bluuebunny/crossref_metadata_2025 huggingface dataset:
Plasma leukotriene C4and reactions to contrast media
Authors: Bester Lourens , Vellet Dale , Chetty Nanthakumarn , Atkinson Peter , Scher Alan
Published: July 2009

Forty-five patients were randomly divided into three groups of 15 and within each group patients were given iothalamate, iopamidol or ioxaglate intravenously during radiological investigations. The plasma leukotriene C4 level was measured before and 30 s and 3 min after the administration of the respective contrast media. In patients demonstrating nonidiosyncratic contrast reactions, a consistent decrease in plasma leukotriene concentration was noted at both 30 s and 3 min following the administration of all three contrast media. A statistically significant decrease in plasma leukotriene occurred at 30 s with ioxaglate, but not with the other two agents. In the limited number of patients who experienced idiosyncratic reactions, the decrease in plasma leukotriene concentration was less apparent. This decrease in plasma leukotriene concentration has been attributed to changes in plasma volume following administration of hyperosmolar contrast media. The inability to demonstrate an increase in plasma leukotriene levels following the administration of both conventional and new, low-osmolar radiographic contrast media supports the cumulative evidence against an allergic mechanism in the majority of non-idiosyncratic and some idiosyncratic contrast reactions.
Results of fast neutron therapy in advanced head and neck cancer
Authors: Skotyszewski J. , Korzeniowski S. , Huczkowski J.
Published: July 2009

Eighty-nine patients with advanced head and neck cancer were treated with a fast neutron beam of mean energy 5.6 MeV. The standard tumour dose was 1320 cGyn,γ in 20 fractions over 4 weeks, but 13 patients with laryngeal cancer received 1200 cGyn,γ. Complete remission was achieved in 50 patients (56%). Fifteen patients (17%) survived 2 years, 14 of them being symptom-free. Survival correlated with the stage of disease. Encouraging results were obtained for cervical node metastases, oropharynx and salivary gland cancer. In laryngeal and hypopharyngeal cancer, neutron therapy seems to be disadvantageous. The main reason for treatment failure was local recurrence. Two patients died of complications.
Increased 252Cf therapeutic advantage for an advanced murine lymphoma (LSA) growing in vivo
Authors: Maruyama Yosh , Darwazeh Nabil B. , Magura Clara
Published: July 2009

The relative biological effectiveness (RBE) was determined for252Cf irradiation of the murine LSA lymphoma growing in vivo. Irradiation was performed on Days 1–3, i.e. on the young and rapidly growing tumour, on Day 5, i.e. the early stationary phase, or on Day 7, i.e. the advanced tumour. Mice inoculated with 105 cells would die on about Day 9 with disseminated tumour if untreated. Irradiation with acute 60Co or low-dose-rate 252Cf total-body irradiation increased the mean survival time (MST). For 252Cf the MST increased linearly with dose, the effectiveness being independent of the day of irradiation. For 60Co, the MST increased linearly with dose for the tumours irradiated on Days 1–3 but two-component curves were noted after irradiation on Days 5–7. Tumour response showed an increasing photon–resistant component which gave no increase in MST with dose. The RBE was ∼ 4 for the early tumours but was greater than 5 for the advanced and more photon-resistant tumours. 252Cf was effective for the treatment of early or advanced stages but was especially effective against the advanced, more radioresistant tumours.
Pycnodysostosis with right heart failure due to hypoplastic mandible and chronic upper airway obstruction
Authors: Fitzgerald T.
Published: July 2009

Pycnodysostosis is a rare condensing bone dysplasia of recessive inheritance and well over 50 cases have now been reported.

Two further illustrative cases are now reported, one with the unusual feature of right heart failure, occurring in an 18-month-old child, as a result of micrognathism. This has been described previously as a serious clinical feature only once, by Maroteaux and Faure (1973), in one of their series of cases. The second case illustrated is of an 18-year-old woman with a more typical, uncomplicated presentation.

A brief discussion of the findings in pycnodysostosis is appended.

An 18-month-old Asian girl presented to the Children's Hospital with respiratory difficulties. The pregnancy had been normal, and her birth weight was 3 kg. At delivery, the umbilical cord was noted to be short.

Her parents were first cousins, and the paternal grandparents had also beenfirst cousins.

An enlarged posterior fontanelle was described in the neonatal period, withwidened sagittal sutures and a micrognathic appearance.

She was managed at home for the first few months, but was always difficult to feed. On her first admission, she had difficulty in breathing, especially during feeds, and although there had never been obstructive episodes, shehad always been a noisy breather. She required tube feeding and very careful oral feeding but eventually was able to swallow reasonably normally from about 6–7 months of age.
A variant of the Mirizzi syndrome
Authors: Prober A. , Cozacov C. , Barkai M.
Published: July 2009

Common hepatic duct obstruction, secondary to a stone impacted in the cystic duct or gallbladder neck, and associated inflammation is an uncommon cause of biliary obstruction known as the Mirizzi syndome (Mirizzi, 1948). We report a case in which a stone, lodged in an enlarged Hartmann's pouch,caused obstruction of the common hepatic duct. The case is unusual in that the stone impressed the medial aspect of the common hepatic duct.
Portal and hemiazygos continuation of the inferior vena cava: report of an unusual case
Authors: Ghossain Michel A. , Haddad Soha N. , Aoun Noel J. , Atallah Nagi G. , Jebara Victor A. , Moussally Aida S. , Boustany Fouad N.
Published: July 2009

