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 :

 Agenda :

Technology for each demo :

  • Quatre-4: Cardiol, Transplantation
  • Quatre-8: Thoraco, Endosc
  • DVTS-Plus: Technology session
  • Polycom/Vidyo: Health
  • HD: Czech
  • Polycom: Activity/WorldNW

Activity :


#2-1 Telemedicine activity in Brazil and network in South America.

Presenter:   Paulo Roberto de Lima Lopes , Federal University of Sao Paulo, Sao Paulo, Brazil

The National Telehealth Program has, since 2007, funded by Ministry of Health, developed strategies for classifying and qualifying Family Health Teams (FHT), involving 9 states. University centers have been responsible for 1.361 Telehealth connection points for Family Health Unities within 1.113 cities. The deployment of such points was done in favor of cities with population under 100,000 people, low human development index, fair local connectivity, already covered by the FHS, and were located in remote areas (including all the Amazon Region). In general the Telehealth Program offers support to FH Teams through asynchronous and synchronous teleconsultation. This teleconsultation is characterized as a permanent educational activity for those using this service under the FHS. These activities are called Formative Second Opinion (SOF), i.e., they are carried out with educational character, aiming at increasing the resolving capacity of the worker who asks for that service. SOF is based on the best available scientific evidence, tailored to local realities and following the principles of SUS - The National Health System and Primary Care. The object of a SOF is typically either a discussion of a clinical case concerning a specific patient or situations involving an entire family or community. It can also be a complete subject or even a health issue concerning the process of work teams within the FHS. At the end of 2010, the National Telehealth Program entered a new phase aiming at expanding geographically, initially to five additional states before being nationwide, and also by making Telehealth a regular and regulated activity within SUS.

National Telehealth Program also is supported by other national program Telemedicine University Network, RUTE, Ministry of Science and Technology, started January 2006. RUTE is building and updating the application-level infrastructure of university hospitals, in the major cities of the country. The project goal is to allow all the participating hospitals to use the academic network to run telemedicine and telehealth applications including video conferencing for information exchange, second opinion, continuous education and web conferencing. It builds the basis for the inter-hospital collaboration. As part of the RUTE project there is a council which includes members of the major university hospitals, RNP, the Brazilian Association of University and Education Hospitals, a representative of each Ministry of Health, Education, Science and Technology and FINEP, the National Funding Agency for Projects and Studies, which discusses and defines the policies, procedures and all the subjects related to the use of the Telemedicine Network.

Telehealth Public Policies are been established through governmental health institutions, associations and national standards boards in Latin American - LA. Most countries in LA have launched and run Advanced Academic Communication Networks. which have received strong support from the Inter-American Development Bank - Reserach Program - IDBRPG Program. This has definitely been a driving force for innovative research, new intra-institutional articulation and development activities among all LA countries.

Two major National LA Telehealth Programs play an important role and push forwards the Telehealth initiatives in LA, namely the Programs from Mexico and Brazil, and now also Colombia, as the NREN RENATA connected 18 university and teaching hospitals through its ICT Plan and launched October 7th 2010. The aim of this project is to stimulate October 7th 2010. The aim of this project is to stimulate regular use of the Telehealth University Network connecting the national Telehealth programs and activities in Brazil, Mexico, Colombia, Chile, Uruguai, El Salvador and Ecuador with the main focus on establishing and disseminating Telehealth Public Policies in Latin America as well as allowing health professionals collaboration also in the secondary and tertiary level of assistance and research. And the interconnection network support for these activities are supported by several academic pan-American networks, like CLARA.

#2-2 MediNET: Medical network updates in Thailand   Slides

Presenter: Panjai Tantatsanawong, UniNet, Bangkok, Thailand

#2-3 Telemedicine activity in Seattle   Slides

Presenter:   Ken Westermann , Seattle Science Foundation, Seattle, USA

The Seattle Science Foundation is dedicated to fostering collaboration between medical doctors and their peers around the world. In this presentation Ken will introduce the foundation and it's global collaborative outreach potential.

