bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of microwave tissue coagulation on the livers of normal rabbits: a comparison of findings of image analysis and histopathological examination
Authors: Kato T , Suto Y , Hamazoe R
Published: July 2009

The livers of normal rabbits were subjected to microwave tissue coagulation (MTC), and comparison was made of the subsequent time-course changes in tissue observed on MRI, CT and histopathological examination. 16 rabbits were used. MTC was performed with a 21 gauge needle electrode inserted into the liver at laparotomy. 1–2 h after thermal coagulation, a region with slightly lower attenuation than that of surrounding normal liver parenchyma was observed on CT, and no enhancement was detected. With MRI, change from high signal intensity to iso-signal intensity from the inner zone to the margin was found on T  2 weighted images (T  2WI), and heterogeneous high signal intensity was observed on T  2 weighted images (T  2WI). On Gd-DTPA enhanced MRI, no enhancement occurred. 1–4 weeks after coagulation, the cellular structure at the site of coagulation was lost on histological examination, and the tissue became necrotic. On CT, homogeneous water density was observed, and no enhancement was detected. With MRI, regions of iso- or slightly low signal intensity were observed on T  1WI, and regions of heterogeneous high to low signal intensity were seen on T2WI. After 1 week, a granulation layer consisting mainly of fibrous tissue developed, and a ring-shaped enhancement was observed in the low signal intensity region on T  1WI and in the high signal intensity region on T  2WI. The ring-shaped enhancement was also noted on CT. MRI appears to be useful for observation of time-course changes following MTC therapy because of its sensitivity in the detection of tissue changes.
Cross-calibration of a fan-beam X-ray densitometer with a pencil-beam system
Authors: Bouyoucef S E , Cullum I D , Ell P J
Published: July 2009

This study describes the cross-calibration of two Hologic bone densitometers, one using a fan-beam X-ray source (QDR4500/A) and the other a pencil-beam source (QDR1000/W). The QDR4500/A allows spine and hip measurements to be made at three principal speeds. Results from two spine phantoms and 154 patients showed no significant difference in the absolute values or precision between speeds. The middle speed (taking 1 min to scan an adult lumbar spine) was used for the comparison between the instruments. The two densitometers were compared using two spine phantoms and 182 patients. In vivo measurements were made of all lumbar spine, hip, forearm and whole body sites. Regression lines, constrained to pass through the origin, were calculated. Slopes for total bone mineral density (BMD) for each scan type ranged between 0.994 and 1.029, the best value being found for forearm (1.000). Scatter graphs of the individual points were generated and showed results slightly worse than would be expected from repeat measurements on a single machine (79–88% fell within the expected 2 SD range). A trend for the QDR4500/A to overestimate BMD at low values and underestimate it at high values was seen in the femoral neck. The trend was more significant in the lumbar spine. There was an overestimate of total hip BMD throughout the range. Slopes of the regression lines for area and bone mineral content (BMC) were used to improve cross-calibration between the systems on a site-to-site basis, after which the results improved to a level consistent with repeat measurements on a single machine (81–94% within 2 SD). At present only global, rather than site-specific, correction factors can be employed for the spine and hip and no overall improvement in cross-calibration was possible. We conclude that although global correction factors allow adequate cross-calibration to be achieved, improvements could be made by the use of scan-site-specific factors.
Book reviews
Authors: Cooke R W I
Published: July 2009

Neonatal medicine has long since been satisfied merely with assessing outcome in terms of survival, and is increasingly concerned with the quality of that survival in neurodevelopmental terms, 2, 10 and more years later. Perinatal cerebral injury has been demonstrated using CT scanning for two decades, but due to ease and convenience has been largely supplanted by high resolution ultrasound scanning in the neonatal penod The simplicity of the technique has enabled its rapid spread into use in neonatal intensive care units the world over. Although dozens of publications in journals and books have testified to the interest in diagnosing cerebral haemorrhage and infarction in sick preterm infants, most report small and often biased populations of preterm infants, and a wide variety of techniques to discuss them.
Book reviews
Authors: Healey T
Published: July 2009

There are three aspects of quality assurance programmes — acceptance testing against specified tolerances, routine testing and treating against established baseline results and desirable design criteria for performance. There is always a considerable degree of overlap and the same methods of testing often apply. For instance, published “state of the art” parameters enable us to specify a minimum level of performance and the acceptance testing against that standard can be taken as the baseline for the routine quality assurance tests and the day-to-day checking that is so important.
Acute subarachnoid haemorrhage: detection with magnetic resonance imaging
Authors: Chrysikopoulos H , Papanikolaou N , Pappas J , Papandreou A , Roussakis A , Vassilouthis J , Andreou J
Published: July 2009

