which connects to Japan at 1Gbps directly. Many universities such as SNU and HYU or institutes, such as NCC, have been already connected using DVTS. China: Tsinghua University and Jiaotong University have been already connected If the universities or institutes are members of CERNET, then, they can be connected at sufficient speed. There are many routing paths to CERNET from QGPOP. QGPOP selects the route, which is transited by KOREN. CERNET is the R & D network center, located in Beijing. The network quality with Beijing is good, but since CERNET is usually congested, other areas outside of Beijing, cannot guarantee comparable quality. For example, DVTS communication with Jiotong University at Shanghai typically encountered difficulties. Taiwan: The direct 1Gbps R & D link supported by Taiwan can be used for communicating with Taiwanese universities or institutes. The Taiwan link is managed by ASNET and connected to APAN JP and SINET. QGPOP can connect to universities or institutes in Taiwan via SINET or APAN. This 1Gbps has enough capacity to communicate between Japan and Taiwan, but the network quality then depends on Taiwan s domestic network or the campus network capabilities. Singapore: There was no direct R & D network between Japan and Singapore. However, Taiwan is directly linked to Singapore, so Taiwan (ASNET) kindly transmits the packets between Singapore and Japan. In Singapore, SingAREN played a roll as an R & D Internet management, allowing universities and institutes in Singapore to connect to SingAREN for R & D communications. The universities and institutes in Singapore must cover the expense for the link to SingAREN, which has resulted in compromised link speeds. For example, even NUS, the biggest University in Singapore, can use several Mbps as R & D Network. -8-

11 3. Network news Thailand: There was a direct link from Japan to Thailand. Its capacity was 45Mbps and supported by SINET. But this link was not stable. It was not used, except by NECTEC; however, if the link was used by other institutes, heavy routing coordination was necessary and several problems occurred. For example, on June 2005, the link was used for communication between Kyushu University Hospital and Mahidol Siriraj Hospital, but it seems that was the first usage for Mahidol University. The network equipment connecting NECTEC and Mahidol University had been broken. The link can not be used for R & D applications at the time. Australia: There is no direct R & D network between Japan and Australia but very high speed R & D networks can be used via United States. Using this link, very stable network quality was available but there is long delays. DVTS uses UDP, which is not affected by delays but interactive applications can be frequently interrupted. Fig-2 shows the QGPOP network topology after January Abilene Abilene (US) (US) AARNET (AU) (AU) AU CH CERNET (CH) (CH) TW ASnet ASnet (TW) (TW) HARNET (HK) (HK) HK KOREN (KR) (KR) KR APAN-JP QGPOP as2523 SINET SINET (JP) (JP) Fig-2: Network Topology after January JP JGN2 JGN2 ASIA-BB SingAREN (SG) (SG) SG ThaiSARN (TH) (TH) TH -9-

12 3. Network news The new international R &D link from Japan to Singapore and Thailand has been started under JGN2 support. QGPOP has started to use the R & D link for the communication to Singapore and Thailand and has started to consider how to connect to Hong Kong using the R & D network. Singapore/Thailand Since the JGN2 Asian R&D Link has been started, the high speed link between QGPOP and SingAREN became available. The Taiwan link is no longer necessary for communication to Singapore. The JGN2 Asian R&D link for Thailand has also been available, but the speed is currently insufficient--just 45Mbps. If the link is used for DVTS, then, advanced application to the JGN2 center is necessary. If this application is accepted, then, the requested bandwidth is guaranteed. The Asia Broadband Project provides another internet route, from Thailand to Kyushu University, using JGN2. Talks are currently underway, between QGPOP and ASIABB, concerning routing policies to Thailand. Hong Kong: There is no direct link between Japan and Hong Kong but there are many candidate routing paths for high-speed communications. Because it includes several institutes or countries, coordination is necessary. One possibility is transit via Taiwan. -10-

13 3. Network news Fig-3 shows the network topology after TEIN2 becomes available. CH CERNET (CH) (CH) KOREN (KR) (KR) Abilene Abilene (US) (US) KR APAN-JP QGPOP as2523 ASnet ASnet (TW) (TW) TW SINET SINET (JP) (JP) JP JGN2 JGN2 PH TEIN2 TEIN2 AARNET (AU) (AU) MY ID ASIA-BB AU HARNET (HK) (HK) HK SingAREN (SG) (SG) SG ThaiSARN (TH) (TH) TH Fig-3: Network Topology with TEIN2 After TEIN2 is available, QGPOP can use TEIN2-based, high speed communication with Indonesia, Philippines and Malaysia will be possible, and the long delay to Australia will be decreased. More high speed communication to Singapore and Thailand is expected. TEIN2 covers major Easter and Southern Countries, but TEIN2 operates independently from each country s R&D institutes such as SingAREN or ThaiSARN. Namely, via TEIN2, packets from Japan will be delivered to TEIN2's Singapore NOC at high speed but not to SingAREN. As the R&D Internet continues to evolve, we must optimize our current resources, constantly monitoring our applications results and efficiency. Given the rapid rate at which R&D communication technology matures, communication with Russia and India will be available in the near future, surpassing our expectations. -11-

14 4. New instruments and technical tips 4. New instruments and technical tips Here, we add some technical tips for teleconference using DVTS environment. (1) Simplest configuration (for desktop online meeting etc.) Although it is recommended to make configuration described in (1) or (2) to have a comfortable teleconference, it may be difficult to prepare all devices actually. But even in that case, a teleconference can be performed under very simple configuration as follows. The necessary items are shown as Table 4-1. Table 4-1 Items required Item Digital Video Cam-coder Personal Computer Ethernet Cable IEEE1394 Cable DVTS software Network, connected to the Internet Microphone Technical tips relating to each of the above are shown in Table 4-2. Table 4-2 Technical tips Item Descriptions Digital Video Camcoder - In this simplest configuration, a DV camcoder built-in microphone and PC speaker get so close. This situation causes acoustic feedback (howling). It is recommendable to use an external microphone. Personal Computer - Global IP address must be assigned for the PC. - Because the PC has to handle bidirectional DVTS traffics by one machine, it should have not only high CPU power but also high graphics performance. That s why it is not recommendable to use low performance PCs. -12-

15 4. New instruments and technical tips Item Descriptions Network - DVTS software consumes about 35Mbits/sec bandwidth. - Traffic in excess of 35Mbits/sec must be transmitted throughout from a sending site to a receiving site. Any bottleneck on the way to the remote site prevents effective functioning of the DVTS software. - Transmission of such heavy traffic to the Internet requires network system configuration adjustment and international negotiation by network administrators. Microphone - It should have uni-directionality and low sensitivity to avoid acoustic feedback. Connection of devices is shown as Figure 4-1 DVCamcoder IEEE1394 Network Audio UTP(Ethernet) Microphone PC with DVTS Layer2 Switch Figure 4-1 Simplest system configuration -13-

16 4. New instruments and technical tips (2) Another approach (for big conference etc.) In some conferences such as big academic conference, the voice quality should be kept very good and clear. As far as the configurations described in previous sections, the voice is transmitted as a DVTS audio channel. But actually, the quality of voice is sometimes not so good because of IP packet loss. When IP packets are lost so frequently, uncomfortable sound occurs and the attendees can t concentrate on the conference. To avoid this situation, there is another configuration option. The option is using some IP telephony software (for example, Skype). Recent IP telephony software is very useful and can transmit the voice very clearly. Therefore combination of DVTS software and telephony software in teleconference makes the conference very comfortable. The necessary items are shown as Table 4-3 in addition to the items described in section (1) or (2) or (3). Table 4-3 Items required Item Figure Specifications Personal Computer - Desktop or notebook type, running Microsoft Windows XP - High-speed CPU (over 400MHz of clock speed) - Over 128MB RAM - Over 15MB HDD space - Fast Ethernet interface - Stereo audio input / output interface IP telephony software (ex. Skype TM ) - It is downloadable from Connection of devices is shown as Figure

17 4. New instruments and technical tips PC DV Camcoders (for presentation) (scenery) (video content) Network S-Video DVTS PC (for sending) S-Video D-sub 15pin IEEE1394 UTP(Ethernet) Hub/Switch Video Mixer S-Video Scan Converter Audio Mixer UTP(Ethernet) Projector (for local site) Audio Skype PC (for audio) UTP(Ethernet) Audio Microphones Audio S-Video IEEE 1394 Speaker Projector (for receiving) D/A Converter DVTS PC (for receiving) Figure 4-2 Configuration using IP telephony software -15-

