bluuebunny/crossref_metadata_2025 huggingface dataset:
A Prolapsed Lipoma in the Duodenal Bulb
Authors: Klein Norbert
Published: July 2009

Non-Malignant tumours of the stomach or duodenum, such as adenoma, fibroma, myoma, lipoma, and mucous polyp are not common, but their pre-operative radiological diagnosis is now well established. The pedunculated type of tumour which originates in the pre-pyloric part of the gastric antrum is, from its clinical and radiological point of view, of special interest because it has a strong tendency to be propelled through the pyloric canal into the proximal part of the duodenum. There it may simulate a filling defect of the wall of the duodenal bulb itself.

The radiological feature of these benign tumours is a persistent rounded or oval, sharply-defined filling defect in the symmetrically enlarged, barium filled duodenal cap. It is sometimes impossible to differentiate the filling defect in the bulb produced by a prolapsed pedunculated benign gastric growth, from a filling defect in the proximal part of the bulb by herniated pre-pyloric mucosa.

Eliason, Pandergrass, and Wright (1921) described “the radiological diagnosis of pedunculated gastric growths and gastric mucosa prolapsing through the pylorus”. Rigler (1928) reported one case in which the actual prolapse of a pedunculated gastric polyp into the duodenum was observed during X-ray examination. If, as it is in Rigler's case, the growth can be pressed back through the pylorus into the stomach, a benign tumour arising from the duodenum itself can be excluded.
An Approach to the Problem of Scattering of High Voltage Radiation in Non-homogeneous and Limited Media
Authors: Lamerton L. F. , Winsborough Margaret
Published: July 2009

A theoretical approach to the problem of scatter in a nonhomogeneous medium is made on the basis of iso-contribution curves, calculated for given conditions of radiation. Iso-contribution curves drawn round a given point are the curves along which equal elements of volume of the medium will scatter equal amounts of radiation to the given point. The basis of the calculation is that described by one of the authors in previous papers.

The application of these curves to certain problems of air-spaces and bones within the medium is indicated.

The approximate nature of the calculation involved in this treatment is stressed, but it is felt that the results may be of use as a guide in further experimental work.

Another application of the iso-contribution conception is described which enables the depth dose at any point in a medium irradiated by an irregularly-shaped field to be determined with much less labour than has been necessary hitherto.
Correspondence
Authors: Taylor Denis
Published: July 2009

A great many radiation monitoring, and surveying instruments have been developed for use in the “hot” chemical laboratories at the Atomic Energy Research Establishment, Harwell. Some of these instruments are also likely to find application in other laboratories, and one such instrument, which may be of value in hospitals where radioactive materials are being used for therapeutic purposes is shown below.
Editorial
Authors: F.G.S.  , C.B.A.
Published: July 2009

From time to time the Editors of this Journal publish accounts of symposia on specific topics either in the form of the original papers read at a meeting or as reviews of the books which, with increasing frequency though after a rather long latent period, follow the more lengthy gatherings. It is with the latter that this Editorial is chiefly concerned.
Radiumhemmet's Method of Treatment in Hypopharyngeal Cancer
Authors: Hultberg Sven
Published: July 2009

Radiumhemmet's method of treatment in hypopharyngeal cancer is described in detail. Stress is laid upon individualized radiation, exact beam direction and special care of the patients' general condition. The present absolute five-year cure is 12·3 per cent and the relative cure 14·5 per cent. The results are still better in recent years: up to 19 per cent of the patients treated in 1947 are symptom-free.
Whole Body Irradiation—Radiobiology or Medicine?
Authors: Mole R. H.
Published: July 2009

1. Suggested causes of death after single doses of radiation are briefly reviewed. Species differences are prominent.

2. The dose-mortality relation for mammals killed by radiation shows less variability than mammalian responses to other toxic agents. Possible reasons for this are discussed and also its relevance to attempts to find substances which protect in vivo against irradiation.

3. Cell death after whole body irradiation seems to occur in two ways. Delayed death due to interference with cell division is well known, but probably more important in accounting for the immediate histological effects of radiation is some other mechanism responsible for the early death of cells which normally do not divide.

4. General principles of radiobiology are shown to need modification if they are to be applied to whole body irradiation of mammals.
Reviews
Authors: Hills T. H.
Published: July 2009

The need for a reference work on this subject has been very widely felt by the radiologist, the cardiologist and the thoracic surgeon. The technical difficulties encountered in taking angiocardiograms are only exceeded by the pitfalls in their interpretation, and the authors are to be pitfalls in their interpretation, and the authors are to be congratulated on the generally good quality of their illustrations and their method of presentation.
Treatment of Cancer of the Cervix Uteri—A Revised “Manchester Method”
Authors: Tod Margaret , Meredith W. J.
Published: July 2009

The so-called “Manchester” system for the treatment of carcinoma of the uterine cervix, published some 13 years ago, is reviewed, and modifications in the loading of the applicators are suggested to make the dose rate at Point A as constant as possible. An “Ideal” system is outlined with sufficiently detailed specifications to enable any department to adapt their radium to it. Examples of the use of British standard radium and 60Co in this revised “Manchester” system are given.
Reviews
Authors: Brocklebank J. A.
Published: July 2009