The purpose of this study was the evaluation of fluid attenuated turbo inversion recovery (FLAT TIRE) MR pulse sequence for detecting acute subarachnoid hemorrhage (SAH). Seven patients with SAH were studied within 6 days of ictus. Six of them underwent both CT and MRI and one MRI only. Pulse sequences included T  1 spin echo (SE), PD and T  2 turbo spin echo (TSE) and FLAT TIRE (TR/TI/TE = 6500/1800/140–180). All studies were performed on a 0.5 T system (Gyroscan T5, Philips Medical Systems). Simulated acute SAH was also studied with MRI. The FLAT TIRE sequence was better than the SE and TSE in all seven cases and better than CT in two cases. In two cases MRI was equivalent to CT, and in another two MRI underestimated the extent of SAH. The simulated acute SAH could be detected easily with the FLAT TIRE sequence, with difficulty on the T  1 weighted images and not at all on the PD/T  2 weighted images. The specific FLAT TIRE sequence used seems promising for the detection of acute SAH.
Reference ranges of bone mineral density for women in southern England: the impact of local data on the diagnosis of osteoporosis
Authors: Petley G W , Cotton A M , Murrills A J , Taylor P A , Cooper C , Cawley M I D , Wilkin T J
Published: July 2009

The construction of reference ranges that accurately represent the population at large is essential for the correct identification of osteoporosis from bone mineral density (BMD) measurements. In this study, reference data supplied by the manufacturer of the Lunar DPX + bone densitometer were compared with data obtained locally. Lumbar spine, proximal femur and total body BMD measurements were made in an age-stratified random sample of 702 Southampton women aged 20 to 89 years. Relevant demographic and medical data were recorded for each subject using a questionnaire. Reference curves of BMD (mean ± SD) were plotted against age for each measurement site and were found to be higher than the manufacturer's reference values at all ages and sites. Exclusion of women with factors known to affect bone mass only served to increase this discrepancy. According to World Health Organisation definitions, osteoporosis may be identified from BMD values alone. Based upon neck of femur BMD values, 100 (14.8%) of the women in this study group were categorized as osteoporotic using local young normal reference data, compared with only 39 (5.8%) using the manufacturer's data. By normalizing for age distribution, these findings were extrapolated to the local population where it was predicted that 26.0% and 10.1% of females over 50 years of age would be classified as osteoporotic using the respective reference ranges. This study clearly illustrates how the numbers of women diagnosed as osteoporotic vary with the use of different reference populations.
MR imaging of fetal brain abnormalities using a HASTE sequence
Authors: Tsuchiya K , Katase S , Seki T , Mizutani Y , Hachiya J
Published: July 2009

HASTE (half-Fourier acquisition single-shot turbo spin echo) is a sequence that enables T  2 weighted magnetic resonance (MR) images to be obtained in a few seconds. The purpose of this study was to evaluate the usefulness of this sequence in the diagnosis of fetal cerebral abnormalities. Five fetuses suspected of having cerebral abnormalities on ultrasound examination were studied by MR imaging using the HASTE sequence in utero. We compared the images with post-natal MR images or computed tomography (CT) scans. In four fetuses, the abnormality was diagnosed correctly, and the diagnosis was almost correct in the remaining fetus. This sequence is useful because it provides images of diagnostic quality in a very short scanning time.
“Air-in a view”
Authors: England R , Schutz S M , Leung J W C
Published: July 2009

A 57-year-old female was referred to Duke University Medical Center (DUMC) for investigation of recurrent pancreatitis. Her first episode of pancreatitis, which had occurred 3 years earlier, manifested as epigastric pain and a markedly elevated serum amylase level which necessitated hospital admission for 9 days. Her history was negative for relevant pancreatic risk factors including alcohol abuse, medications, family history and hyperlipidaemia. Ultrasound (US) of the gallbladder showed no gallstones. CT of the abdomen showed a swollen head of pancreas with peri-pancreatic inflammatory change and fluid, consistent with pancreatitis. The biliary tree was not dilated. She made a complete recovery and was well until 8 months later when she had recurrent epigastric pain of a similar character with elevation of the serum amylase. She was admitted to hospital for 3 days. A repeat US scan showed no cholelithiasis. Following resolution of her symptoms, she underwent endoscopic retrograde cholangiopancreatography (ERCP) to exclude choledocholithiasis or a pancreatic abnormality. The patient's pancreatogram is shown in Figures 1 and 2. The cholangiogram was reported to be normal. She developed post-ERCP pancreatitis and was referred to DUMC for further evaluation.
Performance characteristics of the Pantak DXT-300 kilovoltage X-ray treatment machine
Authors: Aukett R J , Thomas D W , Seaby A W , Gittins J T
Published: July 2009

The beam and performance characteristics of a new orthovoltage X-ray unit, the Pantak DXT-300 have been evaluated. Data were collated for four qualities: 3.27 mmAl, 7.15 mmAl, 1.65 mmCu and 3.51 mmCu half value layer (HVL) (SE = 0.04mm). Parameters which were investigated included beam quality, central axis depth dose, relative output, backscatter factors, field uniformity, peripheral dose and head leakage. The calibration procedure and the performance of the dosimetry system have also been described.
Radiation protection for radiologists
Authors: Corbett R H
Published: July 2009

