1. International Telecommunication Union Workshop on Standardization in E-health Geneva, 23-25 May 2003 Clinical Study on MPEG-2 Compression Based on the Rec. ITU-R BT. 500-9 Isao Nakajima, M.D., Ph.D. Associate Professor Tokai University Institute of Medical Sciences Invited Researcher Communication Research Laboratory, Japan

2. ITU-T 2 23-25 May 2003 Workshop on Standardization in E-health Agenda 1, Useful ITU Recommendation ! Recommendation ITU-R BT. 500-9 2, Application Ambulatory applications Real time telemedicine

3. ITU-T 3 23-25 May 2003 Workshop on Standardization in E-health User report on ITU Recommendation Clinical Study on MPEG-2 Compression Based on the Rec. ITU-R BT. 500-9 Purpose

4. ITU-T 4 23-25 May 2003 Workshop on Standardization in E-health

5. ITU-T 5 23-25 May 2003 Workshop on Standardization in E-health

6. ITU-T 6 23-25 May 2003 Workshop on Standardization in E-health

7. ITU-T 7 23-25 May 2003 Workshop on Standardization in E-health MPEG-1 power density tested with DFT 3.0 Mbps v.s. 0.5 Mbps

8. ITU-T 8 23-25 May 2003 Workshop on Standardization in E-health

9. ITU-T 9 23-25 May 2003 Workshop on Standardization in E-health

10. ITU-T 10 23-25 May 2003 Workshop on Standardization in E-health

11. ITU-T 11 23-25 May 2003 Workshop on Standardization in E-health

12. ITU-T 12 23-25 May 2003 Workshop on Standardization in E-health Mid gray scale Compressed Mid gray scale Original

13. ITU-T 13 23-25 May 2003 Workshop on Standardization in E-health

14. ITU-T 14 23-25 May 2003 Workshop on Standardization in E-health

15. ITU-T 15 23-25 May 2003 Workshop on Standardization in E-health

16. ITU-T 16 23-25 May 2003 Workshop on Standardization in E-health

17. ITU-T 17 23-25 May 2003 Workshop on Standardization in E-health Comparison as with frozen picture

18. ITU-T 18 23-25 May 2003 Workshop on Standardization in E-health

19. ITU-T 19 23-25 May 2003 Workshop on Standardization in E-health

20. Video Transmission What we are aiming to ! 1. Problem of 3G(IMT2000) ! Frequency selective fading Blocking 2. How we can track a satellite from a high speed vehicle. 3. IP-based multimedia for ambulatory applications. 4. We can reduce medical cost!!

21. ITU-T 21 23-25 May 2003 Workshop on Standardization in E-health What is DPC via telecommunications ?

22. ITU-T 22 23-25 May 2003 Workshop on Standardization in E-health Target images

23. Frequency selective fading due to multipath

24. Flooring Phenomenon Error ratio cant improve with high speed vehicle under the environment of multipath

25. some 10m low mobility <2Mbps pico Node B,TDD some 100m medium mobility <384Kbps micro Node B FDD or TDD max15km high mobility <144Kbps macro Node B FDD Pico cell Micro cellMacro cell Office Home Building Train IMT-2000(3G) IMT-2000(3G) 2Mbps data up-link from moving vehicle is impossible with IMT-2000 (3G). Only 144Kbps expected, but no hardware !!

26. ITU-T 26 23-25 May 2003 Workshop on Standardization in E-health Blocking ( Shadowing ) Blocking; block of line-of-sight communications

27. ITU-T 27 23-25 May 2003 Workshop on Standardization in E-health Calculated by T. Maeda, Hitachi Elevation > 80 deg. Duration [ hour ]

28. Visibility study ( natural image )

29. Natural image Binary image Analysis

30. ITU-T 30 23-25 May 2003 Workshop on Standardization in E-health Result of visibility study diversity distance shall be 2.3m

31. ITU-T 31 23-25 May 2003 Workshop on Standardization in E-health Super Ambulance with diversity satellite antenna(distance 2.3m)

32. How to track a communication satellite from high speed vehicle Non-backlash Quadrant detector

33. N-star(GEO) tracking with Quadrant Detector

34. Real-time Telemedicine MPEG-2,-4, 6 (3+3)Mbps

35. ITU-T 35 23-25 May 2003 Workshop on Standardization in E-health Reduce Medical Cost ! Medical Cost In case of Acute Myocardial Infarction in Japan, Thrombolytic agents are effective within 60 minutes after the attack. To make fine diagnosis of AMI, we have to send 12-lead ECG and Echography from moving vehicle at real time. If 50% of patients will benefit => reduce medical cost => over U.S. $ 2 Billion/10 years Satellite System Cost Total cost of the Quasi-Zenith satellite system ( 3 space crafts, 4800 ground terminals, TTC & operation) => less than U.S. $ 2 Billion/10 years

36. ITU-T 36 23-25 May 2003 Workshop on Standardization in E-health Summary of trials 1, Video in an ambulance shall effective to support real-time telemedicine. 2, 3G ( IMT-2000 ) cannot afford because of its limitation of the data speed. 3, IP-based multimedia for ambulatory applications can save human life and reduce the medical cost. 4, We need challenge !!

37. Thank you ! This study was performed through special coordination funds of the Ministry of Education, Culture, Sports, Science and Technology, the Japanese Government. Thanks to Prof. Leonid Androuchko ( ITU-D SG-2 Q14/2 Telemedicine ) and Mr. Yasuhiko Kawasumi ( Q10/2 Rural communications ) for their many useful suggestions.