This work is arresting both for the excellence of its production and the eminence of its author, and appears to be designed for students of cardiology who have a good clinicopathological knowledge of that subject but with little acquaintance with its radiological aspect. The book sets out excellently to show the assistance which radiology can give to cardiological diagnosis, and in this respect its title is possibly misleading in that the fluoroscopic aspect receives only passing mention in the text and questions of movement are rather scantily described.
Review
Authors: Spear F. G. , Allsopp C. B.
Published: July 2009

Symposium on Radiobiology is a good example of scientific reporting, a type of technical literature which is now appearing with steadily increasing frequency. The purpose of the meeting of which this book is an account was “a thorough examination of the fundamental concepts that exist in radiobiology”. The report begins with a survey of the physical interaction of ionizing radiation and matter, “particularly gases” (four papers), and continues with a discussion of the chemical changes which may arise from the transfer of this physical energy (five papers); it then proceeds to an examination of the few known biochemical effects of irradiation (six papers), and ends with a discussion of the changes occurring in living tissue exposed to radiations (eight papers). It appeared desirable to the organising committee to avoid numerous subdivisions in this last group of papers, and it decided therefore first to centre on the simplest living unit—the cell—and then to proceed directly to the complex living (mammalian) system.
The Use of Short-acting Muscle Relaxants in Radiology
Authors: Inglis J. M. , Astley Roy
Published: July 2009

Techniques for the use of short acting muscle relaxant drugs in paediatric bronchography and angiocardiography are described.

In bronchography, even when there is much bronchial secretion present, radiographs may be obtained free from respiratory movement and in two phases of respiration. Bronchiectatic changes tend to be more obvious in films taken in expiration.

In angiocardiography the short duration and lack of medullary or direct cardiac effects ensures minimal disturbance of the general condition of the subject.
Correspondence
Authors: Heasman R.
Published: July 2009

Of the limitations of the water equivalence of Mix D wax enumerated in my letter to you (Heasman, 1952), the values of the backscatter measurements made on the surface of a phantom of this material have been questioned by Jones (1952).
Correspondence
Authors: Cohen Lionel
Published: July 2009

It is now known that the biological effect of a given physical dose of radiation increases with increasing wave-length, and that the relative efficiencies of different qualities of radiation seem to be constantly related to the half-value layer and independent of the biological object tested.
Transient Radiation Myelopathy
Authors: Jones Arthur
Published: July 2009

Radiation myelopathy of the cervical cord may be revealed by Lhermitte's sign of electrical paraesthesia on neck flexion. A transient syndrome is described, occurring some three to four months after therapeutic irradiation, with electrical paraesthesia as the sole manifestation. This is contrasted with the features of progressive radiation myelopathy which usually appears after a longer latent period of one to two years. Transient radiation myelopathy does not (unless the evocative dose is above the accepted tolerance level) herald later and progressive cord degeneration. The pathogenesis of the condition is discussed in relation to the radiosensitivity of oligodendroglia, together with its significance in clinical neurology and radiotherapeutics.
The Treatment of Carcinoma of the Cervix
Authors: Lederman M.
Published: July 2009

There is no specific remedy or cure for cancer, and this fact is reflected in the pendulum-like swing in therapeutic fashion between radiotherapy and surgery. In the patient's interests there should of course be no competition between surgery and radiotherapy since both methods have their part to play, but when a comparison based on clinical material of similar quality is made between them there is little difference in the results achieved by each. If this fact be accepted, then the considerable advantages of radiotherapy cannot be ignored.

The advantages of radiotherapy are:

(1) The patient can avoid the mutilation entailed by the total extirpation of the female genital tract which is necessary if the patient is to be given the best chance of survival and long term security against recurrence. The domestic repercussions of an operation of this kind can well be imagined but are rarely commented on or reported in the surgical literature. The effects of radical radiotherapy on the genital tractshould not be minimised since atrophy and loss of function inevitably follow, but it still retains its anatomical integrity and most patients after radiotherapy can return home and avoid domestic disharmony.

(2) The mortality rate for both surgery and radiotherapy nowadays is practically nil, but both have a morbidity rate which is higher for surgery and very often more disabling.
Reviews
Authors: Ross F. G. M.
Published: July 2009

This is a short monograph on transverse axial tomography written by a team consisting of a physicist, a superintendent radiographer, a medical illustrator and a radiologist (in the order their names are printed on the title page) from the Christie Hospital and Holt Radium Institute, Manchester. It is divided into two sections, the first 42 pages comprising a descriptive text and the remainder an atlas of transverse axial tomographs of the normal thorax. The descriptive text is brief but it is also readable.
Impermanent Calcification in a Lumbar Nucleus Pulposus in an Adult
Authors: Simpson W.
Published: July 2009

Calcification in the nucleus pulposus in adults is found much more frequently in the thoracic spine than in other regions (Rohan Williams, 1954). Impermanent or evanescent calcification in the nucleus pulposus has been described not infrequently in children (Weens, 1945; Silverman, 1954; Bjelkhagen and Gladnikoff, 1957; Newton, 1958; Connell, 1963), however, descriptions of this condition in adults are not common and a limited search of the literature has revealed only one report of such calcification in the lumbar region (Sandstrom, 1951).

