bluuebunny/crossref_metadata_2025 huggingface dataset:
Hallervorden‐Spatz disease
Authors: Boyacigil Süreyya , Tokoǧlu Figen , Paşaoǧlu Eşref , Ardiç Selim , Çomoǧlu Selçuk , Saka Mustafa , Öztürk Şerefnur
Published: March 2008

In a 22 year old man with dominant extrapyramidal signs, dystonia and mental deterioration, magnetic resonance imaging revealed marked overall low signal from the globus pallidus on each side, with central zones of high signal on T2‐weighted spin echo sequences. There was also a strikingly low signal in the zona reticularis of the substantia nigra, consistent with Hallervorden‐Spatz disease.
MRI appearances of Listeria rhombencephalitis
Authors: Davies RS , Burgin M
Published: March 2008

Listeria monocytogenes is a rare cause of central nervous system infection in the non‐immunocomprised patient and 10% of these patients develop a rhombencephalitis. We present such a case and discuss the clinical, pathological and radiological features.
Penetration of a vertebral body by a limb of the Greenfield filter
Authors: Wambeek NDK , Frazer CK
Published: March 2008

This case report describes penetration of the wall of the inferior vena cava, with subsequent migration into a vertebrai body by a limb of the Greenfield filter.
Assessment of an online radiology reporting system
Authors: Gormly KL , Langlois S Le P
Published: March 2008

This study was designed to assess the efficiency of radiology reporting in the Royal Adelaide Hospital Department of Radiology, which introduced online reporting in November 1994. Seventeen radiologists were monitored without their knowledge, and recordings were made of the times between report dictation and report typing, and the time that the report waited on computer for verification. The total median values for verification time for 9/17 radiologists were less than 12 h and for 14/17 were less than 24 h. On average, reports were available from all reporting areas within 24 h. However, some reports waited up to 13 and 14 days to be verified and to be available on computer for treating clinicians. This report demonstrates that on average rapid reporting is occurring, however some areas need to be considered further to maximize efficiency.
Ultrasonography of breast hamartomas
Authors: Black J , Metcalf C , Wylie EJ
Published: March 2008

The authors present the breast ultrasound findings of nine women with mammographic abnormalities typical of breast hamartomas. Two of the mammographically detected hamartomas could not be identified at breast ultrasound. Six hamartomas were well‐circumscribed masses of heterogeneous echogenicity with no posterior acoustic shadowing. One lesion was a well‐defined hypo‐echoic mass with no posterior shadowing. We conclude that many mammographically and clinically detected hamartomas can be clearly identified at breast ultrasound. The breast sonographer should be aware of the spectrum of appearances that may occur. When a breast abnormality has the characteristic mammographic appearances of a hamartoma, it may be counterproductive to perform an additional breast ultrasound.
Synovial sarcoma: An unexpected ultrasound finding in a post‐partum patient
Authors: Acton CM , Morrison WA , Slavin JL
Published: March 2008

A 20‐year‐old patient presented after an uneventful pregnancy and delivery with an asymptomatic soft‐tissue mass behind her knee with the clinical features of a ganglion or Baker's cyst. An ultrasound scan demonstrated a well‐defined but solid mass with prominent vascularity. The mass was noted to increase in size prior to surgery. The pathological diagnosis was that of a synovial sarcoma grade 2, a rare malignant mesenchymal neoplasm with a serious prognosis.
A review of the radiological features of intracranial meningiomas
Authors: Kizana E , Lee R , Young N , Dorsch NWC , Soo YS
Published: March 2008

To evaluate the role of radiological imaging of meningiomas in confirming the diagnosis and as a neuroanatomical aid to surgical planning, 115 patients with surgically excised meningiomas between 1990 and 1993 were studied. Computed tomography (CT), magnetic resonance imaging (MRI) (on a 0.5T unit) and angiography were reviewed, and compared with histopathology (when available). Seventy‐eight CT, 89 MRI and 85 angiographic studies were reviewed, and correlated with histopathology in 67 cases. In 48 cases, the surgical specimens could not be pathologically classified. The most common lesion sites were the cerebral convexities, falx and sphenoidal ridges. True demarcation of cleavage planes was seen on 73% of MRI and 10% of CT studies. Computed tomography showed hyperostosis in 27% and MRI in 7% of studies. Tumours enhanced strongly with contrast in 98% of CT scans. On MRI there were variable signal intensities on different sequences, and no correlation between signal intensities and histological subtype was found. Oedema was present in 59% of CT and 66% of MRI studies, and was most pronounced in lesions > 3 cm in diameter. Tumour calcification was seen in 62% of CT and 8% of MRI studies. Vascular abnormalities were seen on 65% of MRI, 21% of CT and 84% of angiogram studies. Angiographic tumour vascularity did not correlate with histologic subtype. All three imaging modalities have management roles: CT for bony changes and calcification, MRI for multiplanar and vessel anatomy imaging, and angiography for vessel delineation and embolization if required.
Magnetic resonance imaging of tuberculous spinal infection
Authors: Loke TKL , Ma HTG , Chan CS
Published: March 2008

