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 Medical Working Group
 Chairman :
 Shuji Shimizu ( Kyushu University Hospital, Japan )[ shimizu@surg1.med.kyushu-u.ac.jp ]
 Ho-Seong Han ( Seoul National University Bundang Hospital, Korea ) [ hanhs@snubh.org ]

 Members :
 Network: Koji Okamura
  Audio-visual:   Nobuhiro Torata
  Secretary: Yoko Noda

 Objectives :
 Our goal is to establish a medical network with high-quality moving image on a broadband Internet in all Asia-Pacific regions.
 In order to expand our WG, it is essential for both medical and engineering people to get together on site and discuss our next strategy.
 At the same time, we will demonstrate our new and developing systems to our members.

 Target Audience :
 Medical doctors, Co-medicals, Engineers, Researchers

 Expected Number of Participants :
 30

 Agenda :
 

Healthcare Session 1 : International Collaborative Research on Cancer and Nanotechnology

     Schedule

Session Chair:   Young-Sung Lee (Chung-Buk National University, Korea)


Session 1-a :

Time: 7:00-7:30 IST

Speakers :

1a-1.   Jin-Soo Lee (NCC, Korea)

1a-2.   Judith C. Gasson (UCLA, USA)

1a-3.   Piotr Grodzinski (NCI, USA): Cancer Nanotechnology - Opportunities and Challenges - View from the NCI Alliance for Nanotechnology in Cancer

Abstract:
National Cancer Institute is engaged in efforts to harness the power of nanotechnology to radically change the way we diagnose and treat cancer. Novel and multi-functional nanodevices will be capable of detecting cancer at its earliest stages, pinpointing its location within the body, delivering anticancer drugs specifically to malignant cells, and determining if these drugs are effective. Functionalized nanoparticles would deliver multiple therapeutic agents to tumor sites in order to simultaneously attack multiple points in the pathways involved in cancer. Such nano-therapeutics are expected to increase the efficacy of drugs while dramatically reducing potential side effects. In vivo biosensors would have the capability of detecting tumors and metastatic lesions that are far smaller than those detectable using current, conventional technologies. Furthermore, they will provide rapid information on whether a given therapy is working as expected.

In order to further these research goals, NCI formed a program called Alliance for Nanotechnology in Cancer which was initiated in 2004. The Alliance invests approximately $150 million for the funding period of 5 years to pursue applied nanotechnologies for cancer detection, therapy, and prevention with an aim to achieve clinical translational stage of these technologies towards culmination of the program. The Alliance funds Centers of Cancer Nanotechnology Excellence, the development of nanotechnology platforms, and two training programs: Cancer Nanotechnology Training Centers and Path to Independence Awards. An intramural arm of the Alliance - Nanotechnology Characterization Laboratory provides a characterization support to evaluate clinically promising nanomaterials and establish their physical, pharmacological and toxicological characteristics.

The nine Centers of Cancer Nanotechnology Excellence are: Carolina Center of Cancer Nanotechnology Excellence at the University of North Carolina, Center for Cancer Nanotechnology Excellence and Translation at Stanford University, Center for Cancer Nanotechnology Excellence at Johns Hopkins University, Center for Translational Cancer Nanomedicine at Northeastern University, Dartmouth Center for Cancer Nanotechnology Excellence at Dartmouth College, MIT-Harvard Center of Cancer Nanotechnology Excellence, Nanomaterials for Cancer Diagnostics and Therapeutics at Northwestern University, Nanosystems Biology Cancer Center at California Institute of Technology, Texas Center for Cancer Nanomedicine at the University of Texas Health Science Center.

This presentation will describe the details behind the organization and science and technology of the Alliance.


