Computer technology has impacted the practice of medicine in dramatic ways. Imaging techniques provide noninvasive tools which alter the diagnostic process. Sophisticated monitoring equipment presents new levels of detail for both patient management and research. In most of these technology applications, the com puter is embedded in the device; its presence is transparent to the user. There is also a growing number of applications in which the health care provider directly interacts with a computer. In many cases, these applications are limited to administrative functions, e.g., office practice management, location of hospital patients, appointments, and scheduling. Nevertheless, there also are instances of patient care functions such as results reporting, decision support, surveillance, and reminders. This series, Computers and Medicine, will focus upon the direct use of infor mation systems as it relates to the medical community. After twenty-five years of experimentation and experience, there are many tested applications which can be implemented economically using the current generation of computers. More over, the falling cost of computers suggests that there will be even more extensive use in the near future. Yet there is a gap between current practice and the state-of the-art."

The contents of this volume derive loosely from an EMBO worksh9P held at EMBL (Heidelberg) towards the end of 1989. The topic of Patterns in Protein Sequence and Structure attracted a wide range of participants, from biochemists to computer scientists, and that diversity has, to some extent, remained in the contributions to this volume. The problems of interpreting biological sequence data are to an increasing extent forcing molecular biologists to learn the language of computers, including at times, even the abstruse language of the computer scientists themselves. While, on their side, the computer scientists have discovered a veritable honey-pot of real data on which to test their algorithms. This enforced meeting of two otherwise alien fields has resulted in some difficulties in communication and it was an aim of the EMBO workshop to help resolve these. By the end, most biologists at the meeting had, at least, heard the terms Dynamic Programming and Regular Expression while for their part the computer programmers began to realise that protein sequences might be more than simple Markov chains in a 20-letter alphabet. Thanks to the modern facilities at EMBL, the three day meeting was video-taped and from this a transcript was taken and offered to the speakers as the basis for a contribution to this volume.

are then selected and must meet the general 'biocompatibility' require ments. Prototypes are built and tested to include biocompatibility evalua tions based on ASTM standard procedures. The device is validated for sterility and freedom from pyrogens before it can be tested on animals or humans. Medical devices are classified as class I, II or III depending on their invasiveness. Class I devices can be marketed by submitting notification to the FDA. Class II and III devices require either that they show equivalence to a device marketed prior to 1976 or that they receive pre-marketing approval. The time from device conception to FDA approval can range from months (class I device) to in excess of ten years (class III device). Therefore, much planning is necessary to pick the best regulatory approach. 2. Wound Dressings and Skin Replacement 2.1 Introduction Wounds to the skin are encountered every day. Minor skin wounds cause some pain, but these wounds will heal by themselves in time. Even though many minor wounds heal effectively without scarring in the absence of treatment, they heal more rapidly if they are kept clean and moist. Devices such as Band-Aids are used to assist in wound healing. For deeper wounds, a variety of wound dressings have been developed including cell cultured artificial skin. These materials are intended to promote healing of skin damaged or removed as a result of skin grafting, ulceration, burns, cancer excision or mechanical trauma."

The amount of molecular information is too vast to be acquired without the use of computer-bases systems. The authors introduce students entering research in molecular biology and related fields into the efficient use of the numerous databases available. They show the broad scientific context of these databases and their latest developments. They also put the biological, chemical and computational aspects of structural information on biomolecules into perspective. The book is required reading for researchers and students who plan to use modern computer environment in their research.

This monograph series is intended to provide medical information scien tists, health care administrators, health care providers, and computer sci ence professionals with successful examples and experiences of computer applications in health care settings. Through the exposition of these com puter applications, we attempt to show what is effective and efficient and hopefully provide some guidance on the acquisition or design of informa tion systems so that costly mistakes can be avoided. The health care industry is currently being pushed and pulled from all directions - from the clinical side to increase quality of care, from the busi ness side to improve financial stability, from the legal and regulatory sides to provide more detailed documentation, and, in a university environment, to provide more data for research and improved opportunities for educa tion. Medical information systems sit in the middle of all these demands. They are not only asked to provide more, better, and more timely informa tion but also to interact with and monitor the process of health care itself by providing clinical reminders, warnings about adverse drug interactions, alerts to questionable treatment, alarms for security breaches, mail mes sages, workload schedules, etc. Clearly, medical information systems are functionally very rich and demand quick response time and a high level of security. They can be classified as very complex systems and, from a devel oper's perspective, as 'risky' systems."

