bluuebunny/crossref_metadata_2025 huggingface dataset:
Submarine escape training, lung cysts and tension pneumothorax
Authors: Saywell W. R.
Published: July 2009

Submariners in the Royal Navy are required to undergo escape training, which is performed in a water-filled tower. Entry is gained via air-locks at depths of 9, 18 and 27 m. The subjects ascend to the surface exhaling continuously to compensate for the increased gas volume in the lungs as the pressure decreases. Divers are in the water as safety attendants, and a medical team including a doctor is on standby. Prior to escape training, chest radiography is performed in full inspiration and full expiration. Particular attention is paid to areas of reduced compliance (e.g. scarring) and evidence of airtrapping, either of which may pre-dispose to pulmonary barotrauma (Liebow et al, 1959; Campbell-Golding et al, 1960; Calder, 1985).

The subject of this report is a 21-year-old man who had an apparently normal chest radiograph (Fig. 1) and no significant previous medical history. He made an initial ascent from 9 m, during which he experienced transient right-sided chest pain. Examination by the Medical Officer revealed no abnormality and a further ascent from 9 m was made. On completion of this ascent he emerged from the water pale and unsteady, complaining of dizziness and diplopia, but with no evidence of chest pain or dyspnoea. He was immediately recompressed to 50 m. A Medical Officer entered the compression chamber and found evidence of barotrauma to the ears, but no other abnormalities.
The misleading pre-operative chest radiograph
Authors: Ipinyomi Janet , Watt Iain
Published: July 2009

A 66-year-old man presented to the Accident and Emergency Department with pain in the right hip and difficulty in weight bearing after falling in the street that morning. He smoked about 15 cigarettes a day and had a wheeze which was relieved by Salbutamol. No other relevant history was elicited, apart from a vague story of ill defined upper chest pain in the past.

On examination he was observed to walk with a limp. His right hip was externally rotated, with limitation of movement because of pain. His right lower limb was 2 cm shorter than the left. Radiographs of the pelvis and chest and an apical view are shown in Figs 1 and 2 and frontal tomography of the chest was subsequently performed (Fig. 3).

What are the abnormalities demonstrated? What differential diagnosis should be considered and what might skeletal scintigraphy reveal?

A bone scintigram was performed a few days after admission to hospital. The right femoral head was imaged to assess vascularity (Fig. 4).
The unseen radiation hazards of ultrasound
Authors: Havard A. C.
Published: July 2009

The 1985 Ionizing Radiations Regulations (Health & Safety Commission, 1985) state that the dose limit for the abdomen of a pregnant woman shall be 10 mSv (1.0 rem) during the declared term of the pregnancy. If the declared term of the pregnancy is taken as 40 weeks and the women works a 40-h week, this figure works out to a dose limit of 50 μSv(5.0 mrem) per working day. Assuming a 36-week or 30-week declared term the dose limits would be 55.6 μSv (5.56 mrem) and 66.7 μSv (6.67 mrem), respectively, per working day. The National Radiological Protection Board (NRPB) in their recent publication Interim Guidance on the Implications of Recent Revisions of Risk Estimates and the IRCP 1987 Como Statement (NRPB, 1987), have made recommendations that all radiation workers keep within an average of 15 mSv (1.5 rem) effective dose-equivalent per year. This brings all workers down to the current legal maximum dose-rate during pregnancy.
The relation of radionuclide uptake by bone to the rate of calcium mineralization. I: Experimental studies using 45Ca, 32P and 99Tcm-MDP
Authors: Budd R. S. , Hodgson G. S. , Hare W. S. C.
Published: July 2009

The study of the uptake of radionuclides by bone has been undertaken in a mouse tail graft model using 45Ca, 32P and a routine bone scanning agent 99Tcm-MDP, together with serial calcium determinations. The model provided an experimental system in which the calcium mineral content and the rate of mineralization both changed progressively throughout its development. A significant linear correlation was found between 45Ca and 32P uptake and the rate of calcium mineralization, which held for all stages of the graft's growth. Both radiotracers therefore accurately reflected the calcium mineral deposition. In the case of 99Tcm-MDP, the correlation with mineralization rate only applied for the most active growth period of the graft when the rate was increasing. For all radiotracers, the peak in bone uptake corresponded to the maximum in mineralization rate.
The relation of radionuclide uptake by bone to the rate of calcium mineralization. II: Patient studies using 99Tcm-MDP
Authors: Budd R. S. , Hodgson G. S. , Hare W. S. C.
Published: July 2009

The relation of radionuclide uptake by bone and rate of calcification has been studied in normal vertebrae and in vertebral metastases from cancer of the prostate. Specifically, the determination of 99Tcm-MDP uptake by radionuclide scanning and the estimation of calcium concentration of trabecular bone by dual-energy computed tomography have provided the means of obtaining a relation between these parameters which was similar to that found in an animal model, in which the dependence of radionuclide uptake on the rate of mineralization was established. This relationship has enabled the experimental findings to be extrapolated to those in patient studies and has shown that in sclerotic bone lesions, the increase in 99Tcm-MDP uptake accompanying the progression of the metastases was proportional to the rate of calcification.
Treatment of persistent and recurrent nasopharyngeal carcinoma by brachytherapy
Authors: Sham J. S. T. , Wei W. I. , Choy D. , Ho C. M. , Tai P. T. H. , Choi P. H. K.
Published: July 2009

