bluuebunny/crossref_metadata_2025 huggingface dataset:
New sonographic finding in renal infarction
Authors: Kodama K , Matsuura K , Yamashita R , Yamanaka T , Terao N , Yaginuma T
Published: July 2009

We observed a unique sonographic finding in a patient with right global renal infarction associated with anabdominal aortic dissection. Sonography in the acute phase revealed a highly echogenic and thickened perirenal fascia without demonstrable abnormality of the renal parenchyma. This finding may be helpful inthe early diagnosis of renal infarction by routine sonography.
Comparison of technetium-99m nanocolloid and indium-111 leucocytes in the diagnosis of orthopaedic infections
Authors: Finlay D B L , Belton I P
Published: July 2009

We would like to make the following response to the letter from Dr Stewart and colleagues regarding our paper.

We appreciate some marrow uptake is expected as well as liver and spleen uptake. As, however, our diagnostic criteria was an increase in uptake relative to the rest of the marrow, we do not believe that any of the images obtained were non-diagnostic.
The clinical utility of transrectal ultrasound and digital rectal examination in the diagnosis of prostate cancer
Authors: Shapiro A , Lebensart P D , Pode D , Bloom R A
Published: July 2009

The development of high definition transrectal ultrasound probes has led to an increased interest in the ability of transrectal ultrasound of the prostate (TRUS) to assist in the diagnosis and management of prostate cancer. The present study was designed to examine the correlation of TRUS with digital rectal examination (DRE). The study group comprised 471 patients in whom the results of (a) DRE, (b) TRUS, and (c) histology of tissue obtained by transrectal biopsy of the prostate (TB), were all available. In those patients where both TRUS and DRE were negative, but prostate specific antigen (PSA) was greater than 10 μg ml−1, six random biopsies were performed. In all other cases the biopsies were TRUS directed to the suspicious lesion. There were 142 cases in whom both DRE and TRUS were negative or only mildly suspicious of malignancy. TB in these cases was positive for cancer in 17 cases (12%). In a further 126 cases, TRUS was positive for cancer, while DRE demonstrated no suspicious nodule. TB was positive in only 17 of these cases (13.5%). Similarly, in the 31 cases in which DRE was positive but TRUS was negative, TB was positive in only three cases (10%). In the 172 cases in whom both DRE and TRUS were positive, 99 biopsies were positive (57.5%). It was concluded from this study that DRE remains the most valuable single examination in the diagnosis of prostate cancer. TRUS increases the sensitivity of DRE if both are positive. When there is a discrepancy between the two examinations, the biopsy yield is low. When both are positive, a high cancer yield is obtained, TRUS having added value in directing the biopsy needle to the suspicious site. TRUS is thus a valuable adjunct to DRE in the diagnosis of prostate cancer.
Localization of Lipiodol-radioiodine in hepatic metastases from renal cell carcinoma
Authors: Stansby G , Bhattacharya S , Hilson A J W , Lane D M , Hobbs K E F
Published: July 2009

Lipiodol, an iodinated derivative of poppyseed oil, is selectively retained in hepatocellular carcinoma and has been used as a vehicle to deliver localized doses of chemotherapeutic and radioactive agents to such tumours, thereby reducing the problems of external beam irradiation and the systemic toxicity of chemotherapy. We describe the first reported case where Lipiodol-targeted radiotherapy has been administered to a patient with secondary renal cell carcinoma in the liver. Localization was good and there were no complications. This case suggests that in future such patients may benefit from this therapy for unresectable lesions.
Prone oblique positioning for computed tomographic arthrography of the shoulder
Authors: Turner P J , O'Connor P J , Saifuddin A , Williams J , Coral A , Butt W P
Published: July 2009

Computed tomographic arthrography(CTA)of the shoulder is currently the best investigation of the unstable shoulder. 47 patients had CTA in the prone oblique position to assess its ability to demonstrate both anterior and posterior capsular mechanisms simultaneously. The first five patients were also scanned supine oblique to allow direct comparison with the prone oblique position. All studies were reviewed retrospectively by three musculoskeletal radiologists with regard to how well the relevant structures were demonstrated. In the prone oblique position, the anterior capsule was well shown in 98%, anterior labrum 98%, posterior capsule 91%, posterior labrum 89%, subscapularis tendon 98%, biceps tendon 100% and biceps tendon proximal insertion 78%. In 86% of cases both anterior and posterior structures were well seen simultaneously. In the five cases that also had supine imaging the prone oblique images were superior. The cause of poor demonstration of structures was invariably insufficient intraarticular air. It is concluded that the prone oblique is an excellent technique for CTA of the shoulder and should become the standard position for assessing shoulder instability.
Imaging studies for emphysematous pyelonephritis
Authors: Bistrup C , Christensen J
Published: July 2009

We have the following comments to make regarding the questions raised by Chaudhuri and Fink about our article [1].