18 5.Event List 5. Event List Date Events Contents Materials Venue Kyushu endoscopic Korean Medical SNU(Bundang) surgery live Association Meeting EWU(Mokdong) (pancreas) Venue(GHSH) Medical Teleconference endoscopy slide Kyushu Hanyang endoscopic Shanghai Symposium of video Kyushu surgery Laparoscopic Surgery slide Shanghai JFPH (stomach) Medical teleconference endoscopy slide Kyushu Hanyang Kyushu The 3rd Hematopathology hematology microscopy Siriraj Conference (Bangkok) The 2nd Pancreatobiliary Kyushu hepatobiliary Clinico-pathological slide Bundang pancreas Teleconference Iwate MC The 2nd General Surgery endoscopic Clinical Teleconference video Kyushu surgery between Shanghai & slide Shanghai JFPH (stomach) Fukuoka Taipei Venue APAN-Taipei Demonstration endoscopy Kyushu video NCC Korea slide Tsinghua U NCC Japan endoscopic Kyushu Medical Teleconference in surgery video Tsinghua Core University Seminar (thyroid)/ slide Chungnam transplantation Korean Endoscopic Surgical endoscopic Ewha live Meeting surgery (thyroid) Kyushu Asian Month Public Program healthcare slide Kyushu Hanyang -16-

19 5.Event List Date Events Contents Materials Venue The 5th Fukuoka endoscopic Fukuoka Endoscopic Surgery slide surgery Iwate MC Forum Flinders Bariatric Live endoscopic (Adelaide) live Surgery Teleconference surgery (bariatric) Singapore Kyushu endoscopic Taichung VGH Laparoscopic Colon video surgery Bundang Surgery Teleconference slide (colon) Kyushu th Joint Conference medical video Bundang on Medical Informatics informatics slide Yokohama The 3rd Pancreatobiliary hepatobiliary Kyushu Clinico-pathological slide pancreas Bundang Teleconference Live Surgery for Hanyang urology live Urinary Incontinence Kyushu ELSA Program Meeting endoscopic Kyushu conference for Telesurgical Symposium surgery Bundang Tokyo st APAN Tokyo Kyushu ESD live live Live Demonstration of ESD NCC Korea NTU st APAN Tokyo Tokyo Uncompressed SD Image laparoscopic SD Video Kyushu Transmission gastrectomy KT Demonstration Tokyo Kyushu NCC Korea NTU 21st APAN Tokyo laparoscopic Iwate MC Video Teleconference slide colectomy Bundang among 10 Stations Tsinghua TaichungVGH NUS Flinders -17-

20 5.Event List Date Events Contents Matearials Venue The 3 rd Urological laparoscopic Hanyang live Live Surgery surgery Kyushu endoscopic Fukuka Urological teleconference conference suregery Hanyang *Event numbers are consecutive from our previous report. Abbreviations APAN : Asia-Pacific Advanced Network ELSA : Endoscopic & Laparoscopic Surgeons of Asia SNU : Seoul National University ESD : Endoscopic submucosal dissection SD : Standard definition Figure 5-1 Number of events, institutes and countries -18-

21 6. Event Report 1) Programs 6. Event Report 1) Programs #36 Korean Medical Association Meeting Telesurgical & Teleconference (Seoul National University, Ewha Woman s University & Kyushu University) Date: May 14, 2005 (Saturday), Time: 10:00-12:00 Place: Grand Hilton Seoul Hotel Seoul National University Bundang Hospital, Korea Ewha Woman s University Mokdong Hospital, Korea Kyushu University Hospital, Japan Opening Address: Dr. Yoon-Ung Ko (President of Organizing Committee of the 31 st KMA) Congratulation Address : Young-Sung Lee ( Chairman of Board of Medical Informatic) Moderators: Dr. Ho-Seong Han (Seoul), Dr Hyeon Kook Lee (Ewha), Dr Shuji Shimizu (Japan) 10:00 - Opening Remarks Dr. Ho-Seong Han) Introduction of the presenter from each station. ( 1. Seoul National University Bundang, 2. Ewha Womans University Mokdong 3. Kyushu University) 10:05 12:05 - Live Surgery from Seoul National University Hospital (LADG) Operator: Dr Hyeong-Ho Kim (Department of Surgery, Seoul National Univerisity Bundang Hospital) 10:30 - Presentation - 15 min) Laparoscopic distal pancreatectomy with preservation of spleen and splenic vessels Speaker: Dr. Seog Ki Min Department of Surgery, Ewha Woman s University Mokdong Hospital -19-

22 6. Event Report 1) Programs 11:00 - Presentation min) Laparoscopic pancreatic surgery in Kyushu University Speaker: Dr. Shuji Shimizu (Department of Endoscopic Diagnostic and Therapeutics, Kyushu University Hospital ) 11:30 - Presentation min) Current status of Laparoscopic distal gastrectomy in Japan Speaker: Dr. Eishi Nagai Department of Surgery and Oncology, Kyushu University Hospital 12:00 - Closing Remark (Dr. Shuji Shimizu) -20-

23 6. Event Report 1) Programs #38 Shanghai Symposium of Laparoscopic Surgery The 2nd Symposium on Advance in Laparoscopic Treatment of Alimentary System Magliancies ( June 15~ , Shanghai P.R. China) Time Table(ver 1) In brief Date Time Contents Staff Jun 8:00~17:00 registration 15 Jun 16 8:00~8:30 opening remark prof. Liu Bingqian (president of hospital) 8:30~11:00 demonstration (laparoscopic colectomy) operator guest Prof. Zhen Minghua 11:00~12:00 current status of laparoscopic treatment of colorectal cancer guest Prof. Zhen Minghua 12:00~13:30 lunch and break 13:30~14:30 Advance in laparoscopic diagnosis prof. Qiu Zhengjun and treatment of liver cancer 14:30~15:30 laparoscopic gastrectomy for guest Prof. Qiu Ming benign gastric disease 15:30~16:30 Advance in laparoscopic vice prof. Huang Kejian instruments 15:30 dinner and rest Kyushu Univ. Hospital Jun 7:30~12:00 Telesurgery 17 12:00~13:30 lunch and break 13:30~14:30 radical laparoscopic colorectomy: guest Prof. Wu Shanyuan anatomy and technique 14:30~15:30 advance in treatment of gastric prof. Zhen Ping tumour with combined laparoscopic and endoscopic methods 15:30~16:30 advance in laparoscopic treatment Vise prof. Cao Jun of periampulla carcinoma 15:30 dinner and rest -21-

24 6. Event Report 1) Programs Jun 18 Jun 19 8:00 Current status of laparoscopic anterior resection in Australia 9:00~13:00 demonstration ( laparoscopic gastrectomy or/and laparoscopic colectomy) 13:00~13:30 lunch and break 13:30~14:30 current statue of radical laparoscopic gastrectomy 14:30~15:30 laparoscopyic surgery and systemic immunological response Check out guest prof. Nicholas Rieger operator prof. Qiu Zhengjun prof. Qiu Zhengjun vice prof, Zhang Fang -22-

25 6. Event Report 1) Programs #40 The 3rd Hematopathology Conference Third Asia Hematopathology Conference June 23, 2005 Between Kyushu University, Fukuoka Japan----Siriraj Hospital, Bangkok, Thailand 16:00(14:00) Opening Remark Koichiro Muta, M.D.(Kyushu University) Self Introduction from Each Station 16:15(14:45)----17:45(15:45) Case Presentation (each approx 15min including discussion) Case#1 (From Siriraj Hospital) Case#1 (From Kyushu University Hospital) Case#2 (From Siriraj Hospital) Case#2 (From Kyushu University Hospital) Case#3 (From Siriraj Hospital) Case#3 (From Kyushu University Hospital) 17:45(15:45)----18:15(16:15) Slide Presentation(SRL west Japan) -23-

26 6. Event Report 1) Programs #41 The 2nd Pancreatobiliary Clinico-pathological Teleconference The 2 nd Pancreatobiliary Clinico-pathological Teleconference between Seoul & Fukuoka Date: July 14, 2005 (Thr), Time: 18:00-19:30 Place: Seoul National University Bundang Hospital, Korea Kyushu University Hospital, Japan Guest: Iwate Medical University Hospital, Japan Moderators: Dr Ho-Seong Han (Seoul), Dr Shuji Shimizu (Fukuoka), Dr Akira Sasaki (Iwate) 18:00 - Opening Remarks Prof Masao Tanaka, Kyushu University Hospital) 18:05 - Brief introduction of staff and institution (each station) 18:15 - Case presentation from Kyushu University, chaired by Dr Koji Yamaguchi Case presentation by Dept of Surgery I Radiological images (CT, MRI, etc.) by Dept of Radiology ERCP by Surgery I EUS by Dept of 3 rd Internal Medicine Short discussion Surgical findings by Dept of Surgical I Pathological presentation by Dept of Pathology II Discussion 18:50 - Case presentation from Bundang Hospital, chaired by Dr Ho-Seong Han Case presentation by Dept of Surgery Radiological images by Dept of Radiology Surgical findings by Dept of Surgery Pathological presentation by Dept of Pathology Discussion 19:25 - Closing Prof Ho-Seong Han, Seoul National University Bundang Hospital -24-