The early results of brachytherapy for persistent and recurrent nasopharyngeal carcinoma in 30 patients is presented. Fifteen patients were treated by intracavitary caesium, 12 patients were treated by interstitial gold grain implant using the splitpalate approach and three patients were treated by both intracavitary caesium and interstitial gold grain implant for the first and second relapse in the nasopharynx, respectively. The overall tumour control rate for intracavitary caesium was 5/18 (28%) with median follow-up of 25.2 months, and for interstitial gold grain implant it was 9/14 (64%) with median follow-up of 16.5 months. Interstitial gold grain implantation appears to be effective in the treatment of persistent and recurrent nasopharyngeal carcinoma.
Dysplastic cortical hyperostosis: a new form of lethal neonatal dwarfism
Authors: Kozlowski K. , Tsuruta T.
Published: July 2009

A new form of lethal neonatal dwarfism is reported. The name of dysplastic cortical hyperostosis is proposed for this entity. A Japanese, stillborn, male infant was delivered by a 28-year-old mother by a caesarean section after 28 weeks gestation. The pregnancy was complicated by polyhydramnios (2000 ml).

The mother was not exposed to any teratogenic agent. There was no parental consanguinity nor was there a family history of short stature or bone disease. No details of the father's age or the number of siblings were available.

At autopsy, it was found that the infant weighed 2900 g, crown-heel length was 37.7 cm and head circumference 37.4 cm. There was shortening of both the trunk and extremities and there was considerable oedema (Fig. 1).

The lungs were hypoplastic (left 2.7 g, right 3.0 g) with incomplete lobulation of the right lung. The cerebral sulci were poorly developed (? lissencephaly). There was complete renal duplication on the left and the orifice of the right coronary artery was high in position. Hepatosplenomegaly was noted.

The most striking radiographic finding was the generalized, symmetrical cortical thickening throughout the skeleton. This was most marked in the long bones and ribs, where the cortical thickening was wavy in outline. The medullary cavity was markedly narrowed. Similar sclerosis was seen in the clavicles and scapulae. The metacarpals and metatarsals had milder cortical sclerosis but in addition showed proximal tapering of the bones.
Haemoptysis in a laundry worker
Authors: Jackson J. E. , Allison D. J.
Published: July 2009

A 39-year-old man of Philipino origin, who moved to England in April 1986, presented in January 1987 to his local hospital, as an emergency, following a massive haemoptysis. He had suffered four smaller haemoptyses during the preceding 4 months. The patient denied any history of cough, sputum, chest pain or wheezing although he had noted mild dyspnoea on exertion and had smoked until about 1 year previously. Bronchoscopy on admission revealed friable mucosa but no actual bleeding. He was subsequently referred to this hospital for further investigation.

Physical examination was unremarkable. Baseline laboratory investigations revealed only a mild microcytic anaemia and his arterial blood gases were normal. The chest radiograph on admission (Fig. 1) and a ventilation/ perfusion lung scan (Fig. 2) are shown below.
Effect of cirrhosis on accuracy of 99Tcm-tin colloid scintigraphy and ultrasound scanning in diagnosis of hepatocellular carcinoma
Authors: Goldfarb C. Richard , Ongseng Fukiat , Finestone Howard
Published: July 2009

As diagnostic imagers for the largest alcohol detoxification institute in the United States, we were interested in the report by Dr Powell-Jackson and associates (1987), which compared the accuracy of radiocoUoid scintigraphy and ultrasound in the diagnosis of hepatocellular carcinoma (HCC) in cirrhotics.
Book reviews
Authors: Wells P. N. T.
Published: July 2009

People wanting to be familiar with scientific studies of the bioeffects of ultrasound will certainly find it helpful to have critiques of more than 50 recently published papers on the subject. The “Watchdog Group” of the European Federation of Societies for Ultrasound in Medicine and Biology has met annually since 1979. One of the tasks of the nine members of the Group is continuously to assess the existing documentation, particularly in relation to any new evidence that might modify existing conclusions and recommendations.
Book reviews
Authors: Phelps Peter
Published: July 2009

In the previous two decades, polytomography provided the ultimate imaging mode for fine bone detail, but as Hounsfield correctly foresaw, computed tomography with its greater disciminatory efficiency could supplant polytomography when thin sections and reduced pixel size became available. This dramatic improvement in spatial resolution took place in the early 1980s. Meantime, soft-tissue density discrimination, the original forte of CT, has now to some extent passed to magnetic resonance. Thus the challenge of spatial resolution for the demonstration of small osseous structures within the petrous temporal bone is now by CT.
Book reviews
Authors: Dubbins P. A.
Published: July 2009

When I reviewed the first edition of this book, I remarked that I was looking forward to Volume II. Perhaps my only disappointment about this second edition is that it does not represent a second volume. The presentation and format are the same as in the first edition.
Book reviews
Authors: Gowland M. R.
Published: July 2009

As an atlas this book is devoted almost entirely to images with little accompanying text. The format is the same throughout, anatomic cross sections with ultrasound and/or magnetic resonance (M R) images of the same section on the right-hand page and explanatory line diagrams of that section on the left-hand page.
Book reviews
Authors: Duncan Andrew W.
Published: July 2009