In our article we emphasized the different radiological diagnostic modalities which may be employed in the diagnosis of emphysematous pyelonephritis (EPN). We agree with Chaudhuri and Fink that a complete work-up of a patient with EPN includes an estimation of renal function.
Magnetic resonance neurography of the median nerve
Authors: Howe F A , Saunders D E , Filler A G , McLean M A , Heron C , Brown M M , Griffiths J R
Published: July 2009

A magnetic resonance imaging sequence, combining fat and flow suppression with T  2 weighting, has been used to produce high conspicuity images of the median nerve within the carpal tunnel. Standard maximum intensity projection techniques were then used to produce three-dimensional (3D) reconstructions of the nerve. Comparison of 3D projections with the wrist in a neutral position and wrist flexed at 45° depicted changes in the shape and course of the median nerve through the carpal tunnel of normal volunteers. In some cases of carpal tunnel syndrome evidence of a localized compression was observed. A 3D image of a nerve may help in the diagnosis of peripheral neuropathy and be an aid to surgery of or near major nerves.
Magnetic resonance imaging in myelodysplastic syndromes
Authors: Lewis S , Wainscoat J S , Moore N R , Golding S J
Published: July 2009

In this study we used magnetic resonance imaging (MRI) to examine the axial bone marrow of 11 patients with myelodysplastic syndromes (MDS). T  1 weighted images showed a reduction in signal intensity in all patients. The degree of reduction in signal intensity correlated with bone marrow cellularity rather than percentage blasts or French–American–British Co-operative group (FAB) classification. T  2 weighted images showed an increase in signal intensity in 10 out of 11 patients; however, reliable grading was not possible using this sequence. Both T  1 and T  2 weighted images indicated a homogeneous pattern of disease within the axial skeleton in MDS. We have also shown that iron deposition in multiply transfused patients is a significant factor influencing signal reduction. The results of this study suggest that MRI may have a diagnostic role in MDS but is unlikely to be of value in staging.
A blinded prospective trial of low-residue versus normal diet in preparation for barium enema
Authors: Kember P G , McBride K D , Tweed C S , Collins M C
Published: July 2009

This study was undertaken to determine whether the omission of a low-residue diet in the days leading up to barium enema resulted in poorer bowel preparation. 300 patients were randomized prospectively into one of two groups. One group followed a low-residue diet for the 3 days leading up to the study, the other continued their usual diet. Both groups had two doses of “Picolax” the day before the study. 17 patients did not attend, and a further two patients were excluded, leaving 281 patients for prospective study. The subsequent investigation was assessed blind by a consultant radiologist and graded for faecal residue, mucosal coating and diagnostic quality. No statistically significant difference was found between the two groups for amount of faecal residue (p<0.25), mucosal coating (p<0.25) or diagnostic quality (p<0.5). We conclude, therefore, that a preliminary low-residue diet is unnecessary in the preparation of patients for barium enema. Patients should continue with their usual diet up to the day prior to the test and then have standard purgative preparation.
Perspex blocks for estimation of dose to a standard breast—effect of variation in block thickness
Authors: Faulkner K , Law J , Cranley K
Published: July 2009

Mean glandular dose in mammography may be deduced from measurements made using Perspex blocks. This method is almost universally used in the National Health Service Breast Screening Programme. The effect on the estimated mean glandular dose of variations in the measured thickness of Perspex from a nominal thickness of 40 mm was investigated. Results are presented from three UK Regions. Variations in measured Perspex thicknesses ranged from almost 8% below to about 2% above the 40 mm nominal, causing errors in dose estimation, if uncorrected, of about +20% to −6.5%. A means of correcting dose estimates for measured differences in block thickness is presented. An alternative method of ensuring consistent dosimetry would be to use accurately machined Perspex blocks.
Therapeutic transcatheter embolotherapy in the control of recurrent haemorrhage from lymphoma of the small bowel
Authors: Howlett D C , Farrugia M M , Irvine A T
Published: July 2009

Lymphoma is one of the commonest primary malignancies of the small bowel. Gastrointestinal tract haemorrhage is a relatively infrequent presenting feature or complication. We describe the use of repeated transcatheter embolization as the primary treatment in the control of recurrent haemorrhage from the small bowel in a patient with B-cell lymphoma. Few cases of transcatheter embolotherapy have been described in such situations. This form of treatment is a therapeutic option in those unfit for transcatheter vasoconstrictor infusion or surgery.
Book review
Authors: Faulkner K
Published: July 2009

This succinct document considers the various problems and issues concerning radiation exposure of the embryo, fetus or nursing child. This is a most important practical radiation protection problem.
Book reviews
Authors: Bomford C K
Published: July 2009

This report is a revision of the previous series of reports on the specification of doses culminating in Report 29 published in 1978. This new report recognizes the introduction of the more sophisticated treatment technique resulting from three dimensional computer planning techniques and the use of non-coplanar beams and the increasing need for interdepartmental trials and therefore the transfer of meaningful data.
“…or plat du jour”
Authors: Bhattacharya J , Fraser C , Macdonald L M
Published: July 2009

A 37-year-old man with psoriasis complained of mild neck and back stiffness at a regular visit to a dermatology outpatient clinic. His skin involvement had been wide-spread for the last 4 years, although he had never suffered from psoriatic arthropathy.

