bluuebunny/crossref_metadata_2025 huggingface dataset:
Calcification of the large bowel in schistosomiasis demonstrated by computed tomography
Authors: Al-Hindawi M. , Whitehouse G. H. , Al-Ansari A. G. , Kamel H. , Soni C. R.
Published: July 2009

Calcification within the urinary tract and seminal vesicles is a common sequel of Schistosoma haematobium infection (Delahaye, 1977; Cockshott & Middlemiss, 1979). Local granulomatous reaction and fibrosis follow the deposition of ova in the walls of these organs. The calcification occurs within dead ova. A similar chronic inflammatory response follows the deposition of the ova of Schistosoma mansoni in radicles of the mesenteric venous system. Unlike the genitourinary tract, intestinal calcification has rarely been recorded in schistosomal infection (Lehman et al, 1971; Fataar et al, 1985).

Four patients from an area where S. mansoni is endemic are described, each of whom showed intestinal calcification on computed tomography.

A 23-year-old Egyptian male with a past history of urinary schistosomiasis complained of infertility, dysuria and haematuria. A plain radiograph of the abdomen demonstrated calcification of the urinary bladder and both ureters throughout their length, as well as densely calcified seminal vesicles. Faint linear calcification was also apparent in the ascending and descending segments of the colon and in the appendix. A computed tomographic (CT) scan confirmed the calcifications seen in the genitourinary tract and large bowel. In addition, extensive calcification was apparent in the rectum and sigmoid colon (Fig. 1).

A 49-year-old Egyptian male presented with left loin pain and dysuria. There were no gastrointestinal symptoms. A plain radiograph of the abdomen revealed calcification of the urinary bladder, left ureter and the seminal vesicles.
Ultrafast magnetic resonance scanning of the liver with echo-planar imaging
Authors: Stehling M. K. , Charnley R. M. , Blamire A. M. , Ordidge R. J. , Coxon R. , Gibbs P. , Hardcastle J. D. , Mansfield P.
Published: July 2009

Echo-planar imaging (EPI) is a magnetic resonance imaging (MRI) technique which provides MR images in, typically, 50–100 ms. The potential of EPI as an imaging modality for the liver has been investigated in volunteers and patients with liver disease. Images with improved quality are presented. Obtained at a field strength of 0.52 Tesla, these true unaveraged snap-shot images have larger data arrays, comprising 128 × 128 pixels.
Pseudopermeative skeletal lesions
Authors: Helms Clyde A. , Munk Peter L.
Published: July 2009

Permeative bone lesions are well known to radiologists and usually invoke a differential diagnosis that includes aggressive lesions such as round cell malignancies and infection. In contrast to permeative lesions, which demonstrate multiple small holes at the endosteal surface of the cortex secondary to a medullary process, we describe a series of 19 patients (seven with aggressive osteoporosis, eight with prior radiation therapy and four with hemangiomas) who demonstrated multiple tiny lucencies in the cortex which were superimposed on the medullary space and mimicked a permeative pattern radiographically. We termed this a pseudopermeative pattern. Recognition of a pseudopermeative pattern may allow a less sinister differential diagnosis to be considered and may avert unnecessary biopsy in many instances.
Hour-glass lipoma
Authors: Trigaux J. P. , van Beers B. , Weynants P.
Published: July 2009

A 57-year-old man was referred to our hospital for evaluation of a 4 cm intrathoracic peripheral mass found incidentally on a routine chest radiograph. The patient, a heavy smoker, had no history of cough, hemoptysis or respiratory tract infection. On admission, physical examination and routine blood tests were unremarkable. A postero-anterior chest radiograph (Fig. 1), a lateral chest radiograph (not shown) and a right anterior oblique view (Fig. 2) were obtained.
Total abdominal and pelvic ultrasound: incidental findings and a comparison between outpatient and general practice referrals in 1000 cases
Authors: Rizk B. , Davies M. C.
Published: July 2009

We read with interest the article by Dr Mills and colleagues (November, 1989) reporting incidental findings during abdominal and pelvic ultrasound in 1000 cases. The authors encountered nine cases with extrapelvic abnormality in 55 patients with pelvic pain (16%) and 14 patients with pelvic abnormality in patients referred for examination of the upper abdomen. Our experience in the use of ultrasound in assisted conception confirms their observations; we have reported a case where acute hydrothorax was the only manifestation of ovarian hyperstimulation syndrome (Kingsland et al, 1989), which demonstrates the discrepancy between the site of pathology and the presentation.
Total abdominal and pelvic ultrasound: incidental findings and a comparison between outpatient and general practice referrals in 1000 cases
Authors: Mills P. , Joseph A. E. A. , Adam E. J.
Published: July 2009

It is undoubtedly true that transvaginal scanning gives high resolution images of pelvic structures and is widely used in infertility treatment regimes. In fact this was not available in our unit at the time the study was performed so that question did not arise. Nevertheless, we would hesitate to recommend immediate recourse to transvaginal scanning in patients, many of whom are elderly, who have a possible pelvic abnormality found when being scanned for extrapelvic symptoms. The four patients who had false positive initial scans were correctly diagnosed after simply repeating the scan with a full bladder.
Book reviews
Authors: Taylor P. M.
Published: July 2009