The patient was a married woman who was 56 years old when first seen in March, 1958. She gave a history of an attack of backache starting one month previously, associated with pain passing down the back of the left thigh as far as the knee. She was otherwise well and there were no significant findings on clinical examination.
Discrimination between Strontium and Calcium in Bone and the Transfer from Blood to Bone in the Rabbit
Authors: Kshirsagar S. G. , Lloyd Elizabeth , Vaughan Janet
Published: July 2009

Seven-month-old rabbits were injected intravenously with 90Sr or 45Ca and killed serially at time intervals from ten minutes to 460 days after injection. The uptake of both isotopes was about the same at ten minutes after injection. This uptake represented about one-third of the maximum uptake of 45Ca, which was observed at one day and about half of the maximum uptake of 90Sr which was observed at four hours. Although the maximum uptake of 45Ca is greater than that of 90Sr the rate of uptake and removal of 90Sr was greater than that of 45Ca.

The turnover of both 90Sr and 45Ca was greater in the trabecular bone of the vertebrae and in the ends of the long bones than in the mid-cortex of the femur and tibia at short times after injection. Those portions of bone which showed the highest rates of turnover were found to be associated with relatively lower values for the stable strontium/calcium ratios. This suggested that the net effect of incorporation and release favoured the preferential retention of calcium at metabolically active sites.

Measurements of stable strontium and calcium in the whole skeleton and in plasma showed an overall discrimination of about 1·6 in favour of calcium in the transfer from blood to bone.
Radium 226 in Food and Man in Bombay and Kerala State (India)
Authors: Chhabra A. S.
Published: July 2009

Data are presented on the 226Ra content of various food samples collected from Bombay city and high background areas of Kerala State in India. The experimental technique consisted in measuring the activity of the gaseous daughter product 222Rn in a ZnS-coated α-scintillation counter. Comparison of data for the samples of these two areas, having wide differences in their background radiation level, shows that the Kerala samples have a 226Ra/g ash content which is, on an average, a factor of five to ten times higher. An exception is the coconut sample which is grown profusely in Kerala State; this does not show a higher concentration of 226Ra in spite of the higher availability of 226Ra in the Kerala State soil.

From a tentative model formed for the food habits of the people of these two regions, their 226Ra burden has been estimated. The determination of 226Ra in bones and other organs of the human body indicates that a man from high background areas of Kerala State contains about ten times more of this radioisotope than a Bombay citizen. A value of 0·85 × 10−14 g Ra/g ash of bone was found from direct measurements of a single subject from Bombay.
A Head and Neck Immobilisation Unit for Use with Megavoltage or Teletherapy Units
Authors: Bunting J. S.
Published: July 2009

Satisfactory immobilisation of patients undergoing external beam radiotherapy to the head and neck region is seldom achieved without considerable time spent in the manufacture of plastic shells which, because of the necessity for accurate fitting, have to be individually tailored to each patient. This involves much expense and technicians' time.

Provided that the treatment position can be reproduced accurately by means of jigs or templates and that proper arrangements can be made to stop the less controllable head movements of rotation, flexion and extension, an arrangement of clamps, adjustable to each patient, and not interfering with the treatment beam, provides a satisfactory alternative to treatment shells, and a small clamping unit of this type has been devised and is in current use at St. Bartholomew's Hospital, London.
Correspondence
Authors: Porter E. H.
Published: July 2009

I was very interested in Dr. Barendsen's detailed analysis of a speculation mentioned in passing in my paper. I would like to comment only on the difference between a survival of 0·33 and 0·29 for a 300-rad dose.
Trisomy 17/18
Authors: Astley R.
Published: July 2009

Trisomy 17/18 is accompanied by multiple congenital anomalies that usually cause death in infancy. The radiological picture may be distinctive. The most constant features are: slender, slightly irregular ribs and clavicles; congenital heart disease with a left-to-right shunt; short great toes, non-ossified middle phalanges of the second or third to fifth toes and small, triangular terminal phalanges. The radiological features of Trisomy 13/15 are also described; the two syndromes resemble one another but the X-ray picture is less complete in the latter.
Vascular Lesions of the Colon
Authors: Farman Jack
Published: July 2009

1. Six cases of vascular compromise of the large bowel have been described. Five were the end result of athero-sclerosis. A single case of vascular insufficiency occurring ina young man as a result of trauma is described.