This meeting, organized by the Radiation Protection Committee of the British Institute of Radiology, was held on 22 April, 1996. The programme gave both new recruits to diagnostic radiology and established radiologists the opportunity to learn or refresh their knowledge of radiation protection matters. To this end papers were invited from a range of speakers on diverse topics such as measurement of dose, risk, dose saving methods and hazards. Much is happening in radiation protection matters with improved understanding of the radiobiology of radiation effect and the realization that there is no safe dose threshold. This has led to significant change in radiation safety legislation and guidance. Hence it was rather disappointing that so few radiologists were prepared to spend a day learning about the dangers of the product with which they make their living.
The clinical and radiological features of cholecystocolic fistulae
Authors: Hession P R , Rawlinson J , Hall J R , Keating J P , Guyer P B
Published: July 2009

The clinical and radiological features of seven patients presenting with cholecystocolic fistulae are reviewed. The majority of the patients were elderly (age range 43–85 years, mean 70.7 years) and there was a female preponderance (6:1). The condition usually has a benign clinical course. Diarrhoea was the most common presenting symptom and the typical clinical features of gallbladder disease were absent. Cholangitis occurred in only one patient. The time between onset of symptoms and diagnosis varied from 1 week to 2 years (mean 22 weeks). In only one patient was the diagnosis of biliary–intestinal fistula suspected on the basis of the plain abdominal radiograph (Case 5). A diagnosis of cholecystocolic fistula was established by barium enema (5 cases), endoscopic retrograde cholangiopancreatography (ERCP) (1 case) and diagnostic laparotomy (1 case). The only cause identified in this series was acute or chronic cholecystitis.
Concordance and precision of dual X-ray absorptiometry with a 10 s scan
Authors: Patel R , Seah M , Blake G M , Jefferies A L , Crane F M , Fogelman I
Published: July 2009

Development of dual energy X-ray absorptiometry (DXA) scanners with multidetector array technology has resulted in greatly shortened scanning times. The Hologic QDR-4500 includes an ultrafast (10 s) “turbo” scan mode recommended by the manufacturer for fast screening studies or as an aid to positioning the patient prior to scanning using the normal fast (30 s), medium (1 min) or high definition (2 min) modes. The suitability of the turbo mode for use in routine clinical studies was assessed by examining the concordance of bone mineral density (BMD) measurements obtained in this mode with measurements obtained using the three normal scanning modes. Studies in 151 female patients showed statistically significant discrepancies in four out of the six scan sites studied with systematic differences of 2.9% and 3.1% being observed for the posteroantenor (PA) spine and intertrochanteric region of the hip, respectively. In vivo precision for the 10 s scan found by performing duplicate measurements on 37 patients had a coefficient of variation of 1.3% for PA spine and 2.5% for femoral neck BMD. An investigation of the dependence of precision on body mass index (BMI) shows that the precision of spine and hip BMD was adversely affected with increasing BMI but the trend was statistically significant only in the spine. It was concluded that turbo mode scans are acceptable for routine clinical studies of the spine and hip but should not be used for longitudinal studies or patients with BMI greater than 30 kg m−2.
Risk factors and dose–effect relationship for osteoradionecrosis after hyperfractionated and conventionally fractionated radiotherapy for oral cancer
Authors: Niewald M , Barbie O , Schnabel K , Engel M , Schedler M , Nieder C , Berberich W
Published: July 2009

A high frequency of osteoradionecrosis after hyperfractionated radiotherapy (RT) of head and neck tumours led to a detailed analysis of risk factors in the dental, surgical, and radiotherapeutic areas 168 patients with oral cancer were analysed retrospectively. 19% of them had been irradiated primarily and 81% post-operatively. 116 patients received a total dose mostly ranging from 60 Gy to 70 Gy to the ICRU 29 reference point (daily single dose 2 Gy). 52 patients were treated hyperfractionally with two daily fractions of 1.2 Gy per day, 4 h minimum apart and a total dose 82.8 Gy. Dental findings could be evaluated in 126 patients. Factors were checked for prognostic significance for osteoradionecrosis (ORN). Dose dependency was computed using a PROBIT analysis. Dental status before radiotherapy was generally poor (mean 11/32 teeth present, of these 1 was dead, 2.4 carious, 2.4 loose, 0.3 destroyed). On average, six teeth (range 0–27 teeth) had to be extracted. In one-third of the patients bone surgery was necessary. ORN occurred in 8.6% of the patients treated conventionally but in 22.9% of those treated hyperfractionally (p = 0.029). Biologically effective dose (p = 0.032) and deep paradontitis (p = 0.034) proved to be significant risk factors for ORN. PROBIT analysis showed a steadily rising dose dependency of the ORN frequency after conventional radiotherapy. Using total doses up to 70 Gy the frequency of ORN was 8.6%. Dose escalation using hyperfractionation led to an intolerable ORN frequency (22.9%) where a short interfraction interval was a significant factor. The use of this dose fractionation was therefore discontinued in 1992.
Dose reduction in double contrast barium enema by use of low fluoroscopic current
Authors: Smiddy P F , Quinn A D , Freyne P J , Marsh D , Murphy J M
Published: July 2009

Under standard conditions double contrast barium enema (DCBE) was carried out on a selected patient cohort using either standard (1.5 mA) or low (0.5 mA) fluoroscopic current. A statistically significant (p≤0.01) reduction in total dose was achieved by use of low screening current. This reduction was of the order of 40%. Fluoroscopic image quality was analysed both objectively and subjectively, and was found not to be significantly degraded when the lower current was used. On blinded evaluation all examinations were found to be of diagnostic quality. The use of low fluoroscopic current results in a reduction in patient dose, without compromising fluoroscopic image quality or diagnostic standard of the examination. Low fluoroscopic current technique has been adopted as the standard in our department.
Rupture and growth of adrenal myelolipoma in two patients
Authors: Wong K W , Lee I P O , Sun W H
Published: July 2009

