bluuebunny/crossref_metadata_2025 huggingface dataset:
Book reviews
Authors: Christmas S. E.
Published: July 2009

As is the case with most Symposia Reports, this book is strictly for those with a good background knowledge of the field. There are six main sections but these fall into three broad categories: microbial cytotoxins, immunotoxins and mechanisms of cell-mediated cytotoxicity. Each topic is covered thoroughly by a number of authors and so there is inevitably a degree of overlap, particularly in the latter section.
Book reviews
Authors: Whitehouse G. H.
Published: July 2009

The authors state that this short monograph is aimed at those radiologists and clinicians who need to be able to interpret mammograms. There are mammograms from 46 cases, accompanied by some brief clinical information. The mammographic findings and their interpretation are then described over the page. The object is to create a self-assessment process from examples of common mammographic findings.
Radiology of the pharynx and oesophagus in young adults
Authors: Borgström Pia S. , Birch-Iensen Marianne , Ekberg Olle
Published: July 2009

The indication for and results of radiological examination of the pharynx in 195 young adults (83 men, 112 women; age 13—40 years) were analysed retrospectively. A total of 99 patients were examined because of a suspected foreign body. In only seven was a foreign body revealed; two patients had mucosal tears. Five other emergency examinations were normal. Eightyseven patients were examined because of long-standing upper oesophageal dysphagia. One had a diverticulum in the pharyngooesophageal segment and another had oesophageal achalasia. Nineteen other patients had pharyngeal dysfunction. Eighteen patients were examined because of retrosternal pain on swallowing. One had a pedunculated pharyngeal cyst while two had pharyngeal dysfunction. The other examinations were normal. Our results show that a careful radiological examination of the pharyngeal function is of value in young adults with swallowing complaints. Even in acute dysphagia a foreign body is seldom revealed. In patients who had undergone cineradiography, 21 of 90 (23%) had some form of pharyngeal dysfunction which could account for the patients' symptoms.
Image processing of digital chest ionograms
Authors: Yarwood J. R. H. , Moores B. M.
Published: July 2009

A number of image-processing techniques have been applied to a digital ionographic chest image in order to evaluate their possible effects on this type of image. In order to quantify any effect, a simulated lesion was superimposed on the image at a variety of locations representing different types of structural detail. Visualization of these lesions was evaluated by a number of observers both pre- and post-processing operations. The operations employed included grey-scale transformations, histogram operations, edge-enhancement and smoothing functions. The resulting effects of these operations on the visualization of the simulated lesions are discussed.
Iotrolan versus iopamidol for cervical myelography: a randomized double-blind trial
Authors: Coutinho C. , McGeorge A. , Macpherson P. , Teasdale E.
Published: July 2009

Iotrolan is the first dimeric, non-ionic, hexaiodinated, watersoluble contrast medium available for diagnostic purposes. The dimeric structure enables highly concentrated solutions to be produced which are virtually isotonic with blood and cerebrospinal fluid. A multi-centre study is being undertaken under licence from the Department of Health and Social Security. We have recently reported on its use for radiculography (Coutinho et al, 1988) and with the approval of the Hospital Ethics Committee, have now completed a larger double-blind trial of its use compared with iopamidol for runup myelography.

Fifty-one patients comprising 28 males (mean age 54.3 years) and 23 females (mean age 48.7 years) were examined with iopamidol and 49 patients comprising 31 males (mean age 48.6 years) and 18 females (mean age 46 years) were examined with iotrolan. Iopamidol (Niopam, E. Merck Ltd) was used at a strength of 300 mgI/ml. Because iotrolan (Schering AG) has a longer opacification time, some patients in this group received the 300mgI/ml (iotrolan 300) and others the 240 mgI/ml (iotrolan 240) strength. There were 23 patients in the iotrolan 300 group, comprising 17 males (mean age 50.9 years) and six females (mean age 50 years), while of 26 patients examined with iotrolan 240, 14 were males (mean age 46.4 years) and 12 females (mean age 42.2 years). In each case 10 ml of contrast medium was injected.
Antagonism between radiosensitizing agents
Authors: Watts M. E. , Dennis M. F. , Woodcock M.
Published: July 2009

Dr Berenbaum has raised a number of interesting points. However, the purpose of our investigation was purely pragmatic, i.e. to see whether, as expected, an improved response would result from clinically relevant concentrations of these two radiosensitizers in combination, Newman et al (1986) having shown that patients might tolerate a higher total nitroimidazole dose when these two agents were given in combination rather than singly.
Book reviews
Authors: McLean E. J.
Published: July 2009

This book is the 4th edition of a “concise manual” written primarily for student radiographers but is thought to be of use by other groups such as trainee radiologists and nurses as well as qualified staff. As in the previous editions it comprises three parts: general radiography, regional radiography and radiological procedures.
Book reviews
Authors: Dicks-Mireaux C.
Published: July 2009

In the preface, the author states that his primary objective is to present computed tomographic technology and techniques in a practical form: in particular, “In a form digestible even to those with a distaste for such topics”.
Book reviews
Authors: Butt W. P.
Published: July 2009

