LECTURE 3.

LOCAL AND GLOBAL COMPUTER NETWORKS.

TELECOMMUNICATION TECHNOLOGIES AND
INTERNET RESOURCES IN MEDICINE

FATIMA YUSUFOVNA BOTASHEVA

1
FATIMA [email protected]
 LECTURE PLAN:
1. Network-based information processing technologies
2. Local area network topology
3. Protocols
4. GLOBAL INTERNET. Structure and addressing on the
Internet
5. INTERNET RESOURCES IN MEDICINE
6. Telemedicine. Definition, purpose and directions
7. Areas of telemedicine centres activity
8. Telemedicine sections

2
1. NETWORK-BASED INFORMATION PROCESSING
TECHNOLOGIES
Computer network (CN) — a data processing system that
includes a geographically distributed system of computers and
their terminals, united in a single system.
 The main characteristics of networks include:

 bandwidth — the maximum amount of data transmitted by the

network per unit of time; bandwidth is measured in megabits per
second (Mbps);
 network response time — the time it takes the network devices
and software to prepare for data transmission over a given
channel; network response time is measured in milliseconds
(ms).

3
There exist several classifications of computer networks.

1. By territorial spread there are:

 the local networks (LAN, Local Area Network);

 Metropolitan Area Network (MAN, Metropolitan Area

Network);
 global networks (WAN, Wide Area Network).

2. Computer networks in terms of information transfer speed can

be classified as:
 low-speed, up to 10 Mbps;

 medium-speed — up to 100 Mbps;

 high-speed, over 100 Mbps.

4
 We will consider the most important concepts of network
theory, such as server and client.
A server is a node of a network that provides its resources to
other clients, but does not use their resources, i.e. only serves the
network.
There may be several servers on the network, and the server is
not necessarily the most powerful computer.
A dedicated server is a server dedicated to network tasks only.
A non-dedicated server can perform other tasks in addition to
network hosting. A network printer is a specific type of server.
A client is a network subscriber that only uses network
resources, but does not share its resources with the network, i.e. is
served by the network.

5
 A client computer is also often referred to as a workstation.
Basically, each computer can be both a client and a server at the same
time. Often, the «server» and «client» mean not the computers
themselves, but software applications running on them. In this case, the
software that only provides resources to the network is a server, and the
software that only uses the network resources is a client.
The following classes of local area networks can be distinguished.
By the method of computer interaction:
peer networks;
LAN with dedicated file servers (centralised or hierarchical).
In terms of server technology, there are file-server and client-server
networks. The first model uses a file server where most programs and
data are stored. Upon user’s request, the necessary program and data are
sent to the user. The information is processed on the workstation.

6
2. Local area network topology
The topology (layout, configuration, structure) of a computer
network is usually understood as the physical location of
computers in the network relative to each other and the way in
which they are connected by communication lines.
It is important to note that the concept of topology applies
mainly to local networks in which the structure of connections can
be easily traced.
Topology defines equipment requirements, type of cable used,
possible and most convenient methods of communication
management, reliability of operation, possibilities of network
expansion.

7
 There are the following LAN topologies (by the method of
connecting computers on the network):

 ring topology;
 bus topology;

 star topology;

 hybrid topology.

8
 A ring is a network topology in which each computer always
transmits data to only the next computer in the chain, but receives
data only from the previous one in the chain, and the chain is
closed in a «ring» (fig. 3).

A bus is a network topology in which all computers are

connected in parallel to the same communication line and
information from each workstation is simultaneously transmitted to
all other computers (fig. 1).

9
 Star is a network topology in which the peripheral computers
are connected to one central computer, and each of them uses its
own line of communication (fig. 10.3).
Combinations of basic topologies are often used in practice,
but most networks are of these three types. A brief overview of the
above-mentioned network topologies features.

10
 In addition to the three main, basic topologies presented
above, the «tree» topology is often used, which can be considered
as a combination of several stars.
As in the case of a star, the tree can be active, or true, and
passive.
When the tree is active, the interconnection centres of several
communication lines are computers, and when the tree is passive,
they are routers (hubs).