The object of this book, as its title implies, is to approach a diagnostic problem using a logical deductive pathway, thus providing a diagnostic route which the radiologist may follow. After an initial chapter describing techniques and normal anatomy, subsequent chapters deal with particular abnormalities such as linear densities, nodular densities and chest wall abnormalities. This is a fundamentally sound approach, having been used by other authors not only in the lung but throughout the body. It does, however, make the assumption that the reader can categorize the abnormality he sees: often the most difficult step in diffuse pulmonary disease.
Book reviews
Authors: Glfford D.
Published: July 2009

It is always a pleasure to review a book by a worker in a similar field to one's own, particularly when so much of the author's experience parallels one's own. It is, however, apparent that the standards of the radiology residents in the USA must be significantly lower than that of Part I FRCR candiates in the UK, for the first 76 pages of Dr Kelsey's book deal with material that would be assumed knowledge in the case of an FRCR candidate, consisting of basic physics and mathematics. It is nevertheless well presented and may serve to bridge a gap in the case of less well-prepared candidates.
Book reviews
Authors: Davison L. M.
Published: July 2009

Ref 87–15 (J)

This is a well produced and instructive audiovisual teaching programme consisting of 89 slides and two tapes (47 minutes). The presentation starts with a description of the normal anatomy and the otoscopic and radiological appearances of the middle ear, and progresses to describe various types of pathology affecting the middle ear.

Unfortunately, the title is a little misleading because this audiovisual series only covers a limited range of middle ear pathology. For example, there is no mention of malignant disease, traumatic lesions or congenital abnormalities.
Bacterial contamination of contrast media stored after opening
Authors: Lisle D. , Ratcliffe J. F. , Faoagali J. , Cherian S.
Published: July 2009

A barium suspension, iohexol, iopamidol and ioxaglate which were diluted with tapwater and 0.9% NaCl and dextrose saline (4% and 0.18%) were made into aliquots of 10 ml and stored at 4°C, room temperature and 37°C for 8 weeks. Regular handling and bacterial cultures were performed. These studies confirmed that environmental organisms do contaminate these solutions and that they also support viable organisms, but do not become significantly colonized at room temperature or 4°C. The solutions should be stored at room temperature or at 4°C. The diluted barium solution was the contrast medium least contaminated and if it is not contra-indicated for other reasons should be used in preference to low osmolality water soluble contrast media on the basis of its cost, radiological contrast and low microbial contamination rate.
Assessment of a single lumbar spine radiograph in low back pain
Authors: Padley S. , Gleeson F. , Chisholm R. , Baldwin J.
Published: July 2009

The lumbosacral spine radiographs of 200 patients with unexplained low back pain and without neurological signs were reviewed. The purpose of the study was to determine whether significant diagnostic information would be lost by replacing the standard three film series with a single radiograph, either in the lateral or antero-posterior projection. The contribution of the coned lumbosacral junction view was also assessed. The results show that a single lateral radiograph is diagnostically satisfactory and would have the added advantages of reducing patient radiation dose and radiographic workload.
Skeletal abnormalities in Refsum's disease (heredopathia atactica polyneuritiformis)
Authors: Plant Graham R. , Hansell David M. , Gibberd F. B. , Sidey M. C.
Published: July 2009

Refsum's disease is a rare inborn error of phytanic acid metabolism in which skeletal abnormalities are part of the clinical syndrome. The reported incidence of bone changes in patients with Refsum's disease varies widely and reflects the small series published to date. An analysis of the skeletal abnormalities of the largest series of patients in the world is presented.
Comparison of 5-Fluorouracil pharmacokinetics following intraperitoneal and intravenous administration using in vivo 19F magnetic resonance spectroscopy
Authors: Glaholm J. , Leach M. O. , Collins D. , Jehazi B. Al , Sharp J. C. , Smith T. A. D. , Adach J. , Hind A. , McCready V. R. , White H.
Published: July 2009

Intrahepatic pharmacokinetic studies of 5-Fluorouracil (5 FU) metabolism following intravenous and intraperitoneal administration have been undertaken in four patients using in vivo  19F nuclear magnetic resonance spectroscopy. Following intravenous administration, 5 FU decayed with “half times” ranging from 5 to 17 min. There was considerable variation of 5 FU pharmacokinetics between patients following intraperitoneal administration. Peritoneal contamination by infused 5 FU was considered to be a significant problem in one patient. A technique for providing superficial signal suppression was therefore investigated and its efficacy for excluding signal from the peritoneal space has been demonstrated. Owing to the potential for contamination from peritoneal 5 FU, the accumulation of fluoro-beta-alanine (FBAL) is a more reliable indicator of drug catabolism than the measurement of unlocalized “hepatic” 5 FU. Rapid intrahepatic catabolism of 5 FU to FBAL was demonstrated in all patients. However, there was greater pharmacokinetic variation following intraperitoneal administration than following intravenous administration. Therapeutic implications of intravenous compared with intraperitoneal administration of 5 FU are discussed.
Cylindrical forms of isodoses in gynaecological afterloading therapy: an atlas using the Buchler afterloading machine al-mc
Authors: Busch M. , Dühmke E.
Published: July 2009

Problems with intravaginal applicators and their solution have outlasted the changes from radium applicators to afterloading techniques. The question of interest is how intravaginal afterloading applicators have to be optimized to take account of unchanged clinical necessities and new technical concepts. According to the recommendations of ICRU 38, the rectal reference point is localized 5 mm behind the dorsal vaginal wall. The reference isodose surface defines the reference volume (ICRU, 1985). It is necessary for the isodoses used in combination with a defined applicator to be adapted to this applicator. While the concept of the “optimized applicator” uses applicators manufactured according to existing isodoses (Lambert, 1988), we progressed to the adaption of the isodoses to existing applicators.

