bluuebunny/crossref_metadata_2025 huggingface dataset:
A case of adult polycystic and multicystic dysplastic kidney in a child
Authors: Gholkar A. , Ratcliffe J. F.
Published: July 2009

Multicystic dysplastic kidney is the commonest cause of an abdominal mass in the neonate (Kyaw, 1973). It is thought that unilateral multicystic kidney represents hydronephrosis secondary to atresia of the ureter, pelvis or both during the metanephric stage of intrauterine development (Felson & Cussen, 1975). Physical examination and radiological investigations such as intravenous urography, ultrasonography and isotope renography can usually establish the diagnosis (Griscom et al, 1975). In contrast, adult polycystic kidney disease involves both kidneys and is usually more difficult to diagnose in childhood. It is inherited as an autosomal dominant with high penetrance. We report a case where a combination of these cystic diseases occurred in a patient and this has not been previously reported in the literature.

A boy was born to a 29-year-old primigravida mother at 32 weeks by emergency caesarean section for breech presentation in premature labour. At birth the boy was noted to have a left-sided abdominal mass. He was otherwise normal. There was a strong family history of adult polycystic disease of the kidney. His father, aunt, cousin, grandfather and great-uncle were affected by the disease. An intravenous urogram done soon after birth showed a large left kidney with irregular faint opacification (Fig. 1). No collecting system was recognised at any stage during the examination.
Book review
Authors: Maisey M.
Published: July 2009

The Nuclear Medicine Annual has become established as a classic state-of-the-art annual review and for many of us it is the first source to which we turn for rapid, authoritative information. This 1984 Annual is no exception to the high standard to which we have become accustomed over the last few years. The editors have again assembled a series of authors recognised as authorities in a particular field who have produced a series of excellent definitive reviews.
Brachialis Seldinger puncture with use of introducer sheath
Authors: Andersen Poul Erik
Published: July 2009

In cases where arteriography is indicated and the transfemoral approach is not accessible, the transbrachial route is an alternative. Sones and Shirey (1962) first described coronary angiography, employing the brachial artery as the standard site for catheterisation. This arteriotomy technique has since been in routine use in many places but it is a surgical procedure and takes longer than the percutaneous Seldinger technique. Use of introducer sheath facilitates exchange of catheters and reduces bleeding at the puncture site and discomfort to the patient (Barry et al, 1979; Hillis, 1979). We have therefore used this technique of brachial artery catheterisation in cases where the transfemoral route was not accessible.
The response of pig skin to single doses of irradiation from strontium-90 sources of differing surface area
Authors: Hopewell J. W. , Hamlet R. , Peel D.
Published: July 2009

Radiobiological studies in the pig (Hopewell & Young, 1982a) indicated that there were no differences in the radiation responses of skin areas of 16 cm2 (4 × 4 cm) and 64 cm2 (16 × 4 cm). This absence of a field-size effect applied both to the early epithelial lesion and to later dermal changes, after single doses of X rays. Although this result appeared to be at variance with presently accepted clinical practice, it might be explained by a difference in the interpretation of the clinical term “skin tolerance”. In the clinic it would seem to represent a decreasing scale of normal tissue damage with increase in field size (Ellis, 1942). On the other hand the experimental studies were based on equivalent levels of biological effect (Hopewell & Young, 1982b, 1983).

In more recent studies in which smaller circular areas of pig skin, 1–22.5 mm diameter, were irradiated with strontium-90 (90Sr) plaques, a distinct area effect was observed for the acute epithelial reaction (Peel et al, 1984b). These small fields related more to radiological protection and are below the range of field size relevant to clinical radiotherapy.

In the present investigations the effects of irradiation of pig skin with 22.5 and 40 mm diameter 90Sr plaques are compared. In addition to comparing peak epithelial reactions, comparisons were also made as to the healing times for comparable peak skin reactions for each field size.
Further Backscatter studies and their application in megavoltage photon therapy
Authors: Weatherburn Henry
Published: July 2009

Studies of relative exit doses have previously been reported for 60Co γ rays and 4, 8 and 16 MV X rays, by Lambert et al (1983). The results of further measurements, with 18 MV X rays, and a discussion of the relationship between relative exit dose, peak scatter factor and backscattering are reported here. It is felt that these results are of significance in that number of radiotherapy centres overseas already have 18–25 MV X-ray linear accelerators in operation, while several centres in the UK are in the process of installing such units.
Late reaction following iohexol
Authors: Brown I. W. , Murphy G.
Published: July 2009

A 50-year-old Caucasian man with a six-month history of low back pain was referred for an orthopaedic opinion with minimal weakness of the left extensor hallucis longus, but otherwise normal neurology. His plain radiographs showed minor osteophytic changes at L.5-S.1 only but in view of the clinical findings he was referred for a radiculogram. His past medical history was unremarkable; he described a mild penicillin allergy with the appearance of a rash only.
Book review
Authors: Harvey Jean
Published: July 2009

This second edition of a book familiar to many radiographers and commonly found in schools of radiography libraries, consists of ten chapters which address themselves to a wide range of issues concerned with the principles of “caring”.
Book reviews
Authors: Coleman Michael P.
Published: July 2009

This multi-author text is the third volume in the Wiley series, New Horizons in Oncology. Its declared aim is ‘to help clinicians to recognise and screen individuals at high risk of multiple cancer’. The book devotes six or seven chapters each to carcinogenic factors, markers of cancer risk such as genetic and familial factors, and clinical patterns of multiple primary cancer: chapters in this last section are grouped by site.