2. The radiological appearances in the acute stages and the end results of chronic insufficiency have been detailed.

3. The differential diagnosis has been discussed.

4. The arteriographic findings in three cases are presented.
Reviews
Authors: Glucksmann A.
Published: July 2009

This conference held at Gatlinburg is so far the most out-standing symposium of the very successful series arranged by Dr. A. Hollaender and his colleagues of the Biology Division, Oak Ridge National Laboratory. Two principal problems are dealt with: (1) mutagenesis at the molecular level and its correction and (2) the relation of chemical mutagenesis to carcinogenesis.
Total Angiography in Evaluation of Cerebro-vascular Disease: a Correlative Study of Aorto-cervical and Selective Cerebral Angiography
Authors: Cronqvist Sten
Published: July 2009

The present activity in vascular surgery on stenotic and occlusive changes in the neck vessels has prompted a vast number of reports on the radiological examination of these vessels. It is, however, the opinion of the author that the interest of both surgeons and radiologists has been prejudiced, being directed mainly to the arteries of the neck. Frequency and nature of concomitant intra-cerebral changes have been neglected and as a result a correct understanding of the pathophysiology has been rendered difficult or impossible.

These views have initiated this study in which the results of a series of aorto-cervical angiograms in patients with cerebrovascular disease have been correlated with the findings on selective angiograms in a number of the same patients.

The technique for aorto-cervical angiography used in our department does not differ greatly from the ones recommended by others (Poser, Zosa, Gomez and Hardin, 1964; Lilieqvist and Hellström, 1965). Details, however, have been changed. We have found it of value to use a specially shaped catheter (PE 205). The tip is drawn out over a metal guide to form a 5 cm long tail with a smaller inner and outer diameter than the rest of the catheter (Boijsen, 1964). Several side holes are made proximal to the tail; the smaller diameter of the tail decreases the contrast output through the end holes and a larger amount of contrast passes through the side holes. In this way a jet-stream displacing the catheter will be avoided.
Reviews
Authors: Du Boulay G.
Published: July 2009

This short monograph is the product of a weekly seminar held primarily for physicians at The Presbyterian-University Hospital in Pittsburg.
Percutaneous Transhepatic Cholangiography in Korean Patients
Authors: Weyde Rolf , Galatius-Jensen Frode , Uhm Ik Kun
Published: July 2009

Experience with percutaneous transhepatic cholangiography in 40 Korean patients is reported. Visualisation of the biliary ducts was achieved in approximately 75 per cent of all cases and in approximately 90 per cent of cases with dilated ducts. Four patients developed signs of peritoneal irritation and one a moderate hemoperitoneum, necessitating immediate operation. There were no post-operative complications and all made uneventful recoveries. No other complications were encountered and there were no fatalities.

All successful examinations gave valuable information unobtainable in any other way short of operation.

Cases are shown differing from those usually seen in western countries.
Variation in the Radiosensitivity of the Cell Population in Developing Rat Retina
Authors: Denham Sylvia
Published: July 2009

An autoradiographic study was made of the effects of a single dose of 160 R X rays on the neural retina of two-day-old rats. In rats killed at intervals until 72 hours after exposure, accumulation of degenerate cells was maximal from 15–25 hours. Cells labelled with tritiated thymidine half-an hour before irradiation accounted for only about 10 per cent of the necrotic population six hours after exposure, but their incidence increased to around 25 per cent by 30 hours. Retinal cells in the phases S, Gl and G2 + M of the generation cycle, the durations of which had been previously determined, were labelled with tritiated thymidine before irradiation in each of three groups of rats which were killed six hours after exposure. Comparison of the yield of labelled degenerate cells from each Group of animals revealed that the DNA-synthetic phase was least and G2 + M most sensitive to 160 R X rays, the latter having five times the sensitivity of the S phase. Over 50 per cent of the radiosensitive cells came from the non-proliferative part of the retinal population.
Sodium Activation in Goats Exposed either Bilaterally or Unilaterally to Fast Neutrons
Authors: Batchelor A. L. , Edmondson P. W.
Published: July 2009

After whole body exposure of goats to fission neutrons the plasma 24Na concentration was found to be linearly correlated with dose over the range zero to 2,400 rads. The slope of the regression line for males and females was different, probably because of sex differences in either spatial distribution of body sodium or tissue dose. Variation in body weight had a smaller but statistically significant effect. For goats exposed under similar geometrical conditions the standard deviation of the dose estimate derived from plasma 24Na measurements was ±8 per cent.

Although the relation between dose and sodium activation was the same for unilateral and bilateral irradiation, the biological outcome for the same dose was not identical.
Intracavitary Radiation Probe
Authors: Bruno Fred P. , Mauderli Walter
Published: July 2009

Radium has been utilised to treat carcinoma of the uterine cervix for many years. From the time radium was first used, radiotherapists have been interested in detailed information about the dosages received in the rectum and bladder while the radium was in place in the patient (Fletcher, Brown and Rutledge, 1958). In order to obtain this information, various types of radiation detection instruments have been designed for intracavitary use (Lederman, 1950; Fedoruk, Johns and Watson, 1954; Svensson and Bjarngard, 1964; Benner, Ragnhult and Gebert, 1959). In most cases the associated electronics used with these instruments has made their use awkward. A portable, battery-operated instrument, developed at our institution, is both reliable and easily handled.

Information about the amount of radiation received by the bladder and rectum could be used to develop new techniques or bring about changes in treatment plans which could result in fewer complications due to irradiation of these two organs. In general, the correlation of bladder and rectal dosage with complication has not yet been clearly established (Million, Mauderli and Bruno, 1966).