11
 When the network topology is mentioned in the literature,
there may be four very different concepts that relate to different
layers of network architecture.
Physical topology (i.e. the layout of computers and cables). In
this sense, a passive star is no different from an active star, so it is
often referred to as just «star».
 Logical topology (i.e., the structure of connections, the nature
of signal transmission over the network). That’s probably the best
definition of topology.
The topology of exchange management (i.e. the principle and
sequence of transferring the right to capture the network between
individual computers).
Data topology (i.e. the direction of data flow transmitted over
the network).
12
The components are shown in fig. 10.5 must be present in the
network structure.

13
 Networks can be created with any of the cable types detailed below.
TP, Twisted Pair is a cable made in the form of twisted pairs of wires (the
LAN when using twisted pair should be no more than 100 m).

The coaxial cable consists of one solid or twisted central conductor, which
is surrounded by a dielectric layer. A conductive layer of aluminium foil, metal
braid or a combination of these is surrounded by a dielectric which
simultaneously serves as a shield against interference. A common insulating
layer forms the outer sheath of the cable.

Внутренний проводник

14

Защитное покрытие Изоляция

 Fibre-optic cable is a perspective technology used in
networks. The data carrier is a light beam that is modulated by the
network and carries the signal. Such a system is resistant to
external electrical interference and thus enables very fast, secure
and error-free transmission of data at speeds of up to 2 Gbit/s. The
number of channels in such cables is enormous.
Стеклянное покрытие Оптическое волокно

Защитное покрытие

Microwave radio waves are used as a transmission medium

in wireless LANs or between bridges or gateways to communicate
between LANs. In the first case, the maximum distance between
the stations is 200-300 m, in the second case, the distance is
limited to line of sight. The data transfer speed is up to 2 Mbps. 15
 The channel flow (channel load) is called traffic.
All computers in the network are divided into main and auxiliary ones.
The main computers are user computers (clients) and terminals. They
perform all the necessary data and computing operations and determine the
resources of the network.
A Client is an application that sends a request to the server. It is
responsible for processing, sending information and passing requests to the
server. Any computer can be used as a client.
A terminal is an end device for data input or output.
Auxiliary computers are divided into servers and communication
machines (host computers).
A Server is a personal or virtual computer that performs customer
service functions and allocates system resources: printers, databases,
programs, external memory, etc.
A host computer is a computer installed in the network nodes, which
solves the switching tasks. 16
 Network software is designed to enable a group of users to work
together on different computers. It allows organising a common
file structure, shared databases available to each member of the
group. It provides the ability to send messages and work on
common projects, as well as to share resources.

17
 3. Protocols

 A data transmission protocol is set for each LAN.

 A protocol is a set of rules and descriptions that govern the data

transfer between PCs.
 So, the network protocol, or data transfer protocol, is a common
and approved standard that contains a description of the rules of
reception and transfer between several computers for commands,
files, other data and serving for work synchronisation of the
computing machines in a network.

18
 There is a mail client running on a computer connected to the
network that operates two different application layer protocols
— POP3 (Post Office Protocol) and SMTP (Simple Mail
Transfer Protocol) — and a program to upload files to a remote
server — FTP-client that works with the application layer
protocol FTP (File Transfer Protocol). All of these application-
layer protocols are based on the same transport protocol —
TCP/IP (Transmission Control Protocol/Internet Protocol),
which converts the data stream from the above-mentioned
programs into data packets with an indication of the final
application using this information.
 A gateway is a program that can be used to transfer information
between two network systems using different communication
protocols.
19
4. GLOBAL INTERNET. Structure and addressing on the Internet
The Internet is a term for a global network, which can be defined as the physical
lines of communication and shared resources combined by an agreement to
interconnect networks and use the same communication protocols.
 There are the following types of addresses on the Internet:

 physical (MAC address);

 network (IP address);

 symbolic (DNS name).