Several common therapeutic regimes had failed to procure significant improvement and 2 years prior to this visit his treatment had again been changed.
Contrast media, endothelin, angioplasty and restenosis
Authors: Morcos S K
Published: July 2009

A causal relationship between contrast media (CM), endothelin (ET) and restenosis after angioplasty may exist. In vivo and in vitro studies have shown that CM can stimulate the production of ET, a very potent vasoconstrictor peptide sythesized by the vascular endothelium [1]. In addition to its vasoactive properties ET has mitogenic effects on mesangial and smooth muscle cells [2]. ET can also stimulate the production of growth factors such as the platelet's derived growth factor (PDGF) which is a potent mitogen of smooth muscle and connective tissue cells [3]. A role for PDGF has been proposed in the pathogenesis of restenosis following angioplasty and perhaps in atherogenesis as well [4].
Potential gonadal dose from leakage radiation?
Authors: Nicholson R A
Published: July 2009

The Guidance Notes [1] allow leakage radiation air kerma rates of up to 1 mGy h−1 at a distance of 1 m, through the housing of X-ray tubes; though it is recommended that leakage radiation should not exceed one-tenth of this value in practice. There is no dispute that for overhead tubes the existing limits are acceptable, particularly as leakage dose rates from most of these tubes are orders of magnitude below the required level. In my own experience, however, the highest leakage radiation measurements are to be found in mobile image intensifier (II) units. Bearing in mind some of the uses to which these theatre II units are put, the question of whether the limits for leakage radiation are really adequate should be raised.
Book reviews
Authors: Williams M P
Published: July 2009

This monograph on magnetic imaging of the female pelvis begins with a short chapter on basic imaging principals but no consideration of the physics of MRI. This chapter will be too basic for those already using the technique but unfortunately probably not detailed enough for those coming to MRI for the first time. The next two chapters deal with normal pelvic appearances and are well illustrated in coronal, sagittal and axial planes.
Book reviews
Authors: Sugden E M
Published: July 2009

The paediatric radiotherapist is a member of an interdependant team. Prior to the 1970s, and indeed for long after that in some parts of the country, the radiotherapist was the only oncologist involved in the care of children with cancer. Happily that is no longer the case and all children developing cancer in the UK are (or should be) under the care of a paediatric oncologist. In the final chapter of this book the editor asks; “Will radiation therapy be utilized in the treatment of children with cancer two decades from now?” The late effects seen in children treated often with orthovoltage machines and with radical dises led the pioneers of chemotherapy in padeiatric malignancy to eschew treatment with radiation whenever possible and sometimes more than was possible.
Book reviews
Authors: Chellingworth H
Published: July 2009

This book really does fill a void in the available literature to those radiographers operating in this modality. The vast majority of text books refer to the cross-sectional anatomy and related pathology with reference to case studies and clinical significance, with little specific information about image acquisition.
A pain in the neck
Authors: Murray M E , Heron C
Published: July 2009

A 29-year-old woman presented with persistent neck pain for 1 week, following a road traffic accident in which she had sustained a whiplash injury. On examination, all movements of the neck were slightly restricted by pain, but there was no local tenderness and neurological examination was normal. Anteroposterior, lateral and left oblique radiographs of the cervical spine are shown and certain features marked with arrows (Figures 1–3).
Book reviews
Authors: Faulkner K
Published: July 2009

This is an American textbook aimed at a readership of radiology residents and radiology technologists. It is comprised of a series of short chapters containing what are in effect revision notes on a particular subject followed by a set of short answer questions in the style of the various United States professional examination boards.
Inspiration or expiration? Reducing motion artefact in digital subtraction arch angiography of the extracranial carotid arteries
Authors: Withers D J , Ashleigh R J
Published: July 2009

100 consecutive patients underwent digital subtraction aortic arch angiography for suspected carotid bifurcation disease. Patients were prospectively randomized to suspend respiration in inspiration or expiration during image acquisition. Images were assessed qualitatively as “excellent”, “adequate” or “poor”. 92 studies were available for review. Adequate and poor groups were combined into a non-excellent group due to the small numbers that were scored poor. There were 27 (53%) excellent, 24 (47%) non-excellent in the expiration group and 12 (29%) excellent, 29 (71%) non-excellent in the inspiration group. Analysis of angiogram scores gave χ2(1) = 4.3; p=0.038, indicating that the higher angiogram scores of the expiration group were statistically significant. Pixel shifting was used in 61 cases (66.3%). The proportion was 34.4% lower in the expiration group (95% CI; 17–52%) with χ2(l)=10.5; p=0.0012 indicating that the reduction in the use of pixel shifting for the expiration group was statistically significant. The superiority of arch angiograms obtained with the patient suspending respiration in expiration rather than inspiration has been demonstrated. This was achieved with significantly reduced use of pixel shifting, encouraging greater confidence in the validity of the angiographic findings. The technique is free of cost or time implications.
A phantom based method for deriving typical patient doses from measurements of dose–area product on populations of patients
Authors: Chapple C-L , Broadhead D A , Faulkner K
Published: July 2009