Figure 1 shows the instrument that was developed for use in intracavitary measurements. The detector is an ionisation chamber on the end of a 20 cm long stylus. An amplifier is inserted in the housing directly behind the stylus. The rest of the instrument is used to contain the meter movement, switches and nulling potentiometer.
A Simple Photographic Presentation of a Line Print-out Isotope Body Scan
Authors: Mauldon G. F.
Published: July 2009

Many scanning systems currently in use in radio-diagnostic procedures rely upon a simple dot or line print-out on paper for their presentation of the isotope distribution image. One of the drawbacks of this is that background counts are printed together with the required information and picture contrast is poor.

Electronic means are available for effecting a measure of background suppression. One method relies upon the incoming pulse rate of the signal to close the pen pulse printing circuit whenever a given background level is exceeded. This system, however, causes a distortion of the print-out image due to time constant delays. Another method relies upon a gating system where an electronic gate is closed for a given length of time by a pulse from the photomultiplier, any successive pulse or pulses falling within the time the gate is closed actuating the printing pen. This method is effective in partial background suppression when low radiation levels are being measured but it can also eliminate some of the signal when this rises significantly above background. Despite the use of such devices, the image may still contain a more than desirable amount of background. After some experience with these circuits used with a simple scanner, it was felt that further improvement was possible. This short communication describes a simple manner in which a photographic, background-suppressed image may be obtained from the conventional print-out line scan.
Experiences in Pancreas Scanning using 75Se-selenomethionine
Authors: Colella A. Centi , Pigorini F.
Published: July 2009

The authors discuss their experience in pancreas scanning using 75Se-selenomethionine in a total of 50 persons, of whom 20 were normal subjects and 30 represented a variety of pancreatic disease, viz. chronic pancreatitis, islet cell tumour, carcinoma, and extrinsic mass.

Normal anatomical variants of the pancreas shadow are described.

Using conventional dot-scanning, visualisation of the pancreas was adequate in only 33 per cent of normal cases, while 100 per cent success was obtained when a photorecording system was introduced.

The effects of liver uptake and of areas of radioactivity in adjacent structures are discussed, and the authors stress the importance of performing a series of scans in these circumstances.

Scanning with 75Se-selenomethionine does not give information as to the histology of a lesion in the pancreas, because many diseases have a similar appearance on the scan, but nevertheless the procedure is useful in a field where few diagnostic aids exist.
Multiple Pleural Plaques
Authors: Anton H. C.
Published: July 2009

The radiological features of 12 cases of multiple pleural plaques are presented. Some of their chest radiographs show, instead of the usual holly leaf calcified plaque, a multinodular type of calcification which may be confused with tuberculosis. Only part of a plaque may be calcified, and some plaques show only a soft tissue density. Serial films of one case show only soft tissue density plaques at one stage, but subsequently linear calcification develops. In another case with no apparent calcification a pre-operative radiological diagnosis of multiple pleural plaques such as occur in asbestosis was confirmed at thoracotomy performed for an apical tumour. This is believed to be the first recorded pre-operative diagnosis in a case showing soft tissue density plaques only. The faintness of such lesions helps to distinguish them from intra-pulmonary nodules; this may be called the “faint shadow sign”. The relationship to asbestos inhalation and the significance of the plaques are discussed.
A Pulse Generator for Use with the Picker MagnaScanner Colour Printer
Authors: McCready V. R. , Beechey P.
Published: July 2009

Since its introduction in 1959, the use of colour as an aid to the detection of small changes in radioactivity has become an accepted technique in radioisotope scanning. The original colour scanner (Mallard and Peachey, 1959) had a regular tapping action controlled by a microswitch and cam driven by an electric motor.

More recent scanners (including the Picker MagnaScanner) have a tapper which is driven by the pulses from the scintillation detector, this system having the advantage that black-and-white carbon copies of the colour scan (Mallard, Duggan, Myers and Wilks, 1964) can be produced.

However, this advantage is outweighed by the poor colour density in areas of low counting rates where the number of dots is few and the changes in colour are difficult to pick out. In this situation the colour scan is more satisfactory if a constant dot rate is used making differences in colour more obvious. The constant rate pulse generator described in this note is inexpensive and can be attached directly to the Picker MagnaScanner Colour Printer without any modification.
The origin of deep vein thrombosis: a venographic study
Authors: Nicolaides A. N. , Kakkar V. V. , Field E. S. , Renney J. T. G.
Published: July 2009

A venographic technique has been described which demonstrates the soleal veins in addition to the rest of the deep veins of the lower limb consistently in the presence or absence of thrombosis. In 127 consecutive patients, the soleal veins were demonstrated in all but three. In 97 surgical and medical patients with clinically suspected deep vein thrombosis, the presence of thrombi was confirmed by venography only in 51 (52 per cent); the remainder had normal deep veins. In nine patients the soleal veins were the only site of thrombosis. Only one patient was found with thrombosis proximally and normal soleal veins. In the remaining patients whenever there were thrombi proximally they were also present in the soleal and intervening veins. It is concluded that in the majority of patients thrombi start in the soleal veins in the calf. It has also been shown that the clinical diagnosis of deep vein thrombosis is unreliable and no patient should be given anticoagulant therapy without first confirming the diagnosis with venography.
Book reviews
Authors: Bewley D. K.
Published: July 2009