27 6. Event Report 1) Programs #42 The 2nd General Surgery Clinical Teleconference between Shanghai & Fukuoka The 2 nd General Surgery Clinical Teleconference between Shanghai & Fukuoka Date: July (Tu ), Time: 14:00-16:00 (Beijing time), 15:00-17:00 (JST) Place: Shanghai Jiaotong University affiliated Shanghai First People s Hospital, Shanghai Kyushu University Hospital, Japan Chairmen: Prof. Qiu (Shanghai), Dr. Shuji Shimizu (Fukuoka), Moderator: Dr Huang Kejian (Shanghai) 14:00 (15:00- JST) Opening Remarks Prof. Qiu, Shanghai First People s Hospital 14:05 - (15:05- JST) Brief introduction of staff (each station) 14:10 - (15:10- JST) My learning trip, Dr Huang Kejian (from Kyushu University) Discussion 14:30 - (15:30- JST) Laparoscopic partial gastrectomy, using recorded video Dr Eishi Nagai (Kyushu University) Discussion 15:30 (16:30- JST) Laparoscopic distal pancreatectomy Dr. Shuji Shimizu (Kyushu University) Discussion 16:00 (17:00- JST) Closing Dr Shuji Shimizu, Kyushu University Hospital -25-

28 6. Event Report 1) Programs #43 APAN-Taipei Demonstration Medical BoF-1 st slot: Aug 25 th (Thr): 14:00-15:30 local time Title: International medical teleconference among 4 stations using DVTS Endoscopic treatment for early gastric cancer Session organizer: Shuji Shimizu, MD, PhD Kyushu University Hospital, Japan shimizu@surg1.med.kyushu-u.ac.jp tel: fax: Modulators in each station Taipei (Dr Shimizu, Session organizer) shimizu@surg1.med.kyushu-u.ac.jp Fukuoka (Dr Naoki Nakashima, Kyushu U) knakamur@intmed3.med.kyushu-u.ac.jp Seoul (Dr Young-Woo Kim, NCC) gskim@ncc.re.kr Beijing (Dr Yunsheng Yang, Army General Hospital) yangys@163bj.com or sunny888@medmail.com.cn Objective of the session: Different from the images for regular use, high-quality moving-image is a must for telemedicine. Doctors from four big cities in East Asia will discuss on the very advanced and patient-friendly techniques for early gastric cancer. Session plan 1) Number of speakers: 4 2) Name and contact details of the speakers 3) Title and the abstract of the presentations Programs 1. Opening remarks Dr Hiroshi Mizushima National Cancer Center, Japan hmizushi@ncc.go.jp -26-

29 6. Event Report 1) Programs 2. Message and introduction from each station 3. Speakers and presentations: 1) Endoscopic submucosal dissection in Japan Dr. Kazuhiko Nakamura Kyushu University Hospital, Japan 2) Therapeutic strategy for early gastric cancer in Korea Dr. Chan Gyoo Kim National Cancer Center, Korea 3) Limited experience of endoscopic treatment for the early gastic cancer Dr. Enqiang Linghu, Dr. Yunsheng Yang Chinese PLA General Hospital, China or 4) Therapeutic strategy for early gastric cancer in Taiwan Dr. I-Lin Lee National Taiwan University 4. Discussion Medical BoF-2 nd slot: Aug 25 th (Thr): 15:30-17:30 local time Session organizer: Shuji Shimizu, MD, PhD Kyushu University Hospital tel: fax: Objective of the session: Medical session has newly organized in APAN with the growing demands of using high-quality moving-images in clinical situation in Asia-Pacific regions. This session is to understand current status of telemedicine and to discuss how to expand our activity in AP. -27-

30 6. Event Report 1) Programs 1. Network Supports for Medical Experimentations Koji Okamura Kyushu University, Japan 2. Current activities of telemedicine in AP over APAN Naoki Nakashima Kyushu University, Japan 3. Telemedical activities in Bangkok Nopphol Pausawasdi, and Bordin Sapsomboon Mahidol University Siriraj Hospital, Thailand 4. Telemedical activities in Singapore Lim Sew Hoo National University of Singapore, Singapore 5. Telemedical activities in Adelaide Colin John Carati Flinders Medical Centre, Australia 6. Telemedical activities in Korea Jung-Hun Lee Seoul National University Bundang Hospital, Korea 7. Technical tips for local instrumentation using DVTS Motohiro Ishii Kyuden Infocom Company, Japan 8. Discussion -28-

31 6. Event Report 1) Programs #44 Medical Teleconference in Core University Seminar Teleconference in Core University Program Meeting Date: September 1, 2005 (Thursday) Time: 16:00-17:00 (Local time) 15:00-16:00 (China) Venue: Chungnam National University Topics: Recent advances of endoscopic thyroidectomy in Korea, China and Japan Moderators: Shuji Shimizu (Kyushu University Hospital) Byung In Moon (Ewha Women s University Mokdong Hospital) Liu Yuewu (Peking Union Medical College Hospital) 1. Opening remarks Masao Tanaka Chairman of Department of Surgery and Oncology, Kyushu University 2. Introduction of staff from each station 3. "Endoscopic thyroidectomy in Japan" Akira Oshima, Shuji Shimizu, Masayuki Kojima, Masao Tanaka Nishijin Clinics and Kyushu University Hospital, Japan 4. " Endoscopic thyroidectomy in Korea" Byung In Moon Ewha Women s University Mokdong Hospital, Korea 5. " Endoscopic thyroidectomy in China" Liu Yuewu Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, China 6. Discussion 7. Closing remarks -29-

32 Event Report 1) Programs

33 6. Event Report 1) Programs #45 Korean Endocrine Surgical Meeting Title: 2005 Plenary lecture for Endoscopic thyroidectomy Co-title: Endoscopic thyroidectomy: clnical practice and application Place & Date , Ewha Womans Kokdong Hospital Auditorium Sponsor: The Korean Association of Endocrine Surgeons 08:30-09:00 Registeration 09:00-09:10 Opening remark 09:10-10:10 Mini Lecture Overview of endoscopic thyroidectomy 강성준 ( 원주의대 ) 09:10-09:20 Recent status of endoscopic thyroidectomy in Korea 김이수 ( 한림의대 ) 09:20-09:30 Recent status of endoscopic thyroidectomy in Japan Ikeda Yoshifumi (Teikyo University) 09:30-09:50 Comparative anatomy in thyroidectomy(open vs. endoscopic) Shimizu Kazuo (Nippon Medical School) 09:50-10:10 How I Do? Preaparation and equipment 장항석 ( 연세의대 ) 최준호 ( 서울의대 ) 10:10-10:30 coffee break 10:30-14:00 Live Surgery with lunch box YL Park(Seungkyunkhan U), JS Kim(Catholic U), Shimizu Kazuo (Nippon Medical School) Axillary approach Ikeda Yoshifumi (Teikyo University) Supraclavicular approach Byung-InMoon(EwhaWomans University) 14:00-14:20 coffee break 14:20-15:30 Live Surgery (continued ) 15:30-15:50 Discussion YL Park(Seungkyunkhan U), JS Kim(Catholic U), Shimizu Kazuo (Nippon Medical School) 15:50-16:00 Closing Remark -31-

34 6. Event Report 1) Programs #46 Asian Month Public Program

35 6. Event Report 1) Programs The 1st Symposium for Health Cooperation in Asia September 9, Sentinel Hall, Department of Medicine, Kyushu University, Fukuoka, Japan 1) Symposium 18:00 19:30 Health and medical care cooperation across the border Dr Etsuko Kita, President, Japan Red Cross International Nurse College (Fukuoka, Japan) Dr. NGUYEN NGOC BICH, Vice chief, Training & Researches Dept. Cho Ray Hospital (Ho Chi Minh, Vietnam) Dr. Tak, Young Ran, PhD (on network) Chair, Associate Professor, Department of Nursing, College of Medicine Hanyang University (Seoul, Korea) 2) Panel Discussion 19:30 20:00-33-

36 6. Event Report 1) Programs #47 The 5th Fukuoka Endoscopic Surgery Forum :00 7 TEL TEL FAX ;fesjimu@med.kyushu-u.ac.jp -34-