This book, according to the preface, was written with the aim of giving the paediatrician or the general practitioner with a significant paediatric workload, a comprehensive approach to the diagnostic imaging investigations in clinical problems. The cover also adds that it would give the radiologist a view of paediatricians' problems.
Book reviews
Authors: Fixsen J. A.
Published: July 2009

The stated aim of this book is to give a review of the present state of knowledge of congenital dislocation of the hip and it succeeds admirably. It is aimed at all those with an interest in congenital dislocation and dysplasia of the hip, but particularly orthopaedic surgeons and radiologists. It is a mine of information and beautifully illustrated. There is a wealth of detail on the anatomy of the hip and its radiology and an important chapter on ultrasound.
Book reviews
Authors: Owen Philip
Published: July 2009

The first edition of this work was called X-ray Diagnosis and, in the words of the authors, “covered the subject of conventional radiology in reasonable detail but provided only a few pages on the imaging modalities”. I confess that I never read it, but feel confident that this new edition fully justifies the title Diagnostic Imaging.

Aimed at medical students and young doctors in training, it is destined to achieve a pre-eminent position on their bookshelves. I am amazed that a hard-backed book, so lavishly illustrated, can be offered at a price of only £19.80.
Book reviews
Authors: Sherwood Thomas
Published: July 2009

My comments follow those of a final-year elective medical student, using the book during a period of intensive radiological study. I have had the volume by my side in everyday work for some weeks, and referred to it often. My first reaction is to take my hat off to the author's prodigious industry and inventiveness.
Doppler ultrasound in medical diagnosis
Authors: Wells P. N. T.
Published: July 2009

Christian Andreas Doppler (often erroneously called Johann Christian) was born in Salzburg on 29 November 1803. The paper that made his name famous, “On the coloured light of the double stars and certain other stars of the heavens”, was presented on 25 May 1842 and published in the following year (Doppler, 1843). At that time, Doppler was Professor of Mathematics and Practical Geometry at the Technical Institute in Prague; he subsequently held appointments in Schemnitz and Vienna, and died in Venice on 17 March 1853. A full account of these events can be found in an article by Eden (1986).

Even more intriguing than Doppler's paper is the fact that Doppler was wrong! An Englishman, James Bradley, one-time Vicar of Bridstow, near Ross-on-Wye in Monmouthshire, had earlier published an article concluding that “when the Eye is moving in different Directions, the apparent Place of the Object would be different.” (Bradley, 1729). Doppler used this as the starting-point for his explanation of the effect of relative motion between a source of white light and an observer—a shift towards the blue for an approaching source, and towards the red for a receding source—but he overlooked the then already known fact that the radiation from a visible star extends on each side of the visible spectrum into the ultraviolet and the infrared.
Platinum chemotherapy, radiotherapy and the inner ear: implications for “standard” radiation portals
Authors: Kirkbride P. , Plowman P. N.
Published: July 2009

In this centre, platinum chemotherapy precedes radiotherapy in several primary malignancies arising in structures adjacent to the mastoid bone. The augmented ototoxicity of platinum and radiotherapy to fields encompassing the inner ear is exemplified by a case report. The order of administration may not be critical. This important toxicity, particularly for young patients, may be reduced by careful shielding considerations during planning of radiation portals, as exemplified in two further cases, and by carboplatin chemotherapy.
In vivo viability of 111In-labelled granulocytes demonstrated in a sham-dialysis model
Authors: Becker W. , Schaefer R. M. , Börner W.
Published: July 2009

In seven febrile patients undergoing regular dialysis treatment, sham-dialysis with a dialyzer equipped with a cuprophane membrane was performed during a routine 111In-oxine white blood cell scan with “pure” granulocytes isolated on a discontinuous gradient (Percoll/plasma: n = 5; Metrizamide/plasma: n =2). The patients were in contact with the cuprophane membrane over 45 or 90 min. Twenty-five (±5) minutes after the start of the dialysis, the peripheral leucocyte count (59 ± 22%) and the 111 In activity in the peripheral blood decreased to a minimum of their initial range (64 + 21%) because of leucocyte activation. The activity over both lungs increased symmetrically (29+ 15%), the spleen activity decreased (14.8 + 8%) and the liver activity remained constant. At the end of the dialysis (45—90 min post-injection), the number of circulating neutrophils, peripheral 111In activity and activity distribution in the organs regained their initial level. In conclusion, these data confirm previously described data concerning the sequestration of neutrophils into the lung during dialysis treatment. The data demonstrate the origin of the activated neutrophils in the circulation and the spleen. The identical behaviour of 111In-oxine-labelled and unlabelled granulocytes is demonstrated. Additionally, the accumulation of activity in the spleen is due not to opsonized cells but to sequestrated neutrophils, which are able to migrate from the spleen after adequate activation. The migration of activated cells into the lung explains the diagnostic difficulties posed by diffuse lung uptake in leucocyte scans in patients with leucocyte-activating diseases.
An alignment test jig for measuring the effective focal-spot size of mammographic X-ray tubes
Authors: Ramsdale M. L. , Hiles P. A. , Lawinski C. P.
Published: July 2009

Following publication of the Forrest Report (Department of Health and Social Security (DHSS), 1986) and with the implementation of a breast cancer screening programme in the UK, there is considerable interest in the technical aspects of mammographic systems. The equipment requirements for mammographic X-ray screening units have been identified (DHSS, 1987) and guidance on the commissioning and routine testing of mammographic X-ray equipment is also expected (Institute of Physical Sciences in Medicine (IPSM), 1989). These documents relate to all aspects of the mammographic X-ray set including the specification and measurement of the size of the X-ray tube focal spot.