 A computer in a TCP/IP network can have three address levels (but not less
than two).
 Local address. For units within local networks, this is the MAC- address of the
network adapter. These addresses are assigned by equipment manufacturers
and are unique.
 IP address consisting of 4 bytes, e.g. 109.26.17.100 This address is used at the
network level. It is assigned by the network administrator during the
configuration process.
 Symbolic identifier-name (DNS), e.g. www.kstu.ru. 20
 In the TCP/IP protocol, the IP address is formed by four decimal
numbers separated by dots. Each of the digits can have a value
from 1 to 255. A computer’s address looks like this:
19.226.192.108.
 This number can be permanently assigned to a computer or
assigned dynamically when the user connects to the ISP, but
there are no two computers with the same IP address at any
given time on the Internet.

21
 It is inconvenient for the user to remember such addresses,
which also are not permanent. Therefore, a Domain Name
System (DNS) service exists that allows each computer to have a
name. There are millions of computers on the web and, to
prevent repetition, they are divided into independent domains.
 Thus, the computer address looks like several domains separated
by a dot:
 <segment n> <segment 3>.<segment 2>.<segment 1>.

A domain name is a unique name that the service provider has

chosen to identify itself, for example, ic.vrn.ru or yahoo.com.

22
5. INTERNET RESOURCES IN MEDICINE
 Classification of medical resources and Internet services:

 medical consultations;

 medical e-shops;

 electronic pharmacies;

 online house-call services;

 reference resources;

 professional resources;

 popular science online medical journals;

 socially-oriented resources (Internet schools for patients with

bronchial asthma, diabetes mellitus, etc.).

23
 There exist specialized medical systems.
 Medscape (www.medscape.com), BioMedNet (
www.biomednet.com, http://www.bmn. com), Medbot (
http://medworld. Stanford.edu/medbot/), Medclub (
http://www.medclub.ru).
 MedExplorer. Free medical search engine for doctors, patients
and their families. The system works with 28 different categories
of materials, more than 140 newsgroups, advertisements and the
«The MedExplorer Bookstore and Conferences» online
bookstore.
 MEDBOT Super Search. It allows to use up to 4 systems of
search tools of choice from the proposed 6 categories — index
systems, search engines, medical directories.
 Doctor's Choice is a medical search engine created by doctors.
24
 Medical World Search is a full-text search using the Web Index
and the Unified Medical Language System from the National
Library of Medicine on major medical websites. It can send a
request to several search engines simultaneously (InfoSeek,
PubMed MEDLINE, HotBot, AltaVista, Web- Crawler). Search
through 100,000 Web pages and thousands of selected medical
sites.
 MedHunt — search for medical information, English and French
interface.

25
 CiteLine.com is a targeted search for scientific information for
researchers. It provides referrals to peer-reviewed scientifically-
organised sites, including hundreds of commonly «invisible»
ones and MEDLINE, NIH clinical trials, US Patents databases,
etc. It provides access to the information in the databases that
cannot be indexed by ordinary search engines. The system
ensures confidential search, protection and safeguarding of
user’s interests.
 The Doctors' Reference Site is a search through medical sites.

 Galenicom is a search for medical resources.

26
 WEB Medicine Health On the NET Search is a search for a
variety of medical information in extensive databases.
 MedLinks is all medicine online.

 MEDNAVIGATOR is a directory of Russian-language medical

resources.
 MEDAGENT is a directory of medical websites.

 Medrating is a directory, rating of sites devoted to medicine and

healthcare.
 RUSMEDSERV.com is a Russian medical server.

 Med-Doc.INFO is a portal for doctors, students, patients.

 IT-MEDICAL.RU is a scientific medical internet project. It has a

large amount of literature in Russian for specialists.
 Critical.ru is a site for emergency medicine.

 Rusanesth.com is a Russian anesthesiology server. 27

 There exist several hundred medical databases. The most
famous is the medical bibliographic search system Medline.ru (
www.medline.ru), which contains more than 7 million references
from more than 3.5 thousand medical journals.