Session 1-b :

Time: 7:30-9:00 IST

Speakers :

1b-1.   Anil K. Patri (NCI, USA): Resources for Preclinical Assessment of Nanomaterials

1b-2.   Jacob Berlin (City of Hope, Duarte, USA): Carbon-based Nanovectors for targeted paclitaxel delivery

Abstract:
Many new drugs have low aqueous solubility and high therapeutic efficacy. Paclitaxel (PTX) is a classic example of this type of compound. Here we show that extremely small (<20 nm) hydrophilic carbon clusters (HCCs) that are PEGylated (PEG-HCCs) are effective drug delivery vehicles when simply mixed with paclitaxel. This formulation of PTX sequestered in PEG-HCCs (PTX/PEG-HCCs) is stable for at least twenty weeks. Treatment with PTX/PEG-HCCs is as effective as treatment with Taxol? in vitro and in vivo. This drug delivery platform can be easily targeted by simply mixing with an antibody. The antibody-functionalized PTX/PEG-HCCs selectively kill receptor+ cells in vitro, and in vivo, this targeted formulation is more effective than Taxol? in reducing tumor volumes in an orthotopic murine model of oral squamous cell carcinoma. This work demonstrates that carbon nanomaterials can be effective targeted drug delivery vehicles in vivo when non-covalently loaded with an unmodified drug.

1b-3.   Jose Galvez (NCI, USA) : International Cancer Research Programs

1b-4.   Jeffrey I. Zink Jeffrey I. Zink (UCLA, USA): Multifunctional Mesoporous Nanoparticles for Targeting, Imaging and Drug Delivery

Abstract:
Mesoporous silica nanoparticles (particle diameter ~ 100 nm, pore diameter ~ 2 nm) are derivatized with molecules designed to induce multiple functionality. The most important functionality is the ability to trap molecules in the pores and release them in response to specific stimuli and/or on external command by using molecular machines. Other functions highlighted in this talk include incorporation of smaller metal nanocrystals (for antimicrobial activity and/or magnetic manipulation), targeting molecules (towards specific cells or microorganisms), and fluorescence (for imaging). [1] Two types of molecular machines that are based on molecules that undergo large amplitude motion when attached to mesoporous silica are described: impellers and valves. Derivatized azobenzene molecules, attached to the interior pore walls function as impellers that can move other molecules through the pores. Nanoparticles containing toxic molecules in the mesopores are taken up by cancer cells, and stimulation of the impellers drives out the toxic molecules and kills the cells. Nanovalves consisting of rotaxanes and pseudorotaxanes, placed at pore entrances, can trap and release molecules from the pores in response to stimuli. [2] Two methods of activation that have been demonstrated for in vitro studies will be discussed: pH changes and oscillating magnetic fields. Lysosomal acidification causes self-opening of the valves, and externally applied magnetic fields affords external control. Activation by both of these in living cancer cells will be discussed.


1b-5.   Hsian-Rong Tseng (UCLA, USA): Nano-velcro for Identification and Isolation of Circulating Tumor cells from Whole Blood

1b-6.   Fuyu Tamanoi (UCLA, USA): Anti-tumor Efficacy of Camptothecin-loaded Mesoporous Nanoparticles

Session 1-c :

Time: 9:00-10:30 IST

Speakers :

1c-1.  Xingyu Jiang (NCNST, Beijing, China): What nanoparticles could do to improve the quality of in vitro diagnostic assays?

Abstract:
I will cover our recent progress in using nanotechnology to i) improve the throughput & ii) achieve higher sensitivity and lower non-specific adsorption of in-vitro diagnostic assays. One of the challenges for cancer diagnostics is to assay for multiple biomarkers using body fluids such as saliva or blood during the asymptomatic stage of the emergence of tumors. Our methods based on microfluidics/nanoparticles can address this challenge.


1c-2.Xing-Jie Liang (NCNST, Beijing, China): Unique Biological and Medical Effects of Structures with Nanoscale Characterizations

1c-3.   Amit Dinda (All Institute of Medical Science, New Delhi, India): Cancer cell targeting with nanoparticle for drug delivery; The therapeutic and safety issues

1c-4.  Sangyong Jon (Gwangju Institute of Science and Technology, Korea): Aptide-based Nanomedicine for Cancer Imaging and Therapy

       Abstract

1c-5.  Ji Ho Park (Korea Advanced Institute of Science and Technology, Korea): A Systems Approach to Engineering Cancer Nanotechnologies