One of the chief sources of uncertainty in the comparison of patient dosimetry data is the influence of patient size on dose. Dose has been shown to relate closely to the equivalent diameter of the patient. This concept has been used to derive a prospective, phantom based method for determining size correction factors for measurements of dose–area product. The derivation of the size correction factor has been demonstrated mathematically, and the appropriate factor determined for a number of different X-ray sets. The use of phantom measurements enables the effect of patient size to be isolated from other factors influencing patient dose. The derived factors agree well with those determined retrospectively from patient dose survey data. Size correction factors have been applied to the results of a large scale patient dose survey, and this approach has been compared with the method of selecting patients according to their weight. For large samples of data, mean dose–area product values are independent of the analysis method used. The chief advantage of using size correction factors is that it allows all patient data to be included in a survey, whereas patient selection has been shown to exclude approximately half of all patients. Reduction of the size of the data set may lead to mean dose–area product values that are less reliable indicators of typical practice. The use of size correction factors will be of particular benefit in the analysis of paediatric dosimetry data, where a wide range of sizes exist, even within accepted age bands.
Comparison of light reflection rheography with ascending venography in the diagnosis of lower limb venous thrombosis
Authors: Harris I
Published: July 2009

I thank Doctors Cave and Weston for their comments but feel that they have completely missed the purpose of our paper. Our aim was determine if there was a simple, cheap test which could be performed, if necessary, outside an imaging department (e.g. an A&E department) by unskilled staff (i. e. operator independent) in order to “weed out” patients with clinical symptoms, thought unlikely to be due to deep venous thrombosis (DVT).
Spin lock magnetic resonance imaging in the differentiation of hepatic haemangiomas and metastases
Authors: Halavaara J T , Lamminen A E , Bondestam S , Sepponen R E , Tanttu J I
Published: July 2009

Spin lock (SL) imaging technique, generating Tiρ-weighted images, was applied to the differentiation of hepatic haemangiomas from metastatic focal liver lesions. 17 haemangiomas and 16 metastases in 32 patients were imaged at the field-strength of 0.1 T using a multiple slice SL technique and a conventional gradientecho (GRE) sequence with identical timing parametres. Spin lock effects of the hepatic lesions and different abdominal tissues were calculated. Images with adequate coverage of the liver and of good quality with few motion induced artefacts were acquired. A definite, statistically significant, difference was found between the SL-effects of hepatic haemangiomas and liver metastases. Haemangiomas showed an SL effect of 46.6 ± 3.4% and metastases of 56.2 ± 5.8% (mean ± SD, p>0.0001). The multiple slice SL technique showed potential in distinguishing haemangiomas from metastatic liver lesions and should be considered as an alternative to the conventional T2 and magnetization transfer (MT) based methods.
Dosimetric considerations in 131I-MIBG therapy for neuroblastoma in children
Authors: Bolster A A , Hilditch T E
Published: July 2009

In our recently published paper dealing with radiation dosimetry in 131I-MIBG for neuroblastoma in children [1], the authors regret that we did not make it clear that the estimated average dose to the bladder wall as a proportion of the surface dose referred only to the beta emissions from 131I.
Book reviews
Authors: Walker J D
Published: July 2009

This two volume tome (approximately 1400 pages) is truly the most impressive and comprehensive text of its type on the market today. Its subject coverage is extensive with reasonably short, concise, state of the art chapters written by a team of contemporary contributors each at the forefront of their field in that particular topic. It is a credit to the editors, Murray and Ell, that they were able to rally such an impressive band of experts in such a relatively short period of time to produce a text of this quality.
Book reviews
Authors: Williams M P
Published: July 2009

This book is a comprehensive review of imaging techniques applied to the head and neck for the non-neuro radiologist. It comprises 23 chapters with two appendices and a total of 1700 illustrations. The chapters are logically laid out, typically starting with anatomy and where appropriate embryology, going on to conventional radiographic evaluation, supplemented where appropriate with CT, MRI and ultrasound.
A lateral will do? (2)
Authors: Blease S C P
Published: July 2009

The short communication by Tyrrell et al [1] regarding the use of a single view of the lumbar spine in GP referrals for backache highlights some of the ethical and professional difficulties encountered when attempting to control the use of an insensitive test in the setting of a common clinical problem. It is also another example of the one exception disproving the rule.
Book reviews
Authors: Phelan M
Published: July 2009

Imaging Children is a very welcome addition to the range of paediatric radiology text books. Its two volumes are laid out in thirteen sections and it is systems based. All contributors are European.
Book reviews
Authors: McCall J
Published: July 2009

This book is a comprehensive reference work on all aspects of paediatric neuroradiology. It opens with chapters on imaging modalities and the normal development of infant skull, brain and spine, the latter being particularly important in the recognition and understanding of pathology.
Use of the European image quality criteria for screen–film comparison—application for asymmetric systems
Authors: Guibelalde E , Morillo A , Fernandez J M , Vaño E
Published: July 2009