#2-4 Telemedical activity in India: SGI2010 and more   Slides

Presenter:   Satyanarayana Ungarala , Asian Institute of Gastroenterology, Hyderabad, India

Telemedicine in India played a major role in providing urban facilities at Rural areas. Later in year 2001, after introduction of Video Conferencing equipment and availability of High Bandwidth, conducting live teleconferences has become so easy. Using telemedicine technology (VSAT connectivity) Asian Institute of Gastroenterology came out with its own project called " Rural Healthcare Project " where in the institute has started providing modern health care at the door steps of rural population, without posting any senior gastroenterologist at the rural area. Using this Live teleconferencing technology, AIG has conducted many National and International Live Endoscopy / Surgical workshop as a part of Continuing Medical Education programme. Till end of 2010, we were not aware what is DVTS technology. During the end of 2010 we were asked to transmit Live NOTES workshop to Seoul as part of SGI 2010, only by using DVTS technology to maintain a very high quality of Video and Audio at the receivers end. With lot of encouragement and support from Prof Shimizu, Associate Professor of Department of Endoscopic Diagnostics and Therapeutics and Deputy Director of Telemedicine Development Centre of Asia at Kyushu University, Japan, we could down load the related software from the net and did a trail run within our own network and successfully completed our transmission to Seoul and all this credit goes to the one and only person ?Prof Shimizu for guiding us from a far away country.

Network updates :


#3-1 Network in South Africa   Slides

Speaker:   Andrew Alston , TENET, Wynberg, South Africa

#3-2 East Europe and Central Asia   Slides

Speaker:   Jacek Gajewski , CEENet, Warsaw, Poland
                   Stella Atkins , Simon Fraser University, Vancouver, Canada

In June 2001 NATO agreed to fund a non-military project to bring Internet connectivity to the countries in the Southern Caucasus and Central Asia, using satellite dishes located at key academic institutions in each country. This "Virtual Silk Highway" project was ambitious, innovative and exciting, both technically and sociologically. We present the story of how we used this project to bring telemedicine to Uzbekistan and other countries in Central Asia, to improve pathology diagnosis. Tissue biopsy slides are made locally in the remote regions using microtome equipment, and for difficult diagnoses, the slides are digitized using a digital camera attached to a microscope. The slide images are then transmitted digitally using the internet to a centre in capital city for diagnosis by a country's leading experts. In fall 2010 NATO funded a workshop in Tashkent, Uzbekistan, to extend the Uzbekistan telepathology network into other CA and Caucasus countries. The workshop was designed to introduce the concepts and use of telepathology to mainly developing countries, with the focus on NATO Partner countries in Central Asia. This workshop was used to train a total of 40 pathologists in 4 more developing countries: Georgia, Kazakhstan, Turkmenistan and Tajikistan, other users in the Uzbekistan regions, and pathologists in Russia, to establish a network of telepathology centres in each country, which will be connected to the Tashkent Pathology centre. Additionally, all the participants learnt about distance education techniques using the freely-available General Pathology Certificate Course on the Health Sciences Online (HSO). The participants learnt proper autopsy techniques which are not usually taught in the primarily Muslim countries such as Tajikistan, where same-day burial of a complete body is considered very important. The participants learned about several telemedicine projects in South-East Asia and expressed their willingness for cooperation with that region.

#3-3 Egypt network and Theodor Bilharz Research Institute (TBRI)

Speaker:   Majid M.Al-Sadek , TBRI, Cairo, Egypt

#3-4 NKN for hospitals in India   Slides

Speaker:   Ranjan Kumar , ERNET, New Delhi, India

HDTV & Medical Joint Demo Session (Live Demo of 3D Robot Surgery from CZ) :


Session Chair:   Dr. Shuji Shimizu (Kyushu University) and Dr. JongWon Kim (GIST)

#4-1 Demo Instruction
Speaker: Jiri Navralti - CESNET

Introduction about the live demo will be provided, which is intended for high-level education for surgeons. Also, other technical details about demo (the connections from the hospital in CZ to the venue in HKG and the technical devices for live transmission) will be provided.