Abstract:
Over the past decade, widespread progress in nanotechnology has produced an impressive array of nanodevices with powerful electromagnetic and therapeutic properties. Nonetheless, our capacity to precisely home these materials to regions of disease in vivo has remained very limited and, despite three decades of research, ligand-targeted nanomedicines have yet to provide a benefit to patients. A fundamental limitation of current approaches to nanoparticle targeting is that they lack mechanisms of communication and amplification through which specific targeting events could assist the targeting of materials still in circulation. In this talk, I will discuss the development of nanosystems where a "cocktail" of two distinct nanomaterials work in concert within the bloodstream to amplify tumor targeting and improve therapy in vivo, which was inspired by examples of communication in natural targeting systems (e.g. inflammatory cell recruitment to infection). Specifically, the first activator nanoparticles initially targets tumors and, after arrival, sends signals through the biological cascades or directly to the second responder (diagnostic or therapeutic) nanoparticles to recruit them into tumors efficiently. This approach stands in contradistinction to all current nanotechnologies that utilize formulations of nearly-identical nanoparticles that perform competitive tasks without cooperation in vivo. I believe this work motivates a new paradigm of "systems nanotechnology" for biomedicine, where multi-component, interactive nanoparticle systems are engineered to improve the sensing and treatment of diseases in vivo.


Healthcare Session 2 : International Orthopaedic Networks

     Schedule

Session Chair:   Young-Sung Lee (Chung-Buk National University, Korea)


Speakers :

2-1.   Dong Soo Kim (CBNU, Korea) and Chanho Hwang (MedRIC, CBNU, Korea): A New Way of Medical Communication through Telemedicine

2-2.   Syed M. Awais (KEMC, Pakistan): Global Orthopaedic Residency Training Programs-International Orthopaedic Education

Abstract

2-3.   Anil Jain (University College of Medical Sciences, Delhi, India): "Research: a necessity"/ "Globalization of Orthopaedic Training and Research: Role of APOA"

Abstract:
The practice of Medicine is an art which has transformed from an art based on "belief in sup natural force" to "an art based on science". This art is learnt by observations of talented physicians to documented evidence and validated evidence. Asia pacific region inhabitated ? of the world's population out of which low income countries (LIC) and lower middle income countries (MIC) constitute 66% of Asia pacific and 50% of world's population. The practice of orthopaedics were guided by the west as the disease profile was same 60 years ago. Now there is a huge disparity in the disease profile in LIC and high income countries (HIC). These countries have a very meagre infrastructure and huge burden of disease. The clinical problems vary from simple fractures to neglected or complicated fractures. These countries see the natural history of disease. Since the west does not see the similar disease profile, hence we need to conduct research to evolve the treatment protocols for region specific clinical situations. The emphasis has to be on research conducted locally on need based solutions of clinical problems. Hence research is not to be remained individualistic but has to be policy based for a particular geographic areas. The research contributions from LIC and MIC is very meagre. We need to define regional needs, create a cadre of clinician scientist, provide help in overcoming regional barriers to the research, provide guidance to conduct credible research, modify teaching curriculum,. Creating an avenue for publication and rewarding the researchers for their contributions. The holistic approach is a road map in the direction of achieving pain relief from suffering humanity.

2-4.   Stephen S. Wolff (Internet2, USA): Role of National and Regional Networks for Collaborative Research and Education-Internet2, APAN, TEIN3 and GLORIAD

2-5.   H.K.T. Raza (APOA, India): Globalization of Orthopaedic Training and Research: Role of APOA

2-6. Chadwick F. Smith (LA, USA): Reflection of the Past, Present and Future of International Video-conferencing for Orthopaedics

2-7. W. Edward Johansen (LA, USA): Launch of the Orthopaedic Research and Education Network of Asia and the Pacific

Healthcare Session 3 : e-Health

     Schedule

Session Chair:   Young-Sung Lee (Chung-Buk National University, Korea)


Presentation by speakers :

3-1.   AnkitaPatro (TeachAIDS, USA) - TeachAIDS: A New Prevention Education Model

Abstract:
Solving the problem of how to provide effective health education on diseases subject to social taboos is an immediate need. The social stigma of HIV/AIDS is particularly prominent in the developing world, where 95 percent of all HIV-infected persons live. New approaches must be created to provide education despite whatever social, structural, cultural, and legal barriers exist. Fortunately, the emergence of new media and information and communication technologies (ICT) has provided new ways to help bypass social taboos and provide effective education.