In the radiotherapy department in Göttingen we use vaginal applicators which are cylindrical with a rounded, hemispherical top. From our point of view this form “unfolds” the vagina anatomically without the vaginal walls remaining in contact with each other. Figure 1 represents the attributes of our applicators. The Perspex applicator is cylindrical, available with diameters of 20, 25 and 30 mm. The cylinders are supplied with two copper rings at an interval of 2 cm. The surface of the copper rings is flush with the surface of the Perspex cylinder. From the X-ray film it is possible to identify exactly the applicator as well as the ratio of dimensions.
Intracardiac extension of Wilms' tumour: demonstration by magnetic resonance
Authors: Gibson J. M. , Hall-Craggs M. A. , Dicks-Mireaux C. , Finn J.P.
Published: July 2009

Extension of intravascular tumour thrombus into the right atrium is a well recognized but rare complication of Wilms' tumour (Ritchey et al, 1988). We described the first such case demonstrated by Magnetic Resonance (MR) imaging.

A 5-year-old girl was admitted to hospital with a 1-month history of lethargy and one episode of haematuria. Physical examination revealed a large mass in the right loin and elevation of the jugular venous pressure. Abdominal ultrasound demonstrated a 10 cm echogenic, right renal mass. The inferior vena cava (IVC) was expanded by intraluminal thrombus which extended up to the right atrium. Computerized tomography (CT) confirmed a right renal mass and caval thrombus.
Difficulties in the diagnosis of metastatic testicular teratoma
Authors: Huddart R. , Moore N. R. , Williams M. V. , Dixon A. K.
Published: July 2009

Testicular teratoma is the commonest malignancy in men aged 20–30 years. For those with metastatic disease, long term survival used to be exceptional, but with modern chemotherapy 85% will survive 5 years and be considered cured. We report two cases in whom A 38-year-old man presented with a 1-year history of painless swelling of the right testis. This had become painful during the month prior to admission. Examination revealed an enlarged right testis but was otherwise normal. He underwent immediate orchdiectomy at which a soft haemorrhagic partially cystic tumour was removed. This proved to be a malignant teratoma (undifferentiated) with lymphatic and venous invasion.
Cytomegalovirus infection masquerading as colonic neoplasia
Authors: Lewis-Jones H. G. , Ward R. G. , Garvey C.
Published: July 2009

Cytomegalovirus (CMV) infection in the immunocompromized patient usually represents a reactivation of latent infection and occurs in 60–90% of renal transplant patients after initiation of immunosuppressive therapy (Cho et al, 1981). The range of gastrointestinal presentations is wide but a case with the clinical, radiological and operative features of a colonic neoplasm has not previously been described.

A 53-year-old man was referred with an 8 month history of intermittent epigastric pain associated with diarrhoea for the past 2 months. He had not noticed any blood or mucus in the stools. Nine years previously he had received a cadaveric renal transplant for end stage renal failure secondary to congenital polycystic kidneys. Renal function at presentation was normal on maintenance immunosuppression (Azathioprine 200mg and Prednisolone 6 mg daily). Physical eamination revealed no significant abnormality and full biochemical and haematological investigations were normal.
Epidural abscess of the cervical spine: case report and literature review
Authors: Williams J. W. , Powell T.
Published: July 2009

A 51-year-old fisherman with a centro-blastic centrocytic Grade 4B non-Hodgkin's lymphoma only partially responsive to combination chemotherapy over a period of 6 months received an endogenous bone marrow transplant following intensive chemotherapy. His white cell and platelet counts remained low post-operatively, requiring a number of transfusions and continuous antibiotic cover. Two weeks after the transplant he became febrile and developed neck pain which became gradually more severe. Plain radiographs of the cervical spinewere normal, as was an isotope bone scan, but the pain continued to increase.
Primary osteosarcoma of the uterus
Authors: Caputo Michael G. , Reuter Karen L. , Reale Frank
Published: July 2009

Post-menopausal vaginal bleeding is a common clinical problem. Often, the clinician will call upon the radiologist to perform and interpret studies such as ultrasound or computed tomography (CT), to aid in the diagnosis or to evaluate further a pelvic mass. The following case illustrates an unusual cause of postmenopausal vaginal bleeding, with ultrasound and CT images of the pelvic mass. Certainly, the radiologist, in interpreting scans and correlating them with clinical data, must always consider common etiologies first; but one ust also remember the uncommon and even rare entities that may radiologically mimic a more common pathologica process and, if appropriate, might be included in the differential diagnosis.
Dysphagia after fast neutron therapy to head and neck
Authors: Duncan W. , Munro A. J.
Published: July 2009