In infrahepatic interruption of the inferior vena cava (IVC), continuation is usually through the azygos or hemiazygos systems (Chuang et al, 1974; Smathers et al, 1982; Mayo et al, 1983). Recently, Bercoff et al (1985) described the first case of portal continuation. We observed such an anomaly in a patient who had a single left-sided IVC with hemiazygos-azygos continuation, and a shunt between the portal and hepatic systems. To our knowledge nosuch complex anomaly has yet been reported.
Adverse reactions to contrast media: related to medium or procedure? Observations on a case
Authors: Hald John K. , Jakobsen Jarl Å. , Andrew Erik , Stormorken Helge
Published: July 2009

Adverse reactions to intravascular contrast media are well documented (Andrews, 1974; Ansell, 1976; Lalli, 1980; Shehadi & Toniolo, 1980). However, allergic and toxic reactions to drugs have to be differentiated from adverse reactions to the procedure. To illustrate this, we report the following.

In a Phase I tolerance and pharmacokinetic study, iopentol (Nycomed AS), a new 3.0 non-ionic contrast medium, was to be injected into 24 healthy male volunteers (Aakhus et al, 1987). As part of the study, eight subjects received normal saline intravenously. One of the volunteers was a 30-year-old healthy male. On the trial day, approximately 30 s after the start of the injection of normal saline into his left cubital vein, an adverse reaction occurred (Table I). The subject became pale and dizzy. Three minutes after venepuncture, the blood pressure had fallen to 69/45 mm Hg and the electrocardiogram (ECG) showed absence of the P-wave. The heart rate dropped slightly and the pulse was weak. The condition gradually improved and after 10 min the ECG was normal and blood pressure 121/68 mm Hg. No specific treatment was given. The results of some of the blood tests taken in connection with the trial appear in Table II.
Book reviews
Authors: Thompson D.
Published: July 2009

This book is a compilation of papers on medical imaging presented at a NATO Advanced Study Institute meeting held in Maratea in Italy in the early autumn of 1984. Contributions were made by more than 60 groups of authors from Western Europe and the USA.

The brief introduction argues that research in medical imaging is a sound investment in health care.
Magnetic resonance imaging with even-echo rephasing sequences in the assessment and management of giant intracranial aneurysms
Authors: Jaspan T. , Wilson M. , O'Donnell H. , Worthington B. S. , Holland I. M.
Published: July 2009

The role of magnetic resonance imaging in the assessment of giant intracranial aneurysms was compared with angiography and contrast-enhanced computed tomography (CT) in 18 patients. The use of T  1 -and T  2-weighted spin-echo (SE) sequences demonstrated both the presence and the evolution of thrombus within these lesions. High-velocity flow within the parent vessels and still-patent lumen could be defined as an area of absent signal. The use of even-echo rephasing (EER) sequences provided a rapid technique for demonstrating and confirming the presence of luminal flow, which is shown as areas of high signal The combination of SE and EER techniques proved superior to CT in the assessment of thrombus and flow patterns in these lesions, as well as enabling superior demonstration of the patency of the parent vessel following surgical ligation. Computed tomography remains the most accurate method of defining the presence and location of associated calcification.
Visceral angiographic findings in pseudoxanthoma elasticum
Authors: Belli A. , Cawthorne S.
Published: July 2009

Two cases of pseudoxanthoma elasticum are described in brothers who both presented with gastric haemorrhage. The angiographic findings demonstrate the spectrum of vascular abnormalities seen in this condition. Although rare, the combination of angiomatous malformations, aneurysmal dilatation, narrowing and/or occlusion of visceral or peripheral arteries in a relatively young patient with abdominal pain or gastrointestinal bleeding, should alert the radiologist to the diagnosis. Examination will usually reveal the characteristic xanthomatous papular rash and retinal angioid streaks which confirm the diagnosis.
Lateral thigh varicose veins: a phlebographic study
Authors: Thomas M. Lea , Chan O.
Published: July 2009

The phlebographic findings in nine patients with primary varicose veins on the lateral aspect of the thigh are described. These were shown by varicography to connect primarily with the deep femoral vein via communicating veins: the symptoms were either cosmetic or mild aching in the thigh. Surgical treatment, if indicated, consists of subfascial ligation or sclerosis of the varices, or flush ligation of the incompetent communicating veins at their connections with the deep femoral vein.
Regional blood flow in human tumours measured with argon, krypton and xenon
Authors: Mäntylä M. , Heikkonen J. , LicPhil  , Perkkiö J.
Published: July 2009

Blood perfusion in 19 superficial tumour metastases was measured by injecting three tracers, 41Ar, 85Krm and 135Xe or 133Xe, simultaneously into the tissue. The blood flow rate was calculated from the constants of the biexponential functions fitted to the measured counts. The mean blood flow in the 19 tumours studied was 18 ml/(100 g min) (SD + 10). Alternatively, the relative partition coefficients of argon, krypton and xenon were calculated from the equations obtained using compartmental analysis. The mean values for the ratios of the partition coefficients of these nuclides were found to be between 0.82 and 1.07.
Palliative radiotherapy in the management of pancreatic carcinoma: combined interstitial and external beam therapy
Authors: Kersh C. Ronald , Constable William C. , Eisert Donald R. , Ali Moinuddin
Published: July 2009