On the occasion of his 100th birthday, Sir Harry Platt was honoured by a meeting of orthopaedic surgeons from around 980 the world who discussed recent advances in the areas of orthopaedics which were of interest to Sir Harry. This book collects the papers presented at that meeting.
Book reviews
Authors: Kendall Brian
Published: July 2009

This book considers the radiological investigation of diseases of the ear and of disorders of hearing and balance at a detailed level, suitable for otologists and radiologists with a particular interest and professional responsibility in this region.
Book reviews
Authors: Dacie Janet E.
Published: July 2009

As its subtitle indicates, this 200-page paperback book is aimed at doctors preparing for the MRCP, FRCS, MRCOG and DMRD examinations. It comprises 80 diagnostic exercises taken from a collection of quizzes originally published in Hospital Medicine under the title “What Would You Do?”.
Book reviews
Authors: Joiner M. C.
Published: July 2009

This book describes the present state of radiation biology at its interface with clinical radiotherapy. Those new to the field might suppose naïvely that there must be a limit to what one can say about dividing up a radiation treatment into fractions, but the authors have shown with great skill and clarity how the study of fractionation has continued to play a central role in developing our current understanding of radiation action in living organs and tumours.
Book reviews
Authors: Rawlings D. J.
Published: July 2009

This report, together with other NCRP reports, existing or pending, forms an update of NCRP's existing recommendations regarding basic radiation protection criteria and is based closely on ICRP 26, but with certain modifications to take account of recent and pending changes in the estimation of risk due to exposure to ionizing radiation.
Role of clinical trials in evaluation of cancer therapy
Authors: Baum M.
Published: July 2009

I was very amused by the exchange of correspondence between Drs Haybittle and Freedman on the one side and Dr Thomlinson on the other side, concerning the role of clinical trials in the evaluation of cancer therapy. Dr Thomlinson argues that the authors of the trials of tamoxifen “are so hedged with qualifications that their own confidence in the value of the statistics involved is open to doubt“. As one of the authors of the paper quoted, I would like to take issue.
Concomitant intrauterine and ectopic tubal pregnancy
Authors: Murray J. B.
Published: July 2009

A 25-year-old primigravida presented with painless vaginal bleeding 8 weeks after her last menstrual period. She had been on Clomid for the preceding month. An ultrasound examination demonstrated two intrauterine gestational sacs with a fetal pole identified in the larger sac, and a 5 cm retention cyst was present in the right ovary (Fig. 1). A threatened miscarriage was diagnosed. A further ultrasound examination 1 week later showed a healthy continuing pregnancy of 9 weeks and a collapsed gestational sac.
Book reviews
Authors: McCready V. Ralph
Published: July 2009

Interest in radiotherapy using unsealed sources has declined over the past few years as alternative treatments have become available. However, for a few diseases, for example thyrotoxicosis, the use of radioisotopes for therapy is increasing. This follows the analysis of long-term studies which indicate the absence of radiation-induced side effects.
Relapse of osteoporosis circumscripta as a lytic ring after treatment of Paget's disease with intravenous 3-amino-1 hydroxypropylidene-1,1-bisphosphonate
Authors: Anderson D. C. , O'Driscoll J. B. , Buckler H. M. , Cantrill J. , Brown J. D. K.
Published: July 2009

Two patients with osteoporosis circumscripta of the skull are presented who have each been treated with a 3-month course of intravenous infusions of (3-amino-1-hydroxypropylidene)-1,1-bisphosphonate (APD) (total dose of 185 and 375 mg), which in both cases was associated with rapid and dramatic remineralization of the porotic bone and marked clinical and biochemical remission. However, osteolytic disease reappeared (after 9 and 18 months, respectively) in both cases as an osteolytic ring showing high uptake of radiolabelled bisphosphonate on bone scan, in formerly unaffected bone just distal to the original leading edge of osteolysis. Further treatment was associated with healing of these new lesions. These cases suggest that the diseased osteoclasts entering previously normal bone are protected against the drug probably because normal bone matrix takes up relatively little APD, and that APD taken up by diseased bone behind this front confers long-term resistance to further resorption. In assessing treatment strategies with bisphosphonates for Paget's disease, the response at the leading edge of osteoporosis circumscripta may be particularly informative.
Dynamic low-dose three-dimensional computed tomography: a preliminary study
Authors: Gholkar A. , Gillespie J. E. , Hart C. W. , Mott D. , Isherwood I.
Published: July 2009

Three-dimensional (3D) computed tomographic reformations have been used successfully as an adjunct to standard axial computed tomography (CT) in the evaluation of disorders affecting areas of complex anatomy. The basic requirements for high-quality 3D reformations are an absence of patient movement and narrow-width transaxial sections. Speed of examination is an important factor in optimizing image quality. One hundred examinations were performed on an IGE CT 9800 scanner. For bone studies, 80 rnAs and, for certain soft tissues, 140 or 200 mAs were employed with 120 kVp. The advantages of such a “lowdose” technique are significant reduction in patient skin dose and a faster examination. The main disadvantage is a reduction in signal-to-noise ratio. The image quality obtained in 3D presentations has nevertheless been sufficient to enable all bony abnormalities to be identified. Three-dimensional examinations are now being performed routinely using a dynamic mode and this “lowdose” technique.
99Tcm-HMPAO single photon emission tomography in the diagnosis of cerebral barotrauma
Authors: Macleod M. A. , Adkisson G. H. , Fox M. J. , Pearson R. R.
Published: July 2009