Isaac Berenblum contributes a critical review of two-stage carcinogenesis and multiple cancer, ending with the provocative conclusion that the comparative rarity of multiple cancer in humans (as opposed to animals) is abnormal, and calls for explanation.
Book reviews
Authors: Sikora Karol
Published: July 2009

Despite enormous research efforts there has been little change in the end results of our treatment of most of the common cancers over the last thirty years. Fashions of patient management have come and gone but the survival of patients with lung, colorectal and breast cancer remains consistently dismal once the disease has metastasised. Although there are hints of a new understanding of the biology of cancer emerging from the application of techniques such as genetic engineering, there is little promise of immediate therapeutic benefit round the corner. For these reasons it is appropriate to consider new strategies for screening populations at risk in order to detect early disease, and treated patients for evidence of early relapse.
The Neutron and its Properties
Authors: Chadwick J.
Published: July 2009

The subject of my lecture, the neutron and its properties, has at present no professional applications for the radiologist, but it has some points of general interest apart from its mere novelty.

The conception of a neutral particle is not new. It was suggested by Rutherford in 1920 that a proton and an electron might unite much more intimately than they are combined in the hydrogen atom and so form a particle of a new type, which would have peculiar and interesting properties. The suggestion was made partly because such a particle would be the first step in the formation of atomic nuclei from the two units, the proton and the electron, and partly also to make it possible to understand how complex nuclei can be gradually built up from simpler ones.

Experiments were made in 1921 by the late Professor Glasson and by Roberts to detect the formation of such neutrons when an electric discharge was passed through hydrogen, but with negative results. The possibility that such a particle might exist was, nevertheless, not lost sight of. I myself made some experiments to detect them—in electrical discharges and in both radioactive and artificial disintegrations—but with no success

The first step towards the discovery of the neutron was given by the experiments of Mme. Joliot-Curie and M. Joliot, who were investigating the properties of a radiation emitted from beryllium when bombarded by α particles.
The Presidential Address
Authors: Hopwood F. L.
Published: July 2009

The Presidential Address by Prof. Hopwood was the terminal event of the scientific proceedings of the Congress, and was delivered before a large audience at the Central Hall, Westminster, on Friday afternoon, December 9. It was accompanied by lantern slides, and followed by a cinematograph demonstration.

Prof. Hopwood said that every congress he had attended had organised some excursion for its members, and he proposed to take the audience on an excursion along the new arterial road which has been driven right through science and medicine, the road of radiation.

[The President here showed the electro-magnetic spectrum, indicating the different classes of radiation, from the longest to the shortest waves.]

He then showed examples of recent research in various fields of radiological interest, commencing with a record of experiments carried out by Prof. Bose in the Bose Institute at Calcutta. These experiments related to the effect of short wireless waves on the growing wheat plant. When a strong wireless signal was received by the plant, the plant showed a retardation in growth. Less strong signals showed a retardation of growth followed by growth stimulation, while weak signals were followed by stimulation only. There is a lag of two or three seconds between the transmission of the stimulus and the effect produced.
Fractures of the Upper End of the Femur in the Aged
Authors: Jacobson J. N.
Published: July 2009

(1) Fractures in the region of the neck of the femur are usually subdivided into the intra- and extra-capsular variety. This classification is faulty and misleading.

(2) An analysis of the injuries, in the region examined in this series, shows them to be readily classifiable into five types. Although certain authors have attempted to subdivide the trochanteric variety into two, I am of the opinion that this is not practicable, since a large proportion are true neither to the intertrochanteric nor to the pertrochanteric type.

(3) Since the great majority, at least, of the trochanteric fractures would, according to the older classification, have been called “extra-capsular,” and since it is stated that this type occurs generally in muscular adults and infrequently in old age, the large proportion found in this series directly contradicts the modern teaching.

(4) It is submitted that even trochanteric (the so-called extra-capsular) fractures are not due to direct external violence in the aged. The suggested mechanism can be regarded as a compression action of the affected limb, resulting when the whole weight of the body is suddenly thrown upon it. The bone breaks in the vicinity of its angle (the region of the intertrochanteric line), and not through its weakest point, the neck.

(5) The transcervical, and presumably also the subcapital fractures, are caused by an axial torsion of the cervix femoris.

(6) In the trochanteric fractures there is usually impaction of the upper fragment into the lower. Sometimes, in addition, the great trochanter is comminuted, but more commonly the small trochanter, with or without a thin portion of the shaft, is chiselled off by the most inferior part of the upper fragment, which almost invariably has a sharp lower angle.

(7) The subtrochanteric fracture is in reality a fracture of the shaft proper. It involves the inferior portion of the trochanter major. There appears to be no definite agreement about the trauma producing it.

(8) “Avulsion fractures” of the trochanter major consist of the detachment of the tip of that prominence, presumably as a result of spasmodic muscular action.