37 6. Event Report 1) Programs : : : Live CE ME ,

38 6. Event Report 1) Programs #48 Bariatric Live Surgery Teleconference International teleconference on bariatric surgery: Adelaide-Singapore-Fukuoka Date: Nov. 16 (Wed.) Site: Flinder Hospital in Adelaide, Australia (Dr. Toouli) National Univ. Hospital in Singapore (Dr. Lomanto) Kyushu Univ. in Fukuoka, Japan (Dr. Tanaka) Plan: 1, SAGB Live surgery Dr. Toouli 2. Live treatment (filling process) Dr. Lomanto Agenda: 12:30 p.m. 1:00 p.m (11:00 11:30 JST, 10:00-10:30 SST) Introduction site: Flinder hospital, Kyushu Univ. NUH Introduce each other, briefing the program, /objectives, etc. Dr. Toouli talk about the patient's background, how he does patient selection, OR setup, instruments. After that, he starts the case 1:00 p.m. 2:00 p.m. (11:30 12:30 JST, 10:30-11:30 SST) Dr. Toouli and Dr. Lilian Kow are in the OR and start the case. Participants can ask questions during the case 2:00 p.m.- 2:20 p.m. (12:30 12:50 JST, 11:30-11:50 SST) site: National Univ. Hospital (Dr. Lomanto) Live treatment (filling process) Dr. Lomanto to invite his patient who got SAGB surgery several months before to his place. The live conversation between Dr. Lomanto and his patient regarding filling process will be broadcasted. 2:20 p.m. 2:30 p.m. (12:50 13:00 JST, 11:50-12:00 SST) site: Flinder hospital, Kyushu Univ. NUH Q&A from participants topic: filling process 2:30 p.m. (13:00 13:20 JST, 12:00-12:20 SST) Adjourn We can invite nutritionist and other co-medical staff as well -36-

39 6. Event Report 1) Programs #49 Laparoscopic Colon Surgery Teleconference International teleconference on laparoscopic colon surgery among Taichung, Seoul and Fukuoka Date: Nov. 17 (Thursday) Time: 11:00-12:30 (Taiwan: 10:00-11:30) Moderators: SNH Bundang Hospital (Dr. Han) VGH-Taichung (Dr. Wang) Kyushu Univ. Hospital (Dr. Shimizu) Agenda: 11:00 11:10 (10:00 10:10, Taiwan) Opening remarks Introduce each other, briefing the program /objectives, etc. 11:10 11:30 (10:10 10:30, Taiwan) Presentation from SNU Bundang Hospital by Dr SB Kang Laparoscopic colon surgery in Bundang Hospital, Korea 11:30 11:50 (10:300 10:50, Taiwan) Presentation from VGH by Dr H Chiang Laparoscopic colon surgery in Taichung VGH, Taiwan 11:50 12:10 (10:50 11:10, Taiwan) Presentation from Kyushu Univ by Dr H Konomi Laparoscopic colon surgery in Kyushu University Hospital, Japan 12:10 12:20 (11:10 11:20, Taiwan) Q&A 12:20 12:30 (11:20 11:30, Taiwan) Adjourn -37-

40 6. Event Report 1) Programs #50 The 25th Joint Conference on Medical Informatics

41 6. Event Report 1) Programs The 25 th Joint Conference of Medical Informatics Virtual Site Visit at Seoul National University Bundang Hospital (Cosponsored by WIDE Co. and ezcaretech Co.) Date 25 th November Venue Pacifico Yokohama, room XX (Japanese venue) Seoul National University Bundang Hospital (Korean venue) (This session will be presented in Japanese language) Moderator: Naoki Nakashima the Japanese venue Syuji Shimizu the Korean venue Opening Michio Kimura (Vice president of Japanese Association of Medical Informatics) 2 min (16:20-) Greeting Heung Sik Kang (from Bundang Hosp. conference room) (President of Seoul National University Bundang Hospital) 2 min (16:22-) Introduction of Medical Teleconference System in Asian Area 10 min (16:24-) Naoki Nakashima (Department of Medical Informatics, Kyushu University Hospital) Introduction of Seoul National University Bundang Hospital by a recorded video 5 min (16:34-) Lecture 1: Chairman: Chul-Hee Lee (Otorhinolaryngology, Seoul National University Bundang Hospital, ezcaretech Co.) (from Bundang Hosp. conference room) The medical information system (EMR, PACS, etc) in the Seoul National University, Bundang Hospital, Moon-Keun Yoo (ezcaretech Co.) 20 min (16:39-) (We expect that he will use ppt of EMR user interface written in Japanese.) -39-

42 6. Event Report 1) Programs Navigation in EMR/PACS of Seoul National University Bundang Hospital 40 min (16:59-) (We want to look at user interfaces of EMR and PACS image and movement of the systems. We also want to know how to use system by nurses on the bed side, and how to use the system for hospital management.) Ho-Seong Han Surgery, Seoul National University, Bundang Hospital Kyung-Ho Lee Radiology, Seoul National University, Bundang Hospital Jun-Hun Lee an engineer, Seoul National University, Bundang Hospital Moon-Keun Yoo (ezcaretech Co.) translator Lecture 2: Chairman: Syuji Shimizu (Endoscopic Diagnostics and Therapeutics Kyushu University Hospital) (from Bundang Hosp. conference room) Today s Medical Insurance System In Korea San-Yo Nam (Institute of Health & Welfare, Yuhan College) 20 min (17:39-) Closing: Ho-Seong Han Sergery, Seoul National University, Bundang Hospital 1 min (17:59-) -40-

43 6. Event Report 1) Programs #54 21st APAN Meeting Tokyo Live Demonstration of ESD Live demonstration of endoscopic submucosal dissection (ESD) at APAN-Tokyo Date: Jan 25th (Wed) 14:00-15:30 (Taiwan time: 13:00-14:30) Chairman: Shuji Shimizu (Tokyo Venue) Moderators and discussants at each station: 1) Tokyo Venue 2) Dr Hsui-Po Wang (National Taiwan University, Taipei) 3) Dr Chan-Gyoo Kim (National Cancer Center, Korea) 4) Dr Kazuhiko Nakamura (Kyushu University Hospital, Japan) Program (Japan time): 14:00-14:05: Opening remarks: Shuji Shimizu 14:05-14:15: Introduction from each station 14:15-14:25: Network explanation: Koji Okamura 14:25-15:25: Demonstration of ESD from Kyushu University (Dr Kazuhiro Nakamura) 14:25-14:30: Greetings 14:30-14:40: Introduction of members, endoscopic room and instruments 14:40-14:45: Case presentation 14:45-15:25: Technical demonstration and discussion Operator: Dr Shigetaka Yoshinaga Assistants: Dr Soichi Itaba, Dr Kuniomi Honda 15:25-15:30: Closing remarks: Young-Woo Kim -41-

44 6. Event Report 1) Programs #56 21st APAN Meeting Tokyo Video Teleconference among 10 Stations Demonstration of DVTS teleconference connecting up to 10 stations in Asia-Pacific Date: Jan 25th (Wed) 16:30-17:30 (Japan time) (Adelaide 18:00-19:00, China, Taiwan, Singapore: 15:30-16:30) Theme: Laparosocpic colon surgery: techniques and surgical results Chairman: Shuji Shimizu, Ho-Seong Han (Tokyo Venue) Moderators and discussants at each station: 1) Tokyo venue (Japan) 2) Taichung Veteran General Hospital (Taichung, Taiwan): Dr HweMing Wang 3) National Cancer Center (Seoul, Korea): Dr Seung-Yong Jeong 4) Iwate Medical College (Morioka, Japan): Dr Koki Otsuka 5) National University of Singapore (Singapore): Dr TBD 6) National Taiwan University (Taipei, Taiwan): Dr Jin-Tung Liang 7) Tsinghua University (Beijing, China): Dr TBD 8) Flinder s Hospital (Adelaide, Australia): Dr Masahiko Kawamoto 9) SNU Bundang Hospita (Seoul, Korea): Dr Sung-Bum Kang 10) Kyushu University Hospital (Fukuoka, Japan): Dr Ueki Takashi Program (Japan time): 16:30-16:35: Opening remarks: Shuji Shimizu 16:35-16:45: Introduction from each station 16:45-16:50: Network explanation: Koji Okamura 16:50-17:25: Short presentations on Laproscopic coloctomy 16:50-17:00: Dr Koki Otsuka (Iwate Medical College) 17:00-17:10: Dr Seung-Yong Jeong (National Cancer Center, Korea) 17:10-17:20: Dr HweMing Wang (Taichung VGH) 17:20-17:25: Discussion 17:25-17:30: Closing remarks: Ho-Seong Han -42-