Therapeutic management of carcinoma of the pancreas continues to yield disappointing results regardless of the form of treatment. American Cancer Society estimates for 1987 reveal 26200 new cases and 24 300 deathsfrom pancreatic carcinoma (Cancer Statistics, 1987). Ultimately, over 99% of patients who are diagnosed with pancreatic carcinoma will die of the disease (Brochur, 1980). In spite of advances in interventional radiological techniques and computed tomographic (CT) scanning of the abdomen, fewer than 10% of patients will have tumours confined to the pancreas at the time of diagnosis (Howard & Jordan, 1977; Brooks, 1983). Radiotherapy is often utilized for palliation in advanced lesions. We report on the management of two symptomatic patients recently treated by a combination of interstitial iodine 125 and external beam radiotherapy.
Cell proliferation in human tumours measured by in-vivo labelling with bromodeoxyuridine
Authors: Wilson G. D. , McNally N. J. , Dische S. , Bennett M. H.
Published: July 2009

The causes of failure after radiotherapy or chemotherapy may be related to physical or biological factors. The physical factors will include geographic miss in radiotherapy. The biological reasons may be inadequate drug delivery in chemotherapy or resistance of nutritionally deprived or hypoxic cells, a capacity to repair damage or rapid proliferation of the tumour cells so that repopulation may occur during treatment. There is much current interest in repopulation and it would be of value to identify those tumours which have rapid cell proliferation for, in these cases, a change in drug scheduling or shortening the overall treatment time with radiotherapy may lead to increased success by overcoming the effect of repopulation (Fowler, 1985).

We have previously described a method for labelling proliferating cells in human tumours by measuring the uptake of bromodeoxyuridine (BrdUrd) into cells synthesizing DNA, following an intravenous injection, and the potential applications of this procedure to the measurement of proliferation rates in human tumours (Begg et al, 1985; Wilson et al, 1985). In this preliminary communication we report on three human tumours where kinetic studies have been performed and demonstrate the potential advantages of the technique.
Interpretation of gallium scans using the “negative heart” sign
Authors: Cooke S. G. , Goddard P. R.
Published: July 2009

A recent case report in the Journal described a negative gallium scan in an AIDS patient with pneumocystis pneumonia (Binstock et al, 1987). Using conventional criteria for interpretation the authors had correctly reported the scans as negative. However, we believe the scan in Figure 2b to be positive.
Threshold subtraction in radionuclide imaging
Authors: Chandler S. T. , Anderson P.
Published: July 2009

We thank Perkins and Whalley for their comments. The use of any subtraction technique can potentially produce a number of artefacts. The oral blocking regime we use (Bradwell et al, 1983) using a combination of potassium iodide and potassium perchlorate has, in our experience, resulted in minimal uptake of free iodine.
The measurement of left ventricular function
Authors: Barber R. W. , Stone D. L.
Published: July 2009

We read with interest the recent article (Foster et al, 1987) which compared gated computed tomography (CT) with angiography for the measurement of left ventricular function. In their discussion, the authors were rather dismissive of radionuclide angiography as “a potentially accurate method for measuring ejection fraction”.
Emission tomography and the measurement of divided renal function
Authors: Bowring C. S. , Bisson P. G. , Tobin A. N. , Vennart W.
Published: July 2009

There have recently been two publications in the Journal giving conflicting recommendations with regard to the necessity of making corrections to the simple measurement of divided renal function with 99Tcm DMSA for the different relative depth of positioning of the kidneys. Thus Nimmo et al (1987) conclude that it is not necessary to make corrections provided the supine projection is used and the upper border of one kidney is not below the mid-point of the other, while Wujanto et al (1987) recommend that both posterior and anterior views should be summed geometrically in order to correct for differing kidney positions within the body; they also find a much larger number of clinically significant discrepancies (greater than 5% difference) between the two methods than do Nimmo et al (22% as opposed to 7%).
Book reviews
Authors: Whitehouse G. H.
Published: July 2009

This lavish textbook from West Germany has a clarity which is derived from superb illustrations and a comprehensive text which, one suspects, owes much to the translators. It is a book for the specialist. Surgeons, gynaecologists and radiologists are all likely to find the book helpful in their practice and when studying for examinations.
Left ventricular aneurysm formation: an iatrogenic cause for the third mogul
Authors: Aldridge Sylvia , Frazer John , Tawn Julian , Wilde Peter
Published: July 2009

Two cases of left ventricular pseudoaneurysm formation developing post-operatively after mitral valve replacement are reported. The chest radiographs showed an abnormal protuberance on the left heart border at the site of the “third mogul”. The definitive diagnosis of this protuberance, resulting from the development of a left ventricular aneurysm, was made on angiography in each case. This site is unusual for left ventricular aneurysm formation, with the exception of the annular subvalvular aneurysm described in the negro population. Relevant aetiological factors in the development of these post-operative left ventricular pseudoaneurysms are considered. Since pseudoaneurysms are more prone to rupture than true aneurysms, it is concluded that early diagnosis of development of these left ventricular pseudoaneurysms should be made.
The computer enhancement of digital grey-scale fluorographic images
Authors: Cowen A. R. , Hartley P. J. , Workman A.
Published: July 2009