(9) The degree of shortening of the limb varies considerably in the first three varieties discussed, and it is no criterion, clinically, of the type which has occurred.

(10) The fracture most frequent in the aged is that through the mass of the trochanter major, and X-ray examination alone reveals the nature and extent of the damage.
Medical Members' Monthly Meeting, November 1932
Authors: R.A.M.
Published: July 2009

A well-attended meeting of about fifty, with Dr. L. A. Rowden presiding. At first one missed the usual formidable list of names of those showing cases, and at one time it almost appeared as though there might be a shortage of material, but actually there was a plentiful supply, and the fact that this was not obvious resulted in more time being allotted to discussion after each case.
Proximal, distal and total stomach emptying of a digestible solid meal in normal subjects
Authors: Collins P. J. , Horowitz M. , Chatterton B. E.
Published: July 2009

The gastric fundus and antrum probably play different roles in the emptying of solids and liquids in man, but there is little information about the intragastric distribution of food. We have used a new radionuclide technique to quantify proximal, distal and total stomach emptying of a digestible solid meal (100 g of 99Tcm-labelled liver/ground beef given with 150 ml of 10% dextrose) in 13 normal subjects. A proximal reservoir area was seen after consumption of the meal, and used to define the proximal stomach region. A line drawn immediately below this area divided the total stomach region into proximal and distal stomach. Emptying from the total stomach exhibited two phases—an initial lag period (median 41 min, range 21–57 min), followed by approximately linear emptying. Redistribution of food from the proximal to the distal stomach was a major component of the lag period in 11 of the 13 subjects. In the remaining two subjects, redistribution was rapid (proximal 50% emptying time of 4 and 10 min) and antral retention was the major component of the lag period. In seven subjects, a region of reduced activity (contraction band) was seen. The midpoint of this band closely approximated to the line used to divide proximal and distal stomach. We suggest that a contraction band may be responsible for the proximal gastric reservoir seen after meal consumption and plays an important role in the redistribution and emptying of digestible solid food from the stomach. There is considerable variation between normal subjects in the rate of transfer of digestible solid food from the proximal to the distal stomach.
Hypertrophic pyloric stenosis: determination of muscle dimensions by ultrasound
Authors: Kofoed Poul-Erik Lund , Høst Arne , Elle Bo , Larsen Claus
Published: July 2009

To evaluate the usefulness of ultrasound in hypertrophic pyloric stenosis (HPS) and to analyse the correlation between the dimensions of the pyloric muscle and the age and the weight of the child, 34 children with suspected HPS and 34 controls were examined. An overlap between the dimensions of the pyloric muscle in the HPS group and in the controls stresses the need to assess the muscle length, the muscle diameter, and the muscle wall thickness in establishing the sonographic diagnosis of HPS. We found the following criteria useful: muscle length ≥19 mm, muscle diameter ≥10 mm, and muscle wall thickness ≥4 mm. The results did not confirm previous reports of increasing dimensions of the pyloric muscle with age and weight.
Technetium 99m HMPAO scanning in patients with subarachnoid haemorrhage: a preliminary study
Authors: Rawluk D. , Smith F. W. , Deans H. E. , Gemmell H. G. , MacDonald A. F.
Published: July 2009

Technetium 99m hexamethylpropylene amine oxime (HMPAO) is an agent which, when injected intravenously, gives images which reflect cerebral blood flow. Seven patients who had suffered subarachnoid haemorrhage were examined by cerebral angiography and by 99Tcm HMPAO scanning. The two studies were compared and in six cases there was evidence of decreased cerebral perfusion in relation to the ruptured aneurysm causing the subarachnoid haemorrhage. In one case no cause for the haemorrhage was demonstrated angiographically, and the HMPAO study was normal. In two of the six cases, spasm of the cerebral artery distal to the ruptured aneurysm was seen angiographically and it appears that 99Tcm HMPAO scanning does not correlate with gross arterial spasm but reflects smaller degrees of cerebral underperfusion not demonstrable by angiography. The results demonstrate a relationship between local decreased cerebral perfusion and ruptured cerebral aneurysm and may be of use in determining which aneurysm has bled in patients who have more than one aneurysm demonstrated angiographically.
Parasymphyseal and associated insufficiency fractures of the pelvis and sacrum
Authors: Davies A. M. , Evans N. S. , Struthers G. R.
Published: July 2009

Eleven post-menopausal women presenting with a parasymphyseal insufficiency fracture of the pubis are reported. The plain radiographs showed delayed healing with a mixed lytic and sclerotic area developed at the fracture site simulating a malignant lesion. Aetiological factors included post-menopausal osteoporosis, rheumatoid arthritis and steroid therapy, previous hip relacement and pelvic radiotherapy. Ten patients had concomitant fractures of the pelvis, including nine with sacral fractures. These were all initially missed on presentation because of the subtle radiographic signs of a longitudinal band of sclerosis, usually bilaterally, in the sacral ala. Bone scanning was shown to be the most sensitive technique in detecting the sacral fractures by demonstrating increased uptake in the sacral ala as well as the other fractures of the pelvis. Computed tomography in three cases was helpful in confirming the presence of fractures and excluding the possibility of malignancy.
Lead thickness in shielding in the protection of radiodiagnostic staff
Authors: Russell J. G. B. , Hufton A. P.
Published: July 2009