The TeachAIDS software has been developed, tested, and optimized to provide HIV/AIDS education despite social and cultural challenges. It incorporates key pedagogical and communication theories and approaches in order to maximize its efficacy. To provide psychological comfort and promote coherent understanding, this ICT-based application couples the presentation of biological aspects of transmission with culturally-familiar euphemisms and metaphors to communicate ideas about prevention measures. Created using a rigorous, iterative, and research-based process, the 20-minute application provides detailed yet accessible culturally-appropriate explanations of all key aspects of HIV/AIDS prevention. The positive results of the TeachAIDS research suggest that it is possible to design curricula that are socially-acceptable and accurate, that promote significant gains in learning, retention, and changes in attitudes. Furthermore, these materials can encourage learners to proactively seek more information regarding the taboo topic and share prevention information with others. Educators who are reticent to teach about such subjects due to embarrassment or lack of health expertise can utilize similar approaches to educate students.

3-2.   Chii-Ruey Tzeng (Taipei Medical University, Taiwan): Current status of Telemedicine Network in Taiwan

Abstract:
Telemedicine has been using communication methods built in Taiwan's Healthcare infrastructure to link patients with health care providers. Because of a shift in prevalence of illness from acute to chronic, telemedicine provides an important means for frequent surveillance of health status in patients with chronic disease, such as heart failure, hypertension, diabetes, chronic respiratory disease, chronic renal disease, etc. The advantages of telemedicine is timely, cost effective, and convenient access to qualified health care services across distance. The first telemedicine system in Taiwan was established in January, 1996, between Kinmen's military hospital and the Taipei Veteran's General Hospital. We have experienced serving the underserved Penghu islands, Taiwan. Since 1999, we initiated the Integrated Delivery Systems (IDS) by the Bureau of National Health Institute (BNHI), aiming to cover 48 sub-counties in the remote and off-shore areas. Each of the six branches of the BNHI has certain autonomy to implement particular programs. The purposes are: to enhance accessibility, to integrate medical resources and synergize the effectiveness, to mobilize resources in the community, and to contain the NHI expenditure in those areas. The coordinator is Yuan's general hospital, a large community hospital based on Kaoshiung, the second largest city in Taiwan. It's plan for off-shore islands about acute care, specialty care, rehabilitation care, home care, and preventive care. It also holds networking of family practitioners and community resources for disease management include diabetes, gout, hyperlipidemia, renal disorders, and cancer. IDS seemed to be taking hold in the remote and off-shore areas, and have met a large portion of the needs.

3-3.   Saroj Mishra (India) - Current status of Telemedicine Network in India and Future perspective

Abstract:
India is a vast country with more than 1.15 billion population occupying an area of 3 million sq km. It consists of 29 states and 6 Union Territories governed by a federal system. There is no national health insurance policy for the country. Government supported healthcare delivery follows a three tier system and is the primary responsibility of each state. It has been observed that there is a great deal of disparity in quality and access to healthcare between urban and rural regions. This can be bridged through telemedicine technology if the tool is integrated into existing healthcare delivery system. Both government and private sector have been actively participating in tele-health programmes. India is starting to make strides in the fields of telemedicine and eHealth. The telemedicine market has witnessed spectacular growth during the last two years mainly because of timely convergence in the areas of Information technology, Communication & Healthcare alongwith launching of central e-health schemes including telemedicine by the Ministry of Health & Family Welfare.


3-4.   Manjeet Singh Chalga (India) - Networking of ICT Technologies for Improvement in the Health Care

Abstract:
Information and Communication Technologies (ICT) are increasingly being applied in almost all fields in the world. However, implementation of ICT in the health sector is facing many challenges due to inadequate infrastructure and limited resources. Presently, in India, Health Sector is facing many complex problems. Health Sector is having computer systems up to Block level, Telecommunication facility up to village level and scarcity of skilled workers. One or two ICT technologies alone can not suffice the developing needs of the health sector. There is a need of intelligent networking of various ICT technologies by using optimum resources. Various studies have encouraged the use of different ICT techniques such as Hand held Computers, Web based techniques, SMS System, Software applications for data analysis, Interactive Voice Response System and Computer based devices. This Paper has described a system which can be developed by networking all these techniques and the available telecommunication techniques for efficient implementation of ICT in health informatics and wider coverage in health care using optimum resources. The system envisaged is developed by integrating PRI ISDN line, Telephony board, Interactive Voice Response System programmed using TAPI 3.0, SMS system using telecom GSM service, GIS & GPS technology, Web Server and web applications, Database Server and role of software modules in the integration of these technologies.