Two cases of pathologically confirmed adrenal myelolipoma are described in Chinese patients. The first patient presented with tumour rupture and perinephric haemorrhage. The second patient was operated on 18 months after the incidental discovery of the tumour, due to its large size and the interval growth.
Lymphoepithelial cyst of the pancreas
Authors: Schinke-Nickl D A , Müller M F
Published: July 2009

The case of a rare lymphoepithelial cyst of the pancreas is presented. The non-specific findings on endoscopic retrograde cholangiopancreaticography, endoscopic ultrasound, computed tomography and magnetic resonance imaging are discussed.
Fast CT for aortic dissection
Authors: Small J H , Dixon A K , Coulden R A , Flower C D R , Housden B A
Published: July 2009

Results were evaluated in 81 patients with suspected acute aortic dissection who were examined on a fast CT system capable of a 1 s data acquisition time. 17 patients had Type A and nine had Type B dissections. Radiological assessment provided 78 confident reports and expressed some uncertainty about the diagnosis in three patients. Overall sensitivity for aortic dissection was 96.2% and specificity was 96.4%. When 78 confident reports alone were considered, both sensitivity and specificity reached 100%. Reconstruction of data at 100 ms intervals allowed discrimination between artefacts in the ascending aorta and Type A dissections. CT can often be used as the single investigation prior to surgery for acute Type A dissections.
Does bowel preparation improve the quality of intravenous urography?
Authors: Bradley A J , Taylor P M
Published: July 2009

Many radiology departments continue to use bowel preparation prior to intravenous urography (IVU) despite recent studies questioning its value. This prospective study was designed to test the hypothesis that bowel preparation does not affect the quality of IVU, the number of films taken, or the use of tomography 144 patients were randomized into three groups; 49 had no preparation, 48 received a mild stimulant laxative (Dulcolax), and 47 took an osmotic laxative (Citramag). The subsequent IVUs were then reviewed by two observers; the control and contrast films were scored for the presence of faecal residue, and the visibility of the renal tract, respectively. Patients were also questioned about the side effects of the two preparations.

There was no significant difference in the scores for renal tract visibility in those patients receiving stimulant laxative when compared with the unprepared group. Those receiving the osmotic laxative had significantly less faecal residue but this was at the expense of an increased amount of bowel gas. The osmotic laxative group had significantly higher scores, indicating better visualization of the urinary tract, than the other groups, but no significant reduction in the number of radiographs taken or the use of tomography. This group also reported more side effects.

Overall our results suggest that the routine use of a laxative prior to an IVU examination does not decrease the radiation dose and produces some patient inconvenience. The practice therefore cannot be routinely recommended.
Renal ultrasonic findings in sulphadiazine-induced renal failure
Authors: Kane D , Murphy J M , Keating S , Wilson G F , Mulcahy F M
Published: July 2009

The increased incidence of cerebral toxoplasmosis in AIDS has led to a resurgence in the use of sulphadiazine. One complication of this is acute renal failure secondary to sulphadiazine-induced crystalluria. Three cases are described which demonstrate a spectrum of ultrasound findings ranging from echogenic foci in the renal parenchyma to echogenic material in both dilated and non-dilated collecting systems. In patients with AIDS having sulphadiazine treatment, these ultrasonic findings suggest that sulphadiazine is the cause of the renal failure.
Radiology in the neonatal intensive care unit: dose reduction and image quality
Authors: McParland B J , Gorka W , Lee R , Lewall D B , Omojola M F
Published: July 2009

This paper describes a prospective study of the diagnostic radiation doses received in a neonatal intensive care unit (NICU) for a representative radiological technique used at our institution for a number of years and a “low dose” technique similar to that recommended by the Commission of the European Communities (CEC). A 400 speed film–screen combination was used in both techniques A total of 363 anteroposterior (AP) chest and abdominal films of 77 neonates were accrued. For each radiograph, the entrance skin dose (ESD), energy imparted (EI) and mean whole body dose were determined For a neonatal AP chest, there was an 18% reduction in the mean ESD per radiograph from 20.0 μGy for the representative technique to 16.4 μGy for the low dose technique (p<0.0005). The reduction in the mean EI per radiograph values for the two techniques from 7.9 μJ to 7.1 μJ (10%) was statistically significant at the p<0.017 level, after compensating for the difference in mean field dimensions between the two patient cohorts. The mean whole body dose per radiograph reduction from 4.4 to 3.5 μGy (20%) was statistically significant at the p<0.0028 level. It was determined that the ESD and EI could be fitted by an exponential function in the equivalent patient diameter, a single parameter indicative of neonate size Absolute excess childhood cancer mortality risk per film was estimated using risk factors derived for fetal exposures. A “worst case” absolute excess mortality risk per chest radiograph was estimated to be 1.40 × 10 −7 for the conventional technique and was further reduced to 1.11 × 10 −7 for the low dose technique. A blind comparison of patient-matched film pairs for each technique was performed by three radiologists using criteria similar to those specified by the CEC. No statistically significant difference in clinical image quality was found between the two techniques.
Radiographic skills learning: procedure simulation using adaptive hypermedia
Authors: Costaridou L , Panayiotakis G , Pallikarakis N , Proimos B
Published: July 2009