The magnetic resonance imaging (MRI) characteristics of 15 cases of tuberculous (TB) spinal infection were reviewed. The commonest site was the lumbar spine (53.3%), often with three or more contiguous vertebrae involved (47%). Destruction of the vertebral body and the presence of paraspinal soft‐tissue masses were noted in 73.3%. Posterior element abnormalities, which is a significant finding, were seen in 40%, a slightly lower incidence rate than in other reported series. Epidural disease (53.3%) and disc abnormalities (73%) were more frequent than was realized. The role of intravenous contrast is discussed. Intravenous gadolinium is useful because it increases diagnostic confidence by characterizing and delineating the disease process, detects reactivation in old and healed TB, helps in treatment management and may prove valuable in monitoring therapy. Magnetic resonance imaging should be considered to be the imaging modality of choice for patients with suspected tuberculous spinal infection.
Significance of short tau inversion recovery magnetic resonance sequence in the management of skeletal injuries
Authors: Van Gelderen WFC , Al‐Hindawi M , Gale RS , Steward AH , Archibald CG
Published: March 2008

The conventional radiographs and urgent short tau inversion recovery (STIR) magnetic resonance image (MRI) examinations of 27 consecutive patients with occult bony injuries were prospectively analysed over a 12 month period. A STIR MRI study was undertaken where the plain films were normal (n=15) or inconclusive (n=12) and where the patients’clinical setting was highly suggestive of an underlying bony injury. In six patients, MRI only revealed soft‐tissue injuries or joint effusions and did not demonstrate any bony injury but in the remainder fractures or bone contusions were shown to be present.

The MRI studies were performed on a 0.2 Tesla lower field strength unit and the examinations were expeditiously performed, inexpensive, and done on a priority basis between electively booked patients. Radio‐isotope studies were not available and hence were not included in the study protocol.

Apart from demonstrating the value of STIR MRI (without additional T1‐weighted sequences in most patients), the purpose of this study was to highlight the alteration in management in 18/27 patients (66%) and the significant alteration in management in six of these patients.
Extensive basal cell carcinoma treated with the mould radiotherapy technique
Authors: Leung John T
Published: March 2008

Superficial extensive basal cell carcinoma of the head and neck region can be difficult to treat because of the large area of skin involved, and the changing contour of the head and neck region. A patient with basal cell carcinoma involving the upper chest and neck treated with mould radiotherapy is presented.
Haemangioma of the oesophagus: CT demonstration
Authors: Dumbleton Siobhan A , Warshauer David M , Koruda Mark J , Woosley John T
Published: March 2008

A case of haemangioma of the oesophagus is presented. The computed tomographic findings of an intramural mass with marked enhancement following intravenous contrast enable the diagnosis to be suggested pre‐operatively.
‘Duplication’ of the clavicle or ossification in coracoclavicular ligament
Authors: Schubert F
Published: March 2008

A case is presented in which plain films revealed a short band of ossification adjacent to the inferior aspect of the lateral part of the clavicle. CT findings indicated that the ossification was situated in the coracoclavicular ligament and was not a manifestation of clavicular‘duplication’.
Computed tomography intravenous cholangiography
Authors: Nascimento Sherry , Murray Wynne , Wilson Peter
Published: March 2008

Indications for direct visualization of the bile ducts include bile duct dilatation demonstrated by ultrasound or CT scanning, where the cause of the bile duct dilatation is uncertain or where the anatomy of bile duct obstruction needs further clarification. Another indication is right upper quadrant pain, particularly in a post‐cholecystectomy patient, where choledocholithiasis is suspected. A possible new indication is pre‐operative evaluation prior to laparoscopic cholecystectomy. The bile ducts are usually studied by endoscopic retrograde cholangiopancreatography (ERCP), or, less commonly, trans‐hepatic cholangiography. The old technique of intravenous cholangiography has fallen into disrepute because of inconsistent bile‐duct opacification. The advent of spiral CT scanning has renewed interest in intravenous cholangiography. The CT technique is very sensitive to the contrast agent in the bile ducts, and angiographic and three‐dimensional reconstructions of the biliary tree can readily be obtained using the CT intravenous cholangiogram technique (CT IVC). Seven patients have been studied using this CT IVC technique, between February 1995 and June 1996, and are the subject of the present report. Eight further studies have since been performed. The results suggest that CT IVC could replace ERCP as the primary means of direct cholangiography, where pancreatic duct visualization is not required.
Sucralfate cream in the management of moist desquamation during radiotherapy
Authors: Delaney Geoffrey , Fisher Richard , Hook Carolyn , Barton Michael
Published: March 2008

Randomized trials have shown that sucralfate is effective in the management of acute radiation reactions such as oesophagitis, mucositis and proctitis. However, at the time of commencement of the present trial, it had never been used in the management of moist desquamation of the skin. The purpose of the present study was to assess the value of sucralfate cream in the management of moist desquamation during radiotherapy. Patients who developed moist desquamation during radiation were eligible. Patients were stratified by site of radiotherapy into three groups: (i) the head and neck; (ii) the breast; and (iii) other sites. Patients were randomized to receive 10% sucralfate in sorbolene cream or sorbolene alone. Patients' pain and skin healing were assessed by using linear analogue self‐assessment (LASA) scales and by serial measurement of the desquamated area. Due to poor patient accrual, the trial was terminated after 2 years and 39 patients. No statistically significant difference was found between the two arms in either time from randomization to healing or improvement in pain score. Twenty patients in the sucralfate arm took a geometric mean of 14.8 days to heal whereas 19 patients receiving sorbolene alone took a geometric mean of 14.2 days. The ratio of mean times to healing, 1.043, is not statistically different from 1 (P= 0.86; 95% CI = 0.65,1.67). A total of 75% of the patients reported pain relief on application of either cream. Mean LASA scores for pain for each day after randomization were compared by treatment arm and there was no statistically significant difference (P= 0.32). The present trial was unable to show a difference in terms of time to healing or pain relief in the treatment of moist desquamation. The small number of patients in the trial gave a wide confidence interval for treatment difference, implying that an important effect of sucralfate has not been excluded. Given the poor accrual in the present, single‐institution study, future studies may need to be multi‐institutional and we encourage other centres to perform randomized trials in the management of moist desquamation.
Perforated diverticulum of the ascending colon: Pre‐operative diagnosis by ultrasound
Authors: Khaleghian R , King AR
Published: March 2008