The aim of this study is the comparison of two different techniques of image evaluation: by phantom simulation and by patient anatomical criteria using those proposed in a European Union working document. Both methods of evaluation were applied to asymmetric and conventional screen–film systems. The European image quality criteria as a tool for comparing the use of image systems is a reasonably valid and objective method. However, a complete practical description of a system using complementary phantom images and test object is a convenient means of obtaining a comprehensive description of the system. Results show that sharpness of mobile organs and the visualization of the retrocardiac and retromammal lung, in posteroanterior projection, and vertex in lateral projection is improved with the InSight system. The phantom images suggest, however, an important loss of resolution and contrast.
Malignant haemobilia detected in the gallbladder—retrograde cholangiographic findings
Authors: Osawa H , Mori Y , Inoue F
Published: July 2009

Haemobilia caused by gallbladder cancer is a rare condition and cholangiography rarely detects gallbladder haemorrhage because cancer cells or blood clots obstruct the cystic duct. We describe a patient with haemobilia caused by gallbladder cancer, in whom retrograde cholangiography showed a cast-like filling defect in the common bile duct and, in addition, several string-like defects in the gallbladder. The string-like defects appeared to be streams of clotted blood flowing towards the common bile duct in this case of relatively minor haemorrhage.
Air versus carbon dioxide insufflation in double contrast barium enemas: the role of active gaseous drainage
Authors: Jobling J C
Published: July 2009

I read with interest the article by Farrow et al [1]. I heartily agree that the use of carbon dioxide for insufflation of gas during barium enema examinations is a simple and inexpensive technique which gives a considerable improvement in patient comfort in the post-procedural period. I hope articles like this will improve its uptake.
Treatment of carcinomas of the uterine cervix which remain bulky after initial external beam radiotherapy: a pilot study using integrated cytotoxic chemotherapy prior to brachytherapy
Authors: Tan L T , Jones B , Green J A , Kingston R E , Clark P I
Published: July 2009

The use of cytotoxic chemotherapy (CT) between external beam radiotherapy (EBRT) and intracavitary brachytherapy (BT) in patients with bulky carcinomas of the uterine cervix which regress poorly after initial EBRT has been evaluated in a pilot study. The aim of CT was to limit tumour clonogen repopulation while awaiting further tumour regression in order to improve the BT dose distribution. Between 1989 and 1992, 22 patients with FIGO Stage IIA, IIB and IIIB cervical carcinomas were given two to three cycles of cisplatinbased CT between EBRT and intracavitary BT. Patients were selected for CT if there was bulky residual tumour extending beyond the range of point “A” after completion of EBRT. The median survival of patients with Stage IIA/B and Stage IIIB disease was 24 months and 13 months, respectively. The 5 year actuarial survival rate for patients with Stage IIA/B disease was 42%. There were no long-term survivors among patients with Stage IIIB disease. Survival difference between Stage IIA/B patients and Stage IIIB patients was statistically significant (p <0.04) 5 year actuarial pelvic control rates were 38% and 0% for Stage IIA/B and Stage IIIB patients, respectively. There were no serious late radiation complications in the entire study group. Bulky carcinomas of the cervix which respond poorly to initial EBRT have a particularly poor prognosis. For Stage IB–IIB patients with persistent bulky disease after EBRT, published reports suggest that a 5 year actuarial survival rate of around 40% can be obtained using higher doses of radiation alone, but the risk of serious late morbidity is considerable. The results of our study suggest that in Stage IIA/B carcinomas of the cervix which remain bulky after initial EBRT, the use of integrated cytotoxic chemotherapy prior to intracavitary BT can give similar 5 year survival rates but with minimal treatment related morbidity.
Renal pseudotumours mimicking tumour recurrence after partial nephrectomy
Authors: Sy M , Van Gansbeke D , Simon J , Willemart S , Braudé Ph , Struyven J
Published: July 2009

Partial nephrectomy and tumour enucleation are increasingly accepted as an organ sparing approach for small renal cell carcinomas. Repeated computed tomography or sonography for the early detection of tumour recurrence are mandatory during the follow-up. We report two cases of renal pseudotumour mimicking a tumour recurrence: one case is related to the pseudotumoral appearance on sonography of a tumour defect filled by a fatty flap, and the other to the relative migration of an accessory spleen into the site of the cuneiform nephrectomy. The recognition of renal pseudotumours following partial nephrectomy prevents confusion with tumour recurrence on follow-up examinations.
Assessment of target recovery after TV camera saturation in X-ray fluoroscopy using a personal computer with frame-grabber
Authors: Okkalides D
Published: July 2009

X-ray fluoroscopy images were digitized with a personal computer and frame-grabber system. This system was used to measure the recovery from saturation of the target of a TV camera by calculating the time at which contrast falls to 50% (C½). This measurement was performed on images of: (a) a rotating lead disk with a slit at its side and (b) a square hole in a thick lead sheet. These images represented the moving (MOTR) and stationary (SOTR) object target recovery. The SOTR method produced much higher C½ values in two mobile fluoroscopy systems used for cardiac catheterizations where waveforms permitted the application of both methods. The SOTR method was also applied to three additional fluoroscopy systems. It was found that, contrary to expectations, C½ increased with exposure rate in all five machines. Target recovery characteristics of the machines tested, represented by the gradient of C½ against exposure rate, were found to increase with inherent noise level measured in the vidicon camera target. The set-up used here for measuring target recovery proved to work quickly and reproducibly for both SOTR and MOTR. If initial values are calculated then the condition of any fluoroscopy system may easily be followed irrespective of the method used.
That's torn it!
Authors: Moss M S , Wingate J P
Published: July 2009