#4-2 Live Demo of 3D Robot Surgery

Operator: Dr. Jan Schraml - MNUL, Czech Republic

Live surgery demo of a patient with carcinoma of the prostate cT2N0M0 will be performed to demonstrate the advantages of mini-invasive robotic-assisted radical prostatectomy in preserving neurovascular bundles and bladder neck.

#4-3 Wrap-up (moderated by Session Chairs)

Healthcare-1 :


#5-1 Gold Nanorod-Based Nanomedicine

Speaker:   Yongdoo Choi , PhD, National Cancer Center, Republic of Korea

Recently noninvasive molecular imaging and therapy (MI&T) technologies using nanomaterials has been one of the greatest interest in biomedical research fields. The usefulness of nanomaterials is mainly derived from their small size, large surface area, and size and/or shape dependant changes in their optical, magnetic, and electrical properties. For examples, gold nanoparticles have been shown great potential as a biosensor, drug delivery carrier, ultraefficient quencher for fluorochromes, and a drug for hyperthermic therapy. In this seminar, gold nanorod-based nanomedicine for molecular imaging and therapy of various cancers will be introduced. We combined gold nanorod with other reagents including photosensitizer, MRI contrast agent, and radioisotope to maximize their utility in the imaging and therapy. Recent advances achieved in our laboratory will be introduced.

#5-2 in vivo Nano-Molecular Imaging of Cancer Slides

Speaker:   Keon Wook Kang , M.D., Ph.D, Seoul National University, Seoul, Korea

in vivo imaging such as MRI, positron emission tomography (PET) has been playing an important role in diagnosing diseases and monitoring treatment for decades. Recently, in vivo imaging is widening its field through revealing molecular events in cells and tissues. Molecular imaging is used for early detection, characterization of disease and an early assessment of treatment efficacy through imaging molecular/cellular events in living organisms. Molecular imaging is useful not only for clinical studies but also for developing new drugs and new treatment modalities such as gene or stem cell therapy. Pre-clinical molecular imaging using animals such as mice shows biodistribution, pharmacokinetics, mechanism of action, and efficacy in vivo.

Nanoparticles are able to carry fluorescent dye, radioisotope, drugs, genes, and targeting biomarkers on their surface and inside. These multifunction nanoparticles can be used for diagnostic in vitro and in vivo and therapeutic purpose as well. One of the examples is molecular imaging targeting biomarkers. For example, Quantum dots conjugated Herceptin could be used for evaluating Her2 status in tissues and in vivo as a companion diagnostics to select appropriate patients who will be treated with Herceptin.

For the imaging sources, fluorescent materials, radioisotopes, and MRI enhancers can be used. Each modality has its own advantages and limitations with respect to sensitivity, resolution, and tissue penetration of signal. Multimodal technique combined PET/MRI/optical imaging will overcome the limitations of each modality. We examined the feasibility of PET/MRI/fluorescent tri-modal imaging for sentinel lymph node detection using radiolabeled silica nano-particles and molecular targeted imaging using liposome nanoparticle conjugated with SLX for cancer in mouse models.

If we combine nanotechnology and high throughput proteomics searching for individual biomarkers, personalized targeting therapy can be possible after validating the targeting efficiency using multimodal multiplexing in vivo imaging.

#5-3 Speaker:   Dr. Young Sung Lee , M.D. Ph.D., Korea

#5-4 Speaker:   Fuyu Tamanoi , PhD, Professor, University of California, Los Angeles

#5-5 The Application of Telehospice Service at NTUH Taiwan
Speaker:   Yu-Jen Hsieh , RN MNS

More than 50% of cancer patients preferred that home as the place of death. However, many of patients did not fulfill their final wishes to die at home. One of the common reasons for terminal cancer patient with stable condition refused to discharge from hospice ward is the fear of not having enough support networks in the skills and knowledge of care at home. In year 2010, the telehospice service program was introduced in the hospice ward at National Taiwan University Hospital Taiwan. This new service model did not intend to provide the service which replaced the traditional home care but allowed the terminal cancer patients and their caregivers to receive additional support. The outcome of this service application addressed some positive feedbacks and benefits to the patients and families at home. A case exemplar will be presented to show that how can telecommunication technologies be used to deliver the end of life care for patient and family in improving the quality of life and satisfactions in receiving home based hospice care.