In this article we describe the results of a preliminary investigation of computerized processing of digital grey-scale fluorography (DGF) images. Image processing techniques used include dynamic range equalization, adaptive contour enhancement and non-linear transformation of grey-scale data. Original and processed images derived from non-subtractive digital angiography and digital spot-film investigations are used to illustrate our findings. The quality of the processed images confirms the promise of digital image processing in DGF.
Re-irradiation of recurrent head and neck cancer with fast neutrons
Authors: Skołryszewski J. , Korzeniowski S.
Published: July 2009

Recurrent inoperable cancer of the head and neck after a full course of radical radiation therapy is a major challenge to all radiation oncologists. According to Marcial and Pajak (1985), after radiation therapy for head and neck cancer 21% of treated patients had locally persistent tumour and 18.8% developed recurrence at the primary site within 5 years. In our previous study, the results of irradiation with 60Co teletherapy in 20 patients with recurrent head and neck cancer were presented (Skolyszewski et al, 1980). As 10 out of 20 of those patients survived without evidence of disease for at least 3 years after the second course of radiation therapy, the irradiation of recurrent head and neck cancer has become standard policy at our institution, providing the patient is not qualified for rescue surgery, the surface of treatment fields does not exceed 50 cm2, and the interval of time between the two courses of therapy is at least 6 months. Looking for a way of improving the results, in 1979 we started re-irradiating the patients with more advanced recurrent tumours of the head and neck with fast neutrons. This paper discusses the value of this procedure.
Book reviews
Authors: Coakley A. J.
Published: July 2009

The 1987 Year Book of Nuclear Medicine reviews journals to July 1986, and conforms to the standard Year Book patterns of summaries of recent publications followed by brief editorial comment. The range of chapters is as in previous editions, and the 58 pages on magnetic resonance means that this has taken over from the cardiovascular system as the longest chapter.
Book reviews
Authors: Levick R. K.
Published: July 2009

In his preface Dr Felman aims “to bring together the clinical and radiological features of pediatric chest disease in a form that is comprehensible to the most uninitiated medical student, yet valuable to the sophisticated pediatric radiologist.”
Book reviews
Authors: Smith M. A.
Published: July 2009

This is a booklet which sets out to list the published papers on the health and safety aspects of NMR imaging. It is divided into the following six sections: general reviews, guidelines, biological effects, pacemaker EMI (electromagnetic interference), implants and other ferromagnetic hazards and site planning.
Proximal humeral defects in Gaucher's disease
Authors: Li J. K. W. , Birch P. D. , Davies A. M.
Published: July 2009

Defects in the medial aspect of the proximal humeral metaphysis of two patients with Gaucher's disease are reported and their aetiology discussed. Similar cortical irregularities have been described as a normal variant in children and their presence in patients with an infiltrative disorder suggested as being coincidental. The two reported cases indicate that there is a causal association in Gaucher's disease since the defect persisted post-skeletal maturity in one case and progressed to bilateral pathological fractures of the proximal humeri in the other case. A review of the radiographs of 50 patients, pre-skeletal maturity, presenting with idiopathic scoliosis revealed a defect of the proximal humeral metaphysis in only one case, to give an estimated incidence of this anomaly in the “normal” population of 2%. It is suggested that the presence of this defect is non-specific with a spectrum of occurrence from the normal variant to the clearly pathological. The presence, however, of subtle abnormalities in the underlying bone tend to indicate a pathological entity.
A potential pitfall of pelvic computed tomography
Authors: Meanock Colin I. , Ward Caroline S. , Williams Michael P.
Published: July 2009

The cross-sectional areas of the common iliac veins were measured by pelvic computed tomography (CT) in 51 patients. The left common iliac vein was significantly larger than the right (p < 0.01) and in 35% of patients there was at least a two-fold difference between the cross-sectional areas of the veins. Recognition of this normal asymmetry is important when interpreting pelvic CT scans. It is thought to be due to the oblique course of the left common iliac vein and to partial obstruction of the left common iliac vein by the right common iliac artery.
Erbium filtration for dose reduction in dental radiography
Authors: Horner K. , Lawinski C. P. , Smith N. J. D.
Published: July 2009

Previous work has suggested that rare-earth filtration of diagnostic X rays is an effective means of dose reduction in radiology. Erbium (atomic number 68) is particularly promising in this respect. The effects on the X-ray beam and surface dose of the addition of 0.1 mm of erbium foil to the conventional filtration of a GE1000 dental X-ray set were investigated. Filtration by 0.1 mm of erbium produced a beam of narrower spectrum, greater penetration but lower intensity than that filtered conventionally by aluminium alone. The overall dose reduction achieved in dental radiography was > 30% between 65 and 85 kVp with a maximum dose reduction of 42% at 65 kVp. The question of the cost-effectiveness of erbium filtration as a radiation protection measure is also addressed.
A novel X-ray transmission ionization chamber dosemeter for patient dose measurements in diagnostic radiology
Authors: Sankaran A. , Patki V. S.
Published: July 2009

This paper describes an X-ray transmission ionization chamber diagnostic dosemeter for patient dose measurements and control. The chamber uses a commercially available radiofrequency screen as the wall material in a parallel-plate configuration. A digital varactor bridge electrometer serves to measure air kerma times area of fluoroscopic and radiographic beams. Detailed investigations on the characteristics of the chamber such as saturation, sensitivity, energy dependence (50–150 kV), response versus radiation field area, uniformity of response of the chamber, effects of distance and long-term stability have been carried out. The results demonstrate that the chamber meets all the requirements and can measure the incident patient dose with an overall uncertainty of ±11%. The chamber can be either mounted on the housing of the light beam diaphragm of the X-ray unit or used as a stand-alone system along with an image-intensifier TV monitor. It is inexpensive to build and is recommended particularly for hospitals in developing countries.
The 10-year results of a prospective trial of post-operative radiotherapy delivered in 3 fractions per week versus 2 fractions per week in breast carcinoma
Authors: Bates Thelma D.
Published: July 2009