We indicate the principles which can be used to apply cost–benefit analysis to radiation protection of staff in an X-ray department. The cost of saving radiation exposure to staff by varying the lead equivalence of lead gowns and lead protective screens is calculated. The cost is compared with the financial values of the detriment as assessed by the National Radiological Protection Board. The expenditure required to avoid a man-Sv for staff protection in diagnostic departments is suggested. In the examples we take, it is found that the larger staff dose reductions, and often the cheaper reductions, can be obtained by reducing the radiation dose to the patient. There are, of course, major additional advantages to the patient in reducing this dose.
Possible dose rate dependence of recovery kinetics as deduced from a preliminary analysis of the effects of fractionated irradiations at varying dose rates
Authors: Dale R. G. , Huczkowski J. , Trott K. R.
Published: July 2009

Data relating to jejunal crypt survival following fractionated total body irradiation of C311 mice have been subjected to a preliminary analysis using the linear-quadratic formalism. Because the regimes considered involved fairly closely-spaced fractions, delivered at dose rates in the range 1.2–72 Gy h−1, it was necessary to further develop previously established forms of the model in order to carry out the evaluation. The magnitude of the recovery half-life has been deduced for each of the regimes and found to be in the approximate range 0.1–0.6 h−1. For any given fraction number, the half-life appears to be markedly dependent on dose rate, increasing with dose rate up to ≈ 25 Gy h−1, falling off thereafter. Tentative reasons for this behaviour are given, together with an assessment of the possible shortcomings of the analytical method.
The management of intussusception
Authors: Paes R. A. , Hyde I. , Griffiths D. M.
Published: July 2009

A scheme of management to achieve maximum success in hydrostatic reduction of intussusception is presented. This takes into account patient selection, radiological technique and the follow-up clinical assessment. By standardizing the management we have increased our success rate and avoided laparotomy in 64% of our patients. Most of the patients in whom the technique failed had infarcted bowel which required resection.
Ocular lens dose in cerebral vascular imaging
Authors: Casselden Patricia A.
Published: July 2009

Ocular lens dose was considered with respect to cerebral vascular imaging, using both digital subtraction angiography (DSA) and conventional angiography. A dose measurement study is described in which doses were found to be minimal (0.327 cGy) in DSA, but high (60 cGy) using conventional techniques. The use of an undercouch tube in DSA and an increased focus-lens distance, when compared with the conventional angiographic approach were considered the major factors contributing to the difference in lens dose. The implications for selection of technique are discussed.
Changes in the cell kinetics of pig epidermis after single doses of X rays
Authors: Morris G. M. , well J. W. Hope
Published: July 2009

Changes in the cell kinetics of pig epidermis have been investigated after irradiation with single doses of 15 Gy and 20 Gy of X rays. The epidermis exhibited an initial degenerative phase when the rate of cell depletion was independent of radiation dose. Changes consistent with repopulation were evident between the 14th and 18th day after irradiation. The severity of cell depletion and the rate of recovery of the epidermis were dose dependent. The regenerative phase was characterized by an increased cell proliferation; values for the labelling index (LI) were greater than those in the non-irradiated epidermis, from 14 days after 15 Gy and from 18 days after 20 Gy. The LI was still elevated at the end of the observation period, i.e. Day 56. No change in the time for DNA synthesis was found. Eighteen days after 15 Gy and 22 days after 20 Gy, islands of cells (colonies), with an appearance similar to the cells in the normal epidermis, were seen. The minimum turnover time (T  T) for the proliferating cells of the basal layer of the epidermis in radiation-damaged skin was 61–68 h as compared with 125 h in unirradiated skin. For the basal cells in the colonies, T  T was 16–22 h.
Serum thyroglobulin in the investigation of patients presenting with metastases
Authors: Edmonds C. J. , Willis C. L.
Published: July 2009

Serum thyroglobulin (Tg) is often very elevated in patients with metastaticthyroid carcinoma and, in 18 out of 40 patients examined, serum Tg was found to exceed 400 μg/1. In only two of 55 patients with benign nodular thyroid disease did serum Tg exceed 400 μg/1. In patients presenting with metastases of unknown origin, the finding of a very elevated serum Tg concentration may therefore be of value as an indicator that the metastases are due to thyroid carcinoma. During a period in which 128 new patients with differentiated thyroid carcinoma were seen, in five who presented with metastatic disease the initial estimation of serum Tg had proved useful in suggesting the thyroid origin of the metastases.
Determination of human skin pain threshold using 27 MHz radiofrequency heating
Authors: James R. D. , Williams P. , Jones A. , Nelis P. , Farrow N. , Lukka H. , Pye D. W.
Published: July 2009

The success or failure of any cancer treatment depends on the respective dose received by tumour and by critical normal tissues. Clinical studies define safety standards for the most sensitive normal tissue and these allow clinicians to protect their patients whilst comparing different treatment techniques.Safety standards may preclude the use of otherwise valuable techniques.