The NATO workshop on Disordered Systems and Biological Organization was attended, in march 1985, by 65 scientists representing a large variety of fields: Mathematics, Computer Science, Physics and Biology. It was the purpose of this interdisciplinary workshop to shed light on the conceptual connections existing between fields of research apparently as different as: automata theory, combinatorial optimization, spin glasses and modeling of biological systems, all of them concerned with the global organization of complex systems, locally interconnected. Common to many contributions to this volume is the underlying analogy between biological systems and spin glasses: they share the same properties of stability and diversity. This is the case for instance of primary sequences of biopo Iymers I ike proteins and nucleic acids considered as the result of mutation-selection processes [P. W. Anderson, 1983] or of evolving biological species [G. Weisbuch, 1984]. Some of the most striking aspects of our cognitive apparatus, involved In learning and recognttlon [J. Hopfield, 19821, can also be described in terms of stability and diversity in a suitable configuration space. These interpretations and preoccupations merge with those of theoretical biologists like S. Kauffman [1969] (genetic networks) and of mathematicians of automata theory: the dynamics of networks of automata can be interpreted in terms of organization of a system in multiple possible attractors. The present introduction outlInes the relationships between the contributions presented at the workshop and brIefly discusses each paper in its particular scientific context.

The visualization of human anatomy for diagnostic, therapeutic, and educational pur poses has long been a challenge for scientists and artists. In vivo medical imaging could not be introduced until the discovery of X-rays by Wilhelm Conrad ROntgen in 1895. With the early medical imaging techniques which are still in use today, the three-dimensional reality of the human body can only be visualized in two-dimensional projections or cross-sections. Recently, biomedical engineering and computer science have begun to offer the potential of producing natural three-dimensional views of the human anatomy of living subjects. For a broad application of such technology, many scientific and engineering problems still have to be solved. In order to stimulate progress, the NATO Advanced Research Workshop in Travemiinde, West Germany, from June 25 to 29 was organized. It brought together approximately 50 experts in 3D-medical imaging from allover the world. Among the list of topics image acquisition was addressed first, since its quality decisively influences the quality of the 3D-images. For 3D-image generation - in distinction to 2D imaging - a decision has to be made as to which objects contained in the data set are to be visualized. Therefore special emphasis was laid on methods of object definition. For the final visualization of the segmented objects a large variety of visualization algorithms have been proposed in the past. The meeting assessed these techniques.

Medical imaging is a very important area in diagnostic (and increasingly therapeutic) medicine. Many new techniques are being developed or extended which depend on digital methods. Although conventional x-radiographs still comprise the bulk of the medical images acquired in a hospital, digital methods such as computerized tomography and magnetic resonance imaging are now often claimed to have a more significant clinical impact. This book is concerned with three aspects of such digital images: their formation, or how they can be acquired; their handling, or how they may be manipulated to increase their clinical value; and their evaluation, or how their impact and value may be assessed. The book is divided into three parts. Part 1 comprises a series of reviews in the general subject area written by authorities in the field. Part 2 includes papers on theoretical aspects: 3D images, reconstruction, perception, and image processing. Part 3includes papers on applications in nuclear medicine, magnetic resonance, andradiology.

Computer technology has impacted the practice of medicine in dramatic ways. Imaging techniques provide noninvasive tools which alter the diag nostic process. Sophisticated monitoring equipment presents new levels of detail for both patient management and research. In most of these high technology applications, the computer is embedded in the device; its presence is transparent to the user. There is also a growing number of applications in which the health care provider directly interacts with a computer. In many cases, these applica tions are limited to administrative functions, e.g., office practice manage ment, location of hospital patients, appointments, and scheduling. Nev ertheless, there also are instances of patient care functions such as results reporting, decision support, surveillance, and reminders. This series, Computers and Medicine, focuses upon the direct use of information systems as it relates to the medical community. After twenty five years of experimentation and experience, there are many tested ap plications which can be implemented economically using the current gen eration of computers. Moreover, the falling cost of computers suggests that there will be even more extensive use in the near future. Yet there is a gap between current practice and the state-of-the-art."