#5-6 Detection of several cancer biomarkers by semiconductor Si nanowires
Speaker:   TD Hien ,   Slides

#5-7 APAN as a Partner for International Collaborative Research in Cancer and Nanotechnology
Speaker:   W. Edward Johansen, MS, JD   Slides

Healthcare-2 :


#6-1 The various possibility of telemedicine for cardiovascular intervention

Speaker:   Dr Josip Car , MD PhD DIC MSc, Imperial College Academic Health Sciences Centre

BACKGROUND: Research on patient care has identified substantial variations in the quality and safety of healthcare and the considerable risks of iatrogenic harm as significant issues. These failings contribute to the high rates of potentially avoidable morbidity and mortality and to the rising levels of healthcare expenditure seen in many health systems. There have been substantial developments in information technology in recent decades and there is now real potential to apply these technological developments to improve the provision of healthcare universally. Of particular international interest is the use of eHealth applications. There is, however, a large gap between the theoretical and empirically demonstrated benefits of eHealth applications. While these applications typically have the technical capability to help professionals in the delivery of healthcare, inadequate attention to the socio-technical dimensions of their use can result in new avoidable risks to patients. RESULTS AND DISCUSSION: Given the current lack of evidence on quality and safety improvements and on the cost-benefits associated with the introduction of eHealth applications, there should be a focus on implementing more mature technologies; it is also important that eHealth applications should be evaluated against a comprehensive and rigorous set of measures, ideally at all stages of their application life cycle.

#6-2 A mHealth solution for diabetes management in hospitals   Slides

Speaker:   Antonio J. Jara , Alberto F. Alcolea, Miguel A. Zamora, Antonio F. G. Skarmeta,Dhananjay Singh and Daeyeoul Kim

Blood sugar management in Hospitals is a complex task since factors such as patient's illness, treatments, drugs, and meals plan affect patient's blood sugar level. Nowadays, the insulin infusion calculations are made based on boards elaborated by the physicians. These boards do not take into account very influential factors such as glycemic index from the diet causing mistakes in the dosage which can cause unpredictable and potentially dangerous fluctuations in blood sugar levels. For that reason, this process should be supported by a Diabetes Management System that recollects the information needed in order to calculate efficiently the right dosage for the insulin infusion. This paper proposes a mHealth solution based on Internet of things (IoT) to provide a global connectivity and management architecture of sensor, users and Information Systems in clinical Environments. Specifically, the use of the IoT is, on the one hand, RFID cards and bracelets to provide the patient's identification and profile. On the other hand, it is used 6LoWPAN to connect the mHealth device to the network from the hospital, in order to transfer the glucose value to the Hospital Information System and calculate the dosage with the Diabetes Management System. This solution is composed by an intuitive application to configure the patients' health card and bracelets based on RFID. A mHealth device for the nurses and physicians, which offers a RFID reader, a 6LoWPAN transceiver and a jack to connect the glucometer, this 6LoWPAN transceiver allows communicating with the network of the hospital to reach the Information Systems. Finally, this is composed by a Diabetes Management System, which calculates the insulin infusion and sent it to the nurses and physicians to the mobile phone or the developed mHealth device. This Diabetes Management System access to the information from the Hospital Information System or the patient's health card based on RFID to get the patient's profile, this also has a database with the glycemic index of the meals, as such to offer an accurate insulin dosage for the patient's insulin therapy.

#6-3 eHealth Trends and the Use of Standards and Guidelines  Slides

Speaker:   Mr. Landry , the Health Information Technical Officer with the WHO Western Pacific Regional Office (WPRO).