The design and development of a simulation tool supporting learning of radiographic skills is reported. This tool has by textual, graphical and iconic resources, organized according to a building-block, adaptive hypermedia approach, which is described and supported by an image base of radiographs. It offers interactive user-controlled simulation of radiographic imaging procedures. The development is based on a commercially available environment (Toolbook 3.0, Asymetrix Corporation). The core of the system is an attributed precedence (priority) graph, which represents a task outline (concept and resources structure), which is dynamically adjusted to selected procedures. The user interface imitates a conventional radiography system, i. e. operating console, tube, table, patient and cassette. System parameters, such as patient positioning, focus-to-patient distance, magnification, field dimensions, tube voltage and mAs are under user control. Their effects on image quality are presented, by means of an image base acquired under controlled exposure conditions. Innovative use of hypermedia, computer based learning and simulation principles and technology in the development of this tool resulted in an enhanced interactive environment providing radiographic parameter control and visualization of parameter effects on image quality.
Bladder dose estimation during intracavitary brachytherapy for carcinoma of the cervix using a single line source system
Authors: Tan L T , Warren J , Freestone G , Jones B
Published: July 2009

The estimation of maximum bladder doses from orthogonal radiographs is unreliable when triple source systems are used for intracavitary brachytherapy (BT) for gynaecological cancers. For single line source systems, the estimation of maximum bladder doses from radiographs should be more reliable due to the radial symmetry of the isodose distribution. A pilot study has been carried out to compare the estimated maximum bladder doses from standard radiographs with data obtained from CT for single line source BT treatments. 12 patients undergoing treatment for carcinoma of the cervix were selected for CT assessment of their bladder doses. For each patient, the dose rates at the International Commission of Radiation Units and Measurements (ICRU) bladder reference point B1 and a second reference point B2 2.5 cm cranially were computed from orthogonal radiographs and were compared with the maximum bladder dose rate as determined by CT scanning. Dose rates were computed for two different source loading patterns (1) a 6 cm line source with uniformly distributed linear activity along its length, (2) a 6 cm line source with increased activity in the central 2 cm segment. The mean ratio of the maximum CT bladder dose rate to the dose rate at the ICRU reference point B1 on orthogonal radiographs for the line source with uniform linear activity was 1.32 (range 0.62−2.43, SD = 0.54). When the dose rates at both reference points B1 and B2 were considered, the mean ratio of the maximum CT dose rate to the maximum dose rate from radiographs was only 1.05 (range 0.72–1.72, SD = 0.24) For the line source with increased activity in the central segment, the mean ratio of the maximum CT bladder dose rate to the dose rate at B1 was 1.38 (range 0.60−2.63, SD = 0.64) When both B1 and B2 were considered, the variation in the ratio of the maximum CT dose rate to the maximum dose rate from radiographs was considerably smaller (mean ratio = 1.07, range 0.69−1.76, SD = 0.26). For single line source systems, single point dose estimation using the ICRU reference point on orthogonal radiographs will underestimate the maximum bladder dose although the discrepancy is less than for triple source systems. If the ICRU reference point is used in conjunction with a second reference point 2.5 cm cranially, then underestimation of the maximum bladder dose is unlikely to occur as at least one of the points is likely to be a reasonable estimate of the maximum bladder dose.
A lytic lesion in bone
Authors: Ng V W K , MacVicar D
Published: July 2009

A 16-year-old Caucasian male presented with pain in his left leg which he attributed to a footballing injury. A radiograph showed a lesion in the left femoral neck (Figure 1).
Book reviews
Authors: Corbett R H
Published: July 2009

This is a compilation of seven papers examining the issue of nuclear contamination, that it exists, is insidious, has already done great damage and has fearsome potential. The main theme of the papers is to present detailed research on radiation effects, especially low level radiation, and to present views that strongly dissent from the prevailing view of acceptable levels and test procedures.
Malignant mesothelioma of tunica vaginalis testis presenting with spinal metastasis—report of two cases
Authors: Mathew B S , Jyothirmayi R , Nair M K
Published: July 2009

Malignant mesotheliomas of tunica vaginalis testis (TVT) are rare tumours with a tendency to disseminate by lymphatic and haematogenous routes. Osseous metastasis is extremely uncommon. We report two cases of malignant mesothelioma of TVT presenting with spinal metastasis.
Focal spot sizes in dual-track Mo and Rh target mammographic X-ray tubes
Authors: Law J , Robinson A , Underwood A C
Published: July 2009

It is well known that the focal spot size in an imaging system is one of the major factors which determine the resolution. In mammography systems very high resolution is required to visualize small microcalcifications of the order of 100 μm or less [1]. This has led to the requirement for smaller foci, e.g. less that 0.5 mm as specified by the Department of Health (DoH) in the UK [2].
Book reviews
Authors: McCall J M
Published: July 2009