It is recommended (DHSS, 1987) that effective focalspot sizes are measured using a pair of slit radiograms in the manner described in BS 6530 (British Standards Institution (BSI), 1985). This standard provides details on the construction of the slit diaphragm and the geometry to be employed when performing focal-spot measurements. In particular, the method requires that the centre of the slit diaphragm and its axis of symmetry are aligned with the reference axis, which is defined as the line through the centre of the radiation source and parallel to the reference direction or that specified direction to which the characteristics such as target angle are referenced. The manufacturer should specify the reference axis when providing data on anode target angle and size of focal spot.
An isolated capitate fracture in a 9-year-old boy
Authors: Gibbon W. W. , Jackson A.
Published: July 2009

Fracture of the capitate in children is rare but probably underdiagnosed. Diagnosis may require delayed radiographs or, if clinical suspicion is high, alternative investigations such as tomography or radionuclide bone scanning may be helpful. The presence of scaphoid tenderness should not reduce suspicion of a possible capitate fracture. The relatively high incidence of quite serious complications in both scaphoid and capitate fractures should alert one to the possibility of carpal bone fractures even in children.
Splenic accumulation of 99Tcm-methylene diphosphonate
Authors: Alevizaki C. , Georgiou E. , Nikiforakis E. , Proukakis C.
Published: July 2009

The case reported by McHugh et al (1988) refers to their interesting observation that in a patient with chronic lymphocytic leukaemia, complicated by a Coombs-positive haemolytic anaemia, 99Tcm-MDP(methylene disphosphonate), a bone scanning agent, was selectively concentrated in the spleen.
The cost of imaging procedures
Authors: Day M. J.
Published: July 2009

Dr Jeans (1989) is of course quite right to draw attention to the benefits as well as the possible harm resulting from diagnostic radiology.
Book reviews
Authors: Tindall V. R.
Published: July 2009

This meeting dealt with carcinoma of the cervix in developing countries. Amongst other aspects, the book considers the relationship between the different cultures of the respective countries, the high incidence of the condition, the difficulty in screening and why most women present in the late stages.
Book reviews
Authors: Gleeson J. A.
Published: July 2009

It was to be expected that the advent and use of the newer methods of imaging would alter the content and format of the new edition of what was formerly known as A Textbook of X-ray Diagnosis.

The changes are major and reflect clearly the beliefs and clinical practice of the editor and the numerous contributors from both Britain and North America.
The production of chromosome structural changes by radiation: an update of Lea (1946), Chapter VI
Authors: Savage John R. K.
Published: July 2009

No one can read the papers of the early radiation biologists without being impressed, almost awed, by the depth and thoroughness with which they tackled their topics. Every ounce of information is extracted from the results, every possible avenue of interpretation and implication is explored.

Douglas Lea's Actions of Radiations on Living Cells (first edition, 1946) is a classic example. It is a work that has had a profound influence on radiobiology and is still widely quoted today.

Many of Lea's fundamental concepts were based on the qualitative and quantitative production of visible chromosome structural changes, particularly in the plant Tradescantia. In accord with Sherlock Holmes' aphorism, before theorizing, he summarizes and evaluates in Chapter VI the experimental facts. In the intervening years an enormous amount of radiation cytogenetics has been done and it is fair to ask the question “How stands the foundation?”. I do not intend to review the whole field in this paper but, using the same section headings Lea used, to comment on and update, in the light of more recent work, some of the statements and ideas he developed. The format of the comments presupposes that the reader has a copy of Lea (1946) to hand.†

Before looking at the individual sections, it will be helpful to describe some of the conceptual changes that have occurred since Lea wrote his book and that influence current thinking.
Comparison of techniques for thallium-201–technetium-99m parathyroid imaging
Authors: Brownless S. M. , Gimlette T. M. D.
Published: July 2009

It is impracticable to compare the variety of techniques advocated for thallium–technetium (Tl–Tc) subtraction parathyroid imaging by repeated studies in patients. We therefore carried out studies using a phantom assembly to simulate thyroid and parathyroid in the neck, containing activities of 99Tcm and 201T1 similar to those likely to be present in patient imaging. An initial study of imaging protocol confirmed that correction for scatter from 99Tcm in the 201T1 window usefully improved the image. After making a preliminary selection of gamma cameras and collimators it was found that the GE Maxicamera 400T just visualized the 0.3 g “parathyroid” in a 5 min image with the pinhole collimator and 6 mm insert (A). It performed slightly less well with the HR converging collimator (B) and only marginally better with the 4 mm insert (C), but this is unduly slow unless it is placed close enough to limit the field of view unacceptably. The Siemens Orbiter 75 ZLC with special thyroid collimator (D) gave results similar to (A), is convenient for positioning the patient and is very suitable for parathyroid imaging.
Spontaneous abrupt changes in the distribution of ventilation: a cause for apparent mismatching on ventilation/perfusion scintigraphy
Authors: Peters A. M. , Gordon I. , Kaiser A. M. , Arnot R. N. , Lavender J. P.
Published: July 2009