The 10-year results are presented of a prospective trial of 411 patients with Weast carcinoma treated by mastectomy and post-operative radiotherapy given in either 2 or 3 fractions per week (i.e. a comparison of 6 fractions in 18 days with 12 fractions in 28 days). The early radiation effects on the normal tissues were similar and acceptable. The late skin changes in the chest wall (treated with 70 kV X rays) were progressive and by 10 years were slightly more marked with 6 fractions. Late subcutaneous fibrosis in the axilla (treated with cobalt-60 teletherapy), however, was much less in the 6-fraction group. Twelve fractions resulted in greater restriction of shoulder movement and an increased incidence of lymphoedema of the arm. Doses were selected on the basis of past clinical experience. The dose used to treat the axilla in 6 fractions was 35 Gy, 14.99% less than that predicted by NSD. The dose predicted by α : β, using a value of 2 Gy for late reactions, is 38.14 Gy. Thus simple theory, which omits time, still predicts too high a dose for 6 fractions, although it is closer than NSD. In this trial, the 6-fraction technique showed an advantage over the 12-fraction technique. It was equally effective in controlling local recurrence and had fewer late sequelae. It was also convenient for patients and economic in the use of radiotherapy resources.
A radiographic test object for the LDR Selectron remote afterloading system
Authors: Lambert G. D. , Lambert K.
Published: July 2009

As part of our monthly quality assurance programme for the Selectron LDR remote afterloading systems, we decided to take contact autoradiographs of the loaded source trains. Although various electronic and electromechanical interlocks are incorporated into these machines to ensure “fail-safe” operation, a radiograph serves as a definitive check of correct source placement and also as a permanent record for filing.
Fibrovascular polyp of the oesophagus: the appearances on computed tomography
Authors: Walters N. A. , Coral A.
Published: July 2009

Fibrovascular polyp of the oesophagus is a rare and benign intraluminal tumour. In this case, we present the radiological and also the computed tomographic findings which, to our knowledge, have not been previously described.

A 64-year-old woman presented with a history of having “vomited” a fleshy lump 4 months previously, which had been promptly swallowed. She had then experienced progressive pain on swallowing until she was unable to eat solids. Endoscopy showed a smooth, lobulated tumour filling the upper 11 cm of the oesophagus, but did not reveal the origin of the tumour.
Dislocation of the manubriosternal joint: detection on frontal chest radiographs
Authors: Nicholson A. A. , Holt M. E. , Jessop J. D.
Published: July 2009

Dislocation of the manubriosternal joint is a recognized complication of thoracic kyphosis in patients with rheumatoid arthritis (Rapoport et al, 1979; Holt & Rooney, 1980; Wiseman, 1981; Khong & Rooney, 1982; Kelly et al, 1986). It has also been described as a result of trauma (Sevitt, 1968; Park et al, 1980) where acute flexion of the thoracic spine transmits a downward and backward force on the manubriosternal joint via the first ribs (Fowler, 1957).
Radiopharmaceuticals for myocardial infarct imaging: a clinical comparison of 99Tcmm-pyrophosphate and 99Tcm-dimethylaminomethylene diphosphonate
Authors: Bell D. , Millar A. M. , Grayshan R. , Muir A. L.
Published: July 2009

99Tcm-pyrophosphate (PYP) has been shown to concentrate in acutely damaged myocardium (Bonte et al, 1974). This has resulted in myocardial infarct imaging with 99Tcm-PYP becoming an established technique in nuclear medicine (Bruno et al, 1976; Parkey et al, 1976). The technique is of value in patients in whom the diagnosis of acute myocardial infarction is uncertain as a result of equivocal changes in the electrocardiogram or cardiac enzymes. A major limitation, however, is the uptake of 99Tcm-PYP into bone which can result in visualization of the myocardial infarct being obscured by activity in the overlying ribs and sternum.

In an investigation of new 99Tcm-labelled diphosphonates for skeletal imaging, 99Tcm-dimethylaminomethylene diphosphonate (DMAD) was found to exhibit the highest abnormal/ normal bone ratio (Subramanian et al, 1983). This was shown to be a consequence of low uptake in normal bone rather than high uptake in the lesions. If 99Tcm-DMAD was to concentrate in acutely infarcted myocardium, then its low uptake in the ribs and sternum could make interpretation of the planar images more reliable. We have therefore compared 99Tcm-PYP with 99Tcm-DMAD in patients with acute myocardial infarction to determine if 99Tcm-DMAD is a superior radiopharmaceutical for myocardial infarct imaging.
Cause for collapse
Authors: Nicholson A. A. , Hayward M. W. J.
Published: July 2009

