title: A remote educational system in medicine using digital video.
abstract: OBJECTIVE
  Telemedicine has opened the door to a wide range of learning experience and simultaneous feedback to doctors and students at various remote locations. However, there are limitations such as lack of approved international standards of ethics. The aim of our study was to establish a telemedical education system through the development of high quality images, using the digital transfer system on a high-speed network.
  
  
  METHODS
  Using telemedicine, surgical images can be sent not only to domestic areas but also abroad, and opinions regarding surgical procedures can be exchanged between the operation room and a remote place. The Asia Pacific Information Infrastrucuture (APII) link, a submarine cable between Busan and Fukuoka, was used to connect Korea with Japan, and Korea Advanced Research Network (KOREN) was used to connect Busan with Seoul. Teleconference and video streaming between Hanyang University Hospital in Seoul and Kyushu University Hospital in Japan were realized using Digital Video Transfer System (DVTS) over Ipv4 network.
  
  
  RESULTS
  Four endoscopic surgeries were successfully transmitted between Seoul and Kyushu, while concomitant teleconferences took place between the two throughout the operations. Enough bandwidth of 60 Mbps could be kept for two-line transmissions. The quality of transmitted video image had no frame loss with a rate of 30 images per second. The sound was also clear, and time delay was less than 0.3 sec.
  
  
  CONCLUSIONS
  Our experience has demonstrated the feasibility of domestic and international telemedicine. We have established an international medical network with high-quality video transmission over Internet protocol, which is easy to perform, reliable, and economical. Our network system may become a promising tool for worldwide telemedical communication in the future.
authors.affiliation: Department of Internal Medicine, College of Medicine Hanyang University, Korea. hamjs@hanyang.ac.kr
authors.forename: Joon Soo
authors.initials: JS
authors.lastname: Hahm
authors.forename: Hang Lak
authors.initials: HL
authors.lastname: Lee
authors.forename: Sun Il
authors.initials: SI
authors.lastname: Kim
authors.forename: Shuji
authors.initials: S
authors.lastname: Shimizu
authors.forename: Ho Soon
authors.initials: HS
authors.lastname: Choi
authors.forename: Yong
authors.initials: Y
authors.lastname: Ko
authors.forename: Kyeong Geun
authors.initials: KG
authors.lastname: Lee
authors.forename: Tae Eun
authors.initials: TE
authors.lastname: Kim
authors.forename: Ji Won
authors.initials: JW
authors.lastname: Yun
authors.forename: Yong Jin
authors.initials: YJ
authors.lastname: Park
authors.forename: Nakashima
authors.initials: N
authors.lastname: Naoki
authors.forename: Okamura
authors.initials: O
authors.lastname: Koji
mesh_terms: D003195:Computer Communication Networks; D003199:Computer Systems; D003479:Curriculum; D020375:Education, Distance; D005762:Gastroenterology / Q000193:education*; D013502:General Surgery / Q000193:education*; D006785:Hospitals, University; D006801:Humans; D020407:Internet; D007564:Japan; D007723:Korea; D014741:Video Recording