Health is an information intensive sector. Using information and communications technology (ICT) for health-or eHealth-can undoubtedly lead to better health outcomes, including higher quality and affordable services with universal access. The depth and breadth of eHealth experience globally is rich with tested, documented, cost-effective and successful examples of valuable services and applications that are compatible with ICT infrastructure already paid for and in place. It is time to move beyond eHealth demonstrations, pilot projects, and proofs of concept and begin implementing eHealth at national scale. We know what works and generally what will work. The proliferation of mobile phones and available ICT infrastructure reaches even the most remote, underserved, and hard-to-reach populations, suggesting the possibilities are enormous for innovative and tailored use eHealth in diverse environments. eHealth can have transformational impact on both an individual basis and improvements to the overall health information system. Addressing the five grand challenges in eHealth (governance, technical, financial, legal/ethical, and localized factors) is not only feasible, but also aided by tools and standards available coupled with the promotion and use of good techniques-including enterprise architectural approaches for improving the overall design and implementation of future eHealth investments. The expansion of existing and introduction of new, innovative eHealth solutions in Asia and the Pacific is accelerating and will continue to save more lives and improve health.

#6-4 Laying country wide e-infrastructure for Distance Medical Education - Network Design, Pilot and scaling up Deployment for National Medical College Telemedicine Network: India Case Study  Slides

Speaker:   S. K. Mishra , Lucknow, India

Development of a nationwide Virtual Private Network linking all the Government Medical Colleges, Universities and Central/State autonomous Medical Institutes is for Improving quality of medical/paramedical education and meeting the educational needs of the students despite paucity of teachers and infrastructure, Improving quality and reducing the cost of health care delivery by tele-consultation and tele-follow up, Case & Problem based learning, skill development through tele-proctoring / tele-mentoring, linking Medical College Libraries with National Medical Library. This will enable the Clinicians to practice "Evidence Based Medicine" armed with access to current knowledge and decision support and promote medical research by providing infrastructure for quick exchange of ideas and co-ordination with group of researchers involved in collaborative multicentre studies and facilitating current information access through digital library network. Continuing Medical Education (eCME) enhance knowledge and teaching skill and possible Accreditation of Medical Teachers and Health Care Professionals by enhancing computer literacy and ICT based skill among medical students & teachers and facilitating eHealth Governance. Selected tertiary care academic Medical Institutes from different regions of the country will be identified as Medical Knowledge Resource Centres (Regional Hub), each of which will be connected to Medical Colleges (Nodes) in that region. One of these regional hubs will be identified as the Central Hub which will be made overall responsible to co-ordinate the National Medical College Telemedicine Network in addition to providing infrastructure for Central Content Development Centre. Telemedicine network linking all the nodes with the regional hub and central hub will be based on IP-MPLS (Internet Protocol- Multi Protocol Labeled Switching) VPN (Virtual Private Network) backbone.

#6-5 Speaker:   Madeleine de Rosas-Valera , MD, MScIH (Heidelberg)

#6-6 Infectious Disease Surveillance System in Korea  Slides

Speaker:   Byungguk Yang , MD

Cardiology :


#7-1 A case of robotic right lower pulmonary lobectomy requiring sutured closure of the bronchus   Slides

Speaker:   Fumiaki Ikeno , MD, Cardiovascular Medicine, Stanford University

The da Vinci Surgical System is a telerobotic system consisting of 4 components, including the insite vision system with a true 3-dimensional endoscope providing a high-resolution binocular view of the surgical field, and the Endo Wrist instrument system, which is capable of 7 degrees of freedom and 2 degrees of axial rotation to replicate human wrist-like movements.

We will show a video of a lung cancer case that required sutured closure of the bronchus following lobectomy. The tumor in the right lower lobe formed an endobronchial polyp which projected deep into the bronchus intermedius. After an adequate resection margin was confirmed with bronchoscopy, the lower lobe bronchus was divided with a knife. The bronchial stump was then sutured and closed utilizing the da Vinci surgical system. The Endo Wrist system facilitated endoscopic suturing by a great amount.

With further innovations to come, the da Vinci Surgical System has potential to enable new, minimally invasive options for complex thoracic surgery procedures.