A 65-year-old man with a past history of hypertension was admitted after collapsing in the street. He complained of chest pain and dizziness following brief loss of consciousness. Two years previously he had suffered a right-sided cerebrovascular accident but had made a good recovery. Examination was normal apart from a systolic blood pressure of 80 mmHg which responded to one unit of plasma expander. Routine biochemical investigations and an electrocardiogram were normal. The initial antero-posterior and lateral chest radiographs are shown in Fig 1. A differential diagnosis of myocardial infarction or pulmonary embolism was made. During the night his condition deteriorated and he complained of further chest pain.
Liver and spleen scans in systemic mast-cell disease
Authors: Biersack Hans J.
Published: July 2009

We read with interest the paper by Huang et al (1987), dealing with the radiological features of systemic mast-cell disease. Our own group has reported on the scintigraphic findings in the liver and spleen in this disease (Rodermund et al, 1987).
Personnel dosimetry—an unusual occurrence
Authors: Murnaghan David J.
Published: July 2009

Occasionally, but with relentless inevitability, a radiation protection puzzle arises which requires an “insight” to reach a credible explanation. Such a problem arose when a routine filmbadge dosemeter was reported as having received a β dose of 1 mSv (100 mRem) in a monitoring period of 2 weeks. Beta doses were reported on subsequent but not all film badges and the initial investigation revealed no apparent source of the β radiation.
Contrast medium reactions—does Buscopan reduce them?
Authors: Hartnell G. G. , Hemingway A. P.
Published: July 2009

A number of possible theories have been produced to account for adverse reactions to contrast media, including the theory that cholinergic pathways (Lalli, 1980) or cholinesterase inhibiting activity may be important (Manhire et al, 1984). With the introduction of digital subtraction angiography (DSA) it has been our practice to give the anticholinergic agent Buscopan (hyoscine butylbromide) to all patients in whom DSA images of the abdomen are required, to prevent bowel gas motion artefacts. It appeared to us that patients who received Buscopan experienced far fewer adverse reactions than those who did not.
The cost of imaging procedures
Authors: Foord K. D.
Published: July 2009

Having recently undertaken a costing exercise for our small Radiology Department based on total labour, material and overhead departmental costings (including capital depreciation amounts), the figures produced by Bretland (1988) came as no surprise.
Book reviews
Authors: Sweet Elizabeth M.
Published: July 2009

This is the report of a workshop held in Berlin in August 1985 under the sponsorship of Schering AG, West Germany, edited by Dr Herbert Kaufmann, who instigated the Workshop to expand on a symposium at the 21st Congress of the European Society of Paediatric Radiology in Florence in 1984. Nineteen papers were presented by 17 lecturers, 13 from West Germany and one each from the Netherlands, Norway, Switzerland and USA. The dominant theme was non-ionic contrast media and the case for their increasing utilization in childhood, particularly in the neonatal period.
Digital subtraction dynamic cavernosography
Authors: Hartnell G. G. , Mulcahy M. J. , Kiely E. A. , Williams G. , Allison D. J.
Published: July 2009

Digital subtraction angiography (DSA) was used in the investigation, by dynamic cavernosography, of 35 men with acquired erectile impotence. The benefits of using DSA included shorter examination times, lower contrast medium dosage and better definition of abnormal veins. In particular deep crural veins are more clearly seen than in conventional studies and these may be of more importance than was previously thought.
A simple air mattress for use during prolonged radiological procedures
Authors: Svensson W. E.
Published: July 2009

For many patients undergoing a long radiological procedure the abiding recollection is of the hard table. Interventional procedures may require the conscious patient to lie on an X-ray table for over an hour and in most departments, padding is either not used or restricted to a thin PVC-covered piece of polyurethane foam sometimes supplemented by foam pads. Lack of padding causes discomfort, particularly for thin, debilitated patients and those with spinal deformity, increases the risk of decubitus ulceration and may increase movement as the patient seeks a more comfortable position, with the risk of catheter or needle displacement.
A technique for image density matching in radiotherapy planning radiographs
Authors: Samarasekara M. G. , Hudson F. R.
Published: July 2009

Many sophisticated and expensive imaging devices are in common use for the planning of radiotherapy treatment. At the same time wide use is made of routine radiographs, for which much scope remains for the development of image-enhancement techniques. One approach recently reported by McFaul et al (1987) is the use of scanning equalization radiography to balance the exposures of different areas of the X-ray field. However, it will be some time before techniques of this type come into widespread use.

This paper reports a much simpler but potentially very useful approach to exposure balancing applied to radiographs of the head, neck and shoulder region. Often in the planning of radiotherapy treatment for sites such as nasopharynx, trachea, thyroid or cricoid it is necessary for fields to be specified running from the neck through to the shoulder level or lower. However, the lateral radiographs of this area will contain a wide density variation because of the large changes in lateral separation from the neck through to the shoulders. The simple technique described in this report permits important structures such as cord to be visualized clearly on one film even when large changes in separation are present.