Until now there has been no comprehensive practical guide to the field of interventional radiology. With this book, Tony Watkinson and Andy Adam have filled this gap in the radiological literature.
Safety of diagnostic ultrasound
Authors: Haar G Ter
Published: July 2009

There is a general, widely held view that diagnostic ultrasound, as currently used, is safe and presents no measurable hazard to the patient. This view is supported by the published literature, in which no reported potentially adverse effect has been convincingly reproduced by a second, independent research team.
Pseudomonas aeruginosa bronchopulmonary infection in patients with advanced human immunodeficiency virus disease
Authors: Traill Z C , Miller R F , Ali N , Shaw P J
Published: July 2009

Pseudomonas aeruginosa is increasingly reported as a respiratory pathogen in patients with advanced human immunodeficiency virus (HIV) disease. We retrospectively reviewed the chest radiographic appearances of 29 HIV-infected adults with bronchopulmonary infection in whom Pseudomonas aeruginosa was the sole respiratory pathogen isolated. The commonest radiographic abnormality was a diffuse reticular (11 patients) or reticulonodular (9 patients) infiltrate in the pulmonary interstitium. Alveolar opacification was seen in seven patients. Cavitation was rare (2 patients), as was ground-glass opacification (2 patients). Five patients had pleural effusions. No patient had mediastinal or hilar lymphadenopathy. Normal chest radiographs were seen in eight patients. Although the radiographic appearances of Pseudomonas bronchopulmonary infection in HIV-infected patients are non-specific, an interstitial infiltrate is a common finding. Pseudomonas aeruginosa should be considered along with the commoner pathogen Pneumocystis carinii in the differential diagnosis of an interstitial infiltrate in this group of patients.
CT appearances of intrathoracic Kaposi's sarcoma in patients with AIDS
Authors: Traill Z C , Miller R F , Shaw P J
Published: July 2009

Although there have been many studies of the plain radiographic appearances of intrathoracic Kaposi's sarcoma in patients with the acquired immunodeficiency syndrome, the computed tomography (CT) findings are less well established. We performed a retrospective review of the thoracic CT findings of 15 patients with tracheobronchial Kaposi's sarcoma diagnosed at bronchoscopy in whom concurrent respiratory infection had been excluded. The commonest CT finding was the presence of ill-defined nodules, seen in all patients. In eight patients more than 20 nodules were seen. Small areas of ground-glass attenuation surrounded one or more nodules in 11 patients. Bilateral perihilar infiltrates were seen in 14 patients, extending into the pulmonary parenchyma along bronchovascular bundles. Interlobular septal thickening was seen in 13 patients and fissural nodularity in 15 patients. To our knowledge this latter finding has not been described before. Discrete areas of ground-glass attenuation were seen in six patients. Small bilateral pleural effusions occurred in six patients; four patients had a pericardial effusion. Shotty mediastinal lymphadenopathy occurred in six patients, and mediastinal nodes greater than 1 cm were present in four patients. None of the patients had CT evidence of chest wall or bone involvement. Although none of these findings are specific, the combination of poorly defined nodules, fissural nodularity and a bronchovascular distribution of perihilar opacities on CT is highly suggestive of pulmonary Kaposi's sarcoma.
Role of MIBI breast scintigraphy in evaluation of palpable breast lesions
Authors: Lam W W M , Yang W T , Chan Y L , Stewart I E T , King W , Metreweli C
Published: July 2009

The sensitivity and specificity of MIBI breast scintigraphy, conventional mammography and ultrasound in differentiating malignant and benign palpable breast lesions was compared in 48 women. MIBI breast scintigraphy had a sensitivity of 97%, a specificity of 69%, a positive predictive value of 87.5% and a negative predictive value of 91.7%. Ultrasound and mammography had comparable results with accuracy rates of approximately 93%. We conclude that MIBI breast scintigraphy may have a complementary role in the evaluation of palpable breast lesions, but is not specific enough to replace current imaging modalities.
Performance of Chromogenic In Situ Hybridization on Testing HER2 Status in Breast Carcinomas With Chromosome 17 Polysomy and Equivocal (2+) HercepTest Results
Authors: Gong Yun , Sweet William , Duh Yi-Jing , Greenfield Larry , Tarco Emily , Trivedi Smita , Symmans W. Fraser , Isola Jorma , Sneige Nour
Published: July 2009

This study specifically addressed the performance of chromogenic in situ hybridization (CISH) on HER2 testing in 66 breast carcinomas with chromosome 17 polysomy and 49 carcinomas with an equivocal HercepTest (DakoCytomation, Carpinteria, CA) score by comparing CISH with corresponding FISH results at 2 test sites and evaluating intersite agreement of CISH results. For tumors with chromosome 17 polysomy, when using the manufacturers’ criteria, the concordance values between CISH and FISH at site A, site B, and intersite CISH agreement were 95.8%, 95.5%, and 93.5%, respectively; when using the American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) criteria, the values were 100.0%, 100.0%, and 100.0%, respectively. For tumors with an equivocal HercepTest score, when using the manufacturers’ criteria, the concordance values between the 2 methods at site A, site B, and intersite CISH agreement were 88.2%, 95.1%, and 91.1%, respectively; when using the ASCO/CAP criteria, the values were 96.7%, 97.3%, and 97.4%, respectively. These results indicate that CISH is reliable for testing these 2 types of tumors, especially when the ASCO/CAP criteria are used.
Usefulness of Cytokeratin 5/6 and AMACR Applied as Double Sequential Immunostains for Diagnostic Assessment of Problematic Prostate Specimens
Authors: Trpkov Kiril , Bartczak-McKay Joanna , Yilmaz Asli
Published: July 2009