This is an excellently produced book, with a wealth of diagrams and tables. It is intended for the engineer designing practical shields rather than for the physicist who thinks more in terms of idealized systems.
Subcutaneous emphysema and pneumomediastinum in diabetic keto-acidosis
Authors: Ruttley M. , Mills R. A.
Published: July 2009

Two cases of subcutaneous emphysema and pneumomediastinum in diabetic keto-acidosis are presented. The mechanism of production of pneumomediastinum from alveolar rupture in ketosis is reviewed. The association is of importance as some of the clinical features of severe diabetic keto-acidosis, together with free mediastinal and subcutaneous gas, may simulate oesophageal rupture.
The design of a practical fast neutron therapy equipment for routine clinical use
Authors: Lundberg D. A.
Published: July 2009

A 14 MeV neutron therapy equipment, incorporating a sealed tube neutron generator with an output of 1 × 1012 neutrons per second, is under construction and will be installed at the Christie Hospital, Manchester. The machine is designed for clinical use and has all the features normally provided on radiation therapy equipment. The neutron shield is 0·5 m thick and comprises an iron core surrounded by a layer of hydrogenous material. It provides a dose attenuation factor of 99 per cent. The treatment head can be rotated about a horizontal axis 0·8 m from the neutron source. At this distance the machine delivers a dose-rate of 4·5 rads/minute.

An important feature of the design is the reduction to acceptable levels of γ dose-rates from neutron-induced radioactivity. A movable tungsten plug in front of the neutron source reduces the exposure rate at 1 m from the source from 157 mR/hour to 1 mR/hour. The surface exposure rate on the shield is reduced from 61 mR/hour to less than 4 mR/ hour by the use of pure iron rather than a standard grade of steel, for the shield core. Similar precautions in the construction of the treatment table and the treatment room ensure that the total activity levels in the room are such that radiographers using the equipment will not receive excessive doses.
Considerations on the use of 14 MeV neutrons for radiotherapy
Authors: Duncan W. , Greene D. , Meredith W. J.
Published: July 2009

An experimental arrangement for shielding a Services Electronic Research Laboratory sealed tube neutron source is briefly decribed, and the properties of the resultant neutron beams are summarized. At 55 cm from the target a dose-rate of 5 rads/minute is obtained and the percentage depth dose at 10 cm deep to a 10 × 10 cm field is 40 per cent.

The beam will be used in the first instance to study skin reactions during treatment of advanced pelvic cancer. The principles involved in setting up a clinical trial for fast neutron radiotherapy are discussed.
A 14 MeV neutron tube for radiotherapy
Authors: Hillier M. , Lomer P. D. , Stark D. S. , Wood J. D. L. H.
Published: July 2009

A sealed tube is being developed as a neutron source for radiotherapy. Essential features of such a source for clinical use are an output of at least 1012 neutrons/second to ensure a reasonably short treatment period and a life of several hundred hours to minimize maintenance. The design principles and performance of this and earlier tubes are outlined.

The device contains an ion source which provides a mixture of deuterium and tritium ions in equal proportions. These are accelerated to 250 keV, with which energy they strike a thick target film where they generate 14 MeV neutrons according to the reaction:

The use of this mixture of deuterium and tritium atoms which constantly recirculate between the target and ion source avoids the usual progressive decrease in output due to isotopic dilution in the target. This, together with the development of a high-capacity gas replenisher and very thick target films, provides very long operational lives at high neutron output rates. At the time of presentation of this paper, outputs in excess of 3 × 1011 neutrons/second were achieved and extrapolation of the tube performance data indicated that the design output and life would be achieved.
Book reviews
Authors: Kendall Brian
Published: July 2009

Since this excellent atlas was first published ten years ago the ascendancy of angiography and brain scanning has caused a decrease in the use of encephalography in most centres. Positive contrast ventriculography and encephalography are also used more extensively, especially in the posterior fossa.
Macroradiography in severe congenital heart disease in neonates
Authors: Pierce J. W. , Simon G.
Published: July 2009

With the availability of an X-ray tube with a focal spot of 0·3 mm, macroradiography, or image enlargement, can be undertaken as a routine procedure. Its use was described by Ablow, Greenspan and Gluck (1969). Using a similar technique, a series of babies with very severe congenital heart disease was examined and the radiographs compared with conventional ones taken at the same time.

At first a conventional radiograph was taken with the 1 mm focus and the 0·3 mm focus, at 6 ft. sitting up. Since the film with the fine focus gave more information, all the conventional films were then taken with this, and only these were used to compare with the macrofilms.
Book reviews
Authors: Adams J. E.
Published: July 2009

The authors are experts in their field and have already published widely on the topic of CT of the head and neck, and this expertise and experience is reflected in their book.