28
 6. Telemedicine. Definition, purpose, and directions

 Telemedicine is an applied field of medical science related to

the development and practical application of remote medical
care methods and the exchange of specialized data based on the
use of modern telecommunications technologies, eliminating
geographical, temporal, social and cultural barriers.
 The aim of telemedicine is to bring highly qualified and
specialized consulting services to the regional health centres at
minimum cost and to provide simultaneous clinical training to
physicians.

29
Remote
biomonitoring Home telemedicine
systems

The main directions of

telemedicine

Telemedicine Mobile telemedicine

consultations complexes
 The areas of telemedicine in practical healthcare include:
 initial assessment of the patient’s condition in emergency cases
coordination of treatment, stabilization or transportation issues;
 supervising the actions of nursing staff in case of doctor’s
absence locally;
 one-time or long-term instructions on specialized treatment in
case of specialist’s absence locally;
 counselling, including councils of physicians;

 monitoring and follow-up of critical and chronically ill patients;

 using information and experience from other clinics to manage

and treat patients with specific diseases and conditions.

31
 7. Areas of telemedicine centres activity
 Areas of Telemedicine Centres Activity are the following:

 clinical;

 educational;

 research and development;

 organisational and methodical;

 informational and communicational.

32
 Basic telemedicine tools
 Videoconference is the main tool of telemedicine.

 Videoconference is a way of exchanging video, audio and other data

between two or more points equipped with the appropriate hardware
and software.
 The objectives of interactive real-time medical video-conferences
include the following:
 training activities (lectures, seminars, group sessions discussions);

 advice on various medical and socio-medical situations, including the

medical consequences of natural disasters, epidemiological or
environmental conditions;
 scientific discussions, debates, seminars, etc.;

 exchange of information of an organisational and methodological

nature;
 activities aimed at further development of telemedicine and its
33
applications in healthcare.
 The main directions of TV and video conferences are as follows.
 Primary (prehospital) counselling of patients who are then referred
for elective surgeries to the leading metropolitan centres. A
videoconference is arranged to clarify the preliminary diagnosis,
review and discuss the diagnosis and treatment results, analyze the
examination quality and prepare the patient for surgery. The
economic and social aspect of video-conferences consists of saving
significant resources (both money and time and effort) for patient’s
travel, sending documents, inefficient telephone consultations, etc.
 Consulting or observing patients after complex surgeries, such as
heart surgery. The purpose of the videoconference is to discuss the
condition of the patient with specialists from the leading medical
centres, without the need to transfer patients to their facilities.
 Urgent consultations for patients in critical condition (life-threatening
injuries). In this case, an urgent videoconference is the most effective
way to provide immediate, qualified advisory support. 34
 8. Telemedicine sections
 Space telemedicine. Introduction of space flight medical
support into the system. The ISS telemedicine system for
manned flights is being developed.
 Telesurgery and remote examination. It allows to carry out
active intervention on the patient’s body by a specialist at a
distance. It is currently developing in two ways: remote control
of medical equipment in interactive mode during diagnostic
manipulations and remote medical and surgical operations based
on the use of remotely controlled robotics.

35
 Urgent telemedicine. Introduction of telemedicine into the
practice of providing emergency medical care and ensuring
survival in extreme conditions, as well as the use of
telemedicine technologies in the aftermath of man-made and
natural disasters and the provision of assistance to victims of
hostilities and terrorist acts.

36
 Dynamic telemedicine monitoring systems are used to monitor
patients with chronic illnesses, as well as in-home care. Often a
separate line is singled out, which is called «Home
telemedicine». The same technologies can be used at industrial
facilities to control the health of operators (nuclear power
plants).

37
 Military telemedicine. If necessary, specialists will be
able to consult with colleagues from medical institutions
of Moscow and St. Petersburg in online mode. In
addition, military hospitals and polyclinics, which are far
apart and have different capabilities, will find it easier to
share experiences.

38
 You have questions?
Thanks for you attention!

39