45 6. Event report 2) Configuration maps 2) Configuration maps #36 Korean Medical Association Meeting #37 Medical Teleconference

46 6. Event report 2) Configuration maps #38 Shanghai Symposium of Laparoscopic Surgery #42 The 2nd General Surgery Clinical Teleconference between Shanghai & Fukuoka

47 6. Event report 2) Configuration maps #43 APAN-Taipei Demonstration #44 Medical Teleconference in Core University Seminar

48 6. Event report 2) Configuration maps #46 Asian Month Public Program #47 The 5th Fukuoka Endoscopic Surgery Forum

49 6. Event report 2) Configuration maps #48 Bariatric Live Surgery Teleconference #49 Laparoscopic Colon Surgery Teleconference

50 6. Event report 2) Configuration maps #50 25th Joint Conference on Medical Informatics #51 The 3rd Pancreatobiliary Clinico-pathological Teleconference

51 6. Event report 2) Configuration maps #52 Live Surgery for Urinary Incontinence #54 21st APAN Meeting Tokyo Live Demonstration of ESD

52 6. Event report 2) Configuration maps #56 21st APAN Meeting Tokyo Video Teleconference among 10 Stations #57 The 3rd Urological Live Surgery

53 3) Snaps/ Brief explanation #36 Korean Medical Association Meeting Event Report 3) Snaps/Brief explanation Event Korean Medical Association Meeting Date Venue Kyushu University Hospital Seoul National University Bundang Hospital Ewha Womans University Meeting venue in Seoul Comments The biggest medical meeting in Korea, where the live surgery was held between Korea and Japan. The advanced technology such as high-definition transmission or 3D image was tried, which is why the news was broadcasted at prime time in KBS. Conference view Dr Shimizu and Dr Nagai joins at Kyushu side Dr Han HS chairs the session. Picture taken at Venue at Grand Hilton Seoul Conference view at Congress venue Picture taken at Venue at Grand Hilton Seoul Dr Tanabe made a question with Dr Watanabe aside. Flat monitor view at Kyushu station. -51-

54 6. Event Report 3) Snaps/Brief explanation #37 Medical Teleconference on endoscopy Event Medical Teleconference on Endoscopy Date Venue Kyushu University Hospital Hanyang University, Korea Comments The teleconference on endoscopy was performed during the stay of Dr Han Sung-Hee from Hanyang University. She made a presentation about what she learned in Kyushu University Hospital. Conference view Audience in both sides are shown in the monitor. Dr Han SH is ready for her presentation. Dr Han SH is having conversation with her collegues. Dr Yada is discussing with Dr Choi. Staff attendant in Kyushu University. -52-

55 6. Event Report 3) Snaps/Brief explanation #38 Shanghai Symposium of Laparoscopic Surgery Event Shanghai Symposium of Laparoscopic Surgery Date Venue Shanghai Jiaotong University First People s Hospital Kyushu University Hospital Comments The 2 nd Symposium on Advance in Laparoscopic Treatment of Alimentary System Malignacies was held on June in Shanghai First People s Hospital. The video of laparoscopic distal gastrectomy was transmitted to the venue for joint discussion. Surgical view on the left side of the monitor. Gatroscopic images and the audience in Shanghai. The audience in Shanghai venue. Picture taken at Shanghai First People s Hospital The Shanghai venue with technical staffs aside. Picture taken at Shanghai First People s Hospital One screen for surgery and the other for counterpart. Picture taken at Shanghai First People s Hospital Conference view at Shanghai venue. Picture taken at Shanghai First People s Hospital -53-

56 6. Event Report 3) Snaps/Brief explanation #40 Hematopathological conference Event The 3 rd hematopathological conference Date Venue Kyushu University Hospital Mahidol University Siriraj Hospital, Bangkok Comments The hematological conference between Mahidol University Siriraj Hospital, Bangkok, Thailand, and Kyushu University was held for the first time between the two universities. The subject included unique disorders in Asia like thalassemia. Two parities on the screen. Conference view at Kyushu University. Conference view at Siriraj Hospital in Bangkok Picture taken at Mahidol University Siriraj Hospital Kyushu University staff and presentation material from Mahidol University side. Dr Muta is receiving a commorative gift at the venue. Picture taken at Mahidol University Siriraj Hospital Technical team on duty for teleconference. Picture taken at Mahidol University Siriraj Hospital -54-

57 6. Event Report 3) Snaps/Brief explanation #41 Pancreatobiliary clinico-pathological teleconference Event The 2 nd pancreatobiliary clinicopathological teleconference Date Venue Kyushu University Hospital Seoul National University Bundang Hospital Comments The 2 nd clinico-pathological teleconference was held between SNU Bundang Hospital and Kyushu University Hospital. This time Iwate Medical College was invited as a guest for discussion, commemorating the inauguration of broadband network. Conference view at Kyushu University The resident is making a case presentation. Prof Tanaka is making a question to Korea side. Multi-screen showing 3 stations and CT image. Prof Yamaguchi watches screens ahead. Dr Huang joins the conference during his stay here. -55-

58 6. Event Report 3) Snaps/Brief explanation #42 Clinical teleconference on endoscopic surgery Event The 2 nd clinical teleconference on endoscopic surgery between Shanghai and Fukuoka Date Venue Shanghai Jiaotong University First People s Hospital Kyushu University Hospital Comments The second teleconference on endosocpic gastric surgery between Shanghai First People s Hospital and Kyushu University was held during the stay of Dr Huang Kejian from Jiaotong University. Dr Nagai makes a comment during the conference. The Shanghai venue and surgical view on screen. Dr Huang makes a presentation. Dr Huang and Dr Shimizu at Kyushu side. Conference view at Kyushu University Hospital Dr Huang introducing Shanghai city for the audience. -56-

59 6. Event Report 3) Snaps/Brief explanation #43 Teleconference on Endoscopic Submucosal Dissection Event Teleconference on new endoscopic procedures called ESD at APAN medical workshop Date Venue Taipei APAN venue National Cancer Center, Korea Tsinghua University, Beijing Comments The first teleconference on ESD was held among 4 stations connecting Taipei, Seoul, Beijing and Fukuoka during APAN medical workshop. Because this is a new technique on endoscopic treatment, the discussion was heated among participants. Kyushu University Hospital Four stations are shown on the screen. Picture taken at Taipei APAN Meeting venue Participants at Taipei venue. Picture taken at Taipei APAN Meeting venue Conference view at Taipei venue. Picture taken at Taipei APAN Meeting venue A presentation on screen in Kyushu side. Dr Nakamura is making a comment. Conference view at Kyushu station. -57-

60 6. Event Report 3) Snaps/Brief explanation #44 Medical teleconference in Core University Program Event Medical teleconference in Core University Program Date Venue Kyushu University Hospital, Fukuoka Chungnam National University, Daejeon Tsinghua University, Beijing Comments Teleconference on endoscopic thyroid surgery was held as a live event during the Joint Symposium of Core University Program with the attendance of presidents of CNU and Kyushu University. The venue in Daejeon was connected with Kyushu University Hospital and Tsinghua University. Opening address in the ceremony. Picture taken at Chungnam National University The venue of the symposium in CNU. Picture taken at Chungnam National University The conference room in Kyushu University Hospital Screen shows the three connected stations. Picture taken at Chungnam National University The president of Kyushu U watches the live event. Picture taken at Chungnam National University Kyushu staffs and the president address. -58-

61 6. Event Report 3) Snaps/Brief explanation #45 Korean Endoscopic Surgical Meeting Event Live Demonstration of Thyroid Endosocopic Surgery Date Venue Ewha Woman s University, Seoul Kyushu University Hospital Comments Kyushu University Hospital joined the live surgical event in the Korean Association of Endocrine Surgeons in Seoul. Two endoscopic thyroid surgeries were sent for discussion from Ewha Woman s University Hospital to Kyushu University Hospital. Conference view in the venue. Picture taken at Ewha Woman s University Hospital Dr Moon in the OR and his surgical view Picture taken at Ewha Woman s University Hospital Conference view in Kyushu University Hospital Transmitted surgical view is in the center screen. Three different shots in the screens in the venue Picture taken at Ewha Woman s University Hospital Technical staffs and the instruments in the venue Picture taken at Ewha Woman s University Hospital -59-