The format of the book is based on the same teaching principles as those of Lucy Squire in the Exercises in Diagnostic Radiology series. There are nine chapters covering various anatomical structures in the head and neck, including orbit, temporal bones, sinuses and larynx, amongst others.
Magnetic resonance (MR) cine imaging of the human heart
Authors: Waterton J. C. , Jenkins J. P. R. , Zhu X. P. , Love H. G. , Isherwood I. , Rowlands D. J.
Published: July 2009

A novel approach has been developed for MR cine imaging of the human heart by a modified ECG-gated 2DFT method. A pulse sequence has been devised to minimise the effects of saturation which can be anticipated in sequences that require rapid pulsing. Five frames are produced at the same anatomical level at predetermined intervals during the cardiac cycle. The total time taken to achieve this data is 8 minutes. Additional frames can be interleaved by repeating the sequence with an ECG-gated delay. The anatomical sections, which can be in any orthogonal plane, are then displayed as a cine loop. Cine display in the coronal plane has been used to examine 10 volunteers and 12 patients. In addition to the morphological feature displayed in single slice ECG-gated imaging, areas of dyskinesia can be detected and subjective estimates have been made of left ventricular function.
The role of breast scintigraphy in detecting breast masses
Authors: Khayat Gina , Achram Mitri , Rizk Ghassan
Published: July 2009

127 breast scans were performed on 83 female patients using technetium-99m diphosphonate. 46 out of 48 patients with breast cancer had positive breast scans manifested by a focal increased uptake in 37 patients and a diffuse increased uptake in the remaining 9 patients. Benign breast lesions such as fibrocystic disease, fibroadenoma and fat necrosis may also concentrate the radioactive agent in a focal or a diffuse pattern. So breast scanning is a sensitive though nonspecific modality to detect malignant breast lesions and it is worthwhile performing it on all women referred for bone scan.
Measurement of blood flow, oxygen utilisation, oxygen extraction ratio, and fractional blood volume in human brain tumours and surrounding oedematous tissue
Authors: Lammertsma Adriaan A. , Wise Richard J. S. , Cox Timothy C. S. , Thomas David G. T. , Jones Terry
Published: July 2009

The blood flow, oxygen utilisation, oxygen extraction ratio, and fractional blood volume were measured in brain tumours and the surrounding cerebral tissues. A total of 21 patients were studied. These included 10 primary tumours, eight secondary and three with unknown histology. Measurements were performed using the oxygen-15 steady state inhalation technique and positron emission tomography. Within the tumours no relation between blood flow, oxygen utilisation and blood volume was found. In all tumours oxygen supply was in excess of the oxygen demand of the tissues as reflected in oxygen extraction ratios that were lower than those of normal brain tissue. No indication of local ischaemia in peritumour oedema was found.
Effect of hyperthermia on the radiation response of Chinese hamster small intestine
Authors: Milligan A. J. , Metz J. A. , Leeper D. B.
Published: July 2009

The Chinese hamster small intestine was surgically exteriorised from the ligament of Trietz to the ileocaecal junction and heated for 8 min at 44.3°C (a non-lethal dose) at various intervals before or after whole-body 60Co irradiation. Hyperthermia exposure immediately after irradiation reduced the LD50/7 from the control of 1,230 cGy to 798 cGy (thermal enhancement ratio, TER, of 1.5). At an interval between irradiation and hyperthermia of 2 h the LD50/7 was 935 cGy, and it remained at that value for intervals of 2–24 h. The increase in the LD50/7 by 2 hours after irradiation probably represents the repair of radiation damage that can interact with hyperthermia, and after two hours the two modalities interact independently.

When the small intestine was exposed to 44.3°C hyperthermia immediately prior to irradiation, the LD50/7 was reduced to 658 cGy (TER = 1.8). As hyperthermia and radiation treatments were separated the LD50/7 returned to the control value by 24 h and was unchanged over 24–72 h. This indicates that by 24 h, recovery from hyperthermia damage that could interact with radiation damage was complete.

For the sequence hyperthermia → radiation, 33% of the hyperthermia damage was repaired by 1 h; whereas for radiation → hyperthermia, 85% of the radiation damage was repaired by 1 h. The sequence-dependent interaction of hyperthermia and radiation damage in normal tissues is complex, but the kinetics of interaction for the sequence radiation → hyperthermia seem to be predictable for several normal tissues in different species.
Dose rate dependence of response of mouse lung to irradiation
Authors: Lehnert Shirley , Rybka Witold B.
Published: July 2009

The dose-rate dependence of lung damage in mice has been studied using LD50/50–180 as an index of the incidence of radiation pneumonitis. Mean lethal doses for 60Co γ radiation to the thorax delivered at 100, 25 and 6 cGy/min were 1403, 1923 and 2488 cGy respectively. There were statistically significant differences between values obtained at 6 and 25 cGy/min and between those obtained at 25 and lOOcGy/min.