Figure 1 shows typical head and neck radiographs taken of the Rando radiotherapy phantom using Agfa-Gevaert film and a Curix MR400 cassette (Agfa-Gevaert pic). The exposures were chosen to optimize the definition either of the facial region (a) or of the shoulder region (b). Good definition of one region results in bad definition in the other.
The linear-quadratic model
Authors: O'Donoghue J. A.
Published: July 2009

Dr Scott's recent letter (1987) raises some interesting points, all of which are related to the question, can optimal fractionation schedules be deduced using the LQ model? In the absence of a time factor the answer is certainly no. To take the mathematically simplest case of one relevant normal tissue with (α/β)n and a tumour with (α/β)t, if (α/β)t, < (α/β)n the optimal schedule tends to an infinite number of infinitesimally small fractions whereas if (α/β)t > (α/β)n the optimal schedule corresponds to the single fraction equivalent dose defined by (α/β)n and an acceptable level of normal tissue toxicity.
The linear-quadratic model
Authors: Wheldon T. E. , Amin A. E.
Published: July 2009

In his recent stimulating letter, Scott (1987) raises a number of important points about the use of the linear-quadratic (LQ) model in fractionated radiotherapy and the validity of the prediction of hyperfractionation as the optimal strategy for most human tumours. Here we shall confine attention to one feature: the absence of a time factor in the LQ model and its possible consequences. It has been argued (Fowler, 1984) that time factors are relatively unimportant for late-responding tissues. However, the strategy of hyperfractionation and even more so of acceleration will increase the relative clinical importance of acute-responding tissues, damage to which will be worsened by each of these approaches.
The linear-quadratic model
Authors: Révész L.
Published: July 2009

Scott (1987) has proposed an intrinsic “α/β(i)” ratio which should “include the oxygen status of the tissue concerned”, i.e. the ratio needs to be corrected in regard to OER.
The linear-quadratic model
Authors: Yaes R. J.
Published: July 2009

Oliver Scott (1987) has pointed out some real shortcomings of the linear-quadratic (LQ) model that radiotherapists and radiobiologists are working to overcome. The LQ formula was originally obtained by Kellerer and Rossi (1972, 1978) from a biophysical model describing the spatial distribution of radiation-induced lesions in mammalian cells, and the combination of these lesions to cause lethality. Douglas and Fowler (1976) subsequently noted that the LQ model could be used to obtain isoeffect relations for normal tissue damage, in terms of a single parameter, that would vary from tissue to tissue and have the dimensions of radiation dose, the α/β ratio.
The linear-quadratic model
Authors: Fowler J. F.
Published: July 2009

In Scott's (1987) letter in the October issue of BJR he asked “Is a tumour an early-responding tissue?” and emphasized the difficulties of deriving α/β ratios for tumours. He questioned the clinical implications of the findings of Williams et al (1985), who reviewed the literature and found relatively high values of α/β, resembling those of early reacting tissues. Williams et al had only considered experiments where reoxygenation was minimized by the use of clamping, hyperbaric oxygen or misonidazole, and they were aware that proliferation in the tumour could lead to decreased values of α/β.
The linear-quadratic model
Authors: Withers H. R.
Published: July 2009

As is his wont (Scott, 1980, 1984, 1986a, b), Oliver Scott has again put a cat among the pigeons, this time in questioning the usefulness of the linear-quadratic (LQ) isoeffect equation in clinical radiotherapy (Scott, 1987). For the pigeons, I think the linear-quadratic model is very useful indeed, and certainly better than any earlier isoeffect equation (Ellis, 1968) but, on the feline side, I agree with Dr Scott's implication that it is potentially dangerous if its limitations are not continually, even continuously, recognized (Withers et al, 1983). I shall now attempt to answer his specific questions.
Book reviews
Authors: Harrison R. M.
Published: July 2009

How much physics should a radiologist know? A glib answer, of course, is “just enough to pass Part 1 Physics”! However, the recent changes in radiology resulting from far-reaching scientific and technical innovations have meant that a radiologist is expected to acquire an understanding of the physical basis of the subject which is sufficient not only for present day needs but which also forms a sound foundation for the appreciation of future developments. Whichever view is taken, this book succeeds admirably. With the expansion of imaging techniques, it would have been understandable if the authors had written a text twice as long (and twice as expensive). They are to be congratulated on maintaining a concise and readable style in which the essentials are explained extremely well.
Book reviews
Authors: Haggith J. W.
Published: July 2009

It is obvious that this author has taught trainees in nuclear medicine for many years. Reading the book is like listening to a competent teacher explaining for the umpteenth time the basic facts of nuclear medicine, explanations honed by years of experience of getting his points across. As a result the book is lucid and simple although, in places, simplistic and mannered.
Towards 2000: the radiology business
Authors: Mountford Grahame
Published: July 2009

Presidential Addresses of this Institute have covered a variety of subjects. Some medical Presidents have spoken on their specialized subjects, whilst others have spoken about the Institute in its 30, 70 and now 90 years of life and growth. The British Institute of Radiology (BIR), unlike most national societies of radiology, is a multi-disciplinary society; scientists, industrialists, physicists, radiobiologists, radiographers, ultrasonagraphers, nuclear medicine specialists, as well as radiotherapists and diagnostic radiologists, are all members of the BIR.

My predecessor, in his Presidential Address (Berry, 1987), took us through the 90 years of the Institute's life, and reminded us that after X rays were discovered in November 1895, a special commission was set up under Dr Sydney Rowland to report on “the application of the new photography to medicine and surgery”. Whilst covering the last 90 years, Professor Berry mentioned that “the pattern and materials of radiological endeavour have changed almost beyond recognition, but that the strength of the Institute is in its diversity and our future is in our enthusiasm”.