62 #46 Asian Month Public Program Event Report 3) Snaps/Brief explanation Event The first Asian Month Public Program: Healthcare in Asia Date Venue Kyushu University Hospital Hanyang Unviersity, Seoul Comments The public program on the healthcare in Asia was first organized by Division of Asian Medical Cooperation in Kyushu University Hospital. In addition to local lectures, the remote presentation from Seoul was made for the audience. The organizing staffs at the reception desk. Symposium view chaired by Dr Muta. Dr NN Bich from Cho Ray Hospital in Vietnam The presentation view at the auditorium Remote lecture by Dr Young Ran Tak from Seoul Dr Kita and Dr Bich at the symposium -60-

63 6. Event Report 3) Snaps/Brief explanation #47 Fukuoka Endoscopic Surgery Forum Event The 5 th Fukuoka Endoscopic Surgery Forum Date Venue Fukuoka Acros, Fukuoka Iwate Medical College, Iwate Comments The meeting was held with the audience of about 200 nurses. This is the first time for FES to invite other remote station. One presentation was performed from Iwate side and good discussion was made between two venues. This new plan was favorably accepted by the audience. A large audience in the venue. Picture taken at Fukuoka Acros The conference view with two screens. Picture taken at Fukuoka Acros Mr Mishima, clinical engineer, makes a presentation. Picture taken at Fukuoka Acros The staffs of Iwate Medical College. Picture taken at Iwate Medical College The venue at Iwate Medical College Picture taken at Iwate Medical College Ms Takagi, chairperson, makes closing remarks. Picture taken at Fukuoka Acros -61-

64 6. Event Report 3) Snaps/Brief explanation #48 Bariatric Live Surgery Teleconference Event Bariatric Live Surgery Teleconference Date Venue Kyushu University Hospital, Japan Flinder s University Hospital, Australia National University of Singapore, Singapore Comments The first teleconference connecting Fukuoka, Adelaide, and Singapore. The live surgery was sent from Flinder s Hospital to the other two. Because the number of obese patients was increasing rapidly, the discussion was hot among three stations. The Kyushu U staffs make greetings. The four station views in the flat monitor. Dr Toouli and Dr Carati are in Adelade venue. Picture taken at Flinder s University Hospital Dr Toouli and Dr Kow are at surgery. Picture taken at Flinder s University Hospital Dr Lomanto and Mr Lim at the Singapore venue. Picture taken at National University of Singapore The two screens in the Singapore venue. Picture taken at National University of Singapore -62-

65 6. Event Report 3) Snaps/Brief explanation #49 Laparoscopic Colon Surgery Teleconference Event Laparoscopic Colon Surgery Teleconference Date Venue Kyushu University Hospital Seoul National University Bundang Hospital Taichung Veteran General Hospital Comments The teleconference on laparoscopic colon surgery was held between Japan, Korea, and Taiwan. This is the first event where Taichung VGH was connected via our broadband network. The sound quality was not so good at Seoul station in this conference. Japanese staffs in Kyushu University venue. Three stations were shown in the screen. Dr Han leads the session in Korea venue. The recorded surgery was transmitted on network. Dr Chiang in Taichung venue. The instruments in Kyushu University Hospital -63-

66 6. Event Report 3) Snaps/Brief explanation #50 The 25th Joint Conference on Medical Informatics Event Korean Medical Association Meeting Date Venue Meeting venue in Yokohama (Pacifico Yokohama) Seoul National University Bundang Hospital Comments The venue, gathering many professionals of Japanese medical informatics, was connected to SNU Bundang hospital, an e-hospital in Korea. 260 attendants could visit Korea virtually to know EMR and PACS. They also enjoyed a remote lecture about Korean medical insurance system. Korean station view Picture taken at SNU Bundang Hospital Yokohama venue view Picture taken at Pacifico Yokohama Greetings by H-S Kang, President of Bundang Hosp. Picture taken at SNU Bundang Hospital Demo of PACS with CT image in Bundang Hosp. Picture taken at Pacifico Yokohama Demo of nursing support system with a fake patient Picture taken at SNU Bundang Hospital A question from Yokohama to Prof. S-Y Nam Picture taken at Pacifico Yokohama -64-

67 6. Event Report 3) Snaps/Brief explanation #51 Pancreatobiliary Clinico-pathological Teleconference Event The 3 rd Pancreatobiliary Clinico- Pathological Teleconference Date Venue Kyushu University Hospital Seoul National University Bundang Hospital, Korea Comments The third teleconference on pancreato-biliary diseases, covering preoperative diagnosis, operative procedures and postoperative pathology. One case of presentation was made from each hospital. Conference view at Kyushu University Hospital. Dr Lee KH explains CT on electric medical record. Dr Yoon YS explains the surgical specimen. Dr Yamagchi H makes a question to Korean side. Dr Yamaguchi co-chaired the teleconference. CT is shown in the center screen. -65-

68 6. Event Report 3) Snaps/Brief explanation #52 Live Surgery for Urinary Incontinence Event Live surgery for urinary incontinence Date Venue Kyushu University Hospital, Fukuoka Hanyang University Hospital, Seoul Comments The live surgery was transmitted from Seoul to Fukuoka. This is the first event in the field of urology, preparing for the coming Japanese Urological Congress in April. The overall condition was very good. Urological staffs in Kyushu University Hospital The screen shows Prof Naito talking with Dr SI Kim. The surgical view is shown in the center screen. Conference view in Kyushu University Hospital. Kyushu staffs discussing with Korean counterpart. Kyushu University team in the venue -66-

69 6. Event Report 3) Snaps/Brief explanation #54-1 Live Demonstration of ESD in APAN Medical Workshop Event Live Demonstration of endoscopic submucosal dissection Date Venue Akihabara Convention Hall, Tokyo Kyushu University Hospital, Fukuoka National Cancer Center, Seoul National Taiwan University, Taipei Comments The live demonstration of ESD was transmitted for the first time from Fukuoka to Tokyo, Seoul, and Taipei. The two lines of DVTS were set up with the IPsec security, one by Quatro with bidirectional and one by reflector with unidirectional transmission. The event was so exciting and successful. The conference view in Tokyo venue. Picture taken at Akihabara Convention Hall The center screen is for showing four stations. Picture taken at Akihabara Convention Hall Prof Hilvano from Philippine makes a comment. Picture taken at Akihabara Convention Hall The 61-inch plasma display shows endoscopic view. Picture taken at Akihabara Convention Hall Dr Shimizu explains on clear transmitted images. Picture taken at Akihabara Convention Hall Tokyo venue with three screens. Picture taken at Akihabara Convention Hall -67-

70 6. Event Report 3) Snaps/Brief explanation #54-2 Live Demonstration of ESD in APAN Medical Workshop Event Live Demonstration of endoscopic submucosal dissection at APAN medical workshop Date Venue Akihabara Convention Hall, Tokyo Kyushu University Hospital, Fukuoka National Cancer Center, Seoul National Taiwan University, Taipei Comments At Kyushu station, Dr Nakamura moderated the live demonstration, showing skillful technique of Dr Yoshinaga. The procedures were beautiful with minimal bleeding, and speedy enough to finish within the limited time frame. The mobile DVTS system saved the time and effort for the set-up. Dr Nakamura explains the procedures. The monitor shows Dr Yoshinaga in operation. Four stations in screen. The resected specimen by ESD. The engineering staffs in Tokyo venue. Picture taken at Akihabara Convention Hall The instruments in Kyushu station. -68-

71 6. Event Report 3) Snaps/Brief explanation #55 SD uncompressed transmission Event Demonstration of SD uncompressed transmission Date Venue Akihabara Convention Hall, Tokyo Korean Telecom, Seoul Kyushu University Hospital, Fukuoka Comments The high-definition recorded surgical video was transmitted with SD uncompressed quality from Tokyo to Seoul. The discussion was made among three stations using Polycom. Prof Okamura explains the system configuration. Picture taken at Akihabara Convention Hall Transmitted image from Tokyo station. Picture taken at Akihabara Convention Hall Dr Han HS chairs the session. Picture taken at Akihabara Convention Hall Dr Shimizu explains the surgery. Picture taken at Akihabara Convention Hall Conference view at Kyushu station Prof Okamura and Mr Ishii prepares for the event. Picture taken at Akihabara Convention Hall -69-

72 6. Event Report 3) Snaps/Brief explanation #56-1 Laparoscopic colon teleconference with 10 stations on DVTS Event Laparoscopic colon teleconference in the 21 st APAN meeting in Tokyo. Date Venue Tokyo venue Kyushu U Iwate U NCC SNU Bundang Tsinghua U Taiwan NU Taichung VGH NUS Flinder s U Comments The teleconference was held connecting 10 stations with DVTS for the first time, using newly developed instrument by NICT and ISID. The stations included three in Japan, two in Korea and Taiwan, one in China, Singapore and Australia. Mr Kumagai explains the system configuration. Picture taken at Akihabara Convention Hall Dr Han chairs the teleconference. Picture taken at Akihabara Convention Hall Dr YW Kim and his associate in NCC in Korea Picture taken at Akihabara Convention Hall The screen shows all the connected 10 stations. Picture taken at Akihabara Convention Hall Doctor in Taiwan National University The monitor in Kyushu station -70-