Medical imaging is an important topic and plays a key role in robust diagnosis and patient care. It has experienced an explosive growth over the last few years due to imaging modalities such as X-rays, computed tomography (CT), magnetic resonance (MR) imaging, and ultrasound. This book focuses primarily on model-based segmentation techniques, which are applied to cardiac, brain, breast and microscopic cancer cell imaging. It includes contributions from authors working in industry and academia, and presents new material.

This volume is based on lectures held at the NATO Advanced Study Institute on Multiple Criteria Decision Making and Risk Analysis Using Microcomputers that took place in Istanbul, Turkey from June 28 to July 8, 1987. The book considers aspects of multiple criteria decision making and risk analysis, with numerous methods and applications using microcomputers. The methodology included is fairly representative of the field. It covers the Analytical Hierarchy Process of Saaty, the approaches of Zionts and Wallenius and their colleagues, and the work of Dyer, Steuer, and Yu. Important behavioral considerations in decision making, psychological aspects of judgement and choice, and preference elicitation are discussed, followed by a number of applications of methods in various fields including hospital diagnostics systems and production planning. Special emphasis is placed on the growing importance of computer graphics in multiple criteria models. The approach of Korhonen and Wallenius in "A Pareto Race" is presented as a decision support system. The "Trimap" approach by Climaco, an approach that has some potential for end users, is of particular interest to MCDM researchers.

The three-volume set LNCS 7510, 7511, and 7512 constitutes the refereed proceedings of the 15th International Conference on Medical Image Computing and Computer-Assisted Intervention, MICCAI 2012, held in Nice, France, in October 2012. Based on rigorous peer reviews, the program committee carefully selected 252 revised papers from 781 submissions for presentation in three volumes. The third volume includes 79 papers organized in topical sections on diffusion imaging: from acquisition to tractography; image acquisition, segmentation and recognition; image registration; neuroimage analysis; analysis of microscopic and optical images; image segmentation; diffusion weighted imaging; computer-aided diagnosis and planning; and microscopic image analysis.

Computer technology has impacted the practice of medicine in dramatic ways. Imaging techniques provide non-evasive tools which alter the diagnostic pro cess. Sophisticated monitoring equipment presents new levels of detail for both patient management and research. In most of these high technology applica tions, the computer is embedded in the device; its presence is transparent to the user. There is also a growing number of applications in which the health care provider directly interacts with a computer. In many cases, these applications are limited to administrative functions, e.g., office practice management, loca tion of hospital patients, appointments, and scheduling. Nevertheless, there also are instances of patient care functions such as results reporting, decision support, surveillance, and reminders. This series, Computers and Medicine, will focus upon the direct use of infor mation systems as it relates to the medical community. After twenty-five years of experimentation and experience, there are many tested applications which can be implemented economically using the current generation of computers. Moreover, the falling cost of computers suggests that there will be even more extensive use in the near future. Yet there is a gap between current practice and the state-of-the-art."

This collection of papers is the result of a symposium sponsored by NATO's Defense Research Group Panel VIII in the Spring of 1985. The symposium came into being when it became obvious to the NATO countries that research, development and utilization of advanced technologies for training was the best means of increasing both training effectiveness and efficiency. This symposium was the second in a series of three devoted to training. The series was structured to cover all aspects of training. The first series addressed the value of training, the second one dealt with the application of training technologies and the third and last of the series focused on academic issues concerned with the effect of prior learning on subsequent learning. The fact that a major American publisher has determined that computer based instruction is the technology of greatest interest to the NATO community is not surprising. Advances in microprocessor technology have revolutionized both how and where we train. During this symposium there were a limited number of carefully chosen exhibits to demonstrate the various applications of computer based training techniques. In the following papers you will find both a practical and scientific basis for the way current and future training and training systems should be designed, applied and utilized. We know that training must be done faster and more effectively.