A 7-year-old male victim of a road traffic accident was admitted to hospital. On examination he was drowsy with a bruise on the left side of his forehead and a clinically obvious fracture of his right femur. He was described as being “completely flaccid” and unresponsive to painful stimuli. No physical signs were found in the chest, abdomen or central nervous system. Plain radiographs of the cervical spine, skull and pelvis were interpreted as normal. The chest radiograph is shown in Figure 1. What is the abnormality? How may it have arisen?
3M Mayneord Memorial Lecture: Functional brain imaging — an overview
Authors: Orrison W W
Published: July 2009

Several methods can detect or infer the disruption of basic brain physiology; these methods include the techniques of computerized axial tomography, magnetic resonance imaging, positron emission tomography, single photon emission computed tomography, electroencephalography, magnetoencephalography, and magnetic resonance spectroscopy. Until recently any information on the actual function of the brain has been restricted to that deduced from the clinical examination, as most imaging methods have been limited to providing only anatomical references. In the past 10 years magnetic resonance has become a standard part of many neuroradiological practices Tremendous advances in computed tomography have resulted in dramatic improvement in both image resolution and imaging times. During the 1990s, as interest shifts toward the analysis of brain function or dysfunction, the focus on the brain's electrical activity has resurged. Functional evaluation techniques, such as magnetoencephalography, began in the 1960s and early 1970s, sophistication in the technology has led to much shorter examination and analysis times, leading to further clinical utility. Magnetoencephalography, when combined with magnetic resonance images, forms a functional image of the brain, or magnetic source image. The advent of such methods for evaluating actual functional acitvity of the brain has resulted in new clinical applications for previous methods of brain imaging and the arrival of new clinical imaging modalities.
Contrast reduction using energy dependent intensifying screens
Authors: Shah G A , Hassam G , Newman D L
Published: July 2009

The speed of intensifying screens, in particular rare earth screens, increases with beam energy. Using such a screen, the measured contrast of an aluminium disc, with optical densities in the linear region of the characteristic curve, was found to be significantly and consistently less than that calculated from the gamma of the film–screen combination for all tube potentials from 40 to 140 kVp. This contrast reduction effect can be explained in terms of the filtering action of the disc which increases the effective energy of the beam. Hence, the film–screen combination is exposed to X-rays which have different effective energies. This results in two characteristic curves of different speed. The contrast of the disc image is not dependent on the gamma of either curve, but an effective gamma which links the two curves. This effective gamma is less than the gamma of either curve. Contrast calculated using the effective gamma gave good agreement with the measured contrast of the disc image over the tube potential range examined.
Bronchial to coronary artery anastomosis — a potential hazard in bronchial artery embolization
Authors: Van Den Berg J C , Overtoom T Th C , Valois J C De
Published: July 2009

Bronchial artery embolization is a well-established treatment for patients with haemoptysis. Communications between coronary and bronchial vessels have been seen on coronary angiography. This report describes a case of a bronchial to coronary artery anastomosis diagnosed prior to embolization in a patient with haemoptysis.
Pregnancy after uterine artery embolization to control haemorrhage from gestational trophoblastic tumour
Authors: McIvor J , Cameron E W
Published: July 2009

Gestational trophoblastic tumour (GTT) of the uterus can cause severe and even life threatening haemorrhage in patients who may be contemplating future pregnancy. Three cases of successful pregnancy after uterine artery embolization to control severe haemorrhage from uterine GTT are reported. Both uterine arteries had been selectively catheterized and embolized in these patients. The areas of pathological circulation measured on the pre- and post-embolization films had been reduced by over 80%. Embolization failed to control haemorrhage in another four patients in whom the uterine arteries had not been selectively catheterized and embolized and where the embolization procedures had reduced the areas of pathological circulation by less than 65%. The conclusions are that control of severe haemorrhage from uterine GTT is likely if both uterine arteries are selectively catheterized and embolized. Patients thus treated can become pregnant.
Fracture of central intrauterine tube following insertion of high dose rate intracavitary applicator
Authors: Tyrie L K , Hoskin P J
Published: July 2009

We present a unique complication of high dose rate afterloading intrauterine brachytherapy occurring in a patient requiring treatment for carcinoma of the uterus. A high dose rate afterloading intrauterine insertion was performed under general anaesthetic, following which routine check films revealed that the central uterine tube had fractured at the level of the cervical os.
Image quality and safety after iodixanol in intravenous urography; a comparison with iohexol
Authors: Sundgren P C , Bååth L , Törnquist C , Grynne B Hougens , Kjaersgaard P , Almén T
Published: July 2009