73 6. Event Report 3) Snaps/Brief explanation #56-2 Laparoscopic colon teleconference with 10 stations on DVTS Event Laparoscopic colon teleconference in the 21 st APAN meeting in Tokyo. Date Venue Tokyo venue Kyushu U Iwate U NCC SNU Bundang Tsinghua U Taiwan NU Taichung VGH NUS Flinder s U Comments Although this system was tried the very first time, it went very well and the results were satisfactory. However, we did find our some problems to be discussed and to be better prepared, such as sound adjustement and swiching of 10 stations. Ms Bao at Tsinghua University station in Beijing The conference view at Kyushu University Hospital Dr Kawamoto and Dr Otsuka are on discussion. Conference view at Tokyo venue. Picture taken at Akihabara Convention Hall Instruments set up for the event. Picture taken at Akihabara Convention Hall Tora-chan with Colin and Sew Hoo Picture taken at at the reception site -71-

74 6. Event Report 3) Snaps/Brief explanation #57 3 rd Urological Teleconference with Live Surgery Event 3 rd Urological Teleconference with Live Surgery Demonstration Date Venue Kyushu University Hospital Hanyang University Hospital, Korea Comments Live surgical demonstration was performed from Hanyang University Hospital to Kyushu University Hospital. This is the first to send the view of urological endoscopic surgery. The medical students in their 5 th grade joined the conference. Attendance at Kyushu University Hospital Surgical views are shown in the center screen. Surgical view transmitted from Seoul Multiple pictures were sent to Kyushu University. Short business discussion after live surgery Students also joined the conference. -72-

75 6. Event Report 4) Results of questionnaires 4) Results of questionnaires #48 Bariatric Live Surgery Teleconference #49 Laparoscopic Colon Surgery Teleconference Q1 Which date did you participate? Nov.16th 3 Nov.17th 10 Both dates 4 Pre-Test Nov.10th 1 Total 18 Both dates (22%) Pre-Test Nov.10th (6%) Nov.16th (17%) Nov.17th (55%) Q2 Where were you when the program was held? Australia 2 Korea 2 Japan 2 Singapore 2 Taiwan 3 Total 11 Taiwan (28%) Australia (18%) Singapore (18%) Japan (18%) Korea (18%) -73-

76 6. Event Report 4) Results of questionnaires Q3 Evaluation ( To All Participants ) poor / bad acceptable excellent / good Average Australia Korea Japan Taiwan Singapore Image fineness Image brightness / contrast Image color Image delay Sound quality Sound delay Network connection Overall satisfaction *n= number of answers excellent / good poor / bad 0 Image fineness Image brightness / contrast Image color Image delay Sound quality Sound delay Network connection Overall satisfaction -74-

77 6. Event Report 4) Results of questionnaires Q4 Would you like to use this BB technology actively in the future? All "Yes"!! Reason: It has enormous potential, It is easy to implement. Q5 With this broadband technology, what would you like to try next? Teleconsultation, Cardiology demonstration, Multiple point connection~10 stations. Conference and Live demonstration. Tele-mentoring KOL meeting, KOLs can discuss the certain issue via the BB line. Tele-conference, Tele-education, Tele-surgery Q6 Evaluation ( To doctors / co-medical staff ) a. poor acceptable excellent b. short appropriate long c. hard acceptable easy Average Australia Korea Japan Taiwan Singapore n a. Program content None 5 b. Program duration None 5 c. Setting up None 5 *n= number of answers excellent poor 0 Program content Program duration Setting up -75-

78 6. Event Report 4) Results of questionnaires Q7 Evaluation ( To Engineers ) a. complicated acceptable simple b. Lent from other organization Prepared by yourselves c. poor acceptable good Average Taiwan /A Taiwan /B Singapore /A Singapore /B n a. System complexity b. Equipment c. Security solution *n= number of answers good poor 0 System complexity Equipment Security solution -76-

79 6. Event Report 4) Results of questionnaires #50 25th Joint Conference on Medical Informatics Q1 Interest for Internet Conference Number of answers : 26 Few interesting (4%) Not interesting No answer (4%) (4%) Very interesting (38%) Interesting (50%) Q2 Evaluation of the KJ Symposium Number of answers : 26 Not very good (8%) Bad (0%) No answer (4%) Very good (58%) Good (31%) -77-

80 6. Event Report 4) Results of questionnaires Q3 Interest for Korean Medical Informatics Number of answers : 26 Not interesting (0%) Few interesting (0%) No answer (8%) Very interesting (46%) Interesting (46%) Q4 Occupation of Participants Number of answers : 26 Others (19%) Doctor (Med Info) (19%) Student (4%) (28% (12% Doctor (other) (4%) (12%) Med engineer (31%) (12%) Vender Office worker (0%) Nurse -78-

81 7. Meeting and lecture list 7. Meeting and lecture list 1. Shimizu S Remote medical activity in Asia-Pacific 21 st Asia-Pacific Advanced Network End-to-end performance workshop Tokyo, Japan 2006/01/23 Workshop 2. Nakashima S, Shimizu S Asia-Pacific Medical Network Project over super-broadband Internet 21 st Asia-Pacific Advanced Network Medical workshop Tokyo, Japan 2006/01/24 Workshop 3. Shimizu S Asia-Pacific Medial Network Project over big broadband Internet JBIC Study Team Meeting for Development of Faculty of Medicine and Health Sciences of Syarif Hidayatullah State Islamic University Jakarta, Indonesia 2006/01/19 Invited lecture 4. Nakashima N, Shimizu S Virtual Site Visit at Korea -The Hospital Information System in Seoul National University Bundang Hospital and Medical Insurance System in Korea- The 25 th Joint Conference of Medical Informatics 2005 Yokohama 2005/11/24-26 Symposium 5. Nakashima N, Shimizu S, Okamura K, Hahm JS, Kim YW, Moon BI, Han HS, Lee JH Rapid growth of Broad-Banded Telemedicine Network in Asia-Pacific Area The 7th China-Japan-Korea Medical Informatics Conference 2005 ShenZhen, China 2005/11/14 Oral 6. Shimizu S, Nakashima N, Okamura K Telemedicine project in AP APAN Medical Active Member Meeting in Flinder s University Adelaide, Australia 2005/10/ Invited speaker -79-

82 7. Meeting and lecture list 7. Shimizu S, Han HS Update of Medical Team Activity in Hyeonhae/Genkai Project Hyeonghae/Genkai Meeting Seoul, Korea 2006/9/6 Workshop 8. Shimizu S, Nakashima N, Okamura K Telemedicine using broadband Internet APAN Medical Active Member Meeting in Hanyang University Seoul, Korea 2006/09/06 Invited speaker 9. Shimizu S Recent development in medical applications on APII APII Workshop 2005 Seoul, Korea 2006/9/5 Workshop 10. Shimizu S Recent advancement of endoscopic thyroidectomy -Differences in indications,techniques and surgical results Core University Program Meeting on New Generation Network Daejeong, Korea 2006/9/1 Chairman 11. Nakashima S Current activities of telemedicine in Asia-Pacific area over APAN 20th Asia-Pacific Advanced Network Medical workshop Taipei, Taiwan 2006/08/23-27 Workshop 12. Shimizu S Medical Workshop 20th Asia-Pacific Advanced Network Medical workshop Taipei, Taiwan 2006/08/23-27 Chairman -80-

83 7. Meeting and lecture list 13. Shimizu S, Nakashima N, Okamura K, Hahm JS, Kim YW, Moon BI, Han HS, Tanaka M Telemedicine with uncompressed moving-images over broadband internet in Asia-Pacific region 7th Asia Pacific Congress of endoscopic Surgery Hong Kong, China 2005/08/17-19 Poster 14. Shimizu S, Nakashima N, Okamura K Telemedicine project in AP: Asia-Pacific Medial Network Project over big broadband Internet APAN Medical Active Member Meeting in NUS Singapore, Singapore 2005/8/1 Invited speaker 15. Shimizu S Tele-medicine using BB Internet 2005 Samsung Medical Center Sungkyunkwan University School of Medicine International Symposium Seoul, Korea 2006/6/10 Special lecture 16. Shimizu S, Nakashima N, Okamura K, Hahm J, Kim YW, Moon BI, Han HS, Tanaka M International transmission of uncompressed endoscopic surgical images over super broadband Internet SAGES 2005 Fort Lauderdale, FL, USA 2005/4/13-16 Poster -81-