The paper “Dysphagia after fast neutron therapy to the head and neck” by Alexander et al (1989) is most interesting. It is important, not only as a valuable account of late radiation damage following neutron therapy, but also in providing further evidence of the high incidence of serious late complications observed in the patients treated in the studies conducted at the MRC Cyclotron Unit. Very few of these patients were long-term survivors and so the number at risk for late complications was correspondingly small.
Book reviews
Authors: Pilling D. W.
Published: July 2009

This latest volume in the Clinics In Diagnostic Ultrasound Series gives a very comprehensive update on obstetric ultrasound with particular emphasis on the diagnosis and management of fetal anomalies. The authors are all world experts from both sides of the Atlantic.
Quantitative microfocal radiography of children with renal osteodystrophy; comparison with laboratory and histological findings
Authors: Buckland-Wright J. C. , Spring M. W. , Mak R. H. K. , Turner C. , Compston J. , Vedi S. , Haycock G. B. , Chantler C.
Published: July 2009

High definition microfocal radiography permitted the quantitative assessment of the radiographic features of renal osteodystrophy in the phalanges of 11 children in stable chronic renal failure, treated with phosphate binders for 1 year. The most consistent feature was subperiosteal cortical resorption, expressed as a ratio total length of resorbed subperiosteal bone/total length subperiosteal bone × 100. It was found that the extent of resorbed bone was significantly greater in the middle phalanx and on the ulnar surface of the phalanges. The radiological findings over the duration of the disease were compared with laboratory assessments and bone histomorphometry. The extent of the percentage of subperiosteal resorption at base line and its change during the study period correlated significantly with the level of serum parathyroid hormone levels and its change over the same period. No other significant correlations were found between radiographic features and laboratory assessments or with bone histomorphometry.
The effects of steel and titanium mandibular reconstruction plates on photon and electron beams
Authors: Delacroix Sabine , Rymel Jurek , Smith Philip J. , Clubb Bryce S.
Published: July 2009

The use of metal plates, designed to be screwed into the bone in reconstruction of composite mandibular defects is an accepted and widely used procedure in oral cancer therapy (Castillo et al, 1988; Sindet-Pedersen, 1988). Many of these patients must receive post-surgical radiotherapy in the course of their treatment because of possible residual microscopic disease.

The effects of radiation on tissue-metal interfaces have been studied for photon (Dutreix & Bernard, 1966; Gibbs et al, 1976; Hudson et al, 1984) and electron beams (Weatherburn et al, 1975; Khan et al, 1976; Gagnon & Cundiff, 1980; Klevenhagen et al, 1982). They have been found to result in an enhancement of the dose to the tissue in the immediate vicinity of the interface on the side facing the beam. A search through the literature has revealed limited studies on the effects of radiation beams on metal mandibular implants of the oral cavity (Castillo et al, 1988; Scher et al, 1988). These investigations were confined to stainless steel and vitallium plates irradiated with 6 MV photons.

In the last few years, titanium reconstruction plates have become available and are growing in popularity because of the increased strength relative to the thickness of the plate, greater tissue compatibility and easier adaptation to the bony fragments.
Invisible pulmonary markings due to air in the pulmonary vasculature: a post-mortem study
Authors: McHugh K. , Brunton F. J.
Published: July 2009

Pulmonary vascular markings were invisible on a postmortem chest radiograph because of air in the pulmonary vessels in a patient who had exsanguinated. This unusual case illustrates that it is the blood in the pulmonary arteries and veins, rather than the vessels' walls, that accounts for the normal lung markings on the plain chest radiograph.
Strongyloidiasis of the colon
Authors: Rowlands P. C. , Speechly-Dick M. E. , Grech P.
Published: July 2009

A 60-year-old Iraqi woman with chronic B-lymphocytic leukaemia was admitted with pyrexia, generalized abdominal pain, cough and sputum.

Two years previously she had been admitted to hospital with right upper quadrant pain. Investigations at that stage, including ultrasound and acetanilidoiminodiacetic acid (HIDA) scan, had been negative. The pain had recurred intermittently since then.

One month before admission she had noticed a worsening of her pain and she was unable to sleep. At that time her white cell count had increased and she was commenced on a 2-week course of chemotherapy.

On examination she looked pale and unwell. Her temperature varied between 37.5°C and 40°C. There were petechiae on her back and upper arms and an erythematous rash on her trunk.
Macronodular hepatic tuberculosis in a child: computed tomographic appearances
Authors: Moskovic Eleanor
Published: July 2009

Hepatic tuberculosis (TB) is usually miliary, associated with pulmonary miliary disease. Large tuberculous hepatic abscesses are not frequently seen, and are extremely rare in children, in whom the overall incidence of hepatic TB is lower than in adults. The largest reported series of hepatic TB to date described 200 cases in all, of which only one case, an adult, demonstrated macronodular caseating abscesses (Hersch, 1964). This form of TB is usually seen in extremely debilitated patients with poor immunological resistance, which often serves to complicate the clinical picture and make the diagnosis difficult. In the case described, computed tomography (CT) proved invaluable in making the diagnosis and on follow-up.

A 4-year-old black male child presented to the Red Cross Childrens' Hospital in June 1985 with a 2-month history of weight loss, fever, vague abdominal pain and malaise. On examination he was clearly emaciated, pale, with a distended abdomen, ascites, nodular hepatomegaly, and pyrexial with a temperature of 38.5°C.
The forgotten incident
Authors: Tran T. L. , McCarty M.
Published: July 2009

A 47-year-old man was referred by his general practitioner to the medical outpatient clinic with a 4-week history of colicky abdominal pain in the epigastrium and peri-umbilical region, anorexia and weight loss. He also complained of flatulence and abdominal distension after meals. The only relevant past medical history was bilateral inguinal hernia repairs 12 months previously.