A double-blind, randomized phase III study compared intravenous urography in 100 adult patients receiving iodixanol 320 mgI ml−1 (VisipaqueR) with 99 patients receiving iohexol 35O mgI ml−1 (OmnipaqueR). The aim of the study was to investigate differences in image quality between a non-ionic dimeric contrast medium (CM) and a non-ionic monomer at 40 ml per patient and 60–100 ml per patient volume levels. There were no statistically significant differences between iodixanol and iohexol with respect to overall diagnostic information, which was found to be optimal in 86% and 79%, respectively. Immediately after the injection, the renal border was better delineated with iohexol than with iodixanol (p = 0.0001). Marked papillary blush occurred more often in the iodixanol group (16%) than in the iohexol group (0%), as did visualization of the collecting ducts (24% vs 5%) (p = 0.0001). The incidence of adverse events was similar and low for both contrast media. In patients who received the higher doses of CM (60–100 ml), the frequency of discomfort was significantly lower after iodixanol than after iohexol (p = 0.006). We conclude that, in intravenous urography, iodixanol provides at least as good image quality as does iohexol. Iodixanol may cause less discomfort than iohexol, in particular when larger volumes of CM are injected.
Influence of dose reduction recommendations on changes in chest radiography techniques
Authors: Warren-Forward H M , Haddaway M J , McCall I W , Temperton D H
Published: July 2009

A previous dosimetric study on chest radiography identified ways to reduce patient entrance surface dose (ESD). This present study was designed to monitor changes that had occurred in the use of applied potential and film–screen sensitivity, after a series of recommendations were issued. The study falls into two parts: (1) an assessment of the impact of the recommendations and (2) what factors were responsible for change. Where changes had occurred, exposure factors were collected for 30 patients per tube and the mean ESD was calculated for each tube. Intercomparison (r = 0.93, p<0.001) was made between calculated and measured (TLDs) values of mean ESD for 10 X-ray units, to ensure that the calculated values provided accurate estimates of the new mean ESDs. 89% of units previously monitored for patient ESD now use average applied potentials greater than 90 kVp and 51% are using film–screen sensitivities of 400. The mean ESD has been reduced on average by 47%, from 0.15 mGy to 0.08 mGy. It has been estimated that the annual collective dose from diagnostic radiology procedures in 30 hospitals in the West Midlands has been reduced by a value in excess of 40 man Sv. Reasons for change could be attributed to some of the following factors: (a) a knowledge of dose levels in comparison with other centres; (b) personal contact with departments; (c) feedback in terms of results and dose savings and (d) positive encouragement to make changes.
Dose rates and energy spectra in the maze of a linear accelerator treatment room
Authors: Morgan S , Morgan H M , Lillicrap S C
Published: July 2009

Since the publication of our paper [1] describing the measurement of dose rates and energy spectra in the maze of a linear accelerator treatment room, we have had useful correspondence with Dr R C McCall (McCall Associates, Woodside, CA, USA) over shielding calculations and the different practice between the USA and UK in the use of lead protective doors.
Is sonographic flow imaging useful in the differential diagnosis of adrenal masses?
Authors: Ghiatas A A , Chopra S , Schnitker J B
Published: July 2009

This prospective study was carried out to assess the ability of colour Doppler ultrasound (CDUS) and power flow imaging to differentiate between benign and malignant adrenal masses. We examined 56 adrenal masses, discovered at CT, in 47 patients who had undergone CT for known extraadrenal malignancy or unrelated benign conditions. The nature of the masses was confirmed by histopathology or assessed for likelihood of malignancy by CT appearance, MRI appearance, recent development or increase in size. In none of the adrenal masses was blood flow detected by colour Doppler or power imaging, despite optimizing scanning parameters for the detection of slow flow. We conclude that colour Doppler ultrasound and power imaging do not help in differentiating benign from malignant adrenal masses.
A technique for delivering carbogen with high dose rate intraluminal brachytherapy in carcinoma of the oesophagus; early results and toxicity
Authors: Hoskin P J , Powell M E B , Saunders M I
Published: July 2009

A technique to deliver carbogen with high dose rate afterloading therapy to the oesophagus is described. Treatment is given using a standard high dose rate (HDR) afterloading catheter which is passed through the tumour-bearing area of the oesophagus within a nasogastric tube. In order to achieve a gas-tight seal, a standard “oxygen” mask used for delivery of carbogen is modified to incorporate the nasogastric tube allowing the treatment catheter to pass through the mask and be connected to the afterloading machine. The technique has proven to be feasible and well tolerated during treatment in four patients treated in this way. Severe acute radiation toxicity, possibly attributable to the carbogen, has been encountered in these patients receiving 1500 cGy at 1 cm via the HDR catheter after 4050 cGy in 27 fractions in 9 days using CHART external beam. Modifications to the radiation scheduling is recommended to enable carbogen to be incorporated in this way.
Electron spin resonance imaging studies of biological systems
Authors: Lurie D J
Published: July 2009