84 7. Meeting and lecture list Meeting and lecture list (in Japanese) 1. ESD 2006/3/18 2. NTT 2006/3/ /2/ /1/ /1/ /1/13-82-

85 7. Meeting and lecture list 7. PACS /11/ E-learning Shockwave /11/ /10/ : 16 isuc(intermediate System Users Conference) 2005/10/ Kim YS,Kim SM,Hahm JS, /9/

86 7. Meeting and lecture list 13. E-learning /8/ /6/ /5/ Update

87 8. Paper list 8. Paper list 1. Shimizu S, Nakashima N, Okamura K, Hahm JS, Kim YW, Moon BI, Han HS, Tanaka M International transmission of ucompressed endoscopic surgery images via superfast broadband Internet connections. Surg. Endosc. 20(1):167-70, Nakashima N, Okamura K, Hahm JS, Kim YW, Mizushima H, Tatsumi H, Moon BI, Han HS, Park YJ, Lee JH, Youm SK, Kang CH, Shimizu S Telemedicine with digital video transport system in Asia-Pacific area Proceeding of Advanced Information Networking and Applications (AINA)2005 pp , Nakashima N, Shimizu S, Okamura K, Hahm JS, Kim YW, Moon BI, Han HS, Lee JH Rapid growth of Broad-Banded Telemedicine Network in Asia-Pacific Area Proceeding of the 7th China-Japan-Korea Medical Informatics Conference 35-37, Okamura K International Collaborations using Next Generation Internet in Asia Proceedings of International Workshop on Applied Information Technology 2005 (IAIT05) pp1-8, Young-Woo Kim Joon-Soo Hahm 10(4):

88 8. Paper list -86-

89 9. Press list 9. Press list Press Release, Newspaper, TV, Magazine, Web page 1. NICT TV TV TV Telemedicine through High-Speed Broadband The CIT Newsletter on Instructional Development, Enhancement & Support National University of Singapore IT Pro on the web QualImage/Quatre 4 INTERFACE vol 46, 14-15, June KBS IT MBS Internet News KBS Yahoo Korea

90 9. Press list Medical Tribune BB NEW MEDIA AARNet News Issue Flinders Explores medical applications for advanced networking Flinders University, School of Medicine

91 10. Collaborating institutes 10. Collaborating institutes (In order of ABC) AARNet: Australia's Research and Education Network English ASCC: Academia Sinica Computing Center English Chinese ANF: Advanced Network Forum (English) APAN: Asia-Pacific Advanced Network (English) CERNET: China Education and Research Network Chinese English Chungnam National University (Korean) (English) Core University Program: Development and Operation of the NGI (Next Generation Internet) Technologies (English) (Japanese) e! project (Japanese) -89-

92 10. Collaborating institutes Ewha Womans University (Korean) (English) -Hospital (Korean) (English) Flinders University English G/H project: Hyeonhae/Genkai project (Japanese) General Hospital of People s Liberation Army (English) GIST: Gwangju Institute of Science and Technology (English) (Korean) GyeongSang National University Korean Hanyang University (Korean) (English) -Hospital (Korean) HIJK: High Internet Project between Japan and Korea (English) (English) Iwate Medical College Japanese -90-

93 10. Collaborating institutes JAMINA: Japan Medical Information Network Association (Japanese) Johnson & Johnson K.K. English Japanese KISDI: Korean Information Strategy Development Institute Korean English KOREN: Korea Advanced Research Network (English) (Korean) KT: Korea Telecom Korean Chinese Kyushu Electric Power Co., Inc. (Japanese) (English) Kyushu University (Japanese) (English) -Hospital (Japanese) (English) Mahidol University (Thai) (English) National Cancer Center, Goyang, Korea (Korean) -91-

94 10. Collaborating institutes National Cancer Center, Tokyo, Japan (Japanese) (English) NCHC: National Center for High-performance Computing, Taiwan English Chinese NECTEC: National Electronic and Computer Technology Center, Thailand Thai NICT: National Institute of Information and Communications Technology, Japan (English) (Japanese) NII: National Institute of Informatics, Japan (English) (Japanese) National Taiwan University Chinese English National University of Singapore English NORTH: Network Organization for Research and Technology in Hokkaido (Japanese) NTTcommunications Japanese English QGPOP: Kyushu GigaPOP Project (English) -92-

95 10. Collaborating institutes QIC: Kyuden Infocom Company, Inc. (Japanese) QTNet: Kyushu Telecommunication Network Co., Inc. (Japanese) (English) Sapporo Medical College (Japanese) (English) -Hospital (Japanese) Seoul National University (Korean) (English) -Main Hospital (Korean) (English) -Bundang Hospital (Korean) Shanghai Jiaotong University affiliated Shanghai First People s Hospital Chinese SingAREN: Singapore Advanced Research and Education Network English Taipei Veterans General Hospital (Chinese) (English) TWAREN: Taiwan Advanced Research and Education Network English Chinese -93-

96 10. Collaborating institutes The University of Adelaide English ThaiSarn: Thai Social/Scientific, Academic and Research Network English Thai UniNet: Thai University Network Thai English Tokyo University (Japanese) (English) Tsinghua University (Chinese) (English) Yamanashi University (Japanese) (English) -94-

97 11. Closing 11. Closing Conversion from Experiment to Business, from Collaboration to Cooperation Naoki Nakashima, MD, PhD Department of Medical Informatics Kyushu University Hospital The last year was a turning year for AQUA project. Our activity which used to be a BoF (birds of a feather) in APAN (Asia Pacific Advance Network), was formally approved by the voting in APAN Taipei in August This fact should suggest us to convert the view of AQUA project. We need to change it from experiment base, which allows to be quit anytime, to business base, which should have social responsibility. AQUA project is accumulating outcomes and well-known as an experimental group so far. However, it has been unstable as an organization because it has depended on personal nature and effort. Now, AQUA has a social responsibility in international telemedicine activities in Japan, for example, it should manage and support for the new medical project from other research group in this area. We need to uncover the future plan to become a self support project, to escape from the system depending upon subsidies and volunteer activity. Additionally, we need to show incentives for participation (economic, educational, academic, etc) for the domestic and international collaborators, and we need to ask them to be a cooperator for the self-supportive AQUA project, instead of a mere collaborator. Achieving these is necessary to keep social responsibility and to take over the assets of effort and outcomes produced by AQUA. The conversion needs big efforts, time and abilities, although we already found in previous AQUA activities that there are bigger needs for international telemedical network in all Asia-Pacific countries. We also feel a favorable wind of developing information communication technology (ICT). Aim of AQUA is to develop an infrastructure for Asia-Pacific medical standardization which means we support to provide standard medical care for people suffering from lower leveled medical system. Thus, AQUA is now asked quick conversion with the important social responsibility. -95-

98 Honorary Advisors Sachiyo Suita, MD, PhD Superintendent of Kyushu University Hospital Chairman and Professor Masao Tanaka, MD, PhD Department of Clinical Medicine, Faculty of Medical Sciences Members Shuji Shimizu, MD, PhD Department of Endoscopic Diagnostics and Therapeutics Kyushu University Hospital Maidashi, Higashi-ku, Fukuoka , Japan Tel & Fax: Naoki Nakashima, MD, PhD Department of Medical Informatics Kyushu University Hospital Maidashi, Higashi-ku, Fukuoka , Japan T e l: Fax: nnaoki@info.med.kyushu-u.ac.jp Koji Okamura, PhD Computing and Communications Center Kyushu University Hakozaki, Higashi-ku, Fukuoka , Japan T e l: Fax: oka@ec.kyushu-u.ac.jp

99 Motohiro Ishii Internet Data Center Kyuden Infocom Company, Inc Watanabe-dori, Chuo-ku, Fukuoka , Japan T e l: Fax: ishii@qic.co.jp Hiroshi Imamura e-business Group Kyuden Infocom Company, Inc Watanabe-dori, Chuo-ku, Fukuoka , Japan T e l: Fax: imamura@qic.co.jp Nobuhiro Torata Department of SurgeryI Kyushu University Hospital Maidashi, Higashi-ku, Fukuoka , Japan T e l: Fax: tora@surg1.med.kyushu-u.ac.jp Yasuaki Antoku Department of Medical Informatics Kyushu University Hospital Maidashi, Higashi-ku, Fukuoka , Japan T e l: Fax: antokuy@info.med.kyushu-u.ac.jp