Abdominal examination in the outpatient clinic did not reveal any abnormality. His complaints were thought to be related to gall bladder or peptic ulcer disease. Initial investigations included an upper abdominal ultrasound which was normal.
Complete remission of metastatic squamous carcinoma after cisplatinum chemotherapy without sustained control, following primary tumour control by californium-252 brachytherapy
Authors: Maruyama Yosh , Macdonald John , Patel Pushpa
Published: July 2009

The case report by Burnet and Blake (1989), “Sustained complete remission of Stage IV carcinoma of the cervix with cisplatinum, methotrexate and bleomycin chemotherapy”, was of great interest. We have found californium-252 (Cf-252) neutron brachytherapy (Cf-NT) to be highly effective for local control of bulky T4 squamous cell carcinoma of the tonsiloropharynx (Maruyama, 1984). Hence, we tested Cf-NT with adjuvant cisplatin-based chemotherapy for treatment of a case of advanced and metastatic oral cavity squamous cell cancer. Cisplatin plus 5-fluorouracil is an effective combination (Decker et al, 1983; Campbell et al, 1987; Toohill et al, 1987; Taylor et al, 1989), which we used.
The traceability of brachytherapy sources supplied by Amersham International
Authors: Rossiter M. J.
Published: July 2009

The NPL has received several enquiries concerning the traceability route to national standards for brachytherapy sources. The purpose of this note is to describe briefly the current traceability links for brachytherapy sources and to outline measures that are planned to reinforce and formalize these linkages.

The first line of traceability for Amersham International's cobalt-60 sources is in terms of the quantity activity. Reference sources have been compared ionometrically with a base standard of cobalt-60 whose activity was measured by absolute counting at NPL.
Testing a policy for skull radiography (and admission) following mild head injury
Authors: Hornsby V. P. L.
Published: July 2009

I was very interested to read a recent article, “Testing a policy for skull radiography (and admission) following mild head injury” (de Lacey et al, 1990). It occurred to me that it might be an interesting exercise to cost out the financial implications of abandoning our “loose and liberal” policies on skull radiography and the impact of doing that on the hospital admission rate.
Vasopressin release in response to intravenously injected contrast media
Authors: Morcos S. K. , Nahas A. M. El , Haylor J. , Sayed A. A. El
Published: July 2009

The hypothesis of Trewhella et al (1990) that the renal vascular response of contrast media (CM) is mediated by vasopressin is interesting. However, we have recently demonstrated that CM can exert a direct effect on renal vascular resistance (RVR) independent of the influence of systemic hormones using the isolated perfused rat kidney model (El Sayed et al, 1990).
Comparison of spin echo T
1-weighted and FLASH 90° gadolinium-enhanced magnetic resonance imaging in the detection of cerebral metastases
Authors: Cherryman Graham , Golfieri Rita
Published: July 2009

A direct comparison of post-gadolinium FLASH® 90° magnetic resonance (MR) images against conventional post-gadolinium T  1-weighted spin echo MR images obtained in patients with suspected cerebral metastatic disease shows the FLASH sequence to be inferior. False negative FLASH 90° gadolinium-enhanced MR scans are thought to be a result of either magnetic susceptibility artefact or inferior contrast resolution. False positive FLASH 90° gadolinium-enhanced MR images are a result of either difficulty in interpreting the high signal seen in small vessels or, again, magnetic susceptibility effects. In addition, our study shows small abnormalities suggestive of cerebral metastases on the FLASH 90° gadolinium-enhanced sequences which were not seen on the spin echo T  1 -weighted gadolinium-enhanced sequences. We believe that spin echo T  1-weighted gadolinium-enhanced MR sequences demonstrated 131 out of 139 (94.2%) and FLASH 90° gadolinium-enhanced MR sequences detected 122 out of 139 (87.8%) possible metastases. From this, we conclude that spin echo T  1-weighted gadolinium-enhanced MR sequences is a better test than FLASH 90° gadolinium-enhanced MR in the diagnosis of brain metastases and that either sequence alone is limited as a screening test.
Film cassette for quality assurance of dental X-ray tubes
Authors: Baldock C. , Arnold M. T.
Published: July 2009

The guidance notes for the protection of patients against ionizing radiations arising from medical and dental use specify that dental X-ray installations should be surveyed at least once every 3 years (HMSO, 1988). X-ray equipment in Community Dental Clinics, for whom we provide a radiological protection service, is not routinely serviced by the manufacturer. We felt it would be desirable to monitor the performance of the X-ray equipment at more frequent intervals as faults may go undetected leaving the equipment radiologically unsafe.

We have developed a film cassette (Fig. 1) to enable routine quality assurance checks of equipment to be made by dental staff without the use of an ion chamber. The film is sent to the Physics Department for processing and densitometric analysis.