We evaluated the usefulness of double immunohistochemical staining for cytokeratin (CK)5/6 and α-methylacyl coenzyme A racemase (AMACR) applied sequentially on 1 slide by assessing 223 foci in 110 consecutive prostate specimens. Double-chromogen reaction was used to visualize the antibodies: brown for CK5/6 and red for AMACR. Staining was scored as diffuse, focal, or negative. To establish the diagnosis, CK5/6 and AMACR were correlated with the morphologic features. All cancers lacked CK5/6 staining (100% specificity). AMACR showed diffuse or focal positivity in cancer, high-grade prostatic intraepithelial neoplasia, and atypia in 96.8% (120/124), 85% (22/26), and 80% (16/20) of cases, respectively. In atypical cases, diagnosis was because of non–immunohistochemical staining reasons in 80% of cases. In adenosis (n = 14), AMACR was diffusely positive in 4 cases (29%). Double immunohistochemical staining for CK5/6 and AMACR is a simple assay to perform and may be used as an alternative to antibody cocktails for routine evaluation of problematic prostate specimens.
Customary Land and the Language of the Common Law
Authors: Corrin Jennifer
Published: July 2009

Independence constitutions in most small island countries of the South Pacific acknowledge the significance of customary law by giving it official status in the hierarchy of laws recognized by the state. More particularly, many of those constitutions make special provision for customary land, limiting its alienation and allowing it to be governed by customary law. However, in practice, the philosophy underlying these provisions has been betrayed. While paying lip service to customary law, changes have been introduced through the written law. In addition, more subtle changes have crept in through the inaccurate representation of customary concepts in common law terms. Using examples drawn mainly from Samoa and Solomon Islands, this paper seeks to demonstrate that, in spite of the constitutionally enshrined intention to protect customary land and the customary law governing it, the operation of the common law has led to significant changes in customary land concepts. It is argued that such changes have the potential to bring about dramatic and unplanned changes to customary society in the South Pacific.
Relocating Officially Induced Error of Law: Fitting the Remedy to the Wrong
Authors: Briggs Margaret
Published: July 2009

The rule that ignorance or mistake of law is no excuse is one of the pillars of the criminal law. However, it can prove problematic in some cases including those where an individual commits an offence in reliance on incorrect official advice. This paper argues that the orthodox judicial approach to such claims fails to address the concern that the defendant is held responsible for what is essentially the state's own mistake. Rather than advocating a full defence of officially induced error of law, a more appropriate solution is for the court to exercise its inherent jurisdiction to prevent an abuse of process by staying the proceedings. This ‘procedural’ approach, which identifies the state's role in the commission of the offence, has recently been adopted by the Supreme Court of Canada, and has the potential to be applied in other common law jurisdictions including Australia, New Zealand and the United Kingdom.
The English Law on Adverse Possession: A Tale of Two Systems
Authors: Woods Una
Published: July 2009

This paper discusses the divergence in the operation of the doctrine of adverse possession which the Land Registration Act 2002 brings about, resulting in a separate approach to registered and unregistered land. The Law Commission justified the new dichotomy by explaining that while adverse possession runs counter to the fundamental concept of indefeasibility which is a feature of registered title, its role in encouraging the owner of land to guard possession is fully compatible with the unregistered title system which is based on possession. It also noted that the doctrine plays a vital role in the investigation of title to unregistered land and concluded that making the requirements for adverse possession of unregistered land too demanding could weaken the security of title to that land. Section II of this paper investigates claims that the doctrine of adverse possession is at odds with principles of title registration. Section III examines the role played by possession and adverse possession in the unregistered conveyancing system. It is submitted that the reasons adduced by the Law Commission for restricting the reforms of the doctrine to registered land do not hold up under scrutiny. Once this is acknowledged, it becomes necessary to consider whether the reforms could be extended to unregistered land in a manner which would not raise concerns about the functionality of the unregistered conveyancing system or the reliability of the Land Register once first registration has occurred. The marketable title legislation which operates in the US illustrates how title defects that may not be revealed by a standard investigation of title may be eliminated without reliance on the doctrine of adverse possession. If England were to borrow the basic premise behind the US approach, requiring the registration of certain older interests in order to preserve their validity, an extension of the veto system to unregistered owners could be contemplated. The paper concludes by discussing the advantages of introducing such reform and suggesting solutions for certain practical difficulties which it would raise.
Implied Terms in English Contract Law: The Long Voyage of the Moorcock
Authors: Austen-Baker Richard
Published: July 2009