A case of acute perforation of a diverticulum of the ascending colon is presented. The ultrasound features that helped in making a pre‐operative diagnosis are discussed. This rare surgical emergency and the similar clinical entities of perforated caecal or transverse colon diverticula are often clinically misdiagnosed as more common conditions such as acute appendicitis, acute cholecystitis or perforated ulcer. Awareness of this entity will help radiologists in making a correct pre‐operative diagnosis.
Radiation dose in computed tomography of the pelvis: Comparison of helical and axial scanning
Authors: Pitman Alex G , Budd Ray S , McKenzie Allan F
Published: March 2008

An anthropomorphic Rando phantom was used to compare radiation doses sustained during helical and conventional axial CT of the pelvis. The values obtained with the Rando phantom were validated against cadaveric phantoms, and show good agreement. For the authors’particular CT unit, helical scanning was found to deliver a lower radiation dose than conventional axial scanning. This was most prominent at 1.0‐s tube rotation times (average dose ratio 1.24). For realistic scanning parameters and exposure factors, the ratio of radiation dose to pelvic organs can be expected to lie in the range of 40‐100 mGy. The whole‐body effective dose (ED) depends on selection of scanning parameters and patient anatomy. In a favourable case scenario, the ED for CT scanning of the pelvis in a male can be expected to be between 10 and 20 mSv if the scrotum is not included in the radiation field, while the ED in a female will be −20 mSv. An examination of scatter radiation fall‐off curves from a single slice shows that the spread of scatter radiation is only marginally affected by slice thickness. A total of 10‐12 cm of human soft tissue acts as a good barrier against internal scattered radiation. The use of such scatter fall‐off curves, together with manufacturers’dosimetry specifications, allows a fast estimate of absorbed dose.
Splenic irradiation for hairy cell leukaemia
Authors: Al‐Moundhri M , Graham PH
Published: March 2008

Splenic irradiation in the management of hairy cell leukaemia is previously unreported. A case is presented here to illustrate that splenic irradiation may be a useful addition to systemic therapies.
Phaeochromocytoma with central nervous system manifestations
Authors: Eclavea Anthony , Gagliardi Joseph A , Jezior Jim , Burton Brad , Donahue John P
Published: March 2008

A 35‐year‐old Samoan male presented with intermittent headaches and hypertensive episodes for several months. A subsequent left adrenal gland phaeochromocytoma was discovered and surgically excised. An MRI of his brain demonstrated periventricular, basal ganglia, and centrum semi‐ovale infarction. We suggest that catecholamine excess and neuropeptide Y may contribute to intracerebral haemorrhage and infarcts associated with phaeochromo‐cytomas. Additionally, our surgical approach in removing the phaeochromocytoma is discussed.
Detection of renal arteries with fast spin‐echo magnetic resonance imaging
Authors: Tello Richard , Mitchell Peter J , Witte David J , Thomson Kenneth R
Published: March 2008

With the increasing use of non‐invasive imaging with MR and volumetric CT to evaluate renal arteries, the ability to accurately detect the number and state of native renal arteries becomes critical if conventional angiography is to be supplanted in these settings. The present study evaluated the utility of a fast spin‐echo (FSE) T2‐weighted sequence to detect the number and course of renal arteries and their ostia compared to conventional angiography. Ten patients underwent conventional catheter angiography either for renal artery stenosis evaluation or as potential renal donors. Each patient then had an MR study of the renal arteries and kidneys with FSE MR (TR = 4000 ms, TE = 102 ms, eight‐echo train length, 5‐mm‐thick interleaved 128 phase encodes, superior and inferior saturation pulses, number of excitations (NEX) = 4, on a 1.5‐T superconducting magnet (GE, Milwaukee, Wl, USA). Images were reviewed by two‘blinded’radiologists and renal arteries were counted and their ostia were evaluated. Results were compared with angiography and inter‐ and intra‐observer statistics were calculated. All 10 patients underwent MR successfully, nine for renal artery stenosis (RAS) evaluation and one was a renal donor. A total of 24 renal arteries were imaged in 19 kidneys. Fast spin‐echo MR is 95% accurate (95%CI: 88‐100%) in detection of renal arteries, with no statistical difference between FSE MR and catheter angiography (McNemar P= 0.0). Inter‐ and intra‐observer statistics demonstrate good‐to‐excellent agreement in renal artery detection (kappa: 0.63‐0.90). In one case of RAS evaluation an incidental adrenal mass was detected as the aetiology of the patient's hypertension. Fast spin‐echo MR can be a useful adjunct as part of the imaging for renal arteries with MRI.
Huge adrenal haemangioma
Authors: Hisham AN , Samad SA , Sharifah NA
Published: March 2008

Adrenal tumours are either functioning or non‐functioning. Non‐functioning adrenal tumours are generally asymptomatic and usually of enormous proportions at the time of presentation. A case is presented here of a patient with a huge right adrenal haemangioma which was successfully treated surgically. This unusual tumour was 25 cm in diameter, was well encapsulated and weighed 4 kg. The literature pertaining to this interesting case is reviewed.
Fluid‐fluid levels in a simple bone cyst on magnetic resonance imaging
Authors: Maas EJ , Craig JG , Swisher PK , Amin MB , Marcus N
Published: March 2008

