Using off-the-shelf hardware components and a specially developed high-end software communication system (WinVicos) satellite networks for interactive telemedicine have been designed and developed. These networks allow for various telemedical applications, like intraoperative teleconsultation, second opinioning, teleteaching, telementoring, etc.. Based on the successful GALENOS network, several projects are currently being realized: MEDASHIP (Medical Assistance for Ships); DELTASS (Disaster Emergency Logistic Telemedicine Advanced Satellites Systems) and EMISPHER (Euro-Mediterranean Internet-Satellite Platform for Health, medical Education and Research).

SHL was founded in 1987, based in Tel Aviv Israel. SHL is a leading provider of personal telemedicine systems and services. SHL operates a medical call center in Israel that offers remote monitoring services to approx.65000 subscribers. Currently SHL is implementing successful Israeli business model in international markets and has established a number of strategic relationships with leading consumer and healthcare companies in Europe, including Philips Electronics and Nestor Healthcare. As of June 2002, Raytel Medical, a US based company, became a wholly- owned subsidiary of SHL. Core products are FDA approved, carry the CE mark and have a long established reputation in the medical community and a successful track record. SHL offers subscribers and their physicians, Internet access to selected medical data. SHL is publicly traded on the SWX market (Switzerland).

UTMB is developing with industrial partners the "24/7 telemedicine triage project" to provide emergency medical care to offshore oil and gas rigs and platforms in the Gulf of Mexico. The oil and gas industry is second only to the US department of defense in the number of employees stationed in remote areas. Providing medical care to such populations is logistically complex and expensive. In addition, emergency evacuation is often time-consuming and poses risks for both patients and medical crews. By utilizing high-resolution videoconferencing technology, through a satellite communication, patient visits will be conducted in real time and will provide more informed decisions about the need for more extensive treatment, thereby reducing unnecessary evacuations. In addition, patients who require evacuation will receive a higher standard of care while waiting for transport to a medical facility. UTMB physicians report that 39% of all patients from offshore facilities treated in the emergency department, could have been successfully treated through telemedicine without being evacuated to a hospital. The telemedicine project will employ standard procedures for medical triage, in which patients are directed to appropriate medical experts based on their symptoms or type of injury.

World class health care for common man at low affordable cost: anywhere, anytime The project envisages to set up a national network of satellite Medical centers. Each SMC would be manned by doctors, nurses and technicians, six doctors, six nurses, six technicians would be required to provide 24 hour cover, each SMC would operate 24 hours x 7 days. It would be equipped with the Digital telemedicine devices for capturing clinical patient information and investigations in the form of voice, images and data and create an audiovisual text file - a virtual Digital patient. Through the broad band connectivity the virtual patient can be sent to the central hub, manned by specialists, specialists from several specialists sitting together can view the virtual patient and provide a specialized opinion, they can see the virtual patient, see the examination on line through video conference or even PCs, talk to the patient and the doctor at the SMC and controlle capturing of information during examination and investigations of the patient at the SMC - thus creating a virtual Digital consultant at the SMC. Central hub shall be connected to the doctors and consultants in remote locations or tertiary care hospitals any where in the world, thus creating a virtual hub the hierarchical system shall provide upgradation of knowledge to thedoctors in central hub and smc and thus continued medical education and benefit the patient thru the world class treatment in the smc located at his door step. SMC shall be set up by franchisee who shall get safe business opportunity with high returns, patients shall get Low cost user friendly worldclass health care anywhere anytime, Doctors can get better meaningful selfemplyment with better earnings, flexibility of working time and place. SMC shall provide a wide variety of services from primary care to world class Global consultation for difficult patients.

The rapid development of technology and its integration into the spectrum of medical care are creating a pressing need for healthcare professionals to continuously update their knowledge and skills. In view of these needs the European Association of Visceral Surgery (AECV) which had been a platform for medical congresses in Luxembourg (1988, 1992, 1995, 1998) has developed TeleMEDiana a new broadband communication service introducing standards of excellence in Continuous Medical Education.TeleMEDiana broadcast a daily program with pedagogically enhanced video content in a number of therapeutic areas to MD's, professors and students in hospitals, universities and research centers. The educational programs are provided by leading European hospitals which have joined the TeleMEDiana Scientific Network TSN. The scientific integrity is certified by an international committee composed of recognized pioneers. Committed to deliver high resolution video streaming, TeleMEDiana has set up and successfully tested a new platform built on secure and cost-efficient satellite operator SES-ASTRA complemented by the Internet and can deliver programs to any workplace equipped with satellite dishes and high-quality set-top boxes. Telemediana offers herewith an optimal collaboration and dissemination platform to decisive players involved in Continuing Medical Education.