This paper considers the antecedents and the legacy of the case of The Moorcock, a leading authority on the law of implication of terms in fact into contracts. It traces the ‘voyage’ of the precedent through a period of 120 years down to the present day, adumbrating the disputes that continue to surround it and considering the continuing significance of the case for contract lawyers, judges and jurists today, concluding that the Moorcock test is robust, hard-headed and continues to set the fundamental standards for implication in fact to this very day.
Truth through Court Interpreters
Authors: Koo Anna
Published: July 2009

This article examines the law and ethical principles applicable to the interpretation of trial evidence as developed in Hong Kong, but with comparative reference to other jurisdictions where pertinent. The rationale for the right to interpretation and the main applicable precepts are considered. An examination of case law indicates a general lack of awareness amongst legal practitioners and judges of the evidential and ethical rules applicable to court interpretation, which may in some cases lead to miscarriages of justice and quashed convictions. The article concludes by arguing for a reappraisal of the importance of court interpretation and for making an understanding of the relevant rules more central to the discipline of criminal evidence.
International Comparative Perspective of Police in Schools Resulting from a Fulbright Alumni Initiatives Award
Authors: Briers Andrew N. , Dickmann Ellyn M.
Published: July 2009

This article outlines the results of a Fulbright Alumni Initiatives Award 2005–8, which provided resources and support for an international school police officer exchange programme between officers in the United States and the United Kingdom. This multi-year exchange programme had several outcomes including exchange opportunities for 11 officers from London and Colorado; the development of a school/community safety curriculum; international collaborative school safety research project planning and implementation; and programme dissemination opportunities. Extensive knowledge and idea sharing resulted from this exchange programme and current as well as future school policing programmes around the world can benefit from the details outlined in this case study.
Decision-Making Skills That Encompass a Critical Thinking Orientation for Law Enforcement Professionals
Authors: Phillips Wesley E. , Burrell Darrell Norman
Published: July 2009

This article discusses the challenges of engaging in critical thinking skills for law enforcement professionals and the importance of making sound decisions in the wake of new emerging threats that stem from domestic to international crime. Critical thinking skills are inevitably becoming a new business function for all types of organisations. Traditional management methodologies of some law enforcement agencies may be antiquated, dictating the fact that organisational development/change may be required. Critical thinking skills can prove to be necessary for law enforcement professionals in acquiring new ways of thinking more proficiently and becoming more proactive in combating traditional violent crimes and more modern crimes, such as terrorism, organised crime and cyber crimes.
Eye-Witness Identification Procedures and Stress: A Comparison of Live and Video Identification Parades
Authors: Brace Nicola A. , Pike Graham E. , Kemp Richard I. , Turner Jim
Published: July 2009

Recent amendments to the Police and Criminal Evidence Act 1984 of England and Wales, allow video identification parades to be employed as the primary mechanism to collect identification evidence. One important difference between the video procedure and the more established live identification parade is that the video procedure does not require the witness to come face to face with the perpetrator, and this may therefore reduce any stress experienced by the witness. A field experiment was conducted to compare the experiences of participant-witnesses attending both a video and a live identification parade. Approximately 70 per cent of participant-witnesses judged attending the live parade to have been more stressful than the video parade. However, analysis of responses to a mood adjective checklist revealed no statistically significant differences in the stress or arousal experienced after attending the live and the video parade. In relation to video parades, participant-witnesses who believed that the perpetrator was not present reported significantly lower levels of stress than those who believed that the perpetrator was present in the parade. There was no such difference in the case of live parades.
Criminal Interrogation and the Right to Remain Silent — A Study of the Hong Kong Customs Service
Authors: Chiu Jessica Wing Kay
Published: July 2009

Hong Kong has come to a turning point in the implementation of the right to silence after its sovereignty reverted to mainland China in 1997. While the United Kingdom began to draw adverse inferences from silence, China moved towards protection against involuntary confessions through legal reforms and the Bill of Rights was passed in Hong Kong in 1997. The Rules and Directions for administering the Caution and treatment of persons in custody in Hong Kong were issued in 1992 but do not have the force of law. Ambiguity in the wording of the Caution is a problem for both law enforcers and suspects. Analysis of the documents served on the suspect and a comparison with the statutory requirements for the Independent Commission Against Corruption, suggest a need for codification of the treatment of persons in custody. The results of this study of 150 Customs officers suggests that there might be benefits in rewording the Caution. Furthermore, statistical tests show that professional training and recruitment of front-line officers with higher academic qualifications would safeguard the administration of justice.
Using Expectancy Theory to Explain Officer Security Check Activity
Authors: Johnson Richard R.
Published: July 2009

Expectancy motivation theory (Vroom, 1964) posits that employees will perform tasks if they are expected to do so, have the ability to do so, the opportunity to do so, and believe that their efforts will be rewarded. While this theoretical framework has been used successfully to explain differences in individual officer behaviour with regard to arrest productivity, it has yet to be tested with officer behaviours that are not easily verified. The present study used expectancy motivation theory to account for officer differences in the amount of time they spent on crime prevention security checks of businesses and residences. The findings suggest that while expectancy motivation theory explains a sizeable amount of variation in officer activities that are easily verified (such as arrests), it is not well suited to explain officer variation in work activities that are not easily verified.