An unusual case is presented here of simple bone cyst (SBC) with fluid‐fluid levels on MR and cementum‐like substance on microscopy in an atypical location in the distal femur. Fluid‐fluid levels are commonly described in the literature within aneurysmal bone cysts, giant cell tumour, chondroblastomas and telangiectatic osteosarcomas, but a literature review revealed only one reported case with multiple fluid levels occurring in a simple bone cyst on MRI. A cementum‐like matrix is diagnostic of SBC and is seen in ± 10% of cases.
Foetal intracardiac transfusion for the treatment of severe anaemia due to human parvovirus B‐19 infection
Authors: Goodear M , Hayward C , Crowther C
Published: March 2008

Intra‐uterine parvovirus infection may result in severe foetal anaemia and death. Ultrasound diagnosis of foetal parvovirus is presented, together with ultrasound‐guided foetal transfusion to treat the anaemia.
Quality‐of‐life assessment during palliative radiotherapy
Authors: Kearsley JH , Schonfeld C , Sheehan M
Published: March 2008

A total of 164 consecutive patients with a range of biopsy‐proven locally advanced or metastatic cancers were interviewed t o assess quality of life using the Rotterdam Symptom Check List (RSCL) at three longitudinal time intervals during a course of palliative radiotherapy. Of the 164 patients, 120 were able to complete all 3 question‐naires. Paired t‐tests were used t o assess the significance of changes in the patients mean scores over time. Of the 33 symptoms assessed in the RSCL, changes in the degree o f symptomatology were highly consistent with changes expected in clinical practice, as a result of either disease progression or side effects o f treatment. It is concluded that the RSCL provides a practical assessment of various symptoms in patients receiving palliative radiotherapy, and that the changes in symptom profile over time are relevant to clinical practice. The RSCL has never been previously used in the assessment of palliative radiotherapy, and the present study validates this instrument.
Focal organizing pneumonia mimicking small peripheral lung adenocarcinoma on CT scans
Authors: Chen Suet Wan , Price Jeremy
Published: March 2008

The present report of four cases highlights the potential for focal organizing pneumonia (FOP) to masquerade as a small peripheral lung adenocarcinoma on CT scans. Both entities may present the CT appearance of a peripheral spiculated lung nodule, often with an air bronchogram. A history suggestive of an infectious aetiology and the presence of other foci of inflammatory change on CT scan may be helpful clues to the diagnosis of FOP. Because FOP is comparatively rare, surgical excision will usually be required to exclude malignancy. In some cases, however, particularly after a negative percutaneous biopsy, conservative management with a follow‐up CT scan at 3‐4 weeks may be an alternative to immediate surgical intervention.
Pachymeningitis in Wegener's granulomatosis
Authors: Burrell Helen C , McConachie Norman S
Published: March 2008

A case of Wegener's granulomatosis is described in which meningeal thickening and enhancement was demonstrated on MR imaging. The diagnosis was suggested by the clinical picture, imaging findings and a positive anti‐neutrophil cytoplasmic antibody; and confirmed by biopsy of ethmoidal tissue.
Translumbar inferior vena cava access for Hickman line insertion
Authors: Brooks Mark
Published: March 2008

The procedure of translumbar inferior vena cava access and Hickman line insertion is described in a patient with acute myeloid leukaemia and thrombosis of the right internal jugular and right innominate vein. This is a useful technique for the interventionist offering a central venous access service.
Liver metastases from transitional cell carcinoma are lipiodol avid
Authors: ATeoh  , Hewitt PM , Kearsley JH , Morris DL
Published: March 2008

A case of transitional cell carcinoma of the bladder with symptomatic liver metastases is presented. When conventional chemotherapy failed, a lipiodol CT scan demonstrated avid uptake by the tumours, which has implications for targeted cancer therapy.
Traumatic carotid cavernous fistula: Anatomical variations and their treatment by detachable balloons
Authors: Phadke RV , Kumar S , Sawlani V , Mazumdar B , Gujral RB
Published: March 2008

Endovascular balloon occlusion has become a standard mode of therapy in carotid cavernous fistulas. Many angio‐architectural variations are, however, encountered in individual cases, some of which influence the therapeutic mode and outcome. We report on three patients with carotid cavernous fistulas treated by endovascular techniques.
Short tau inversion recovery magnetic resonance imaging in occult scaphoid injuries: Effect on management
Authors: Gelderen WFC Van , Gale RS , Steward AH
Published: March 2008

Over a 21‐month period, 16 patients with possible scaphoid fractures, where conventional radiographs were essentially normal on the day of injury and 10 days later, were examined by coronal short tau inversion recovery (STIR) and T1 weighted sequences on a 0.2 Tesla scanner. The magnetic resonance (MR) examinations were done in between electively booked patients and management was altered in 50% of patients. It was expedient to do MR as radio‐isotope facilities were not available at the hospital. In four patients, the examination was entirely normal. In another four patients, intercarpal fluid collections only were demonstrated (two generalized and two localized). In these patients a plaster cast was not re‐applied. In two patients, bony injuries of the distal radius were demonstrated instead, with the scaphoid being normal. In the remaining six patients, variable appearances were shown, ranging from an actual fracture line demonstrated on both STIR and T1‐weighted images with the remainder of the scaphoid being hyperintense on STIR and hypointense on T1, to non‐visualization of the actual fracture line, which appeared to be represented by a much more hyperintense band through the waist of an otherwise hyperintense scaphoid on the STIR sequence. In all these patients a plaster cast was re‐applied empirically, including those patients with a definite fracture and those patients with apparent bone contusion only. Although the T1‐weighted images were anatomically superior, their addition did not alter management and it is suggested that coronal STIR images should suffice to demonstrate occult fractures of the scaphoid.
Corticosteroid prophylaxis for patients receiving intravascular contrast agents: A survey of current practice in Australia and New Zealand
Authors: Bensusan D , Stevenson JD , Palmer FJ
Published: March 2008