3-5.   Myungja Koh (MedRIC, CBNU,Korea)- Development and Management of National Health Education System for Emerging Infectious Diseases

Abstract:
Influenza Pandemic is a national emergency. Therefore in this public health emergency situation need to be trained through well-planned public health education system.

Infectious diseases such as SARS, avian influenza (AI), swine fever, foot-and-mouth disease, and others require advance preparation.

An outbreak of such diseases have direct or indirect impact on a variety of areas such as health, life, and national economy.

In 2006, the infection and the epidemic zone have spread to the Middle East, Europe, and Africa, and new patients and the number of death caused by the influenza dramatically increased in that season were.

Although the currently spreading influenza A virus records a high mortality rate among infected patients, the virus has not to acquire the ability to easily transmit from person-to-person, yet.

Due to the rapid change and widely accumulated knowledge for pandemics the current plan must continuously be reviewed.

Development and Use of a Public Health Education system in Preparation for a Pandemic.

  • This information system is needed to manage and assess through the group, it's named, "The influenza pandemic advisory committee."

  • During the Pandemic Alert Period, this committee select prosper content's items for specialist, and confirm and then report our development team. Our team make Senarios and develop the contents by using flash web animation.

  • A system that links to APAN, Medric video conference system, a public health center of korea's province,

  • It's contents also is databased and the database and education system covering all pandemic response workers and specialist is needed.

Education Target group is public healthcare workers, healthcare service professionals, and workers at public health authorities and related civil organizations.

Develop education material to be provided to health care organization personnel

  • Pandemic influenza preparation and response guideline

  • Clinical and laboratory diagnosis method

  • Planning for treatment, and for possible shortage of hospital beds and vaccine, antiviral drugs during treatment

The contents should be easy to access, therefore we shall make the contents easy to comprehend. For that reason the contents is developed by a flash web animation.

Our team's project use a Medric video conference system. In the future, we will upgrade our system as a real time local broadcasting, and then practice various educational needs.

3-6 Demonstration of CliniSpace (30~45 minutes) by   Parvati Dev et al.

CliniSpace is an application program which provides medical training for healthcare professionals on clinical diagnosis and patient management in the 3D virtual environments

Title: A Multi-User Virtual Environment for Healthcare Training
Abstract:
Online virtual environments are well known in video games and have been adapted for use in medical training. These medical environments are built using available game technology. One such technology is Second Life. We have built our environment, CliniSpace, using a different game engine, Unity3D, because of its support for a wide range of devices including iPads and smartphones.

CliniSpace lets you join a 3D medical experience in minutes, entering spaces such as wards or emergency rooms, with interactive medical objects, and with virtual patients. The user logs in as a nurse or doctor, alone or along with others as a team. The team encounters medical crises such as mass casualties or infections, and must work together to make decisions and save lives. All performance is tracked and assessed.

Learning in virtual environments addresses some important problems. It focuses on learning new behaviors and attitudes by being immersed in situations that demand these new approaches. This targets current healthcare problems of error reduction, infection reduction, and cost reduction.

DVTS-Plus Session :

     Schedule


Technology Session :

     Schedule


Session Chair:   Ti-Chuang Chiang (National Taiwan University, Taiwan)

Endosc Session :

     Schedule


Transplantation Session :

     Schedule

7-1. India Habitat Centre, New Delhi (ERNET), India
Current situation of the transplantation in India (15min)
  Doctor: Ravichandran Rajan

7-2. Viet Duc Hospital, Hanoi, Vietnam
Current situation of the transplantation in Vietnam (15min)
  Doctor: Hai An

7-3. Groote Schuur Hospital, UCT, Cape Town, South Africa
The past and the future of the transplantation in South Africa. (15min)
  Doctor: Sandie Thompson   Dr Alistair Millar   Dr Elmi Muller

7-4. Fujita Health University, Japan
Current situation of the transplantation and social background in Japan (15min)
Doctor: Fukami N, Yoshida J

7-5, Discussion and Summary (30min)

Surg Session :

     Schedule

Session Chair:   Shuji Shimizu ( Kyushu University Hospital, Japan )


 Remarks :
  We will have many sessions using DVTS and other technologies. We would like to have enough time for preparation or rehearsals at the same room.

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