The cassette is used to measure kilovoltage, half value layer (HVL), tube output and beam diameter at the patient end of the cone.
Ultrasonic detection of a retroperitoneal haematoma causing duodenal obstruction following ureterolithotomy
Authors: Ritchie D. A. , Frazer C. K. , Taylor A. D. , Newling D. W.
Published: July 2009

Many authors have documented the clinical features and ultrasonic appearances of retroperitoneal haematomas which are usually a result of blunt epigastric trauma, bleeding diatheses or leaking aneurysms (McVerry et al, 1977; Foley & Teele, 1979; Shirkoda et al, 1983; Mittelstaedt, 1987). With adequate perioperative drainage, retroperitoneal haemorrhage is an uncommon complication of ureteric surgery (Straffon, 1986), although there may be an increased risk where the surgery is complicated. We present a case of duodenal obstruction resulting from a retroperitoneal haematoma following ureteric surgery diagnosed by ultrasound.

A 51-year-old man, with a history of several previous operations for bilateral recurrent urinary calculi, presented with a 2-month history of intermittent right renal colic and an intravenous urogram confirmed a calculus in the distal right ureter. Following unsuccessful attempted dormia basket removal, an open ureterolithotomy was performed to remove the impacted calculus. Although scarring and adhesions from previous surgery made the operation technically difficult, he made a satisfactory recovery and was discharged after 10 days.

Four days later he was re-admitted with a history of bile stained vomiting and upper abdominal distension. Abdominal examination revealed some epigastric swelling and satisfactory healing of his right lower abdominal wound. His serum amylase was normal. A barium meal confirmed an obstruction at the mid-portion of the second part of the duodenum, and appearances suggested an extramural lesion (Fig. 1). Delayed radiographs showed passage of barium distally indicating an incomplete obstruction.
Leiomyosarcoma following therapeutic irradiation for ankylosing spondylitis
Authors: Stevens G. N. , Tattersall M. H. N. , Biro C. , Stalley P.
Published: July 2009

The occurrence of soft tissue sarcomas following therapeutic irradiation for both benign and malignant conditions is a well recognized, though uncommon, event (Souba et al, 1986; Laskin et al, 1988; Robinson et al, 1988). The majority of these tumours have been classified as malignant fibrous histiocytomas (MFH), with fibrosarcomas and a wide range of other histological subtypes occurring less frequently. Of particular note is the scarcity of reports of leiomyosarcomas that fulfil the criteria for a radiation-induced malignancy. Within the literature, we could find only four such cases, three of which followed the treatment of bilateral retinoblastoma (Lynch & Herr, 1981; Folberg et al, 1983; Font et al, 1983). In this report we present a case of leiomyosarcoma following irradiation for ankylosing spondylitis.

In 1987, a 61-year-old Caucasian male presented to a district hospital with a history of upper thoracic back pain that had been present for several years. The patient had been aware of a subcutaneous, non-tender lesion in the upper thoracic paravertebral region for the previous 3 years. A computed tomographic (CT) scan showed a 2–3 cm diameter mass on the right, adjacent to the second and third thoracic vertebral bodies. A biopsy indicated a soft tissue sarcoma but no treatment was offered as the tumour was considered unresectable. Over the subsequent year, the mass fluctuated in size. It then started to grow, with an increase in back and right shoulder pain.
Ultrasound of the normal thymus in the infant: a simple method of resolving a clinical dilemma
Authors: Carty H.
Published: July 2009

The normal thymus has many variable appearances on a chest radiograph. Many of the variations on the theme are seen sufficiently often to be easily recognized by the experienced radiologist. Occasionally, however, the pattern is odd and the presence of a widened mediastinum causes concern, particularly when the child presents with stridor thought to be due to airways obstruction. It is important to exclude an obstructive mass. Two radiographic techniques help: a penetrated view and a lateral view of the chest. The normal thymus is of low radiodensity and it is usually possible to see normal lung markings through it, which are not usually visible with solid neoplastic masses. On the lateral view, a normal thymus is of low radiodensity and it is usually possible to see this, concern may persist.
Book reviews
Authors: Dixon D. W.
Published: July 2009

This guide is similar in structure to the previous publication, IAEA Safety Series No. 43, the main difference being that the discussion of hazards by work environment is omitted. This enables the current guide to deal more effectively with the planning, implementation and interpretation of monitoring methods in mines and mills, which it does very well.

A particularly useful approach is the separate description, for each monitoring method, of the principles, equipment, procedures and limitations, with graphs and tables of calculation factors. Some of the material is the same as in the earlier guide, but much has been expanded and updated. Several more recent measurement methods are described, producing a comprehensive reference volume from which the characteristics of all the most common procedures can readily be evaluated. Descriptions are also included of some more specialized methods of measurement more suitable for research work.
Book reviews
Authors: Sikora Karol
Published: July 2009

There are several pocket references available to help with the management of cancer patients. This is the first that I have seen that includes radiotherapy, which after all is still the best single agent for the majority of cancers. Written by an experienced consultant, it provides a modern comprehensive approach for all those involved in the treatment of adult cancer patients.
Book reviews
Authors: Whitehouse G. H.
Published: July 2009