Cerebral barotrauma, or the neurological manifestation of the “bends”, is a relatively common disease of divers and aviators. To date, however, no–one has succeeded in demonstrating a cerebral or spinal cord lesion in vivo following a decompression incident, despite the presence of definitive clinical signs and symptoms of central nervous system involvement. This paper describes the use of 99Tcm-labelled hexamethylpropyleneamine oxime (99Tcm-HMPAO) with single photon emission tomography in a study of three individuals involved in driving accidents. All three suffered cerebral barotrauma during decompression and all exhibited clinical signs and symptoms of dysbarism to a varying degree. Imaging was performed at time intervals ranging from 2 h to several days following the incidents. The results showed well defined cerebral ischaemic lesions in all three subjects. We conclude that 99Tcm-HMPAO imaging provides a significant advance in locating and demonstrating cerebral lesions following barotrauma and will contribute greatly to our understanding of the pathophysiological processes involved.
Reduction of tumour bed effect after angiogenic stimulation
Authors: Penhaligon Miranda , Courtenay V. Doreen , Camplejohn R. S.
Published: July 2009

A new two-tumour system has been developed to examine the effect of an angiogenic stimulus on the tumour bed effect (TBE) in C3H mouse skin treated with 20 Gy X rays. The first tumour was implanted intradermally to stimulate angiogenesis. The Lewis lung carcinoma (3LL) was used for this since it is isogeneic in C57 Bl mice and after initial growth (mean volume 69 mm3), tumours completely regressed within 24 days. The second tumour, the RIF–1 fibrosarcoma (RIF) isogeneic to C3H mice was used to assess stromal function using the TBE assay. After complete regression of the 3LL tumour, RIF cells were implanted into the centre of the stimulated sites and 24 days later the resulting RIF tumours were excised and the TBE measured from the yield of viable RIF cells obtained from each tumour. There was an approximately 10-fold increase in cell yield from tumours implanted into stimulated, pre-irradiated beds compared with those implanted into unstimulated, pre-irradiated beds. This suggests that the angiogenic stimulus provided by the growth of the 3LL tumour led to a substantial restoration of the capacity of the radiation-damaged stroma to support tumour growth. If stromal restoration, as seen during these experiments using artificially induced angiogenesis, was to occur in unstimulated stroma during the normal course of repair and regeneration, this slowly dividing tissue constituent might eventually recover given sufficient time. This raises the possibility that the role of the stroma in late radiation damage might not be as important as was previously thought.
Book reviews
Authors: Wilson D. J.
Published: July 2009

Written by a skeletal radiologist and an orthopaedic surgeon specializing in sports medicine, this book is essentially an atlas of plain radiographs and scintigraphy. Abnormalities of the lower limb and spine are illustrated in anatomical sequence with a short legend and often a rather longer acknowledgment of the source of radiographs.
Book reviews
Authors: Dick R.
Published: July 2009

Arnold Friedman, Head of Imaging at Temple University, Philadelphia, has edited an impressive, expensive book covering all imaging possibilities for the liver, biliary tract, pancreas and spleen. Altogether, thirty-three North American gastrointestinal experts have contributed, under effective editorship. It is clearly a radiologist's book for radiologists, the detail being inappropriate for readers not interested in imaging.
Book reviews
Authors: Pickering D. G. L.
Published: July 2009

There have now been three international meetings to review progress in radio-oncology held in Vienna at 3 yearly intervals. These proceedings are of the last meeting held in March 1985 and have been published by the International Club for Radiooncology/Austria. The quality of reproduction is, on the whole, good although the titles of some graphys are not legible, and the reproducion of CT scans makes a clear assessment difficult.
Book review
Authors: Hopewell J. W.
Published: July 2009

This publication, one of a series produced by the International Commission of Radiological Protection, outlines the report of a task group charged by the Commission to carry out a critical evaluation of the data relating to radiation-induced effects on the central nervous system during development. Special attention was to be given to radiation-induced mental retardation, assessing the gestation age and the quantitative risk at low doses.
Book reviews
Authors: Patrick G.
Published: July 2009

This report of a Task Group of the International Commission on Radiological Protection is specifically concerned with indoor exposure to inhaled radon and radon daughter nuclides, and therefore with exposure of members of the public. It follows on from a previous report by the same Task Group, ICRP Publication 32 (1981), which dealt, however, with limits to inhalation exposure of radon for workers such as uranium miners and similarly exposed groups. For these workers, in the past, exposure was high enough to produce a significant excess incidence of lung cancer.
Book reviews
Authors: Mould R.
Published: July 2009

This 131-page ICRP Publication 51 is very useful for a rather specialized readership, but will not be required routinely by all medical physicists. However if for no other reason than it is an ICRP Report, it ought to be purchased for the libraries of all medical physics departments.
Book reviews
Authors: Dearnaley D. P.
Published: July 2009