#7-2 Speaker:   Dr Paul Hsien-Li Kao , MD

#7-3 An evaluation on the utility of DVTS system in Interventional Cardiology

Speaker:   Dr Adrian Low , Associate Professor with the Yong Loo Lin School of Medicine, National University of Singapore

Transplantation :


Topics: Transplantation and Bioethics in Asia: Reports from Four Countries

Main medical organizer: Dr Sugitani A
Main engineering organizers: Prof Okamura K, Mr Torata N

#8-1 Hong Kong Convention and Exhibition Centre (HKCEC), HK, China

Current situation of the transplantation in Hong-Kong
Doctor: Po Chor Tam

#8-2 Asan Medical Center, Seoul, Korea

Current situation of the transplantation and Bioethics in Korea, etc.
Doctor: Park JB / Han DJ

#8-3 University of the Philippines Manila, Philippine

Current situation of the transplantation and Bioethics in Philippine, etc.
Doctors: Dennis Serrano, Siegfried Paloyo, and Allan Consejero

#8-4 Fujita Health University, Japan

Current situation of the transplantation and social background in Japan
Doctor: Fukami N

#8-5 Discussion and Summary

Connecting the HKCEC with three remote stations
"Future direction to develop appropriate transplant medicine, Proposal of Asian transplant Bioethics", etc.

Technology updates :


Chairpersons: Bao Congxiao ( Tsinghua University, China)
                           Chiang Ti-Chuang ( National Taiwan University, Taiwan)

11:00-11:05 (HK)

            #9-1 Opening remarks/ Bao /Chiang

11:05-11:40 (HK)

            #9-2 Greetings from each station and share their DVTS plus experiences

                       Taiwan's Experience of Telehealthcare in Rural Natural Disaster Areas - Mei-Ju Su   Slides


            #9-3 DVTS-Plus updates
            Presenter: Bao Congxiao (Tsinghua University, China)


            #9-4 Q&A /comments/new requirements for real use/ all station & Bao


            #9-5 How best can we use this technology? Next step?

Thoracoscopic surgery :


#10-1 The various possibility of telemedicine for cardiovascular intervention

Speaker:   Dr. Takashi Suda , MD, Fujita Health University, Toyoake, Japan

The cardiovascular intervention was started in 1977 by Andreas Gruentzig, To make this procedure more common, he selected the live transmission educational method. Currently, we continue doing this educational activity in each country. However, the technology of devices for interventional cardiology is now progressing very rapidly and we think this kind of educational activity is necessary between different countries.

In APAN 2011 meeting, we will have the 1st teleconference among Asian Pacific countries with experiences interventional cardiologists. We are going to discuss various possibility of telemedicine for the cardiovascular interventional education.

#10-2 Robotics in General Thoracic Surgery -How the Robotics Evolutes Procedures

Speaker:   Ryuichi Waseda , M.D. and Ph.D. , Kanazawa University, Japan

Da Vinci surgical system was introduced in our university in the year 2005, and has been used mainly in cardiac surgery. We have also been working on introducing the robot in the general thoracic surgery.

Cooperating with East Carolina University, we invented novel procedures by using human cadaver. We also evaluated its feasibility and safety by using animals. In the year 2010, we started to apply robots in clinical use. I will present our work.

#10-3 Robot-Assisted Pulmonary Resection for Lung Cancer

Speaker:   Dr. Hyun-Sung Lee , MD, PhD, Center for Lung Cancer, National Cancer Center, Korea

Minimally invasive surgery (MIS) for early stage lung cancer has been an important treatment modality. However, the ergonomic discomfort and counterintuitive instruments hindered the application of VATS to more advanced procedures. To improve the compliance with MIS, robotic surgery was adopted. This advance aimed to alleviate the shortcomings of VATS by maximizing the comfort of the surgeon while providing instruments that enabled technically demanding operations and three-dimensional views with increased freedom for intrathoracic movement owing to EndoWrist?. In this session, I will introduce the clinical applications and its results of robot-assisted thoracic surgery in the field of lung cancer surgery.

Endoscopy :


Topics: Endoscopy Case Teleconference

16:00-16:05 (HK)

            #11-1 Opening remarks by Dr Seo DW

16:05-16:10 (HK)

            #11-2 Greetings from each station


            #11-3 Case presentations and/or mini-reviews


            #11-4 Comments from each station


            #11-5 Closing remarks/Dr Lau J

 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. Necessary equipments may include multi-point videoconference system, microphones, mixers, and several high-quality monitors.

© Copyright 2009 - 2011 APAN | | Last updated: 22 Mar 2011