A defect seen in the perfusion scan in a region of lung that is normally ventilated is usually interpreted as indicating pulmonary vascular disease. Since the distribution of 99Tcm macro-aggregated albumin (MAA) represents the distribution of perfusion (Q) only at the time of MAA injection, the assumption is required that the distribution of ventilation (V) remains unchanged between MAA injection and the commencement of imaging. We report the V/Q scintigraphic findings in six patients (including four children), in whom this assumption could not be sustained. Thus ventilation imaged with 81Krm was seen to change during image acquisition in lobes that showed perfusion abnormalities. In some, but not all, views the appearances were typical for pulmonary vascular disease, which might easily have been misdiagnosed if the changes in the distribution of ventilation had not announced themselves by occurring during image acquisition. A ventilation image obtained immediately before injection of 99Tcm-MAA may be useful.
Congenital ureteric diverticula in children and adults: classification, radiological and clinical features
Authors: Sarajlić M. , Durst-Zivković B. , Svoren E. , Vitković M. , Batinić D. , Bradić I. , Vučković I.
Published: July 2009

To date, about 100 cases of a blind-ending branch of a bifid ureter have been reported. We present 13 clinically, radiologically and histologically evaluated cases of congenital ureteric diverticulum. We believe this anomaly is not as rare as hitherto believed and suggest the term congenital ureteric diverticulum for a blind-ending branch of a bifid ureter.
Biological equivalence between fractionated radiotherapy treatments
Authors: Deehan C. , O'Donoghue J. A.
Published: July 2009

Mills and Martin-Shaw draw attention to a feature of the equations for general equivalence of fractionated radiation schedules (Equations 9 and 10, Deehan & Donoghue, 1988), which is implicit in the equations themselves and evident in the worked examples, although it is not explicitly stated in the paper. This is, that given a uniform schedule and a heterogeneous schedule that are generally equivalent, i.e. independent of α/βt ratios, the heterogeneous schedule must have a greater total number of fractions.
Book reviews
Authors: Pilling D. W.
Published: July 2009

This atlas, the senior author of which is well renowned for other texts on normal variants and radiological measurement, sets out to demonstrate the normal radiological appearances at all ages from birth to 20 years.
Book reviews
Authors: Davies A. M.
Published: July 2009

As indicated in the title, this is an atlas consisting of plain radiographs paired with explanatory line diagrams. The first third of the book is on normal skeletal anatomy and bone trauma. The remainder covers bone radiology in a conventional manner, with chapters on infection, joint diseases, bone tumours, etc.
Book reviews
Authors: Rubens M.
Published: July 2009

The author's intention is to provide physicians with a step-by-step guide to radiograph analysis. This is attempted by advising the reader to evaluate seven aspects of the chest radiograph. These are lung aeration, the parenchyma, vascular structures, the trachea and mediastinum, the pleura, the position of tubes and catheters and finally the soft tissues, bony structures and upper abdomen.
Book reviews
Authors: Galasko C. S. B.
Published: July 2009

This book consists of a series of clinical photographs and radiographs illustrating a wide variety of orthopaedic conditions. The book is set out in the form of questions and answers, one or more questions being posed after each clinical photograph, radiograph, or paired clinical photograph and radiograph. The answers are given at the back of the book.
Book reviews
Authors: Maddison I. D.
Published: July 2009

The book is a densely written essay concerning the application of computers in all fields of medical interest. It is an attempt to cover the field in as wide and useful a way as possible. Diagrams are used, where appropriate. The book does not claim to contain all the pertinent facts and excessive detail is restricted so that the book remains portable and less likely to be rendered obsolete by developments at the advancing fringe of particular specialties.
Acute aorto-iliac thrombosis in a young man shown on unenhanced computed tomography
Authors: Adler Julian , Robey Geoffrey
Published: July 2009

The detection of acute arterial thrombosis on unenhanced computed tomography (CT) at several sites, particularly the intracranial vessels, has been previously documented (Gacs et al, 1983; Vonofakos et al, 1983; Matsumura et al, 1987; Pressman et al, 1987; Hankey et al, 1989). We report a case of acute aorto-iliac thrombosis in a young man in which the typical changes were observed retrospectively in the aorta and left common iliac artery.
No way out
Authors: Guest P. J. , McLean A. , Graham N.
Published: July 2009

A 51-year-old man presented with a 2-week history of painless haematuria following which he had experienced some severe pain in the right groin. Examination was unremarkable. The control radiograph of an intravenous urogram is shown (Fig. 1). Intravenous contrast medium demonstrated diffuse parenchymal loss of the right kidney with partial obstruction of the right ureter. A spot radiograph taken during screening of the lower right ureter is also shown (Fig. 2). Computed tomography (CT) of the pelvis was subsequently performed, which demonstrated the lesion (Fig. 3).
Are the results of the St Thomas' trial of post-mastectomy radiotherapy inconsistent with the predictions from the linear-quadratic model?
Authors: Bentzen S. M. , Thames H. D.
Published: July 2009

