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Biomedical subjects

B Schütze

Publications and source records attributed to B Schütze.

At least 19 recordsLinked to original sources
PubMed2007

[Legal general regulations of teleradiology].

The following article describes the legal aspects of teleradiology in Germany. At first we analyze the general significance of teleradiology in the sense of"achieving medical service over spatial distances". Next we take a closer look at teleradiology according to the German Radiation Control Law ("Deutsche Röntgenverordnung") in the sense of primary diagnostic findings. It is obvious that, apart from the Radiation Control Law, several other laws have to be obeyed when using teleradiology. Currently all of these legal requirements concerning teleradiological service can be fulfilled by applying modern IT.

Germany↗
PubMed2006

[E-Learning in radiology; the practical use of the content management system ILIAS].

PURPOSE: Due to the possibility of using different kinds of visualization, e-learning has the advantage of allowing individualized learning. A check should be performed to determine whether the use of the web-based content management system ILIAS simplifies the writing and production of electronic learning modules in radiology. MATERIALS AND METHODS: Internet-based e-learning provides access to existing learning modules regardless of time and location, since fast Internet connections are readily available. RESULTS: Web Content Management Systems (WCMS) are suitable platforms for imparting radiology-related information (visual abilities like the recognition of patterns as well as interdisciplinary specialized knowledge). The open source product ILIAS is a free WCMS. It is used by many universities and is accepted by both students and lecturers. Its modular and object-oriented software architecture makes it easy to adapt and enlarge the platform. The employment of e-learning standards such as LOM and SCORM within ILIAS makes it possible to reuse contents, even if the platform has to be changed. CONCLUSION: ILIAS renders it possible to provide students with texts, images, or files of any other kind within a learning context which is defined by the lecturer. Students can check their acquired knowledge via online testing and receive direct performance feedback. The significant interest that students have shown in ILIAS proves that e-learning can be a useful addition to conventional learning methods.

Computer-Assisted Instruction↗
PubMed2006

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.

Algorithms↗
PubMed2005

Micromachined sensor for lactate monitoring in saliva.

A miniaturised sensor for continuous lactate measurement in saliva was developed and tested. The sensor was built using silicon microfabrication technologies. The size of the chip is 5.5 mmx6.4 mmx0.7 mm and features a working, a counter and an Iridium reference electrode. The chip has a cavity whose floor is perforated by fine pores. The cavity contains the enzyme lactate oxidase (LOD), which is immobilised in an agarose gel. Prior to the amperometric detection of the reaction product hydrogen peroxide at the working electrode, the analyte lactate has to pass the pores to reach the cavity with the lactate oxidase by diffusion. To test the silicon sensor, capillary blood and saliva samples were obtained during standardised ergometer tests. Salivary lactate concentrations were determined with the sensor and compared to photometrically derived data from a lab-automate. In addition the saliva data were compared to standard capillary blood lactate concentrations measured with a pocket photometer. Lactate concentration versus load graphs were plotted and compared visually showing very similar progressions. The novel approach enables a location independent, permanent real-time measurement of the lactate concentration during exercise.

Biosensing Techniques↗
PubMed2005

[A solution to add digital signatures to medical images according to the DICOM standard: embedded systems].

Radiology departments often underestimate the importance of protecting medical data during transmission, including the precautions taken to ensure data protection. In teleradiology, transmitted as well as stored patient data have to be signed digitally according to the currently valid regulation (Rontgenverordnung, RoV). The DICOM standard facilitates a digital signature. So far, medical image manufacturers only announced to support this security feature. We introduce a solution that extends the feature of digital signing to older modalities.

Computer Communication Networks↗
PubMed2005

[Teleradiology with DICOM e-mail: recommendations of @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.

Computer Communication Networks↗
PubMed2005

[Teleradiology according to the x-ray ordinance--exemplary application of the 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.

Computer Communication Networks↗
PubMed2004

[Pulmonary infiltrates in a 19 year old patient with dysuria and hypercalcemia].

A 19 year old patient presented with the typical constellation of sarcoidosis. In the presence of indefinable pulmonary infiltrates, hypercalcemia, raised angiotensin converting enzyme and even evidence of giant and epitheloid cell granulomas, cocaine abuse should be considered. Chronic inhalative cocaine abuse can cause foreign body associated granulomatosis of the lung and other organs. It is important to establish this differential diagnosis by confidential interview and systematic polarisation microscopy to detect foreign material in tissues: unnecessary therapies with potential side effects should be avoided and drug weaning with rehabilitation of the patient should be initiated. However the potential for rapid progressive respiratory failure should not be underestimated.

Administration, Inhalation↗
PubMed2004

Patient data security in the DICOM standard.