A survey was made of the use of corticosteroid prophylaxis in patients receiving intravascular contrast media. The replies of 807 respondents were available for analysis and they indicate that such a strategy is common for‘high‐risk’patients (62.4%), but very few respondents use corticosteroid prophylaxis for all patients (0.74%).
Routine chest radiography following endoscopic oesophageal dilatation for benign peptic oesophageal strictures
Authors: Foster DR
Published: March 2008

Endoscopic oesophageal dilatation is a well‐established procedure for management of patients with benign oesophageal strictures. The most important complication of the procedure is perforation with a recorded incidence of approximately 1%. Patients undergoing the procedure require close observation after dilatation. Routine chest radiographs are advisable following the procedure.
Leptomeningeal carcinomatosis from carcinoma of the palatine tonsil
Authors: Biswal Biswa Mohan , Goyal Mayank , Prasad Rajiv Ranjan , Lai Punita , Sharma Raju , Mohanti Bidhu Klyan , Khader Jamal
Published: March 2008

Distant metastases from carcinoma of the palatine tonsil are very uncommon. We encountered a case of a carcinoma involving the tonsillar region that resulted in subarachnoid mestastases following local radical radiotherapy. Metastases were diagnosed following magnetic resonance imaging and spinal fluid cytology. The patient succumbed to the disease after a rapid downhill course, 1 month following diagnosis of the secondary deposit. The present paper describes the rare site of distant metastasis and reviews the relevant literature.
Intracranial chondroma of the occipital lobe
Authors: Mobbs RJ , Narula S , Berger M , Kwok BCT
Published: March 2008

A case report of an intracranial chondroma is discussed with emphasis on magnetic resonance imaging.
Primary multiple hydatid cysts of the brain
Authors: Popli Manju Bala , Khudale B
Published: March 2008

Primary hydatid cyst of the brain in adults is rare and can pose various diagnostic problems. Multiplicity of these cysts is even rarer. The most important diagnostic tool is computed tomography scanning of the brain. Hydatid cyst should be included in the differential diagnosis when a cystic brain lesion is found in patients from an endemic echinococcosis area.
Are percutaneous transgastric biopsies using 14‐, 16‐ and 18‐G Tru‐Cut needles safe? An experimental study in the rabbit
Authors: Akan Hüseyin , Özen Necati , Incesu Lütfi , Gümü Salim , Günes Mustafa
Published: March 2008

We evaluated perforation, peritonitis and bleeding after 14‐, 16‐, 18‐G Tru‐Cut needles were passed through the stomach in an animal model. Insertions were performed on seven anaesthetized rabbits with 18‐, 16‐and 14‐G needles simulating the clinical technique. Diluted contrast medium with methylene blue (60mL) was administered through a nasogastric tube after the biopsy. Computed tomography (CT) scanning of the upper abdomen was performed 10 min after the insertion for leakage. The abdominal contents were inspected by laparotomy. There was no contrast medium leakage outside the gastrointestinal tract on CT images. Neither methylene blue nor other stomach content leakage was identified by laparotomy, even with manual squeezing. A tiny spot of blood was observed on the serosal surface of the stomach with the 18‐G needle passes (five cases), whereas a relatively large haematoma was present with 14‐G needle (four cases). Six of the rabbits survived and one died due to an inadvertant aortic injury. The results of the study show that transgastric route with an 18‐G cutting needle can be used without fear of peritonitis and bleeding.
Assessment of pelvic stabilization devices for improved field reproducibility
Authors: Rattray G , Hopley S , Mason N , Jenkins M
Published: March 2008

The aim of this study was to evaluate the improvement in patient comfort and field positional accuracy provided by a new pelvic stabilization system when delivering multiple field radiotherapy to the pelvis. The Pelvic Cradle (BEHTS Manufacturing, Brisbane, Qld, Australia) is a stabilization device that provides reproducible patient positioning and levelling. Ninety patients were randomized into three groups. The first group was treated using the Pelvic Cradle, the second group was treated using current stabilization practices, and the third group was treated using the Pron Pillo (Chattanooga Pharmacal Company, USA) and current stabilization practices. Port films were assessed for field displacement in the lateral and cranio‐caudal directions. A patient survey was used to evaluate the patient's perception of comfort while receiving treatment. When compared to the control group, the pelvic cradle group demonstrated a 48% improvement in the mean lateral deviation from 3.8 mm to 2.0 mm (P < 0.001) and a 36% improvement in the mean cranio‐caudal deviation from3.9 mm to 2.5 mm (P < 0.001). The Pelvic Cradle was found to provide an improved level of field positional accuracy while maintaining patient comfort.
Magnetic resonance image detection of coincidental sphenoid sinus aspergillosis and pituitary microadenoma: A potential surgical disaster
Authors: Gupta A , Gupta RK , Banerjee D , Bhatia E
Published: March 2008