This commendable compact volume is the 12th in the publishers' series of oncology-related titles. The editor has marshalled the contributions from 37 authors from seven countries and three continents to produce 17 chapters covering advances in the biology and pathology of bladder cancer, perspectives on current management as practised in Europe, North America and Australia, and an evaluation of the role of the newer combinations of cytotoxic chemotherapy and prospects for improved management in the future. In his preface the editor describes the management of bladder cancer as “evolving through a renaissance” and sets out to present a broad perspective of the innovations and approaches to the practical management of urothelial malignancy, to resolve some of the controversies about what constitutes “optimal management”, and to provide the practising clinician with an overview to assist in the management of this group of neoplasms. It is clearly not possible in a book of this size to cover all topics in exhaustive detail, but references are comprehensive and up to date (all chapters are referenced until at least 1985) which allows ready access to further detail when this is required. It would have been inappropriate for the editor to try and reach a complete consensus on the optimal management of either superficial or invasive bladder cancer but he has balanced the contributions on the use of surgery, radiotherapy and chemotherapy without introducing undue bias and has achieved a consistent concise style to the text without undue repetition of content between the various contributions.
Book reviews
Authors: Deacon Judith
Published: July 2009

The main interests of the IARC continue to be cancer aetiology and prevention, but within these fields the research undertaken at Lyon, and also in the international collaborative studies supported by the Agency, cover a very wide range of disciplines varying from descriptive epidemiology to molecular genetics. This report includes summaries of all the projects undertaken by the Agency during the last 2 years. Summaries are fairly concise, but in general they include all the most important data.
Radiotherapy of epidermoid anal canal cancer
Authors: Dobrowsky W.
Published: July 2009

Forty-eight patients with anal canal cancers were treated with surgery and irradiation or irradiation alone during the period 1970–1982. All cases were treated by external mega voltage equipment. The overall 5-year survival was 50%, and the local recurrence rate 33%. According to the therapy, four major groups were analysed: radical surgery followed by post-operative irradiation (5-year survival 43%, local recurrence rate 38%), incomplete major surgery and post-operative irradiation with very inferior prognosis (none of the patients surviving beyond 52 months). Two groups of patients had sphincter-saving procedures: local surgery followed by irradiation (5-year survival 78%, local recurrence rate 22%) and primary irradiation (5-year survival 57%, local recurrence rate 14%). Lymph node positive patients showed a median survival of 24.5 months against 52 months in N0 cases (5-year survival 21% against 50%). Side-effects of radiotherapy were transient and mild, and no late severe sequelae were seen. The data indicate that post-operative external radiotherapy seems insufficient and unable to decrease the local recurrence rate, especially when surgery is incomplete. Both spincter-saving surgery and radiotherapy, as well as primary irradiation, are effective treatment modalities. These data are analysed and future aspects considering combined radiochemotherapy are discussed.
Discriminant analysis on the treatment results of interstitial radium tongue implants
Authors: Hoshina Masao , Shibuya Hitoshi , Horiuchi Jun-lchi , Matsubara Sho , Suzuki Soji , Takeda Masamune
Published: July 2009

Discriminant analysis was carried out for 48 tongue cancer patients who were treated with radium single-plane implantation. The 48 patients were grouped into 32 successfully cured without complications, five successfully cured with complications, six successfully cured but requiring additional boost therapy and five with local recurrence. To evaluate the relation between the dose distribution and the local treatment results, the analysis was based on a volume-dose relationship. The functions introduced by this discriminant analysis were linear, and the parameters used were modal dose, average dose and shape factors of histograms. Each group of treatment results had a correction rate of >80%, except for the successfully cured group with ulcers. The discriminant functions were useful as an index to obtain a final clinical treatment result at the early time of implantation, and these functions could be used as a criterion for the optimal treatment of tongue carcinoma. We were also able to recognize the limitation of the actual arrangement of sources in the single-plane implant.
An indwelling intrauterine tube to facilitate intracavitary radiotherapy of carcinoma of the cervix
Authors: Smit B. J. , du Toit J. P. , Groenewald W. A.
Published: July 2009

This paper aims to show that the indwelling intrauterine tube (IIUT) is safe and can abolish repeated anaesthetics and large doses per fraction (Joslin et al, 1972) typical of high-dose-rate afterloading intracavitary treatment of carcinoma of the cervix. Highdose-rate schedules for Stage IB disease require as many as 12 (Liversage, 1969) to 17 (Dale, 1985) fractions for radiobiological equivalence with low-dose-rate schedules.

The purpose of the IIUT is to act as a semipermanent channel for the applicator tube of the afterloading unit. We use the Gammamed II with a single high-activity 192Ir source (Busch et al, 1977), but the IIUT could probably be adapted for use with any brachytherapy machine or even manual afterloading systems.
Van Buchem's disease with classical radiological features and appearances on cranial computed tomography
Authors: Cook J. V. , Phelps P. D. , Chandy J.
Published: July 2009

Van Buchem's disease is a rare hereditary sclerosing dysplasia of bone which was first described by van Buchem, Hadders and Ubbens in the Netherlands in 1955. Their original description was of an autosomal recessive disease which particularly affects the skull, mandible and long bones, the characteristic feature of the latter being the endosteal deposition of bone, particularly in the diaphyses.

We present a patient who has the classical recessive form of the disease and has developed auditory and visual symptoms due to encroachment on cranial foramina by hyperostotic bone. The appearances on computed tomography (CT) are described.