This book is primarily aimed at radiologists working in private practice in the United States of America. As well as describing the patient evaluation, aftercare and technical considerations which are necessary for invasive procedures on an outpatient basis, advice is given on the financing and management of outpatient radiological centres. There are some interesting insights into transatlantic radiological practice. While hospital costs in the USA account for 37% of the health care dollar, Medicare reimbursement policies have restricted hospital based diagnostic activities. Any reduction in inpatient procedures is therefore regarded as an asset. Although there has been a resultant expansion in the amount of outpatient invasive procedures, some radiological facilities are owned by physicians or business corporations rather than by radiologists. This factor, together with an overabundance of clinicians, is held to be responsible for half of all radiological examinations now being performed by non-radiologists. This situation must inevitably lead to the performance of procedures which many radiologists would regard as being inappropriate.
Book reviews
Authors: Shields R. A.
Published: July 2009

The development of clinical diagnostic applications of radionuclides has reached a stage at which the discipline of nuclear medicine could be said to be mature. Nevertheless, the pace of discovery and innovation can rapidly render established text-books out of date. The appearance of a new book covering the field is therefore most welcome, particularly as it emphasizes the practical aspects of the current range of techniques.

The first third of this book covers physical principles and the technology of nuclear medicine. Clear accounts are given of the principles of the gamma camera when used for both planar and tomographic imaging, and of the assessment of its performance. A separate chapter explains the use of data processing facilities.
Book reviews
Authors: Sharma H. L.
Published: July 2009

The book is a compilation of proceedings of the Third International Symposium on Synthesis and Applications of Isotopically Labelled Compounds (1988). The research papers published are the fuller or extended versions of proffered papers and also include transcripts of plenary lectures.
Book reviews
Authors: Kenny J. B.
Published: July 2009

The Pocket Atlas of Spinal MRI aims to provide a compact reference to the normal anatomy of the spine as demonstrated by MRI.
Book reviews
Authors: Carty Austin
Published: July 2009

Few radiologists would dispute the primacy of Janet Husband in British whole body computed tomography (CT) for the last decade and a half. One of the outward signs of this primacy is the London Course in Whole Body CT.
The relative biological effectiveness of fractionated doses of fast neutrons (42 MeVd → Bc) for normal tissues in the pig
Authors: Hopewell J. W. , Barnes D. W. H. , Robbins M. E. C. , Corp M. , Sansom J. M. , Young C. M. A. , Wiernik G.
Published: July 2009

The late effects of irradiation with single and fractionated doses of X rays (250 kV) and fast neutrons (42 MeVd→Bc), on the cutaneous and subcutaneous tissues of the pig, have been evaluated from measurements of changes in relative field length. These were determined at intervals of 26–104 weeks after irradiation. For fractionated irradiation with X rays the average fractions exponent, N, obtained from a log–log plot of iso-effect dose (ED50) against fraction number was 0.41. This was independent of the period of assessment, with no significant indication of a time factor. However, the exponent N did vary with the level of effect and was in the range 0.33–0.51. It was greatest for a ≥10% reduction in relative field length. Assuming the validity of the linear quadratic model of cell survival, the α/βp ratio was 1.95 Gy. However, this model fitted the data less well for the least severe levels of damage, and for these the α/β ratios were not significantly different from zero. Irradiation with fast neutrons showed a small effect of fractionation for doses given in ≥ 6 fractions compared with a single dose. There was no significant increase in iso-effect dose when the dose was given in 30 fractions compared with 6 fractions. The relative biological effectiveness for late cutaneous and subcutaneous damage for the energy of fast neutrons used did not vary with the period of assessment, i.e. 26–52 weeks compared with 65–104 weeks, and was not significantly different from that previously obtained for ischaemic dermal necrosis, seen after higher doses, at 12–20 weeks after irradiation.
Additive filtering
Authors: Marugg Silvio , Streule Karl , Hedtler Wolfgang , Berchtold Cyril
Published: July 2009

One of the major goals of diagnostic radiology is to produce a radiograph of high quality while maintaining radiation exposure to the patient at a low level. In addition, the public is more aware of and concerned about radiation exposure (Kohn et al, 1988). Therefore the use of aluminium or plexiglass filters for compensating and eliminating over-penetration in special regions such as shoulders, arch aortograms, chest radiographs and lateral decubitus films has been described (Crow et al, 1983; Feczko et al, 1983; Vyborny & MacMahon, 1984; Vezina, 1985). For an overall reduction of radiation exposure, yttrium, niobium and copper filters are in use. The shape and thickness of the different filters are highly variable. To achieve a correct positioning a sliding teflon mount was used by Crow et al (1983).

A filtering system with ferromagnetic plates at the tube-housing and magnets glued onto the filters has been developed and used by us. The system allows free positioning of filters of different sizes, the use of more than one filter at the same time and, with a second coupling plate, even the addition of two filters.
Spinal cord sarcoidosis with intramedullary cyst formation
Authors: Clifton A. G. , Stevens J. M. , Kapoor R. , Rudge P.
Published: July 2009

We report a case of spinal cord sarcoidosis with surgically confirmed localized cyst formation and probably syringomyelia involving almost the entire spinal cord, an association which has not been documented previously. The magnetic resonance (MR) findings before and after gadolinium diethylenetriamine-pentaacetic acid (Gd-DTPA) are described. There has been only one previous report of the MR findings in histologically confirmed spinal cord sarcoidosis, and in this case Gd-DTPA was not given.