While localizing the microadenoma in a patient with Cushing's disease on magnetic resonance imaging (MRI), fungal granuloma of the sphenoid sinus was coincidentally detected. This helped in the proper management of sphenoidal disease before undergoing trans‐sphenoidal removal of the microadenoma, thus averting the possible catastrophe of direct intracranial spread of aspergillus infection.
Complications of epilepsy and a ruptured pyonephrosis: Radiology to the rescue in the Brooks murder case
Authors: Foote GA , Koelmeyer TD , Eyre KED , Astley TM
Published: March 2008

A woman and her lover were accused of murdering the woman's husband. Five weeks after fracture/dislocations of both shoulders and a central fracture/dislocation of the right hip were diagnosed the woman's husband died of septicaemia consequent on a ruptured infected hydronephrosis. The shoulder and hip injuries and the ruptured hydronephrosis were attributed to a beating with a blunt instrument. A review of the medical records of the deceased, particularly his radiological examinations, led the authors to conclude that his joint injuries and ruptured kidney were not due to the alleged assault. The joint injuries were the consequence of epileptic seizures and the ruptured kidney was also due to natural causes. These medical opinions provided evidence that led to acquittal of the accused.
Retroperitoneal ancient schwannoma: Review of clinico‐radiological features
Authors: Loke TKL , Yuen NWF , Lo KKL , Lo J , Chan JCS
Published: March 2008

A case is reported here of an ancient schwannoma in the retroperitoneum. The findings of abdominal ultrasound and CT in a patient with a retroperitoneal ancient schwannoma are presented, and the clinical and radiological features of this unusual tumour are reviewed. The presence of a large, well‐delineated complex cystic mass in the deep soft tissues should raise the possibility of an ancient schwannoma. It is important to recognize these tumours as benign with excellent prognosis so as to avoid unnecessary radical surgery.
Diffuse panbronchiolitis: Case report and review of the literature
Authors: Ng Perry , Dwyer Ross , Despas Paul
Published: March 2008

Diffuse panbronchiolitis is an uncommon disease of unknown aetiology mainly occurring in Asian races. Treatment with erythromycin acting through unclarif ied mechanisms is promising and may improve the poor prognosis currently associated with the disease. A case is presented illustrating how the imaging features of the disease, particularly on high‐resolution computed tomography, may be used to support a diagnosis suggested on clinical grounds.
Pedunculated hepatic haemangioma with arterioportal shunt: Treated with angio‐embolization and surgery
Authors: Srivastava DN , Sharma S , Yadav S , Nundy S , Berry M
Published: March 2008

A case of symptomatic cavernous haemangioma of the liver with an unusual arterio‐portal shunting, which was treated by pre‐operative angiographic embolization, is described. The arterio‐portal shunting has been reported previously in only two cases.
Inverted Y ureter anomaly and associated distal yo‐yo phenomenon
Authors: Tüney D , Akpinar IN , Biren T , Aribal ME , Gurmen N
Published: March 2008

Duplication of the distal ureter is a very rare anomaly. A case is reported here in which the lower ectopic limb of the duplicated distal ureter presents with a ureterocele, and shows a different pattern of backflow.
Endometrial adenosarcoma with adjuvant tamoxifen therapy for primary breast carcinoma
Authors: Jagavkar RS , Shakespeare TP , Stevens MJ
Published: March 2008

The first documented case of endometrial adenosarcoma associated with chronic tamoxifen usage is reported.
Renal metastasis from squamous cell carcinoma of the lung
Authors: Mathew BS , Jayasree K , Gangadharan VP , Nair MK , Rajan B
Published: March 2008

Symptomatic renal metastases from primary malignancy elsewhere in the body is an uncommon feature in disseminated cancer. Postmortem diagnosis is more frequent. A case is reported here of a patient with renal metastasis from lung carcinoma who presented with haematuria.
Miliary tuberculosis: A complication of intravesical BCG treatment
Authors: Foster DR
Published: March 2008

A case of miliary tuberculosis following intravesical bacillus Calmette‐Guerin (BCG) treatment is described.
Waist circumference correlates with hepatic fat accumulation in male Japanese patients with non‐alcoholic fatty liver disease, but not in females
Authors: Ishibashi Eriko , Eguchi Yuichiro , Eguchi Takahisa , Matsunobu Aki , Oza Noriko , Nakashita Shunya , Kitajima Yoichiro , Kuroki Shigetaka , Ozaki Iwata , Kawaguchi Yasunori , Ide Yasushi , Yasutake Tsutomu , Iwakiri Ryuichi , Mizuta Toshihiko , Ono Naofumi , Fujimoto Kazuma
Published: March 2008

Background and Aim: Abdominal obesity, a component of metabolic syndrome, is a major risk factor for non‐alcoholic fatty liver disease (NAFLD). In recent worldwide definitions of metabolic syndrome, waist measurement has been proposed as a simple and useful estimate of abdominal obesity, taking into account gender differences in waist circumference. The present cross‐sectional study investigated the correlation of hepatic fat accumulation and waist circumference in Japanese NAFLD patients to determine if there are gender differences in this relationship.

Methods: Consecutive patients (n = 2111) who had at least one of two criteria for liver disease (alanine aminotransferase [ALT] level >30 IU/mL and aspartate aminotransferase [AST]/ALT ratio <1) underwent abdominal ultrasonography. Patients positive for hepatitis B virus, hepatitis C virus or autoimmune antibodies and whose alcohol intake was >20 g/day were excluded. Patients with NAFLD underwent abdominal computed tomography. Hepatic fat accumulation was estimated by liver/spleen attenuation ratio (L/S ratio) and visceral adipose accumulation was measured as visceral fat area (VFA) at the umbilical level.