This patient had an unusual appearance at birth. Her birth weight was below the 10th centile for her gestational age and she was noted to have a prominent forehead, a long anteverted upper lip and coarse wrinkling of the skin. She was born of unrelated parents after a full-term, normal delivery and pregnancy and there was no family history of any congenital diseases.

Growth and development progressed normally but a year later she developed a mild chest infection during which she had a chest radiograph which showed sclerosis of the clavicles, ribs and spines of the scapulae. A diagnosis of a sclerosing bone dysplasia was made and a later skeletal survey showed classical features of van Buchem's disease (Figs 1,2,3). Allied investigations were normal apart from a raised alkaline phosphatase of 820 i.u./l. She had a normal female karyotype.
Ossified leiomyoma of the stomach: demonstration on computed tomography
Authors: Savit Russ M. , Horrow Mindy M. , Agarwal Pasha
Published: July 2009

Leiomyomas of the stomach with detectable calcification on plain radiographs are very uncommon, with only a few cases reported in the world literature (Garbarini & Price, 1950; Kolosky et al, 1950; Leigh, 1950; Steen & Newell, 1953; Crummy & Juhl, 1962; Graham et al, 1972; Kojima et al, 1981). We report a case of ossified leiomyoma of the stomach seen on computed tomography (CT) as well as plain radiography.

A 62-year-old white woman with a history of basal cell carcinoma of the face and melanoma of the right arm underwent a routine follow-up CT scan of the abdomen as an outpatient.
A colonic double bubble
Authors: Harrison Antony , Machin Louise , Grundy Alan
Published: July 2009

A 62-year-old woman presented with a 3-month history of two large abdominal swellings. There were no associated gastrointestinal or urinary symptoms and no history of previous abdominal surgery. On clinical examination, two 10 cm diameter, firm, mobile and non-tender masses were present in the left side of the abdomen. They were thought clinically to be arising within the abdominal wall. Clinical examination was otherwise unremarkable.

A supine abdominal radiograph (Fig. 1) was taken. Subsequently, a double-contrast brarium enema was performed (Fig. 2). What is the most likely diagnosis?

The plain abdominal radiograph shows two well circumscribed, oval, air-containing collections in the left side of the abdomen. The bowel gas pattern is otherwise unremarkable. The barium enema shows the sigmoid colon stretched around the two air-filled structures which do not fill with barium. There is evidence of diverticular disease in the adjacent sigmoid colon.
Functional changes in the irradiated rat ureter: assessment by transit-time renography
Authors: Knowles J. F. , Nimmon C. C.
Published: July 2009

A primary requirement in the investigation of experimentally induced urinary tract obstruction is that there must be a reliable method of assessing the functional changes induced. In previous studies of the effects of X radiation on the rat urinary tract, assessment has used the relatively gross end-point of hydronephrosis development, as detected by regular renal palpation followed up by intravenous urography (Knowles, 1985; Knowles & Trott, 1987).

In order to detect early, subclinical changes and to obtain quantitative measures of radiation effects, more sensitive techniques are required. One such method which has proven successful in investigating human urinary tract obstruction is gamma camera renography. Deconvolution of the gamma camera renogram enables the estimation of radionuclide transit times through the kidney. Drawing of separate regions of interest round the pelvi-calyceal region allows separate whole kidney and parenchymal transit times to be calculated (Whitfield et al, 1978; Britton et al, 1979). Using these it is possible to obtain a measure of delay due to the obstruction and to determine whether or not nephron function is reduced.

We have been assessing the use of these techniques to examine changes occurring in the rat subsequent to localized irradiation of a length of ureter. This paper presents transit time results for the unobstructed urinary tract together with a description of the changes so far observed in radiation-induced obstructing uropathy.
Experiences at the new magnetic resonance imaging centre at Bristol
Authors: Thomson J. L. G.
Published: July 2009

The magnetic resonance imaging unit in Bristol has been housed in a new purpose-built centre, shared between three District Health Authorities, but operated entirely separate from the National Health Service. Inasmuch as this is thought to be a unique arrangement, the publication of its finances and statistics have been readily tabulated at the end of its first year's operation, and may be of interest to others planning a similar organization.
Radical radiotherapy for carcinoma of the vulva
Authors: Slevin N. J. , Pointon R. C. S.
Published: July 2009

A study was made of 58 patients with carcinoma of the vulva treated by radical radiotherapy between 1965 and 1982. The choice of treatment technique was influenced by site and extent of disease as well as the general condition of the patient. The crude 5- year survival was 26% (15/58). Local control was achieved in 40% of cases and was associated with tumour size of 4 cm or less. Radionecrosis occurred in nine cases but none of these required surgical intervention. Surgery remains the treatment of choice for carcinoma of the vulva. This report emphasizes that radical radiotherapy has a curative potential in those cases considered unsuitable for surgery and that the necrosis type and rate are within the limits of acceptable morbidity.
Interstitial iridium-192 implantation for malignant brain tumours. Part II: Clinical experience
Authors: Chun M. , McKeough P. , Wu A. , Kasdon D. , Heros D. , Chang H.
Published: July 2009