This book contains a collection of quantitative procedures in common use in pharmacology and related disciplines. It is intended for students and researchers in all fields who work with drugs. Many physicians, especially those concerned with clinical pharmacology, will also find much that is useful. The procedures included may be considered "core" since they are generally applicable to all classes of drugs. Some of the procedures deal with statistics and, hence, have even wider application. In this new edition we have increased the number of procedures from 33 (in the first edition) to 48. Other procedures have been revised and expanded. Yet the basic philosophy of this new edition remains unchanged from the first. That is, the pharmacologic basis of each procedure is presented, along with the necessary formulas and one or more worked examples. An associated computer program is included for each procedure and its use is illustrated with the same worked example used in the text. The discussions of theory and the sample computations are brief and self-contained, so that all computations can be made with the aid of a pocket calculator and the statistical tables contained in Appendix A. Yet it is realized that the proliferation of lower-priced microcom puters is likely to mean that more and more readers will utilize a computer for most calculations. Accordingly, we have modified the format of the book to facilitate computer usage."

Computer technology has impacted the practice of medicine in dramatic ways. Imaging techniques provide noninvasive tools which alter the diag nostic process. Sophisticated monitoring equipment presents new levels of detail for both patient management and research. In most of these high technology applications, the computer is embedded in the device; its presence is transparent to the user. There is also a growing number of applications in which the health care provider directly interacts with a computer. In many cases, these appli cations are limited to administrative functions, e.g., office practice man agement, location of hospital patients, appointments, and scheduling. Nevertheless, there also are instances of patient care functions such as results reporting, decision support, surveillance, and reminders. This series, Computers and Medicine, will focus upon the direct use of information systems as it relates to the medical community. After twenty-five years of experimentation and experience, there are many tested applications which can be implemented economically using the current generation of computers. Moreover, the falling cost of computers suggests that there will be even more extensive use in the near future. Yet there is a gap between current practice and the state-of-the-art."

Intended for nurses who would like to know more about the development of the computerized information systems on which they have become so dependent, Nursing and Computers: An Anthology is a wide-range introduction to the literature of this field. The editors have selected historical and contemporary papers to show both the systems at their inception and examples of how they have evolved. Of interest to both the generalist and the specialist, these articles examine the partnership between nurses and computers in the areas of administration, practice, research, and education.

This series in Computers and Medicine had its origins when I met Jerry Stone of Springer-Verlag at a SCAMC meeting in 1982. We determined that there was a need for good collections of papers that would help disseminate the results of research and application in this field. I had already decided to do what is now Information Systems for Patient Care, and Jerry contributed the idea of making it part of a series. In 1984 the first book was published, and-thanks to Jerry's efforts - Computers and Medicine was underway. Since that time, there have been many changes. Sadly, Jerry died at a very early age and cannot share in the success of the series that he helped found. On the bright side, however, many of the early goals of the series have been met. As the result of equipment improvements and the consequent lowering of costs, com puters are being used in a growing number of medical applications, and the health care community is very computer literate. Thus, the focus of concern has turned from learning about the technology to understanding how that technology can be exploited in a medical environment."

A unified and coherent introduction to the notion of abstraction in interactive computer graphics is provided by this book. Abstraction entails refinement of images based on geometric models so as to reflect the importance of the features of the model for the dialog context and the visualization goal. This may require leaving out irrelevant details or accentuating significant features by adding details or enlarging or deforming parts. Such modifications are routine by hand but are at the leading edge of research in 2D and 3D computer graphics. The authors see the abstraction process as an interactive exploration of complex information spaces, and report especially on zooming and rendering techniques. Benefits are discussed for applications in medical illustration and technical documentation.

An International Conference on "Neurosurgical Training and Reserach" was held in Munich from October 6 - 9, 1996, under the auspices of the EANS, and organized by H.-J. Reulen and H.-J. Steiger. Experts from different countries and neurosurgical organizations have collected information on the present status of resident training in neurosurgery and the mechanisms involved with the training. Various aspects, the recruitment process, the criteria used for selection, the contents and structure of a program, the continuous quality control, exposition to the art of research, fellowships and subspeciality training, etc. have been covered. The present book contains this material and thus provides a unique and comprehensive source of information on the complex of modern neurosurgical training. " ... The beauty of this work is that it puts in one place the many varied aspects of a neurosurgical training program that one needs to be aware of ... should be required reading for the faculty of any academic training program as well as for others who may have a misconception of what residency training is ... an excellent book for any program director or active faculty member. It should be required reading for all faculty members before the next round of resident interviews ..." Neurosurgery "... well edited, published to a high standard and will naturally be of interest to those specifically involved in the areas of selection and training ... a useful text for aspirants to surgical training posts ..." British Journal of Neurosurgery