Results: Of the 221 NAFLD patients, 103 were females. In males, the relationship between L/S ratio and waist circumference was negative (r =−0.356,P < 0.01), and there was no correlation in the female group. The relationship between L/S ratio and VFA was negative in both groups (males:r = −0.269,P < 0.01; females:r = −0.319,P < 0.01). Subcutaneous fat area/total fat area ratio at the umbilical level was larger in females than in males (P < 0.01).

Conclusions: In NAFLD patients, waist measurement is more susceptible to gender differences than VFA.
Longitudinal study of the mental health of caregivers caring for elderly patients with dementia: Effect of institutional placement on mental health
Authors: MATSUDA OSAMU , HASEBE NAOKO , IKEHARA KEIKO , FUTATSUYA MUTSUMI , AKAHANE NAOKO
Published: March 2008

Abstract  One hundred and three family caregivers of relatives with dementia were longitudinally surveyed to examine the course of caregivers' mental health after the relatives had been placed in full‐time care facilities. Mental health was assessed twice, with a 6‐month interval, using the Japanese version of the 60‐item General Health Questionnaire. The degree of social dysfunction was significantly reduced within 6 months after placement, while the other indicators of mental health (e.g. anxiety‐insomnia, depression, somatic symptom and psychiatric morbidity) were not reduced within this term. However, anxiety‐insomnia and psychiatric morbidity were significantly reduced more than 6 months after placement. Analyses by caregivers' lineal relations to the relatives indicated that only daughters‐in‐law showed a significant decrease in anxiety‐insomnia and a marginal reduction in psychiatric morbidity. This study suggests that caregivers' social dysfunction was more greatly reduced than anxiety‐insomnia and psychiatric morbidity within a relatively short term after placement, and that its effects on mental health might vary with the lineal relations.
Kidney transplantation and liaison psychiatry, part I: Anxiety before, and the prevalence rate of psychiatric disorders before and after, transplantation
Authors: FUKUNISHI ISAO , HASEGAWA AKIRA , OHARA TAKEHIRO , AIKAWA ATSUSHI , HATANAKA AKIKO , SUZUKI JIRO , KIKUCHI MICHIKO , AMAGASAKI AND KOICHI
Published: March 2008

Abstract  Abstract We examined psychiatric problems before and after kidney transplantation in a sample of 36 patients with end‐stage renal failure. The prevalence rate of psychiatric disorders was 11.1|X% (4 of 36 cases) before the transplantation and 36.1|X% (13 of 36 cases) within 2 months after the transplantation. Except for a patient with schizophrenic disorder, no patients were found to have a psychiatric disorder from 2 to 6 months after the transplantation. In this study, we also examined anxieties and/or conflicts related to the transplantation using the synthetic house‐tree‐person (HTP) drawing test, a measure of mood states by means of a nonverbal expression method. The upper part of the tree trunk was not drawn in 25|X% of this sample (5 of 20 cases). In the HTP drawing tests immediately after the transplantation, however, trees missing the upper part of trunk were not drawn. Based on these findings, we discussed psychiatric problems in kidney transplantation.
Modifying psychotropic drug prescription patterns:A follow‐up survey
Authors: UNGVARI GABOR S. , CHOW LOK‐YEE , CHIU HELEN F. K. , NG FUNG‐SHING , LEUNG AND TONY
Published: March 2008

Abstract  Cross‐sectional surveys of prescription patterns of psychotropic drugs provide a quick, global estimation of the appropriateness of psychopharmacotherapy. Recurrent inadequacies in prescribing for psychiatric patients include polypharmacy, high doses of antipsychotics (APS), the use of multiple APS simultaneously, and the administration of these drugs in multiple divided doses. Faulty prescribing patterns are difficult to amend. Following a survey in a rehabilitation facility lor chronic psychiatric patients, a systematic education program and other measures were introduced to improve prescribing habits. Two years later the survey was repeated. Significant improvements were detected in the following areas: reductions in the doses of APS and antiparkinsonian (AP) drugs, reductions in the number of patients placed on these drugs, and reductions in the percentage of patients receiving multiple antipsychotics simultaneously. Despite these reductions in doses of psychotropic agents, patients' rehabilitative potential was not compromised.
Review of clinical symptoms and spectrum in humans with influenza A/H5N1 infection
Authors: HUI David S.‐C.
Published: March 2008

Abstract:  Influenza A/H5N1 infection has become the major emerging infectious disease of global concern again since late 2003. A history of exposure to dead or sick poultry or wild birds occurs in over 60% of cases of human H5N1 infection. The incubation period of avian‐to‐human transmission is generally between 2 and 5 days and the median duration of symptoms before hospitalization is about 4.5 days. The clinical spectrum has ranged from asymptomatic infection or mild influenza‐like illness to severe pneumonia and multi‐organ failure. Fever > 38°C, cough and dyspnoea are the major symptoms on presentation, whereas gastrointestinal symptoms such as watery diarrhoea, vomiting and abdominal pain are common early in the course of the disease. In contrast, upper respiratory tract symptoms are less prominent in human H5N1 infection when compared to seasonal influenza. Laboratory features of human H5N1 infection include leucopoenia, especially lymphopenia, elevated amino‐transaminases, thrombocytopenia, prolonged prothrombin time and activated partial thromboplastin time, increased D‐Dimer, increased serum lactate dehydrogenase and creatinine phospho‐kinase, and hypoalbuminemia. A low absolute lymphocyte count on admission is associated with more severe disease and death. Radiographic abnormalities include multi‐focal airspace consolidation, interstitial infiltrates, patchy or lobar involvement, with rapid progression to bilateral and diffuse ground‐glass opacities consistent with ARDS. However, none of the clinical, laboratory and radiographic features are specific to H5N1 infection. A detailed exposure history needs to be elicited, including any close contact with sick or dead poultry, wild birds, other severely ill persons, travel to an area with A/H5N1 activity or work in laboratory handling samples possibly containing A/H5N1 virus.
Avian influenza: Update on pathogenesis and laboratory diagnosis
Authors: NICHOLLS John M. , PEIRIS J.S. Malik
Published: March 2008