The St Thomas' experience in post-mastectomy radiotherapy (Bates, 1975; Bates & Peters, 1975) became one of the cornerstones in demonstrating that the nominal standard dose (NSD) formalism (Ellis, 1969), in general, underestimates the deleterious effect of large dose fractions on late-responding normal tissues. It is therefore with interest that we read the 10- year update of the treatment results in this series in the July 1988 issue of BJR (Bates, 1988). There are, however, several points where this paper is at variance with the experience from other clinical radiobiological analyses published in the last few years. We would like to discuss briefly some of these.
Intraoperative localization of an osteoid osteoma
Authors: Todd B.
Published: July 2009

We thank Dr Thomas for his comments. On reviewing plain radiograph in question we agree that the distal half of capitate is sclerotic.
Book reviews
Authors: Forbes W. St. C.
Published: July 2009

The authors' stated aim was to produce a book that was “a synthesis of clinical, pathologic, and radiologic approaches to cranial and cerebral diseases… needed by both the paediatrician and the radiologist”. In this the authors, a paediatric neurologist and a neuroradiologist, admirably succeeded, providing an excellent, authoritative and comprehensive text successfully combining the clinical, radiological, developmental and pathological aspects of paediatric neurological diseases.
Book review
Authors: Field S. B.
Published: July 2009

The third edition of this well known book contains 5% more illustrations and 25% more pages than the previous edition. Nearly 25% of the illustrations are completely new and many of the previous diagrams have been redrawn.
Screening for breast cancer: the UK scene
Authors: Forrest A. P. M.
Published: July 2009

Sir James McKenzie Davidson was born in 1856, 39 years before Röntgen discovered X rays. A graduate of the University of Aberdeen, his initial training was in surgery (and what better for a future radiologist!) and ophthalmology. It was following a visit to Wurzberg that he decided to devote his energies to the new specialty of radiology and was appointed to Charing Cross and the Royal London Ophthalmic Hospitals. There he was instrumental in pioneering many new developments, including the use of stereoscopy for localizing foreign bodies, a method of great benefit to the wounded of World War I.

McKenzie Davidson continued to pioneer new developments up to his untimely death at the age of 63 years (Obituary, 1919; Burrows, 1986). Thirty of his colleagues, including Prime Minister Stanley Baldwin, set up a memorial fund, which was used to help purchase 32 Welbeck Street as a home for the Röntgen Society or, as it became in 1924, your British Institute of Radiology. Furthermore, his widow and family endowed this Memorial Lecture so that his name could be kept alive in radiological circles. And so it should be, for McKenzie Davidson was not only a pioneer and innovator but, from all accounts, a warm and generous man, bringing distinction to the field in which he was truly a founding father. It is a great honour to be invited to deliver this lecture in his memory.
A review of occupational exposure in the North-Western Region
Authors: Pratt T. A. , Sweeney J. K.
Published: July 2009

The Ionizing Radiations Regulations 1985 require employers to monitor all classified persons and to demonstrate that all non-classified persons who work in controlled areas do not exceed three-tenths (i.e. the classification level) of any relevant annual dose limit. A review of occupational doses was undertaken to ascertain whether any person needed to be designated as a classified person and to demonstrate compliance with the Regulation regarding non-classified staff working in controlled areas. The occupational-dose data for 1986 were compared with data for 1981 to identify any areas where changes in workload, equipment or techniques had led to increases in whole-body or organ doses. The results demonstrate that the level of whole-body occupational dose received by the vast majority of NHS employees in the North-Western Regional Health Authority is, as expected, extremely low. However, two specific areas were identified where occupational doses are relatively high and need to be carefully monitored. The review has also led to a number of operational changes being implemented by the Approved Dosimetry Service.
A technique for total skin electron irradiation using six large flattened electron beams: implementation on linear accelerators having different modes of electron beam production
Authors: El-Khatib Ellen Grein , Rymel Jurek , Al-Mokhlef Jazi
Published: July 2009

Total skin electron beam irradiation (TSEI) has been considered for the treatment of mycosis fungoides because of the special characteristics of the electron beam, delivery of a maximum radiation dose close to the entrance surface of the tissues and a rapid fall-off in dose beyond the maximum. However, delivering a homogeneous radiation dose over all surface areas of the human body is complicated. This problem has been dealt with in various ways by different institutions.

The use of TSEI dates back to the 1950s (Lo et al, 1979) and clinical studies at Stanford University have demonstrated that TSEI may lead to a long remission or even cure if it is used in the early stages of the disease (Hoppe et al, 1979). Techniques that have been developed to irradiate the entire body surface include the use of pairs of angled beams, two to eight in number (Karzmark et al, 1960; Karzmark, 1964, 1967, 1968; Edelstein et al, 1973; Hoppe et al, 1979; Nisce et al, 1981; Coffey et al, 1982; Fraas et al, 1983; Hogstrom et al, 1984), a pendulum arc technique (Sewchand et al, 1979), and more recently, patient rotation (Kumar & Patel, 1978; Podgorsak et al, 1983).

