Under-Etched Plasmonic Disks on Indium Tin Oxide for Enhanced Refractive Index Sensing on a Combined Electrochemical and Optical Platform.

A simple approach to enhance the refractive index sensitivity of gold nanodisks immobilized on electrically conducting indium tin oxide (ITO) substrates has been demonstrated. A two-fold increase in sensitivity to bulk refractive index change was achieved by substrate under-etching of gold nanodisks on ITO in 50 mM sulfuric acid. The influence of an intermediate titanium adhesion layer was investigated and was found to markedly influence the etching pattern and time. Etching with an adhesion layer resulted in enhanced refractive index sensitivity on disk-on-pin like structures after long etching times, whereas etching of disks deposited directly on ITO resulted in a disk-on-pincushion like configuration and similarly enhanced sensitivity already at shorter times. The gold disks remained electrically connected to the ITO substrate throughout etching and allowed site-specific electrodeposition of poly(3-aminophenol) at the nanodisks, showing enhanced thin-film refractive index sensitivity. This work demonstrates a simple method for enhancing refractive index sensitivity of nanostructures on ITO substrates for combined electrochemical and optical platforms, and subsequently a method to modify the surface of the electrically connected nanostructures, which has potential application in biosensing.

Development of an IHE MRRT-compliant open-source web-based reporting platform.

OBJECTIVES: To develop a platform that uses structured reporting templates according to the IHE Management of Radiology Report Templates (MRRT) profile, and to implement this platform into clinical routine. METHODS: The reporting platform uses standard web technologies (HTML / JavaScript and PHP / MySQL) only. Several freely available external libraries were used to simplify the programming. The platform runs on a standard web server, connects with the radiology information system (RIS) and PACS, and is easily accessible via a standard web browser. RESULTS: A prototype platform that allows structured reporting to be easily incorporated into the clinical routine was developed and successfully tested. To date, 797 reports were generated using IHE MRRT-compliant templates (many of them downloaded from the RSNA's radreport.org website). Reports are stored in a MySQL database and are easily accessible for further analyses. CONCLUSION: Development of an IHE MRRT-compliant platform for structured reporting is feasible using only standard web technologies. All source code will be made available upon request under a free license, and the participation of other institutions in further development is welcome. KEY POINTS: • A platform for structured reporting using IHE MRRT-compliant templates is presented. • Incorporating structured reporting into clinical routine is feasible. • Full source code will be provided upon request under a free license.

The Public-Key-Infrastructure of the Radiological Society of Germany.

Pretty Good Privacy (PGP) encoding is based on the Public-Key-Procedure and permits the safe transmission of medical data. Furthermore it allows the use of an electronic signature provided that keys used belong to the key owner and that the key owner's identity is guaranteed by a trusted third party. Under the auspices of the Radiological Society of Germany (Deutsche Röntgengesellschaft, DRG) its IT-Working Group (Arbeitsgemeinschaft für Informationstechnik, @GIT) built up an appropriate Certification Authority including the required Public-Key-Infrastructure. These @GIT certified PGP keys allow the legal use of telemedicine in Germany. Digital signatures based to those certified keys correspond to the advanced signature according to the German Signature Law.

[Teleradiology according to the x-ray ordinance--exemplary application of the open source software SecTelMed]. / Teleradiologie nach Röntgenverordnung - beispielhafte Anwendung der Open-Source-Software SecTelMed.

PURPOSE: Establishing a teleradiology connection according to the Rontgenverordnung (RoV) between a peripheral hospital and a university clinic will contribute to improve the radiological emergency treatment on weekends, holidays and at night. It will also better the medical care for patients and help to lower the costs. MATERIALS AND METHODS: By using the open source software SecTelMed, the radiological picture is transferred via an internet-linked SSH communication server. The integration of the teleradiological data transfer into the actual workflow is attained by using the already existing PACS infrastructure. While its installation is still under construction, it is actually employed for transferring a patient's preliminary investigations and obtaining second opinions. RESULTS: The project proves a reliable and affordable teleradiology according with RoV by using open source software. The applied infrastructure ensures an unproblematical teleradiological treatment as well as a safe picture transfer for medical consulting (second opinion) even for large CT examinations of 1,000 pictures and more. CONCLUSION: The implementation of the technical requirements on teleradiology according with the Rontgenverordnung can be reliably attained by applying the open source software SecTelMed.

[Teleradiology with DICOM e-mail: recommendations of @GIT]. / Teleradiologie mit DICOM E-mail: Empfehlungen der @GIT.

