Abstract
«Development of the dedicated computer support system for making decision on treatmant of urolithiasis»

Сontent:
Introduction
1. Aims and tasks
2. Actuality of theme of work
3. Supposed scientific novelty
4. Planned practical results
5. Review of research-and-developments on the topic:
   - review of existent methods of processing of images
   - review of existent lithotriptor models
6. Summary of essence of planned SSMD, in particular program for determination of geometrical sizes of stone

Introduction
   lithotripsy is a method of splintering stone in buds, ureters and urinary bladder, being the real alternative to surgical interference. Presently lithotripsy is presented by two basic directions:
   • Controlled from distance lithotripsy
   • Pin lithotripsy
Controlled from distance lithotripsy allows to break stones of bud and ureter. Modern lithotriptors allow effectively to destroy stones with the minimum injuring affecting surrounding fabrics. Nevertheless, in certain situations application of controlled from distance lithotripsy is not effective:
   • it is Presence of narrowing below of place of localization of stone
   • stones of dolly-tub-ureter segment with the signs of development of pyelonephritis
   • stones of urinary bladder
   It is sometimes necessary to come running to the repeated sessions of lithotripsy in connection with absence of complete fragmentation in the leadingouts of stone. However, as a rule, realization of a 1 session of lithotripsy appears sufficient.
Pin lithotripsy is used presently mainly for splintering stone of ureter and urinary bladder. Thus lithotriptor is tricked into through an urethra, urinary bladder and ureter directly to the stone. Efficiency of pin lithotripsy at the concrements of the indicated localization is higher, as compared to the controlled from distance method. However at stenosis of urethra, or expressed inflammatory changes in an ureter as a result of being of stone this methodology can not be used. On the other hand, in case of absence of obstacles for realization of pin lithotripsy efficiency of method arrives at 100%, here, as a rule, there is not a necessity for realization of repeated lithotripsy .    Every method of lithotripsy have both the dignities and defects.
The use of one or another method is determined by a foremost treating doctor in every case.

Aim
   Aim hired : to do realization of lithotripsy as possible more safe and effective for every concrete patient.

Tasks
   To define the parameters of литотриптора, necessary for optimal realization operations and to advise the type of lithotripsy for every patient depending on the type of his disease, his constitution and other parameters.

Actuality
   Actuality of this theme consists of that a method of treatment of urolithiasis the methods of литотрипсии is relatively new and used in practice recently enough. In this connection many patients are well-informed not enough in this methodology and often (especially patients of superannuated) renounce operations on lithotriptor.
Also lithotriptors of different firms and models possess different parameters, such as: working distance, size of reflector, forming a "bunch", pulsewidth, description of wave focus et cetera

Review of research-and-developments on the topic
Review of existent methods of processing of images
   • it is Contrasting. In this case for the change of contrast use the adaptive algorithms of contrasting. I chose the algorithm of the local strengthening of contrast.
   • it is Smoothing out of noises. By the simplest method, smoothed noise, dark-and-light there is smoothing out, i.e. replacement of value to the brightness of every element by a mean value, found on his vinicity - great number of points, belonging to the vinicity of point of fij (including the point of fij); P is a number of points in a vinicity. The considered method effectively removes additive and impulsive noise in every display element.
   • it is Strengthening of borders. The substantial lack of algorithms of smoothing out is смаз images (i.e. decline of clearness of contour elements), here the size of смаза is proportional to the size of mask, used for smoothing out. For the synonymous analysis of images it is very important to clean смаз from the contours of objects in an image, id est to strengthen a difference between gradations of brightness of contour elements of object and nearby elements of background. In this case for processing of images the methods of underlining of contours are used. Underlining of borders is ordinary comes true by the method of high-frequency spatial filtration. Descriptions of filters are set as a mask in which a mean value must be equal to the zero.
   • it is Filtration. Median filtration behaves to the nonlinear methods of processing of images and has next advantages: saves sharp overfalls (borders); effectively smooths out impulsive noise; does not change the brightness of background. Median filtration comes true by motion of some aperture (masks) along a discrete image and replacement of value of central element of mask by the median value (mean value of well-organized sequence) of initial elements into an aperture. In general case, an aperture can have the most various form, but a square aperture is mostly used in practice.
   • it is Segmentation. This stage of treatment is most essential in by the developed system. I applied the different methods of segmentation and selection of contours, but none of them (including and adaptive methods) showed results, satisfying to the put tasks. The selection of ulcers, polypuses and other pathologies on digital representations, got from an endoscope, is laboured in connection with substantial variability and weak contrasty.

Review of existent models of lithotriptors
   General application of controlled from distance lithotripsy of urinary stones and modern lithotriptors, and also the new methods of treatment of urolithiasis changed frequency and character of complications, arising up as a result of this disease. Really, modern lithotriptors became far fewer in size. Frequently they are built in a x-ray table, that allows to diagnose and conduct additional procedures    Presently more than 15 countries (among them there is Germany, China, USA, France, Italy, Russia, Israel, Austria, Slovakia, Poland, Turkey, Sweden of and other) produce own lithotriptors.

   The pioneer of controlled from distance lithotripsy is Germany (firm Dornier), where at the beginning of 80th past century first lithotriptor was produced with electro-hydraulic principle of shock wave impulse. 1988 to practically entire countries were equipped by lithotriptors, produced by a firm Dornier. However in 1987-1990 other countries also began to produce own lithotriptors, that explained by high efficiency of method. A not insignificant role was also played by such factors, as considerable costliness of foreign technique (to 1 million dollars), substantial operating costs (from 40 to 70 thousand dollars of the USA in a year) and protracted outages of lithotriptors (to semiyear and more). Unfortunately, high running expenses did not diminish, and it results in that to 23% of imported lithotriptors, being in medical establishments.
   Such models which it is possible on behave to universal lithotriptors, except the session of lithotripsy, to execute also auxiliary medically-diagnostic urology procedures (nephrostomy, transurethral and through-skin surgery, transurethral resection (TURN), cannulation, setting of stent and other) and which a "floating" surface, providing not only moving of patient but also his inclination (longitudinal), is in[2, 3, 4]. On the sign of universality from the brought table over all lithotriptors, not having the x-ray photography aiming or "floating" table retire automatically, such, as "ЛИТОДИАГНОСТ-МЕ", "Пьезолит", "Медстоун", "Литоринг", "Кассомед", "Компакт-01-У-ЛГК", "Сонолит-300".

Summary of essence of planned SSMD, in particular programs for determination of geometrical sizes of stone

During writing of master's degree work I plan to work out SSMD in the complement of which will enter:
   Base of knowledge on treatment of urolithiasis, made on the basis of researches, studies of literature and according to doctors-urologists. This base will contain the types of stones, on their location, composition; methods of treatment of urolithiasis; chronic diseases which can influence on realization of operation; other data.
   Databases will be controlled through visual forms and can be edited. Doctors will be able to complement and correct information, storable in them.
   The trained nurses will work with SSMD probably. They will be able to fill the electronic cards of patients and enter the results of analyses and inspections there, and on an output to get the already formed report on the general state of patient and offered variant of treatment.

   Program for determination of geometrical sizes of stone on x-ray picture will enable to save the electronic variants of pictures of every patient, open them if necessary, compare two pictures the method of distances of Hausdorff and determine the geometrical sizes of stones on pictures (width and height) in a scale.

Picture 2 - Visualization of the supposed use of planned program for measuring of geometrical sizes of concrement. Animation consists of 6 shots and has 5 cycles of reiteration.