An interactive data preparation procedure for three-dimensional interstitial and intracavitary dose calculation programs.

A computer system has been developed to assist in preparing data for interstitial and intracavitary calculations. This approach used graphic and interactive techniques, and removes all the format problems which led to errors in data preparation. The program reconstructs the implant and rotates it about X, Y and Z axes to allow close examination of the positions of the radiation sources. The site of the dose calculation can be selected by positioning a frame representing the calculation plane in the reconstructed implant. The output of the program is the three-dimensional data of the source and plane co-ordinates, together with the co-ordinates to define the area on the plane where the calculation is to be performed.

An on-line computer graphics terminal for radiotherapy treatment planning.

A programmed graphics terminal has been connected on-line to a large time-shared computer for calculating dose distributions in radiotherapy treatment planning and provides a viable alternative to dedicated systems and batch working. The terminal equipment is based on a mini-computer and includes a function-key devise for outline input, a large-screen refresh oscilloscope for viewing results and an X-Y plotter for hard-copy. Radiotherapy dose computation programs in standard Fortran are stored and run on a large remote computer with graphical interaction at the terminal. External beam programs can calculate dose distributions for most commonly used treatment situations and can compute in off-axis planes. Data input is fully interactive and easy to understnad. Dose distributions are displayed as isodose contours. Advantages of the system include accuracy, speed, ease of use and maintenance, and transferability of the programs between different host computers.

Broadband telemedicine: teaching on the information superhighway.

The INSURRECT project uses the SuperJANET network to link six sites in the UK for interactive teaching and learning in surgery, an area of higher education where visual information is critical to the learning process. Collaboration between the six universities allows students access to a larger pool of surgical expertise and case studies than any single institution could provide. The project expects to improve the time that medical students can devote to surgery by up to 50%, by providing both supervised and unsupervised access to important visual information and case studies. Finally, the reduction in student numbers in operating theatres should reduce the infection risk to patients. A key component of the project is the central image resource, located in London, but allowing students and surgeons access from anywhere on the network. This paper describes the development of the interactive surgical teaching system and our experience with it during the first 18 months. One subjective observation, noticed after just one term's teaching, was the improved quality of the teaching.

Lessons learned during the INSURRECT project (INteractive SURgical Teaching at REmote CeNtres).

The INSURRECT project began in 1993 as a collaboration between six UK universities in distance teaching of undergraduate surgery. The first year was spent in testing the network and preparing the course material. This was followed by a two-year pilot teaching course. During this phase, 108 teaching sessions were conducted, involving more than 1300 students in all. It was found that successful teaching depended on increasing the amount of audience interaction was much as possible and transmitting high-quality video pictures. Although the time taken to deliver material by interactive video was greater than for conventional lectures, both students and teachers responded favourably to the project.

Time effects in molecular radiation biology.

Radiation action occurs over a broad timescale which extends from the very early physical processes associated with energy absorption to the very late biological effects, such as carcinogenesis which may not become apparent until many years later. The various temporal stages of radiation action are classified and their interrelationships described. Experimental projects in cellular radiation chemistry, including pulse radiolysis, are discussed, together with some applications of the techniques in this general area. The paper also deals with some aspects of the oxygen effect in radiobiology and the mechanisms of its action. Various studies employing fast response techniques have been useful in verifying the role of fast free radical reactions in the oxygen effects and examples are given of some applications. Investigations with other hypoxic cell sensitizers, the electron affinic agents, are also briefly discussed, with an account of how studies of the timescale of radiation sensitization can be valuable in understanding mechanisms. Possible mechanisms of action of radiation sensitization by oxygen and other agents, including radical fixation and direct action processes, are considered in the light of evidence from some model systems.

A new approach to patient indexing.

A computer based rheumatology patient index is described. Patients are indexed according to essential clinical and laboratory data without reference to Procrustean diagnostic labels. The stored information can be searched for a wide range of practical and scientific purposes. The software was devised in the windows environment for the Apricot Xen for maximum speed and intelligibility.

Integrating a medical database and advisory system.

A system is described which incorporates the use of a diagnostic and treatment advice expert system into the routine information-handling functions of a surgical breast clinic. The main focus of the system is on identification and management of non-malignant breast disease. The advisor is linked with a clinical database which is used to hold summary case notes, and from which reports forming the basis for audit of case-mix and resource utilization can be produced. The system uses backward chaining of extended production rules and a relational database, and runs on a desktop microcomputer.