The DICOM committee added the section "Security Profiles" to the DICOM standard, in order to provide the opportunity of safe communication between health care system partners. Data complying with the DICOM standard--e.g. pictures, signals or reports of examinations can be provided with one or more digital signatures. Attention should be paid to the fact that these possibilities of the DICOM standard are available or can be supplied subsequently by new acquisitions of radiological modalities. The required information to check these prerequisites are given.

Algorithms↗
PubMed2003

[Does the digital signature of the DICOM standard meet the requirements of German law?].

The DICOM standard offers the possibilities to generate electronic signatures, valid according to German laws. This enhances the reliability of the correlation between image and patient data. However, only so called qualified electronic signatures--conveniently issued by an accredited supplier--are permissible and not rejectable as evidence in German jurisdiction and are completely equivalent to the handwritten signatures. These qualified electronic signatures can be executed only by individuals, whereas the former are not applicable to technical apparatus like image generating modalities. In consequence, a modality is able to provide its pictures with a "common or advanced signature" solely. This limits the use of the digital signature of the DICOM standard for further applications, e.g. the verifiability within the teleradiology.

Algorithms↗
PubMed1998

Diagnostic evaluation of sonographically visualized breast lesions by using a new clinical amplitude/velocity reference imaging technique (CARI sonography).

RATIONALE AND OBJECTIVES: The goal of this study was to evaluate and differentiate breast lesions in patients by sonographic measurements performed using CARI sonography. METHODS: Thirty-one patients with 33 histologically proven breast lesions were examined by mammography, conventional ultrasound sonography, and CARI sonography. Investigation with mammography-like positioning was performed in case of CARI sonography. The ratios of the lesion diameters were calculated in a craniocaudal and a mediolateral plane. The results were compared with the results obtained with conventional modalities. RESULTS: Breast lesions were detected with the best sensitivity (100%) and a high specificity (86%) using B-mode ultrasound sonography. Mammography resulted in a sensitivity of 92% and a specificity of 91%, whereas the CARI sonography yielded 100% sensitivity and 67% specificity. CONCLUSIONS: The differentiation of lesions by measurements performed with CARI sonography resulted in a high sensitivity. The specificity, however, was inferior compared with the other imaging modalities. This may limit the routine application of the technique for clinical diagnoses of breast lesions. However, due to the small number of patients investigated in this pilot study, the full potential should be evaluated in a larger collective of patients.

Adult↗
PubMed1996

A critical analysis of soluble interleukin-2 receptor levels in kidney allograft recipients.

Soluble interleukin-2 receptor (sIL-2R) was measured by the Cellfree Kit (T Cell sciences) in 103 pretransplant and 1590 posttransplant samples from 103 patients with cadaveric kidney allografts. The mean values (+/- SD) detected in pretransplant sera were significantly higher (1932 +/- 1389 U/ml) than in 72 healthy adults (267 +/- 139 U/ml), but after transplantation they continuously fell towards normal levels within the first 3 postoperative weeks. Recipients with acute rejection episodes showed higher sIL-2R levels (1762 +/- 904 U/ml) than those with stable transplants at discharge (937 +/- 398 U/ml). Highest values were detected during antirejection therapy with antithymocyte globulin (4996 +/- 2166 U/ml) or OKT3 (5905 +/- 3910). Increases were also observed during bacterial and viral infections and even, in some cases, without any apparent cause. Because of this lack of specificity, elevated sIL-2R levels should be interpreted cautiously. Nevertheless, sIL-2R level can be useful for monitoring kidney allograft recipients. Increases point to a cellular immune activation process and can predict rejections or infections.

Adult↗
PubMed1989

[Abdominal sonographic findings in patients with AIDS].

The ultrasound findings of 58 patients with AIDS and ARC were analysed retrospectively. In 55% an enlarged liver, in 62% an enlarged spleen, partially with focal lesions, and in 21% enlarged abdominal lymph nodes were diagnosed. The typical focal segmental glomerulosclerosis of the kidney was observed in one case, and cholangitis in 2 patients. Abdominal ultrasound is the first diagnostic procedure to be performed in patients with AIDS and ARC when abdominal pathology is suspected. With US-guided thin needle puncture of the lesions, a histological verification of the pathologic findings is possible.

Abdomen↗
PubMed1988

[Ultrasound findings in patients with AIDS].

The ultrasonographic findings of 43 patients with AIDS and ARC were analyzed. In 63% an enlarged liver, in 66% an enlarged spleen, partially with focal lesions, and in 21% enlarged abdominal lymph nodes were diagnosed. The typical parenchymal lesions of the kidney (focal segmental glomerulosclerosis) were not observed. Abdominal ultrasound is the first diagnostic procedure to perform in patients with AIDS and ARC with the suspicion of abdominal pathology. With additional thin needle puncture of the lesions a histological verification of the pathologic findings is possible.

AIDS-Related Complex↗