Abstract:  In the past 10 years, two respiratory viral infections—severe acute respiratory syndrome (SARS) and H5N1—have emerged that have led to a high mortality among infected individuals. Laboratory investigations have demonstrated that these two emerging infections have similar features; and understanding the pathophysiological mechanisms of the disease causation will lead to insight into standard and novel treatments for these infections. In this review we highlight the similarities and differences of SARS and H5N1, and emphasize the importance of appropriate sampling for laboratory diagnosis of the latter.
Pandemic planning in China: Applying lessons from severe acute respiratory syndrome
Authors: ZHONG Nan‐Shan , ZENG Guang‐Qiao
Published: March 2008

There were three events of severe acute respiratory syndrome (SARS) in China from 2003 to 2004. Starting from 2002, we are also aware of the increasing alert of an avian flu pandemic. Epidemics of SARS and avian flu have posed huge threats to social stability, economic prosperity and human health in this country. What we have experienced during SARS outbreaks has great implications for the protectiion of people against a resurgence of SARS and potential attacks of high‐pathogenic avian flu viruses. To that end, China has been preparing to contain future pandemics by applying lessons learnt from SARS.
Update on influenza vaccines
Authors: TAMBYAH Paul A.
Published: March 2008

Vaccination has been the most effective means for control of viral infections for centuries. While seasonal vaccines have been highly effective in the management of influenza, there are a number of obstacles to the development of safe and effective pandemic influenza vaccines. The good news is that there has been a lot of investment into novel approaches including reverse genetics and whole cell vaccines that hold promise for successful pandemic control if they can be rolled out in time.
MPP+‐induced neuronal death in rats involves tyrosine 33 phosphorylation of WW domain‐containing oxidoreductase WOX1
Authors: Lo Chen‐Peng , Hsu Li‐Jin , Li Meng‐Yen , Hsu Se‐Yei , Chuang Jih‐Ing , Tsai Ming‐Shu , Lin Sing‐Ru , Chang Nan‐Shan , Chen Shur‐Tzu
Published: March 2008

WW domain‐containing oxidoreductase (named WWOX, FOR or WOX1) is a pro‐apoptotic protein and tumor suppressor. Animals treated with dopaminergic neurotoxin 1‐methyl‐4‐phenyl‐pyridinium (MPP+) develop Parkinson's disease (PD)‐like symptoms. Here we investigated whether WOX1 is involved in MPP+‐induced neurodegeneration. Upon insult with MPP+in rat brains, WOX1 protein was upregulated and phosphorylated at Tyr33 (or activated) in the injured neurons in the striatum and cortex ipsilaterally to intoxication, as determined by immunohistochemistry and Western blotting. Also, WOX1 was present in the condensed nuclei and damaged mitochondria of degenerative neurons, as revealed by transmission immunoelectron microscopy. Time‐lapse microscopy revealed that MPP+induced membrane blebbing and shrinkage of neuroblastoma SK‐N‐SH cells. Dominant‐negative WOX1, a potent inhibitor of Tyr33 phosphorylation, abolished this event, indicating a critical role of the phosphorylation in apoptosis. c‐JunN‐terminal kinase (JNK1) is known to bind and counteract the apoptotic function of WOX1. Suppression of JNK1 function by a dominant‐negative spontaneously induced WOX1 activation. WOX1 physically interacted with JNK1 in SK‐N‐SH cells and rat brain extracts. MPP+rapidly increased the binding, followed by dissociation, which is probably needed for WOX1 to exert apoptosis. We synthesized a short Tyr33‐phosphorylated WOX1 peptide (11 amino acid residues). Interestingly, this peptide blocked MPP+‐induced neuronal death in the rat brains, whereas non‐phospho‐WOX1 peptide had no effect. Together, activated WOX1 plays an essential role in the MPP+‐induced neuronal death. Our synthetic phospho‐WOX1 peptide prevents neuronal death, suggestive of its therapeutic potential in mitigating the symptoms of PD.
Crossing habitat boundaries: coupling dynamics of ecosystems through complex life cycles
Authors: Schreiber Sebastian , Rudolf Volker H. W.
Published: March 2008

Ecosystems are often indirectly connected through consumers with complex life cycles (CLC), in which different life stages inhabit different ecosystems. Using a structured consumer resource model that accounts for the independent effects of two resources on consumer growth and reproductive rates, we show that such indirect connections between ecosystems can result in alternative stable states characterized by adult‐dominated and juvenile‐dominated consumer populations. As a consequence, gradual changes in ecosystem productivity or mortality rates of the consumer can lead to dramatic and abrupt regime shifts across different ecosystems, hysteresis and counterintuitive changes in the consumer abundances. Whether these counter intuitive or abrupt responses occur depend on the relative productivity of both habitats and which consumer life‐stage inhabits the manipulated ecosystem. These results demonstrate the strong yet complex interactions between ecosystems coupled through consumers with CLC and the need to think across ecosystems to reliably predict the consequences of natural or anthropogenic changes.