In this paper, we present the methodology we adopted in designing and developing an object-oriented database system for the management of medical records. The designed system provides technical solutions to important requirements of most clinical information systems, such as 1) the support of tools to create and manage views on data and view schemas, offering to different users specific perspectives on data tailored to their needs; 2) the capability to handle in a suitable way the temporal aspects related to clinical information; and 3) the effective integration of multimedia data. Remote data access for authorized users is also considered. As clinical application, we describe here the prototype of a user-oriented clinical information system for the archiving and the management of multimedia and temporally oriented clinical data related to percutaneous transluminal coronary angioplasty (PTCA) patients. Suitable view schemas for various user roles (cath-lab physician, ward nurse, general practitioner) have been modeled and implemented on the basis of a detailed analysis of the considered clinical environment, carried out by an object-oriented approach.
The work here described regards multi-viewer auto-stereoscopic visualization of 3D models of anatomical structures and organs of the human body. High-quality 3D models of more than 1600 anatomical structures have been reconstructed using the Visualization Toolkit (vtk), a freely available C++ class library for 3D graphics and visualization. 2D images used for 3D reconstruction come from the Visible Human Data Set (original and segmented images). Auto-stereoscopic threedimensional image visualization is obtained using a prototype monitor developed at Philips Research Labs, UK. This special multiview 3D-LCD screen has been connected directly to a SC}I workstation, where 3D reconstruction and medical imaging applications are executed. Dedicated software has been developed to implement multiview capability. A number of static or animated contemporary views of the same object can simultaneously be seen on the 3D-LCD screen by several observers, having a real 3D perception of the visualized scene without the use of extra media as dedicated glasses or head-mounted displays. Developed software applications allow real-time interaction with visualized 3D models; didactical animations and movies have been realized as well.
We implemented and applied a new compression method, called Pseudo-gradient Adaptive Brightness and Contrast Error Limitation (PABCEL) method, on singleimages coming from angiocardiographic f lms, recorded and digitized at the Haemodynanric Labs of the Cardiology Division of the Ospedali Riuniti, Bergamo. PABCEL algoritlim a i m at liinitirig maximum difference of brightness between corresponding pixels of the original image and the reconstructed one; it also limits the contrast error when considering corresponding pixels of the original and the reconstructed images on the Peano-Hilbert scan path. We applied our compression method to 168 images coming from 14 different angiocardiographic exams; with the lowest threshold values we obtained a mean conipressiori ratio of about 8:l: consulted cardiologists didn't identify significant diferences between original irriages and reconstructed ones. Qualitative and quantitative evaluation of obtained results has been carried out.
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