An isoeffect plot of this data on a log-log graph shows the sparing effect of dose rate reduction to be greater for the lung than for more rapidly responding systems (colony forming units of small intestine and Chinese hamster cells in culture).
A technique for simultaneous radiography and electromyography
Authors: Heywood L. H. , Wood A. K. W.
Published: July 2009

Radiographic observations have been combined with recordings of other parameters in studies of a variety of body systems. Simultaneous cineradiographic and electromyographic recordings have been made of movements of the hyoid apparatus during chewing (Crompton et al, 1975) and combined radiographic and intraluminal pressure studies have been made of oesophageal motility (Vantrappen et al, 1958; Cohen & Wolf, 1968), gastro-intestinal motility (Smith et al, 1957; Ritchie et al, 1962; Oigaard & Dorph, 1974) and during voiding cystourethrography (Blaivas, 1979). A difficulty in making other recordings during radiographic examinations lies in establishing precise relationships between X-ray images and events recorded on other equipment, such as chart recorders or cathode-ray oscilloscopes. Crompton et al (1975) overcame this problem through the use of a synchronisation signal provided by the cinecamera which enabled events recorded on electromyograph charts to be related to movements of the mandible and hyoid apparatus seen in 16 mm cineframes. In studies of gastro-intestinal motility, Ehrlein (1980) displayed, on different parts of a television screen, images from a videocamera attached to an image intensifier and images from another videocamera scanning a chart recording of intraluminal pressures. We have recently developed a technique for obtaining simultaneous radiographic and electromyographic recordings of oesophageal motility in sheep (Heywood et al, 1984). The purpose of this note is to describe the features of the recording technique and its advantages with illustrations from our observations on oesophageal motility.
Book review
Authors: Steiner G. M.
Published: July 2009

The title indicates this is a book on the “Physics of Imaging Processes in Medicine” and the foreword tells us it is meant to give doctors, medical students and radiographers the basic knowledge needed to make informed decisions on imaging. The book succeeds very well in this aim.
Hepatic artery aneurysm following pancreatitis diagnosed by ultrasound
Authors: Wolinski A. P. , Gall W. J. , Dubbins P. A.
Published: July 2009

Aneurysms of the hepatic artery are rare. If untreated, aneurysms of the extra-hepatic portion of the artery frequently rupture and this is nearly always fatal. Although the diagnosis may be made clinically or radiographically some cases of ruptured aneurysm are only discovered post mortem. We describe a case in which an hepatic artery aneurysm complicating pancreatitis was diagnosed by real-time and Doppler ultrasound.

A 70-year-old woman presented with acute onset of epigastric pain. Physical examination revealed epigastric tenderness with absent bowel sounds. A serum amylase of 8000 + IU (normal ≤ 300 IU) confirmed a diagnosis of acute pancreatitis and the patient received supportive therapy.
Book review
Authors: Hale Brendan
Published: July 2009

This is an excellent, high-standard production of general interest to those in the field of oncology. It is based on the very considerable experience of the contributors in China. It is known that China has unfortunately a high incidence of oesophageal cancer and the book deals with the epidemiology in detail. This, together with the section on the aetiology, makes fascinating reading. Whilst much refers to the situation within China, there is very adequate coverage of the world literature, with full references.
Radium as a Therapeutic Agent—The Case for National Control
Authors: Lee Viscount
Published: July 2009

One of my predecessors in the alarmingly erudite succession of Silvanus Thompson lecturers commenced his paper as follows:—

“For the privileged position I occupy to-night I can at least claim one qualification.”

I am in a regrettably different position, for I can claim no qualification, unless it be the entirely vicarious one of having presided—as a layman—over the National Radium Commission for the past three and a half years, i.e., since its inception.
The Clatterbridge high-energy neutron therapy facility: measurements of beam parameters for clinical use
Authors: Shaw J. E. , Bonnett D. E. , Blake S. W.
Published: July 2009

Measurements have been performed on the 62 MeV proton cyclotron at the Douglas Cyclotron Centre, Clatterbridge Hospital, to determine the variation in beam parameters necessary for clinical use of the neutron therapy facility. These measurements are of total (neutron and γ) doses, and include: depth doses for wedged and unwedged fields at various treatment distances; profile measurements and the production of associated isodose charts; calibration of the dosimetry system of the cyclotron; and determination of variations in calibration associated with changes in field size, wedge and focus-skin distance. Measurements have also been performed to estimate the degree of long-term stability of both calibration and field uniformity.
Stress changes of the wrist in adolescent gymnasts
Authors: Carter S. R. , Aldridge M. J. , Fitzgerald R. , Davies A. M.
Published: July 2009

The radiographic appearances are reported of chronic stress to the wrist joints of eight adolescent males, seven gymnasts and one roller skater. These consist of bilateral, asymmetrical widening and irregularity of the distal radial growth plates with an ill-defined cystic appearance, sclerosis and flaring of the metaphyses in all eight cases. Similar but less marked changes were present in the distal ulnar growth plates in five cases. The aetiology is thought to be that of a Salter Type I stress fracture of the growth plate due to chronic repetitive shear forces applied to the hyperextended wrist joint. Rapid healing of the stress fracture will occur with cessation of the sporting activity but continued strenuous use of the wrists will result in further widening and irregularity of the growth plate. The differential diagnosis of the radiographic appearances and previous literature are discussed.