Electron spin resonance (ESR) was first demonstrated in 1945, the same year that the first NMR experiments were carried out. The earliest publication on twodimensional ESR imaging (ESRI) appeared in 1979, around the same time as the first good quality, whole-body NMR images were presented. Fundamentally, ESR and NMR differ only in the fact that one method involves a magnetic resonance experiment on the unpaired electron, while the other uses the atomic nucleus. Why, then, have the rates of progress in the two fields diverged so significantly? Many thousands of MRI machines are now installed worldwide, and there are several hundred active research groups developing new hardware, methodologies and applications. In contrast, there are less than 20 research groups worldwide working on ESRI for biological and medical applications. Is it a lost cause, or is its day still to come? This article will summarise the current status of ESRI and related techniques, and will indicate how, in the author's opinion, the field is likely to develop over the next decade.
Acute segmental radiation nephritis on bone scintigraphy
Authors: Flanagan F L , Dehdashti F
Published: July 2009

A case of radiation nephritis was diagnosed by the effect of delayed excretion of 99Tcm MDP on the superomedial aspects of both kidneys, which had been included in a radiation port to the thoracolumbar spine 6 months previously. Knowledge of the past history of radiotherapy and the radiation port, together with the classic scintigraphic features enable the diagnosis of this rarely demonstrated condition to be made.
Occupational dose to the radiographer in dual X-ray absorptiometry
Authors: Mazess R B
Published: July 2009

The recent report by Patel et al [1] confirms that the exposure dose, and scattered radiation, from bone densitometry is small compared with many radiological procedures. Two fan-beam densitometers (QDR-2000 and QDR-4500) were shown to produce a scattered dose of ∼2.3 μSv h−1 at 1 m, assuming a throughput of four patients (spine and hip) or eight determinations per hour.
Labor Market Institutions and Global Strategic Adaptation: Evidence from Lincoln Electric
Authors: Siegel Jordan I. , Larson Barbara Zepp
Published: July 2009

Although one of the central questions in the global strategy field is how multinational firms successfully navigate multiple and often conflicting institutional environments, we know relatively little about the effect of conflicting labor market institutions on multinational firms' strategic choice and operating performance. With its decision to invest in manufacturing operations in nearly every one of the world's largest welding markets, Lincoln Electric offers us a quasi-experiment. We leverage a unique data set covering 1996–2006 that combines data on each host country's labor market institutions with data on each subsidiary's strategic choices and historical operating performance. We find that Lincoln Electric performed significantly better in countries with labor laws and regulations supporting manufacturers' interests and in countries that allowed the free use of both piecework and a discretionary bonus. Furthermore, we find that in countries with labor market institutions unfriendly to manufacturers, Lincoln Electric was still able to overcome most (although not all) of the institutional distance by what we term flexible intermediate adaptation.
Service Interruptions in Large-Scale Service Systems
Authors: Pang Guodong , Whitt Ward
Published: July 2009

Large-scale service systems, where many servers respond to high demand, are appealing because they can provide great economy of scale, producing a high quality of service with high efficiency. Customer waiting times can be short, with a majority of customers served immediately upon arrival, while server utilizations remain close to 100%. However, we show that this confluence of quality and efficiency is not achieved without risk, because there can be severe congestion if the system does not operate as planned. In particular, we show that the large scale makes the system more vulnerable to service interruptions when (i) most customers remain waiting until they can be served, and (ii) when many servers are unable to function during the interruption, as may occur with a system-wide computer failure. Increasing scale leads to higher server utilizations, which in turn leads to longer recovery times from service interruptions and worse performance during such events. We quantify the impact of service interruptions with increasing scale by introducing and analyzing approximating deterministic fluid models. We also show that these fluid models can be obtained from many-server heavy-traffic limits.
A General Interindustry Relatedness Index
Authors: Bryce David J. , Winter Sidney G.
Published: July 2009

For empirical work in the resource-based view of the firm, characterizing the resources that are responsible for firm growth is difficult because valuable resources are often tacit, ambiguous, or difficult to identify. This is a particular problem for empirical assessments that rely upon the concept of relatedness between resources to characterize the direction of growth of the firm. We tackle the problem for the general case by developing a general interindustry relatedness index. The index harnesses the relatedness information embedded in the multiproduct organization decisions of every diversified firm in the U.S. manufacturing economy. The index is general in that it can be used across industry contexts without requiring explicit identification of resources and it provides a percentile relatedness rank for every possible pair of four-digit Standard Industrial Classification manufacturing industries. The general index is tested for predictive validity and found to perform as expected. Applications of the index in strategy research are suggested.
Poker Player Behavior After Big Wins and Big Losses
Authors: Smith Gary , Levere Michael , Kurtzman Robert
Published: July 2009

We find that experienced poker players typically change their style of play after winning or losing a big pot—most notably, playing less cautiously after a big loss, evidently hoping for lucky cards that will erase their loss. This finding is consistent with Kahneman and Tversky's (Kahneman, D., A. Tversky. 1979. Prospect theory: An analysis of decision under risk. Econometrica 47(2) 263–292) break-even hypothesis and suggests that when investors incur a large loss, it might be time to take a vacation or be monitored closely.