A 49-year-old man presented with a 3-week history of progressive urinary hesitancy and weakness of both legs. Three years previously he was diagnosed as having sarcoidosis on the basis of bilateral hilar adenopathy on plain chest radiography, and a positive Kveim test. Ten months before this admission he had developed granulomatous uveitis.

On initial examination there was moderate reduction of muscle power in all four limbs, whilst tone and co-ordination were normal. Reflexes were generally brisk, abdominal reflexes were absent, and there were bilateral extensor plantar responses. Vibration and joint position sensation were absent bilaterally in his feet, and there was a spinothalamic sensory level at C8 on the right and D6 on the left.
Contrast medium imbibition in osteoarthritic cartilage
Authors: Spring M. W. , Buckland-Wright J. C.
Published: July 2009

Double contrast arthrography is routinely used in the examination of synovial joints as the articular cartilage and capsular surfaces are more clearly delineated than with a single contrast technique. Tears, pitting and thinning of articular and meniscal cartilages are readily identified (Stoker, 1980; Fujikawa, 1981). Stoker (1980) has described the way that osteoarthritic changes in articular cartilage are heralded by the absorption of the contrast agent. This observation forms the basis of a current investigation into the articular changes in patients with osteoarthritis of the knee using high definition microfocal radiography (Buckland-Wright, 1989; Buckland-Wright & Bradshaw, 1989). To understand the process of contrast medium imbibition into articular cartilage, the present in vitro study was undertaken to determine whether the rate and the volume of contrast medium diffusing into articular cartilage was related to the histological condition of the tissue.

Thirty-seven samples of visually intact articular cartilage were obtained from the tibial plateau of fresh post-mortem subjects, three women and two men with early osteoarthritis and a mean age of 67.2 ± 15.0 years. Only five subjects were obtained for this study as we were not examining inter-subject variation but variation between samples, which were taken from different areas of the central articular regions of the medial and lateral tibial surfaces. The cartilage samples were cut to 3 × 10 mm in area, supported on approximately 10 mm of subchondral bone.
Echo planar imaging of the human fetus in utero at 0.5 T
Authors: Mansfield P. , Stehling M. K. , Ordidge R. J. , Coxon R. , Chapman B. , Blamire A. , Gibbs P. , Johnson I. R. , Symonds E. M. , Worthington B. S. , Coupland R. E.
Published: July 2009

The snap-shot capability of the echo-planar imaging technique is used to freeze motion effectively in human fetal studies in utero. These first results obtained at 0.5 T demonstrate diagnostic quality images without the need for averaging. Although averaging improves the image signal to noise ratio, it is shown that significant image blurring is produced even when only eight separate images are averaged over a period of a few seconds. Results are presented showing anatomical detail of the internal organs of the fetus. Some pathology is also demonstrated. These results were obtained using the modulus blipped echo-planar single-pulse technique (MBEST). Running at 10 frames/second, the modulus version of the fast low-angle excitation echo-planar technique (FLEET) is used to produce ungated fetal cardiac movies.
Magnetic resonance imaging in idiopathic retroperitoneal fibrosis: measurement of T
1 relaxation time
Authors: Brooks Alan P. , Reznek Rodney H. , Webb Judith A. W.
Published: July 2009

Magnetic resonance imaging at 0.08 Tesla was performed in nine patients with proven idiopathic retroperitoneal fibrosis. A total of 11 scans was performed. Three patients were scanned before diagnosis; one of these also had two follow-up scans. A further six patients were scanned a variable time after diagnosis and treatment. On each scan, a periaortic soft-tissue mass was readily identified, the distribution corresponding to that seen on computed tomography. There was no difference in the mean T  1relaxation time of the mass between patients scanned before diagnosis and those scanned after treatment. However, the patient followed with serial scans showed a progressive reduction in the T  1 value of the mass with time. Comparison with results obtained in patients with lymphoma suggests that the T  1 values in retroperitoneal fibrosis are lower than in lymphoma, particularly non-Hodgkin's lymphoma.
The relative biological effectiveness of fractionated doses of fast neutrons (42 MeVd→Be) for normal tissues
Authors: Rezvani M. , Barnes D. W. H. , Hopewell J. W. , Robbins M. E. C. , Sansom J. M. , Adams P. J. V. , Hamlet R.
Published: July 2009

The effect of single and fractionated doses of fast neutrons (42 MeVd→Bc) on the early and late radiation responses of the pig lung have been assessed by the measurement of changes in lung function using a 133Xe washout technique. The results obtained for irradiation schedules with fast neutrons have been compared with those after photon irradiation. There was no statistically significant difference between the values for the relative biological effectiveness (RBE) for the early and late radiation response of the lung. The RBE of the neutron beam increased with decreasing size of dose/fraction with an upper limit value of 4.39 ± 0.94 for infinitely small X-ray doses per fraction.
Skeletal abnormalities in a case of congenital erythropoietic porphyria
Authors: Ito Masako , Hayashi Kuniaki , Uetani Masataka , Isomoto Ichiro , Irifune Hiroko
Published: July 2009

Congenital erythropoietic porphyria (CEP) is an extremely rare disorder of porphyrin metabolism and characterized by the deposition of porphyrins in soft tissue, bone and teeth. Reported radiographic findings of CEP include acro-osteolysis, scleroderma-like calcifications and demineralization of bone. We report a case of CEP which showed, in addition to these findings, multiple osteolytic and sclerotic lesions.