Who could have foreseen the technical pathways that have been driven over the last 20 years—the special technical equipment and materials that have been developed for examinations like vascular catheterization, digital imaging, non-ionic and low-osmolar contrast media, real-time ultrasound, information technology and expert systems-and who could have predicted the precision of diagnosis and treatment that these techniques would offer.
Spinal segmentation anomalies: in utero diagnosis by ultrasound
Authors: Zalcman M. , Avni E. F. , Balasse H. , Pardou A. , Matos C.
Published: July 2009

Three cases of spinal segmentation anomalies were diagnosed in utero during routine sonography. All cases were associated with other malformations. Sonographic features are described and discussed. These cases emphasize the need to exclude other abnormalities if spinal deformity without meningocoele is demonstrated.
Adverse reaction to X-Prep
Authors: Jagjivan B. , Morcos S. K. , Liddell H.
Published: July 2009

X-Prep (Napp Laboratories) is a senna-containing laxative that is widely used for bowel preparation prior to radiological examination. We report the case of a patient who had an adverse reaction following its administration.

Examination revealed generalized abdominal tenderness, but no evidence of peritonism. Fresh bleeding was noted on sigmoidoscopy; however, the mucosa appeared normal. Blood pressure was 170/100 with a pulse rate of 110 per minute in atrial fibrillation.
The expanding infant
Authors: Peck R. J.
Published: July 2009

A 9-month-old child was seen with a history of diarrhoea of varying severity present for several months. The child had, in addition, developed ankle oedema and swelling around the eyes. On examination the abdomen was soft but distended. The major biochemical abnormality was a low serum albumin (19 g/1). Figure 1 is a plain radiograph of chest and abdomen.

Ultrasound showed a normal liver, gallbladder, pancreas and kidneys. Ascites was present. Figure 2 is a transverse scan of lower abdomen, and Fig. 3 is an early radiograph from the barium follow-through.
Short-course neutron therapy for advanced head and neck cancer
Authors: Skołyszewski J. , Fowler J. F. , Huczkowski J.
Published: July 2009

Neutron cancer therapy started in Krakow in September 1978, after the cyclotron, which produces a neutron beam of mean energy 5.6 MeV, had been adapted for medical purposes. Between 1978 and 1987, 202 patients were treated, most of them with head and neck tumours. Data concerning the machine, the dosimetric and radiobiological studies, and the clinical results have been published previously (Skołyszewski et al, 1982; Skołyszewski et al, 1988). In the group of 89 patients with advanced head and neck cancer previously untreated and irradiated with neutrons alone between 1978 and 1983, complete response after treatment was observed in 56% of cases, but only 16% of the treated patients survived 2 years without evidence of disease. Most of the patients (71%) received the standard tumour dose of 13.2 Gy, or 12 Gy in the case of laryngeal cancer patients, given in 20 fractions over 4 weeks. These doses are total neutron plus γ-ray doses and were considered as equivalent to that used in radical megavoltage X-ray therapy of head and neck cancer. The best results were obtained in patients with cancer of the major salivary gland (25% 2-year survival rate), oropharyngeal cancer (27% 2-year survival rate) and metastatic cervical nodes with primary tumour, either healed or unknown (50% 2-year survival rate). The main cause of failure was residual or recurrent cancer at the irradiated site, observed in 49 cases. Twenty-seven patients developed late complications, mostly mucosal necrosis. Two patients died of complications (Skołyszewski et al, 1988).
Bone scintigraphy in parasymphyseal insufficiency fractures
Authors: Langham-Brown J. J.
Published: July 2009

Whilst Dr Davies and colleagues describe the value of bone scintigraphy in diagnosing parasymphyseal insufficiency fractures, their illustration of an anterior pelvic image would be considered non-diagnostic in this department, especially if the examination was directed at the pubis.
OER and RBE for two types of iodine seed
Authors: Hering E. R. , Blekkenhorst G. , Dowman P.
Published: July 2009

The first seeds used for brachytherapy at Groote Schuur Hospital were of Type 6702 supplied by 3M (Minnesota Mining and Manufacturing Company). These seeds have the iodine adsorbed onto three resin spheres which are sealed into a titanium tube. Later, seeds were supplied with the iodine adsorbed onto a silver rod and encapsulated with titanium (Type 6711). Currently, both types of seed are available, but the very high activities (e.g. 10 mCi) only as Type 6702. Seeds of Type 6711 are much more visible radiographically and thus have a real advantage over other models of seed (Ling et al,1983). Since Type 6711 is not available with high activities, both seeds are in use at Groote Schuur Hospital.
Hyperthermia and AIDS treatment
Authors: Weatherburn H.
Published: July 2009

The two main clinical manifestations of AIDS are either as a series of opportunistic infections or as tumours. The most commonly observed tumour is Kaposi's sarcoma, occurring in 21% of AIDS patients in the UK (and accompanying P. carinii pneumonia in a further 7%), but other tumours, particularly non-Hodgkin's lymphoma, have also been observed in afurther 2% of patients (Alder, 1987).
Book reviews
Authors: Mothers M.
Published: July 2009

The first edition of this text appeared 25 years ago and it is now in its eighth edition. Essentially a pocket reference book, it is aimed at radiographers and student radiographers, with a limited use to new entrants in radiology. The general aim of the book is to provide a synopsis of present day radiographic practice in a reference form suitable for everyday use. Recentdvances in radiology have been many and the text has been revised and updated, with short descriptions of recently introduced imaging techniques addedand sections on techniques which were less detailed in the last edition expanded.
Book reviews
Authors: Sherwood T.
Published: July 2009

The first edition of this book (1976) had half the number of authors but almost as many pages. It weighed only a little less.