Patients receiving externally applied hyperthermia without general anaesthetic may experience pain. Skin remains the most sensitive organ despite attempts to reduce heat dose to the skin by surface coiling, since the site likely to absorb most power and which requires most cooling is unpredictable, particularly in non-planar areas like the axilla and perineum.
The study of regional cerebral blood flow in stroke patients using technetium 99m HMPAO
Authors: Smith F. W. , Donald R. T. , Morris A. J. , Sharp P. F. , Gemmell H. G.
Published: July 2009

Seventeen patients who had suffered a stroke in the previous 72 h have been studied using technetium 99m hexamethyl propylene amine oxime (HMPAO) to assess cerebral blood flow. Comparison of the scan appearances and clinical signs were made in all cases. Twelve of the patients had a repeat HMPAO scan 14 days later, together with further clinical assessment. Good correlation between the size and site of perfusion deficit and the clinical signs was found in 14 of the patients. When the results of the 12 patients who had repeat scans were examined at 14 days the correlation between the scan and the clinical signs was less accurate and it seems unlikely that the assessment of the size of cerebral infarction as demonstrated by an HMPAO scan will provide an accurate prognostic sign. Three of the patients, all of whom had suffered right hemiplegia and were dysphasic, had regions of increased uptake adjacent to the area of ischaemia and non deteriorated clinically; it is thought that this sign may represent hyperperfusion around infarction and indicates a fair prognosis. In patients suffering from transient neurological symptoms, the use of HMPAO may be useful by excluding the presence of other cerebral disease.
Dacryocystography after paranasal sinus surgery
Authors: Hunink Myriam G. M. , de Vries-Knoppert Willemine A. E. J. , Balm Alfons J. M. , Luth Wietse J.
Published: July 2009

The influence of nasolacrimal duct dissection and irradiation of the lacrimal system on lacrimal drainage were assessed. Findings at dacryocystography, in correlation with the results of dye tests and symptoms, are presented. Lacrimal drainage obstruction was demonstrated in one of 10 patients after paranasal sinus surgery not followed by irradiation and in four of 10 patients in which surgery was followed by irradiation.
Book reviews
Authors: Blake P.
Published: July 2009

This multi-author book, edited by Nori and Hilaris, draws many of its contributors from the Memorial Sloan-Kettering Cancer Centre in New York. Its American origins are evident in that a short section on the treatment of breast cancer is included in a text otherwise exclusively concerned with the treatment of female genital tract cancer, reflecting the wider scope of the gynaecologist in the US. The book aims to be of interest to all doctors concerned in the care of women with gynaecological cancer and is organized into three sections of General Principles, Clinical Applications and Special Topics.
Magnetic resonance velocity mapping in aortic dissection
Authors: Bogren H. G. , Underwood S. R. , Firmin D. N. , Mohiaddin R. H. , Klipstein R. H. , Rees R. S. O. , Longmore D. B.
Published: July 2009

We describe three patients with chronic aortic dissection in whom both spin-echo magnetic resonance imaging (MRI) and cine field-echo imaging were performed. The field even-echo rephasing (FEER) sequence showed the intimal flaps much more clearly than the spin-echo sequence and provided a distinction between thrombus and static blood. Velocity mapping allowed flow measurements in the true and false lumens. The management of the three patients was based upon the information provided by MRI. It is suggested that MRI may avoid invasive investigation and be the method of choice in haemodynamically stable patients with aortic dissection provided that the FEER sequence is used.
Differential radioprotection of bone marrow and tumour cells by zinc aspartate
Authors: Floersheim G. L. , Chiodetti N. , Bieri A.
Published: July 2009

The radioprotector zinc aspartate did not inhibit the radiotherapeutic effect of γ rays on human tumours grown as xenografts in immunosuppressed mice, while aminothiol radioprotectors afforded a slight inhibition. On the other hand, zinc aspartate significantly reduced the fall in the haematocrit and numbers of thrombocytes, erythrocytes and leucocytes caused by irradiation, indicating a sparing effect on bone marrow precursors of peripheral blood cells. This differential protection of neoplastic and normal cells may be of considerable benefit in clinical cancer radiotherapy, provided that zinc aspartate is better tolerated and has a more favourable therapeutic index in humans than aminothiol radioprotectors.
Clinical trial of a new adaptive TGC system for ultrasound imaging
Authors: Pye S. D. , Wild S. R. , McDicken W. N.
Published: July 2009

One of the skills that an operator has to learn in order to obtain well balanced ultrasound images is the ability to set up the time gain compensation (TGC) controls. Most ultrasound scanners are fitted with several TGC controls. These may adjust the initial gain of the receiver, the rate at which the gain increases with time (the TGC slope) and the delay between the transmission of a pulse and the time at which the gain begins to rise. One or two other controls are often provided to adjust either the overall receiver gain or the power of the transmitter.