The treatment results of 37 patients with malignant brain neoplasms treated with a computed-tomography-guided stereotactic iridium-192 implant are reviewed. Of these, 29 patients with high-grade gliomas (20 with glioblastoma multiforme (GBM), nine with anaplastic astrocytoma (AA)) received an implant as part of their initial management. The median survival was 14.5 and 15.5 months in the patients with previously untreated GBM and AA, respectively. In those patients with recurrent tumour after external-beam irradiation, durable local control over a year was achieved with implantation. Increasing the total tumour dose from 120 to 160Gy did not improve survival or local control. Karnofsky Performance Status (KPS) was used as an indicator of quality of life and was seen to decrease with a median interval of 8.5 months following treatment. No severe complications were noted in the entire group of patients treated with this implant procedure.
Re-irradiation of astrocytoma of the brain
Authors: Rostom A. Y. , Sunderland K.
Published: July 2009

Astrocytoma of the brain in adults is invariably a fatal disease. The majority of cases present with inoperable, high-grade III or IV tumours. The place of radiotherapy in the management of such cases is of limited value. However, prolonged remission, and even occasional cures, have been reported (Sheline, 1977). Recurrence of high-grade astrocytoma long after surgery and/or radiotherapy is a rare event in clinical practice. Radical surgery has no place in such cases. Chemotherapy has also been tried with occasional transient success (Levin et al, 1980). Re-irradiation of selected cases has been tried in the past with occasional short remission in some patients (Dritschillo et al, 1981). We present the treatment result of a 36-year-old woman with recurrent Grade III astrocytoma, 9 years after initial biopsy and radiotherapy, who was given a second course of radiotherapy and chemotherapy.
Intraoperative radioactive localization of an osteoid osteoma: a useful variation in technique
Authors: Todd B. D. , Godfrey L. W. , Bodley R. N.
Published: July 2009

Only complete excision of the nidus of an osteoid osteoma can guarantee cure. Localization of the nidus by using a gamma camera in theatre (Rinsky et al, 1980) is cumbersome and inaccurate in delineating how much bone should be excised. The use of a sterilizable, portable scaler-ratemeter (Colton & Hardy, 1983) provides good results, but the equipment is expensive to buy and maintain. The use of a scintillation well counter outside theatre to measure counts from bone punch biopsy specimens in and around the suspect area has also been reported (O'Brien et al, 1984). However, up to 24 specimens were required and operative time must have been substantially prolonged.

When a patient presented to our hospital with a probable osteoid osteoma we devised a variation on the above techniques which is reasonably speedy and only requires the type of gamma camera found in most nuclear medicine departments.
Alteration of cardiac myosin isozymes after whole-body irradiation
Authors: Litten R. Z. , Walden T. L. , Gainey G. T. , Nagai R.
Published: July 2009

Three myosin isozymes (Vl, V2, V3) have been shown to exist in the heart. V1 isozyme, containing two α heavy chains, has relatively higher actin- and calcium-stimulated myosin adenosine triphophatase (ATPase) activities than does V3, which is composed of two β heavy chains (Hoh et al, 1978; Martin et al, 1982; Litten et al, 1983). V2 isozyme appears to be a heterodimer composed of one α and one β heavy chain (Hoh et al, 1979; Everett et al, 1983a).

The proportions of myosin isozymes are altered under various conditions of stress. During pressure-overload-induced hypertrophy, there is a shift toward the V3 isozyme (Mercadier et al, 1981; Litten et al, 1982). The amount of V3 isozyme is also increased with hypothyroidism and age and is decreased by hyperthyroidism and exercise (Litten et al, 1982; Everett et al, 1983b).

Changes in the relative amounts of V1 and V3 isozymes are believed to be responsible, in part, for altered cardiac performance. A high proportion of V3 isozyme is associated with relatively slow, economic tension development within the heart, whereas a high proportion of V1 isozyme is associated with a faster, but less economical force development (Schwartz etal, 1981; Alpert et al, 1983).

In this study, measurements of cardiac myosin isozymes were carried out in rats subjected to acute sublethal wholebody irradiation. The studies showed, for the first time, that there is a shift in the pattern of myosin isozymes 9 days after irradiation. This change may result in functional alterations of the heart following whole-body irradiation.
Stress changes of the wrist in adolescent gymnasts
Authors: Read M. R. T. F.
Published: July 2009

I note the bilateral nature of the lesions presented in the paper by Carter et al (1988) but I think it important to point out the original lesions that I wrote up were in fact unilateral. All of the bilateral lesions presented here are in males where as mine were originally only in girls.
Book reviews
Authors: Shields R. A.
Published: July 2009

This important publication from the International Commission on Radiological Protection has been long awaited by those involved in making and using estimates of radiation dose to nuclear medicine patients. The earlier “blue book”, ICRP Publication 17, has been available since 1971 and has become out of date, partly because of substantial changes in the range and usage of radiopharmaceuticals. Furthermore, ICRP 17 comprised a compilation of inconsistent results from various authors who had used a variety of biological models to calculate doses to a variety of target organs, generally for adult patients only. Comparisons of radiation dose within and between modalities were very difficult to make; the work pre-dated the emergence of the concept of the effective dose-equivalent.
Book reviews
Authors: Whitehouse G. H.
Published: July 2009