With the use of multiple fields, the depth–dose characteristics of electron beams are changed from those of a single field because of the oblique incidence of electrons (Bjarngard et al, 1977; Pla et al, 1988).
A rare diversion?
Authors: Wardlaw J. M. , Cruikshank J. G.
Published: July 2009

A 47-year-old man attended for a lymphogram in October 1986. In January 1983 he had been treated for a retroperitoneal teratoma with radiotherapy and chemotherapy. Response was good and he remained tumour-free until clinical examination, at routine follow-up in August 1986, revealed a left testicular mass. When excised, this proved to be a seminoma. Review of histology confirmed this to be a second primary tumour. In addition to computed tomography (CT), he was referred for staging lymphography.
Changes in relative biological effectiveness with depth of neutron beams
Authors: Hornsey S.
Published: July 2009

The comments of Professor Hall are both interesting and pertinent, and indicate that if we are to assess the biological and medical effects of neutrons accurately, we should measure relative biological effectiveness changes with depth not only prior to using a new neutron beam but whenever changes in target construction are made or new beam colimation is introduced.
Pioneer discovery of rare-earth fluorescence
Authors: Russell J. G. B.
Published: July 2009

Soon after Roentgen's discovery of X rays in 1895, calcium tungstate was found by Thomas Edison and others to be an excellent phosphor for use in diagnostic radiology. More recently, rare-earth phosphors have been used.
Book reviews
Authors: Wilde Peter
Published: July 2009

This book is a beautifully produced and illustrated atlas which fulfils the promise that one might expect from such distinguished authors. Volume 1 reviewed here is devoted to congenital heart disease and this has been covered as comprehensively as anyone might wish.
Book reviews
Authors: Pilling D. W.
Published: July 2009

Fetal echocardiography is gradually evolving and becoming more widely used and this atlas sets out to indicate the status of the technique at present. The introduction lists those patients for whom the technique is most appropriate and points out some of the conditions that cannot be excluded by the technique. A chapter follows on fetal heart anatomy and physiology with an extensive chapter on the methods of examination. The second half of the book is devoted to the abnormal fetal heart, and the book is completed with short sections on M-mode cardiography, colour flow mapping and Doppler ultrasound. The authors make the subject more complicated using a nomenclature relating the fetal heart position to the position of the fetus and of the fetus within the mother, which is both unnecessary and confusing.
Book reviews
Authors: Pilling D. W.
Published: July 2009

The authors have taken the data from most if not all the papers published on measurements in obstetrical ultrasound, and have critically analysed them. In some cases it has been necessary to reorganize the presentation of the data to give a consistent format and to enable some comparison of the value of the various papers.
Book reviews
Authors: Klngsley D. P. E.
Published: July 2009

In the preface to this book, Dr Elster comments that at the time it was written there was no available textbook devoted exclusively to cranial magnetic resonance imaging (MRI) and that he wished to distinguish established fact from opinion and uncorroborated data. There are now numerous textbooks available devoted to cranial imaging so how does this book differ from the others and has the author achieved his aim ?

The book is divided into 12 chapters, the first two consisting of the physical and technical parameters of MRI and the third and fourth being devoted to normal cranial anatomy and the congenital and developmental anomalies encountered.
Treatment of tumours of the parotid gland and middle ear using obliquely reconstructed computed tomographic images
Authors: Sims C. , Manifold I. H. , Conway J.
Published: July 2009

Conventional planning of radiotherapy of tumours of the parotid, middle ear and other tumours in the head and neck often requires the treatment plane to be non-transverse. This produces major problems in delineating the tumour as well as verifying that vital structures such as the spinal cord are not included in the target volume. The use of computed tomography (CT) generally overcomes some of these problems and we have developed an algorithm to reconstruct transverse CT images into the appropriate oblique plane. Software has been written on the Picker Independent Treatment Planning System (ITPS) to allow planning on central axis and off-axis oblique planes. In addition we have used a beam's eye view facility to aid in the verification process.
Squamous cell carcinoma of the base of the tongue: results of treatment in 115 cases
Authors: Calais Gilles , Reynaud-Bougnoux Agnés , Bougnoux Philippe , Le Floch Olivier
Published: July 2009

Between 1976 and 1986, we treated 115 patients (mean age 53.8 years) with base of tongue carcinomas. The staging system used was the UICC TNM classification of 1979. Seventy per cent of the tumours were T3 or T4 and 42% had N2 or N3 lymph nodes. Locoregional treatment was irradiation alone (98/115) or surgery and post-operative radiotherapy (17/115). Sixtyseven patients received induction chemotherapy. Actuarial survival of the entire group at 3 and 5 years was 25 and 23%, respectively, and 3-year actuarial survival rates for Tl, T2, T3 and T4 lesions were 42, 48, 20 and 17%, respectively. The local control rate at the primary site was 55% and 78% in the neck. Distant metastases occurred in 10% of patients and 8% had a second primary. Nodal status was the only other prognostic factor. The local control rate obtained with irradiation alone was not good. For limited Tl and T2 tumours, interstitial therapy or surgery should improve the local control rate.
Radiotherapy in the management of aggressive fibromatosis
Authors: Atahan I. Lale , Akyol Fadil , Zorlu Faruk , Gürkaynak Murat
Published: July 2009

Aggressive fibromatosis is a rare, slowly growing benign tumour arising from the fascial sheaths and musculoaponeurotic structures (Greenberg et al, 1981; Leibel et al, 1983). Its incidence is reported to be 25 in 100 000 (Greenberg et al, 1981; Leibel et al, 1983). This locally aggressive, non-encapsulated tumour is formed by the proliferation of benign fibroblasts. It extends along the fascial planes and infiltrates the adjacent muscles. Depending on its localization, it may cause erosion of the underlying or neighbouring bones and pressure on the blood vessels, nerves and air passages with related symptoms and restriction of movements of the extremities (Leibel et al, 1983; Raney et al, 1987). Distant organ and lymphatic metastases are very rarely encountered. The incidence of local recurrence following surgical excision varies between 40 and 50%, thus making radical surgical intervention an alternative treatment procedure (Suit & Russel, 1975).