This work consists in implementing a software which controls a chain of acquisition able to collect remotely, via a Telemedical connection, to the same subject simultaneously 16 physiological signals. Our choice related initially to two signals: the first representative of the circulatory function in fact the electrocardiogram and the second representative of the respiratory function in fact the pneumotachogramme.

This invited paper aims to examine how telemedicine and e-health will develop over the coming years and, in particularly, to assess what legal and ethical barriers may lie in the way of this development. A description of the key principles and concepts involved in telemedicine and e-health and a short historical overview of their evolution over the past century is followed by consideration ofwhy empirical research into "Info-ethics" and other deontological and legal issues relating to telemedicine and e-health are so important. Five evolving health telematics applications are examined in some detail: electronic health records; the transmission of visual media in disciplines such as teleradiology, teledermatology, telepathology and teleopthalmology; telesurgery and robotics; the use of call centres and decisionsupport software and, of course, the growing role of the Internet in healthcare. These are discussed in the light of their moral, ethical and cultural implications for clinicians, patients and society at large. Telemedicine and e-health present unique opportunities for both patients and clinicians where they are implemented in direct response to clear clinical needs. But excessive reliance upon technology will damage the traditional clinician-patient relationships and we must therefore avoid complacency regarding the risks and responsibilities - many of which are as yet unknown - that distant medical intervention, consultation and diagnosis carries.

There are a number of challenges that have to be addressed before full-scale implementation of telemedicine technologies can be achieved. These challenges include cost and resource concerns, technical issues, legal issues, lack of awareness of telemedicine and, previously unsuccessful trials using telemedicine technology. This paper will address these challenges and suggest ways in which they can be overcome. The "MEDASHIP" project is an example of the highly beneficial potential that telemedicine can have providing that the challenges referred to in the first part of this paper are addressed. "MEDASHIP" ("Medical Assistance for Ships") is a European Commission co-funded project of 1 8 months duration running under the TEN-Telecom programme of the Directorate General for the Information Society. The project will result in the formation of a European company that will supply integrated solutions for medical consultations on board passenger ships, cruise ships and merchant vessels. The MEDASHIP project aims to address the wide disparities that still exist between the medical care available to European citizens when working or travelling at sea and that available on land as well as to increase the competitiveness of the European cruise industry as compared to American flagged-vessels, which are already using the improved standards of medical care available to passengers through telemedicine as a crucial tool in marketing their cruises.

The performance of high-speed non-directed diffuse indoor infrared wireless communication is mainly affected by intersymbol interference (ISI) due to multipath dispersion. The direct-sequence spread spectrum systems are applied to combat multipath dispersion. However, when the data rate is close to the channel 3dB bandwith, the spread spectrum technique may have a worse performance than OOK transmission as it is affected by more severe ISI. Exploiting muli-spot link, we can improve the performance of spread spectrum technique to be much better than OOK modulation because a higher channel bandwith are obtained. Both the analytical and simulation results are presented.

The present status of the use of fiber-free optics technology for solutions providing high speed local access connectivity is introduced. The advantages of the technologies are presented. By analyzing the factors that limit the public application of the free-space optics, an integrated network solution that combines the benefits of both microwave technology and free-space technology is presented.

An carrier frequency offset estimation algorithm for IEEE8O2. 1 1 a OFDM frame is presented The proposed algorithm estimates the frequency offset ofthe OFDM frame in two steps: acquisition and tracking step. It is proved by simulation result that this algorithm has a large estimation range without degrading the variance ofthe estimation error. Meanwhile, this algorithm has higher throughput efficiency and lower computational complexity than other algorithm using preamble structure for frequency offset estimation.

General Packet Radio Service (GPRS) is a new service designed for digital cellular network (GSM, PCS, etc.). Due to its high efficiency on radio resource and "always on" mobility, GPRS has been widely adopted all over the world. So far, at least seven among the top 10 mobile operators have launched their GPRS services. Shanghai Mobile began its GPRS project in 1999. After well preparation, the Shanghai's commercial trial GPRS network was started in July 2001. During the trial, network performance has been carefully studied, so does customer behavior. By the end of 2001, GPRS network has fully covered Shanghai. In 17 May 2002, Shanghai Mobile announced to put its GPRS service into commercial use. In this paper, the development history of the cellular mobile communication in Shanghai is briefly reviewed first, and then the current GSM network status is offered. Further more, GPRS commercial trial is introduced. Finally some trial results are provided.