The stated aim of this book is to provide an introduction to the essentials of magnetic resonance imaging. There are a number of articles under the headings of General Principles, Neuro Imaging, Abdominal Imaging and Musculoskeletal Imaging.
Book reviews
Authors: Kendall Brian
Published: July 2009

This book commences with a presentation of the principles of magnetic resonance imaging and its application in the recognition of normal and pathological conditions. Neuroanatomy is then described on a regional basis, and beautifully illustrated with cryomicrotome sections juxtaposed to almost identical magnetic resonance sections.
Book reviews
Authors: Dixon Adrian K.
Published: July 2009

A really good atlas of sectional anatomy with radiological correlation is a long awaited product. So many are good up to a point. Others omit key areas of the body. Wagner and Lawson's Segmental Anatomy is one of the best to date. But now comes this tome from Ohio which poses a real challenge. The driving force emanates from Dr Christoforidis who has stimulated his colleagues into sharing the production of a really worthwhile book. To create this work while being Chairman of a Department is an exceptional task, but maybe Chairmen have hidden powers of persuasion!
Book reviews
Authors: Dixon Adrian K.
Published: July 2009

This book is outstanding. It introduces the complex subject of magnetic resonance imaging (MRI) of the knee in an authoritative fashion based on the experience gained from over 2000 such examinations. I was particularly impressed by the views stated in the preface, where Dr Mink expresses his initial doubts about the technique and his slight reluctance to change from arthrography; the honest account of his subsequent conversion to MRI makes compelling reading. Much of the book represents an expanded version of the many scientific papers on this subject which have emanated from these workers.
Paediatric brachytherapy. II. Brain implantation
Authors: Thomson E. S. , Afshar F. , Plowman P. N.
Published: July 2009

The case histories of four children with brain tumours, for whom stereotactic brachytherapy was indicated, are presented from the St Bartholomew's Hospital intracranial brachytherapy programme. The recent evolution of the computed-tomography-directed stereotactic technique is described and the uses of different radionuclides (198Au, 192Ir) are discussed. The future of brachytherapy for paediatric brain tumours is debated.
Experimental intra-arterial administration of SR-2508 in the rabbit V2 carcinoma model
Authors: Coldwell Douglas M. , Huff James , Marcellus Harvey , Coldwell Susan G.
Published: July 2009

The use of the nitroimidazole radiation sensitizers, misonidazole and SR-2508, has been limited by a variety of sideeffects, principally peripheral neuropathies. In order to increase the effectiveness of radiosensitization and thereby reduce the administered dose of the sensitizers, intra-arterial delivery of SR-2508 was performed and followed with lOGy of 4MeV photon beam radiotherapy in the rabbit V2 carcinoma tumour model. Comparison was made with rabbits treated with an identical dose of SR-2508 given intravenously prior to photon beam radiotherapy. Control animals were treated with radiation therapy only, intraarterial SR-2508 only, or had no treatment. Neither the radiation therapy alone nor the SR-2508 alone had any effect on tumour growth. In the intra-arterial group, the tumour growth was slower and the size was significantly smaller than all other groups. The results suggest that the intra-arterial infusion of the radiation sensitizer produces greater response of the tumour than intravenous infusion when each is combined with radiation therapy.
Contribution of computed tomography in the aetiology and prognosis of cerebral palsy in children
Authors: Schouman-Claeys E. , Picard A. , Lalande G. , Kalifa G. , Lacert P. , Brentanos E. , Frija G.
Published: July 2009

Retrospective analysis of computed tomographic (CT) examinations in 76 children with cerebral palsy without any severe intellectual handicap has revealed abnormalities in 63% of these chilren; abnormalities were present in 88% of former pre-term infants. This study highlights the significant pathogenic role of periventricular leucomalacia in cerebral palsy, since in 45% of the cases of this series this diagnosis had been reached as a result of a characteristic CT appearance associated with a history of premature birth and very specific clinical deficits. The CT abnormalities, mostly posterior and generally bilateral and symmetrical, affect the contours of the lateral ventricles, which become straight and angular, and often involve ventriculomegaly (85%). Localized juxtaventricular hypodensities were only found in a few cases (6%). The cognitive and intellectual sequelae in these children were more severe than in those children whose CT examination was normal, and were also more pronounced when the longitudinal fissure of the cerebrum was enlarged.
Precipitation of radiation injury in kidney epithelium reveals a low fractionation sensitivity (α/β = 12.5 Gy)
Authors: Ewen C. , Hendry J. H.
Published: July 2009

The α/β ratio can be used to quantify the sensitivity to change in dose per fraction of tissues. It has been shown that late-responding tissues are more sensitive to these changes than are early-responding tissues, i.e. the former apparently have more repair capacity at low doses per fraction (Thames et al, 1982). For early responses in tissues the α/β ratio is generally between 5 and 20 Gy, and for late reactions it is usually 2–5 Gy (Fowler, 1984; Thames & Hendry, 1987). Of the various reasons currently considered most likely to explain this general difference, the cycling status of the target cells during the fractionation schedule may play a role. A greater initial or radiation-induced heterogeneity in sensitivity among the target cells in early-responding tissues, associated with differences in cell-cycle-phase distributions, could lead to a lesser overall fractionation effect (Zeman & Bedford, 1984; Schultheiss et al, 1987). However, the contribution of this effect for different tissues is difficult to quantify because of the difficulties in defining the target-cell populations and their cycling and sensitivity characteristics (Hendry & Potten, 1988).