Microcomputer-based labs, the use of real-time data capture and display in teaching, give the learner new ways to explore and understand the world. As this book shows, the international effort over a quarter-century to develop and understand microcomputer-based labs (MBL) has resulted in a rich array of innovative implementations and some convincing evidence for the value of computers for learning. The book is a sampler of MBL work by an outstanding international group of scientists and educators, based on papers they presented at a seminar held as part of the NATO Special Programme on Advanced Educational Technology. The story they tell of the development of MBL offers valuable policy lessons on how to promote educational innovation. The book will be of interest to a wide range of educators and to policy makers.

Ever since the early 1960s, the medical ical records. Expert assistance in di- issue might contain a review of an office agnosis and treatment selection will be world has awaited the promise of com- practice management system-of in- as close as the nearest telephone, which terest to the physician, nurse, and office puterization. Many of us were fasci- will provide an immediate link to the nated by the efforts of the pioneers: practice manager. Next to it might be Homer Warner's computerized diag- office computer. found a detailed article about a language nosis system, Octo Barnett's medical Since 1983, M,D. Computing has such as LISP and how it could be ap- information system, Howard Bleich's explored and explained all of these as- plied to medical problems, or a tutorial pects. Our magazine's major focus is on about real-time monitoring of a patient's automated acid/base consultant" and Warner Slack's history-taking program computer systems that serve the health physiological state, along with book re- were foretastes of what was to come. provider in the home or office environ- views and departments reporting on At first, however, physicians and hos- ment. M. D, Computing has also ex- pertinent computer news. pital personnel resisted the computer amined more general computer appli- In several cases, a distinct theme because it was too slow, too fragile, too cations in medical care.

This series is intended for students and practitioners of the health profes sions who are seeking to expand their knowledge of computers in health care. Our editors and authors, experts in their fields, offer their insights into innovations and trends. Each book is practical and easy to use. Since the series began, in 1988, we have seen increasing acceptance of the term "informatics" and of the innovations it brings to health care. Today more than ever we are committed to making this series contribute to the field of healthcare informatics, the discipline "where caring and technology meet. " KATHRYN J. HANNAH MARION J. BALL v Preface Computer technology has transformed health care not only by improving the accuracy and quantity of information available to'clinicians, but also by improving the flow of information among the people who provide, arrange for, and pay for health services. This book is about the new computer networlcs that electronically link people and organizations in the health care field. Its purpose is to explore the impact of new computer networks upon the different organizations in the field, their services to patients, and the way in which organizations collaborate and compete, share information, and guard confidential material. The book explores computer networks primarily from the perspective of public health, discussing the impact that networks have upon communities as well as individuals."

This computer-based nomenclature aims to create a universal environment for the acquisition, review, and transmission of medical information independent of language. MEDCIN systemizes the diagnostic process, by removing the subjective variables of patient information gathering, allowing for a more consistent patient diagnosis, and more reliable data for research. Through a coding structure of hierarchical inheritance, MEDCIN accommodates the individual thought processes of the clinician, while remaining structured enough to capture the clinical findings needed for documentation and analysis. It also provides a universal language base for over 50,000 specific medical findings in French, German and Spanish, enabling the user to read patient chart data, irrespective of the language of acquisition.

This book reports cutting-edge cases of emerging health technologies.Some health care fields are experiencing paradigmatic shifts because of robotic technologies and the new relationships that they create in r-Health (r-Curing and r-Caring) activities.The book explores emerging health care technologies such as image-guided surgical robotics, pharmacy robots, new visualisation methods (3D, 4D & 5D ) and home telehealth management systems and their acceptance in the workplace but also, more generally, their special role in business and society. These technologies allow health care professionals to effectively reach far beyond the current service offerings, providing new methods for communication, diagnosis, and treatment. The relocation of certain knowledge areas from physicians to patients in self-care management or the reconfiguration of health care expertise from one health profession to another are examples of topics developed in this book. The book describes the emerging relocation of innovative visual knowledge and expertise within health care organisations and beyond, such as in the patient's home environment."