This approach to gain compensation was originally borrowed from ultrasound devices used in non-destructive evaluation. When applied to diagnostic imaging, manual TGC is crude and often inaccurate. Its shortcomings are all the more obvious when it is used in the same signal path as the elegant and effective techniques of dynamic focusing and digital scan conversion. Manual TGC can only provide crude gain compensation since the flexibility of the gain control function is limited and the same gain function is applied to all scan lines in the image, despite the non-uniformity of the tissues that may be present. For example, in an obstetric scan, the ultrasound beam may pass in one direction through fetal head and placenta, and in another direction through a deep pool of liquor.
Ring artefacts in X-ray computed tomography
Authors: Cranage R. W. , Tofts P. S.
Published: July 2009

In a recent letter (Coulden & Dixon, 1987) it was suggested that central ring artefacts in computed tomography (CT) are caused by low photon transmission through the centre of the body, rather than by detector miscalibration or malfunction. The authors stated that the “artefacts are sometimes unavoidable in very obese patients, even when meticulous care has been taken with calibration. This is because of low photon transmission and consequent low signal-to-noise ratio.” Their letter has stimulated us to present a more detailed discussion of the origin of central ring artefacts and to produce experimental evidence to support our views.
Monitoring of surface contamination on sealed sources
Authors: Samarasekara M. G. , Williams F. J.
Published: July 2009

We have recently acquired a batch of 70–100 caesium needles from Amersham International to replace our old stock of radium needles. Prior to accepting these needles for use, we carried out a series of tests to check for surface contamination.
Book reviews
Authors: Webb J. A. W.
Published: July 2009

The second fully revised edition of Weill's text on renal sonography provides a thorough review of the subject based on the authors' many years of practice. The chapter on anatomy includes descriptions of normal variants and artefacts. Techniques are well described in a separate chapter. The remaining chapters cover hydronephrosis, cysts, tumours, infection and inflammatory disorders, congenital anomalies, trauma, perinephric collections and renal transplants. Two final chapters briefly review the use of ultrasound of the adrenal and of the lower tract—bladder, prostate and testis.
Duplex Doppler ultrasound in the diagnosis of cavernous transformation of the portal vein
Authors: Raby Nigel , Meire Hylton B.
Published: July 2009

Duplex Doppler ultrasound scans were performed in 10 patients with proven cavernous transformation of the portal vein. All cases exhibited absence of the normal portal vein lumen with replacement by numerous tortuous vessels. Doppler studies revealed a characteristic “flat” waveform with a reduction in the time averaged velocity to less than 8 cm/s which is well below the normal range. The combination of real-time and Doppler ultrasound enabled an accurate diagnosis to be made in all cases.
Cervical myelography of nerve root avulsion injuries using water-soluble contrast media
Authors: Cobby M. J. D. , Leslie I. J. , Watt I.
Published: July 2009

Eight cases of cervical nerve root avulsion injury are presented which were investigated by cervical myelography using a water-soluble contrast medium. The previous literature describes the appearances of this lesion using an oil-based agent and has resulted in emphasis being placed on looking for a traumatic meningocele rather than an abnormality of the roots themselves. The excellent definition of the nerve rootlets and axillary pouch that are obtained with a water-soluble contrast medium resulted in more root lesions per patient being detected than with an oil-based medium. There was complete correlation with the surgical findings at all but one root level explored. The appearances of root avulsion injuries and the advantages of using a water-soluble contrast medium are discussed.
Bone age estimation: a comparison of methods
Authors: Cole A. J. L , Webb L. , Cole T. J.
Published: July 2009

Bone ages assessed by the TW2 method and the GP atlas were compared in 97 children radiographed for trauma. Bone age assessed by the TW2 method was slightly closer to chronological age than the GP estimate, but TW2 was slightly less reproducible between observers. Given the relatively laborious and time-consuming nature of the TW2 method, there seems little point in promoting its use in the general hospital setting. The GP method was improved by recalibrating the standard radiographs to match the local population.
Pharyngeal and oesophageal function in patients with diabetes mellitus and swallowing complaints
Authors: Borgström Pia S. , Olsson Rolf , Sundkvist Göran , Ekberg Olle
Published: July 2009

Pharyngeal and oesophageal function were monitored using cine and video techniques in 18 diabetic patients with swallowing complaints. Morphological lesions had been excluded with double-contrast radiography. Abnormal pharyngeal function was present in 14 patients and abnormal oesophageal function in 10 patients. Eight of these patients had both pharyngeal and oesophageal dysfunction. Dysphagia does not seem to be a frequent symptom in diabetic patients but, when present, warrants a detailed analysis of pharyngeal and oesophageal function in order to reveal the underlying cause. We found cine and video techniques to be of value and we recommend them for use in functional analysis in these patients.
Improvements in snap-shot nuclear magnetic resonance imaging
Authors: Howseman A. M. , Stehling M. K. , Chapman B. , Coxon R. , Turner R. , Ordidge R. J. , Cawley M. G. , Glover P. , Mansfield P. , Coupland R. E.
Published: July 2009

New variants of the ultra-high-speed echo-planar imaging technique have been used to obtain snap-shot images of adult patients and volunteers at 0.1 T. Modified pulsed-gradient sequences together with non-linear signal sampling and activity screened gradients have greatly improved the image quality obtainable by single-shot methods. A particular variant, modulus blipped echo-planar single-pulse technique (MBEST), although slightly slower than the blipped echo-planar single-pulse technique (BEST), is experimentally more robust and incorporates intrinsic T  2 weighting. An account of these improvements together with some experimental results is presented.
Alterations in the length of jejunal villi in mice irradiated with graded doses of X rays
Authors: Rao K. R. , Fritz-Niggli H.
Published: July 2009