Another reason relates to the times available for cellular repair among tissues prior to fixation of potentially lethal lesions consequent on movement in the division cycle (Thames, 1985; Curtis, 1987). Longer repair times will be available for the more slowly cycling target-cell populations in lateresponding tissues.
Autoradiographic imaging of pion stopping distribution utilizing scanning laser stimulated luminescence
Authors: Shirato H. , Gaffney C. C. , Goodman G. B.
Published: July 2009

A new type of detector using scanning laser stimulated luminescence (SLSL system) (Sonoda et al, 1983) makes it possible to visualize small amounts of radiation exposure more efficiently than with conventional X-ray film. An autoradiographic technique using this system has the potential to image radioactivity when previously this was not possible. We have applied the system to the detection of radioactivity induced in aluminium foil by negative pion irradiation. The distribution of the trace of activity was well demonstrated, especially in the pion stopping region.

The new radiation area detector was developed for use in medical diagnostic radiography (Sonoda et al, 1983). The system (CR201) consists of a phosphor screen imaging plate, an image reader, an image processor, and an image writer (Fig. 1). The imaging plate (IP) is a 1 mm thick flexible plastic plate coated with a 0.15 mm thick layer of fine photostimulated phosphor crystals, BaFBr:Eu2+. These crystals act as energy traps when exposed to ionizing radiation, thus producing stored image that is subsequently released by illuminating the phosphor with red light from a helium–neon laser. The surface is scanned by this laser and emitted light is collected by photomultiplier tube. The tube output is amplified and then digitized on a pixel by pixel basis (8 bits/pixel). The resulting digital data are manipulated by the image processor and finally converted back into analogue signals that modulate the intensity of another helium–neon laser beam scanning photographic film to record the image.
Primary orbital lymphoma: staging by computed tomographic scanning
Authors: Mills P. , Parsons C. A.
Published: July 2009

Primary orbital lymphoma is a rare form of extranodal lymphoma and accounts for only 1% of all orbital tumours (Calle et al, 1975). Recently reported series have dealt principally with the clinical and radiotherapeutic aspects of the disease, including risk factors for the development of systemic lymphoma (Knowles & Jakobiec, 1980; Fitzpatrick & Macko, 1984; Barthold et al, 1986; Gordon et al, 1986). Published data on the results of staging investigations have included little information on computed tomographic (CT) scanning (Henk, 1982; Bessell et al, 1989). Most patients undergo extensive investigation including a full blood count and erythrocyte sedimentation rate (ESR), liver function tests, bone marrow examination, chest radiography and, in recent years, abdominal and thoracic CT.

We have retrospectively studied a group of patients with primary orbital lymphoma, with particular reference to their staging investigations and to the factors affecting the development of systemic disease.

All patients with primary orbital lymphoma who were referred for abdominal and thoracic CT were included. This group did not include those patients with known non- Hodgkin's lymphoma and secondary orbital involvement. Many of these patients were referred by Mr J. Wright at the Orbital Clinic, Moorfields Eye Hospital for further management after initial investigation including open biopsy, pathology and orbital CT scanning.

Patients underwent a full clinical examination, blood count and ESR, liver function tests, bone marrow trephine and chest radiography.
An analysis of referrals for primary diagnostic abdominal ultrasound to a general X-ray department
Authors: Fitzgerald R. , Mackie G. , Manns R.
Published: July 2009

We note with interest the findings of Drs Colquhoun, Saywell and Dewbury (1988).

It is our practice to promote ultrasound as the first-line investigation of abdominal symptoms, both for hospital and GP referrals.
An analysis of referrals for primary diagnostic abdominal ultrasound to a general X-ray department
Authors: Dewbury K. C.
Published: July 2009

Drs Fitzgerald, Mackie and Manns are clearly as enthusiastic users of ultrasound as am I. It is the great success of ultrasound that has led to ever increasing workloads. This prompted our detailed retrospective analysis of 1861 patients, which forms only a small proportion of the 23 000 diagnostic ultrasound scans carried out in the department per year.
New developments in the field of acute myocardial infarction imaging
Authors: Jain Diwakar , Lahiri Avijit , Crawley John C. , Raftery Edward B.
Published: July 2009

We read with interest the article by Bell et al (1988) regarding the development of newer and more effective myocardial infarction imaging agents. 99Tcm pyrophosphate and its analogues have severe limitations for the imaging of acute myocardial infarction (Turi et al, 1985) because of low specificity, dependence on blood flow for its uptake by necrotic myocardium and poor image quality. We wish to draw your attention to the development of a promising new agent for the imaging of acute myocardial infarction: radiolabelled mono-clonal antimyosin antibodies.

Experimental work (Khaw et al, 1982) has shown that antimyosin antibodies bind specifically to myocardial cells with acute irreversible damage to the cell membrane. Initial studies using the experimental animal model of acute myocardial infarction (Khaw et al, 1979) have shown that 125I-labelled antimyosin antibodies localize specifically at the site of myocardial infarction in high concentrations and there is a close correlation between the site of radiotracer uptake and histological myocardial necrosis.