In 1928, Ewing was the first to propose radiotherapy as a treatment modality for the management of cases not amenable to surgical resection. He described the radioresponsiveness of this tumour as “slowly but satisfactorily” (Leibel et al, 1983).
Biological equivalence between fractionated radiotherapy treatments using the linear-quadratic model
Authors: Deehan C. , O'Donoghue J. A.
Published: July 2009

Yaes et al suggest that the inclusion of a cell proliferation term with an explicit time dependence in the equations for general equivalence is a simple matter. In fact, they incorporate a time factor (in Equation 2) only to subsequently remove it (in Equation 6).
Outpatient myelography: an acceptable and cost-effective technique
Authors: Davies A. M.
Published: July 2009

Choudhri et al (1989) appear to have underestimated the literature on outpatient myelography with water soluble contrast medium. They only acknowledge the existence of two previous papers on the subject, but prior to 1988, there have been at least seven further pertinent publications (see below), some of which might have merited a passing mention.
Book reviews
Authors: Brindle M. J.
Published: July 2009

It is a pleasure to review this inexpensive, well produced, comprehensive and up-to-date book. In his foreword, the President of the Royal College of Radiologists, Professor Rhys Davies, writes that there is “a great need for this book”. Every radiologist who has been involved with a radiology department development will agree wholeheartedly. The book is based upon a series of articles which appeared in the Journal of the Royal Society of Medicine in 1987. Between the covers is everything you wanted to know about building or extending a radiology department but were afraid to ask. No issue is too small or too large.
Computed tomography of earpits-deafness syndrome
Authors: Ng Y. Y. , Bellman S. , Phelps P. D.
Published: July 2009

Earpits-deafness syndrome is a congenital syndrome in which branchial arch anomalies are associated with hearing loss. The inheritance is autosomal dominant, and the anomalies consist of any or all of the following: auricular deformities, pre-auricular pits or sinuses, branchial fistulae or cysts, external auditory meatus atresia and conductive or mixed hearing loss. Renal anomalies have also been described in association with the syndrome (Melnick et al, 1976; Cremers & van Noord, 1980).
The influence of tube type and operator experience on performance of small bowel enema
Authors: Martin Derrick F. , Nicholson David
Published: July 2009

Dr Bisset makes a number of points to which we wish to respond.

(1) The intubation technique for small bowel enema used by the authors was substantially as described by Nolan and Cadman (1987). We find this an effective technique, which is easy for trainee registrars to learn. It is also simple for the patient, as it requires the minimum of twisting and turning on the unyielding fluoroscopy table, which can be particularly difficult for the elderly, the infirm and the asthenic.
Book reviews
Authors: McCready V. Ralph
Published: July 2009

The Nuclear Medicine Annual for 1988 is the ninth in this series. Unlike the Year Book of Nuclear Medicine, it contains a number of reviews on subjects of current interest in nuclear medicine. The articles are of clinical rather than technical interest. The first is from the Guy's group reviewing the value of bone scintigraphy in breast cancer. It gives the background to bone scintigraphy and contains a series of valuable tables on the frequency of bone mestases, the relative efficiency of radiographs, isotope imaging and the relation between positive scans and survival—all useful information in the days of seeking ways of being cost effective.
Book reviews
Authors: Phelan M.
Published: July 2009

This 300-page textbook contains eight chapters on the liver, gallbladder, pancreas, spleen and the gastrointestinal tract. There is a chapter on interventional procedures and one on Doppler ultrasound in the gastrointestinal tract. This is the second book in this series on gastrointestinal ultrasound and is intended to provide an update for experienced ultrasonographers and to be useful to those in training.
Book reviews
Authors: Hugh A. E.
Published: July 2009

This is an excellent book. It is small, readable and cheap, and contains a lot of simple information which will be of great interest and value to every GP who picks it up, even if he only reads part of it, which is unlikely.

It is also of great interest in another way. The author has taken on the philosophy that, as every patient “belongs” to a GP, it is very important that not only GPs know what is likely to happen to their patients in hospital but also that GPs should recognize the radiologist as a front-line hospital referral specialist, whose proper use of very expensive diagnostic equipment can expedite the solving of patients' problems, and provide a much faster and better service to patients than the alternative referral to X-ray (imaging) departments only via medical or surgical outpatient departments.
Book reviews
Authors: White C. P.
Published: July 2009

The author of this book set out to discover whether there were any characteristic investigative findings in children with centrally mediated visual deficits that would perhaps help in the earlier identification of such deficits.

Twenty-six children and young adults were extensively investigated with detailed neurological and ophthalmological examinations, neuroradiological (computed tomography (CT) scans in all and magnetic resonance imaging (MRI) scans in five) and neurophysiological (opticokinetic nystagmography and visual evoked potentials) examinations.