The length of villi protruding into the jejunal lumen influences the absorptive surface involved in digestion. Since it is an important functional end-point, a correlation between the X-ray dose applied and the average length of jejunal villi was investigated, with the possibility of using it as a radiobiological test system. Mice were given whole-body irradiation in the low- (4–7 Gy) or high-dose (9–12 Gy) range in a single fraction. Villus length was measured in arbitrary units from stained histological sections. It was found that villus length was affected by both the dose ranges used, but the effect observed in the low-dose range was not dose-related, whereas in the high-dose range there was a correlation between the radiation dose applied and the reduction in the average length of villi. Therefore, it is not suitable as an assay for low doses and for high doses there is already a test system (the microcolony survival assay) which is more practical and widely used. Factors which may influence villus length as well as the basic mechanisms involved are reviewed briefly. Experimental data presented indicate that the villus length may also be dependent on the number of crypts per jejunal circumference.
Radiosensitizer–DNA interactions
Authors: Stratford M. R. L. , Dennis M. F. , Watts M. E. , Watfa R. R.
Published: July 2009

We have previously shown (Dennis et al, 1985; Watts & Jones, 1985) that measurements of uptake of the radiosensitizers misonidazole and the weak base pimonidazole (Ro 03–8799) show a good apparent correlation between average intra-cellular concentration and radiosensitization, when differences electron affinity are taken into account.
The relative biological effectiveness of fractionated doses of fast neutrons (42 MeVd→Be) for normal tissues in the pig. I. Effects on the epidermis and dermal vascular/connective tissues
Authors: Hopewell J. W. , Barnes D. W. H. , Robbins M. E. C. , Sansom J. M. , Knowles J. F. , van den Aardweg G. J. M. J.
Published: July 2009

The effects of fractionated doses of fast neutrons (42 MeVd→Be) on the early epithelial and later dermal response of pig skin have been assessed and compared with those after X irradiation. For the early epithelial reaction, i.e. moist desquamation, the relative biological effectiveness (RBE) of the neutron beam increased with the decreasing size of the X-ray dose/fraction. There was an experimentally observed upper RBE value of ∼ 2.75 for X-ray doses/fraction of between 2 and 5 Gy. For the late reaction of ischaemic dermal necrosis the RBE was > 3.0 for X-ray doses/fraction of <3 Gy and, based on the assumptions made in the linearquadratic model of cell survival, an upper limiting RBE of 4.32 ± 0.39 was calculated for infinitely small doses/fraction. These findings were compared with other radiobiological data and the conclusions drawn from the results of clinical trials. It was concluded that for the sparing of late effects in skin and subcutaneous tissues, relative to acute reactions, a relatively small number of fractions in a short overall treatment time may be optimal for fast neutron therapy.
Methotrexate given concurrently with radiotherapy in the treatment of transitional cell carcinoma
Authors: Tomlinson M. J. , Lancaster J. F. , Bullimore J. A. , Smith P. J. B.
Published: July 2009

The use of methotrexate has previously been reported in cases of advanced bladder cancer following failure of radiotherapy (Turner et al, 1977) when it was suggested that their synchronous use may be inadvisable because of the occurrence of side-effects. The following case report documents the successful use of intravenous methotrexate combined with radiotherapy in a patient with extensive urothelial malignancy.

The patient presented initially in 1975, aged 41 years, with a history of haematuria which was found to be due to a Tl average-grade transitional cell carcinoma. This was not controlled by endoscopic resection, Helmstein dilatation of the bladder or intravesical ethoglucid. Cystectomy was offered but turned down by the patient as he considered impotence unacceptable. Therefore he underwent radical radiotherapy to the bladder. Six months later he re-presented with haematuria and cystoscopy revealed extensive tumour. Reluctantly he agreed to cystectomy.
A technique for the removal of retained balloon bladder catheters
Authors: Rickards D.
Published: July 2009

I am glad that Dr Bisset finds our method of needle puncture of retained balloon catheters a good one. I accept that in any interventional technique there is a risk, but the risk associated with this method is minimal.
Book reviews
Authors: Savage John R. K.
Published: July 2009

This book was developed from a symposium sponsored by the American Chemistry Society in 1986. Although radon and it's decay products (part of the natural decay series of 238U) have been studied for many years, it is only in the last few that its potential as a major threat to public health has been recognized. High levels can accumulate within well insulated and poorly ventilated buildings, arising from soil, water and building materials, and with such accumulations comes an increased risk of lung cancer and allied diseases.
Book Reviews
Authors: Stather J. W.
Published: July 2009

Various approaches are available for assessing the body content of radionuclides in workers occupationally exposed to radioactive materials. In exceptional circumstances, such as the analysis of biopsy samples, the organ content of radionuclides can be measured directly.
Pre-natal diagnosis of adult polycystic kidney disease
Authors: McHugo Josephine M. , Shafi Mahmood I. , Rowlands David , Weaver Judith B.
Published: July 2009