E-mail is ideal for ad-hoc connections in teleradiology. The DICOM standard offers the possibility to append DICOM data types as a MIME attachment to any e-mail, thus ensuring the transmission of the original DICOM data. Nevertheless, there are additional requirements (e.g. protection of data privacy) which must be obeyed. Because of the lack of given standards which would grant interoperability as well as manufacturer independence, teleradiology has not been established in Germany until today. Therefore, the IT-Team (Arbeitsgemeinschaft fur Informationstechnologie, @GIT) of the Radiological Society of Germany (Deutsche Rontgengesellschaft, DRG) set up an initiative to standardise telemedicine by using e-mail. Its members agreed that an e-mail-based variant would be the most practicable way to a communication solution -- as easy to implement as to use. In their opinion, e-mail represents the smallest common denominator for a safe data interchange that would fulfill the legal advantages for telemedicine in Germany.

[Automatic classification of liver segments according to Couinaud: development of a new algorithm and evaluation spiral CT data]. / Automatische Klassifikation der Lebersegmente nach Couinaud: Entwicklung eines neuen Algorithmus und Evaluierung an Spiral-CT-Datensätzen.

PURPOSE: To develop a software tool that analyzes the anatomy of the portal vein branches and assigns segmental and subsegmental branches according to Couinaud's classification system and to evaluate its accuracy. MATERIALS AND METHODS: The algorithm was developed in C++ on a PC. The algorithm recognizes the three major branching patterns of the portal vein. Segmental and subsegmental branches are assigned to 8 segments following Couinaud and encoded by 8 colors. The software was evaluated using CT data sets of 39 patients. After the individual segmental anatomy of each patient was determined by an experienced radiologist, automatic classification was performed and the results were compared on a branch by branch basis. RESULTS: The numbering was accurate according to Couinaud's system in 358 of 409 segmental and subsegmental branches (88 %). The assignment failed in 51 of 409 branches due to unexpected anatomy or software problems. CONCLUSION: Automatic classification of portal vein branches and their appendant parenchyma is possible. The automatic designation of liver segments enables the three-dimensional visualization of the segmental anatomy. In the future, automatic analysis might facilitate the reporting and communication of CT findings.

Unusual course of herpes simplex virus encephalitis after acyclovir therapy.

This is a report on a case of herpes simplex encephalitis (HSE) taking an unusual course after initially successful acyclovir therapy. The etiology of HSE was proven serologically, by repeated detection of herpes simplex virus (HSV)-specific DNA sequences in cerebrospinal fluid (CSF) with polymerase chain reaction (PCR) and was supported by cerebral imaging. After both the neurological symptoms and laboratory findings had improved initially under acyclovir therapy, the patient's clinical condition deteriorated accompanied by a renewed increase in CSF pleocytosis and protein content. Nuclear magnetic resonance (NMR) imaging confirmed the finding of bilateral, mainly temporal lesions compatible with a diagnosis of relapsing HSE. The patient responded well to a second cycle of antiviral therapy but required a third treatment cycle due to renewed deterioration later on. HSV-specific DNA sequences could not be demonstrated in several consecutive CSF samples taken after the first week of illness but increased inflammatory changes typical of HSE were seen on NMR during phases of deterioration. IgM-class antibodies against HSV were detected in CSF 4 weeks after onset of symptoms and stayed positive for at least 7 weeks. Reasons for the repeated deterioration and possible explanations for the absence of HSV DNA in spite of what could be seen as relapses are discussed.

[Isolated unilateral hypoglossal nerve paralysis in carotid dissection]. / Isolierte einseitige Hypoglossusparese bei Karotisdissektion.

A 41-year-old man presented with a unilateral atrophy and paresis of his tongue which were not explained by any pathological finding in the brainstem or at the base of the skull. The diagnosis of right internal carotid artery dissection was suggested by magnetic resonance imaging and ultrasound examination and confirmed by arterial angiography. During anticoagulant therapy clinical recovery and angiographical improvement occurred.

[Injuries and traumatic fatalities in sports with special reference to criminal responsibility]. / Verletzungen und traumatische Todesfälle beim Sport unter besonderer Berücksichtigung von Haftungsfragen.

Out of 13 deaths connected with sport, seven were due to a natural death (coronary death) and six were of traumatic origin (cranial and spinal injuries predominated). On the basis of such cases of sport death and expertise on sport injuries with regard to their etiology, the appraisal of sport accidents with regard to legal liability is described. Questions of liability apply both to the institutions responsible for sporting facilities in injuries indirectly connected with sport as well as fellow sportsmen/women as causers of accidents.