The pre-natal diagnosis of adult polycystic kidney disease was first reported by Zerres et al (1982) and subsequently, eight further cases have been reported (Main et al, 1983; Zerres et al, 1985; Pretorius et al, 1987; Toma et al, 1987). In all these cases the kidneys were enlarged and abnormally reflective. Cysts were present in all but three cases. As far as the authors are aware, the ultrasound features of enlarged kidneys with accentuation of the cortico-medullary differentiation without cysts has not previously been reported in adult polycystic disease.
The natural history of renal cysts in an infant with tuberous sclerosis: evaluation with ultrasound
Authors: Moss J. G. , Hendry G. M. A.
Published: July 2009

Tuberous sclerosis is a diffuse neurocutaneous syndrome with predominant involvement of the brain and kidneys. Angiomyolipoma are frequently found in the renal parenchyma but renal cysts are less common. We present an infant with multiple renal cysts and illustrate the rapid involvement of the cysts over the first 4 months of life.
Fibromuscular dysplasia of the external iliac artery: treatment by percutaneous transluminal angioplasty
Authors: Parnell A. P. , Loose H. W. , Chamberlain J.
Published: July 2009

Fibromuscular dysplasia is a rare disease of unknown aetiology first identified in the renal artery, where it is most commonly located. It is increasingly being recognized in other sites and an extensive literature review by Mettinger (1982) suggested that the iliac artery is the third most common site of fibromuscular dysplasia after the renal and carotid arteries.

The following report documents the case of a patient with fibromuscular dysplasia of the external iliac artery treated by percutaneous transluminal angioplasty.
Book reviews
Authors: Savage John R. K.
Published: July 2009

This book is the proceedings of a workshop held under the joint sponsorship of the CEC Radiation Protection Programme and the French Atomic Energy Commission Institute of Nuclear Protection, Fontenay aux Roses.

One of the major problems in estimating radiation doses from the uptake of radionuclides in the environment, or in developing models with which to predict such doses and to set emergency reference levels for public safety, is the fact that the metabolism of and response to such nuclides vary considerably with age or stage of development of the organism.
A. E. Barclay and angiographic research in Oxford
Authors: Guy J. M.
Published: July 2009

At the age of 60 years most doctors are cutting down on their work and looking forward to retirement. When Alfred Barclay (Fig. 1) reached that age he moved to a different university, set up a new research team and began fundamental research in new fields.

He had already achieved great distinction in radiology, beginning in the pioneer era. During his time as a medical student at the London Hospital in Whitechapel at the beginning of this century, and as a resident house officer, he witnessed the early radiographic efforts of Messrs Blackall, Harnack and Wilson, trailblazing in diagnostic and therapeutic radiology, who suffered painfully and eventually fatally for their zeal. Barclay himself visited the X-ray room to set fractures and remove foreign bodies, as all his young colleagues did, and experienced soreness of the eyes as a result, “luckily with no lasting effect”, which gave him a healthy respect for the power of the rays (Barclay 1949; BJR, 1949; Radiography, 1949).
A review of boron neutron capture therapy (BNCT) and the design and dosimetry of a high-intensity, 24 keV, neutron beam for BNCT research
Authors: Perks C. A. , Mill A. J. , Constantine G. , Harrison K. G. , Gibson J. A. B.
Published: July 2009

This paper reviews the development of boron neutron capture therapy (BNCT) and describes the design and dosimetry of an intermediate energy neutron beam, developed at the Harwell Laboratory, principally for BNCT research. Boron neutron capture therapy is a technique for the treatment of gliomas (a fatal form of brain tumour). The technique involves preferentially attaching 10B atoms to tumour cells and irradiating them with thermal neutrons. The thermal neutron capture products of 10B are short range and highly damaging, so they kill the tumour cells, but healthy tissue is relatively undamaged. Early trials required extensive neurosurgery to expose the tumour to the thermal neutrons used and were unsuccessful. It is thought that intermediate-energy neutrons will overcome many of the problems encountered in the early trials, because they have greater penetration prior to thermalization, so that surgery will not be required. An intermediate-energy neutron beam has been developed at the Harwell Laboratory for research into BNCT. Neutrons from the core of a high-flux nuclear reactor are filtered with a combination of iron, aluminium and sulphur. Dosimetry measurements have been made to determine the neutron and gamma-ray characteristics of this beam, and to monitor them throughout the four cycles used for BNCT research. The beam is of high intensity (∼2×l07 neutrons cm−2s−1, equivalent to a neutron kerma rate in water of 205mGyh−1) and nearly monoenergetic (93% of the neutrons have energies ∼24keV, corresponding to 79% of the neutron kerma rate).
High-resolution computed tomography in pulmonary cystic fibrosis
Authors: Hansell David M. , Strickland Basil
Published: July 2009

Twenty-one patients with established cystic fibrosis were examined using high-resolution, narrow-section computed tomography. The bronchiectasis of cystic fibrosis is described and is shown to be characteristic in many respects. Computed tomography was found to be more accurate than standard radiography in locating the disease process and demonstrated pleural involvement which was not apparent on chest radiographs.
Book reviews
Authors: Hansell David
Published: July 2009

This book is the second in a series of Handbooks of Diagnostic Imaging produced by the American division of Churchill Livingstone. If this handsome volume is anything to go by the rest of the series will be worth waiting for. The layout is pleasing and the contents are logically divided into eight chapters. Each chapter begins with a brief consideration of normal anatomy followed by subsections relating to specific diseases rather than to methods of imaging.