bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reduction of patient doses from barium meal and barium enema examinations through changes in equipment factors
Authors: Martin C J , Hunter S 
Published: July 2009

Abstract
A study of patient doses for barium meal and barium enema examinations has been made for X-ray departments throughout Grampian Region. Dose-area products are substantially less than UK reference levels. Contributions from fluoroscopy and radiography varied significantly between different units, with fluoroscopy making up 35–92% of the mean doses for barium meals and 24–57% for barium enemas. Equipment related factors had a greater influence on patient doses than radiologists' techniques. The gain of the image intensifier and the exposure factors selected by the automatic exposure control (AEC) were the most important factors determining doses for fluoroscopy. Changes in kV/mA factors selected by the AEC have allowed reductions of 20–50% to be made in effective dose from fluoroscopy with some units. The method used for recording images was the major influence on radiographic doses. Digital spot images or fluorographic films taken from the intensifier gave only 10–20% of the dose with a film/screen system and are recommended where the image quality is satisfactory for the application. Changes in film/screen systems have given worthwhile reductions in radiographic doses. If all factors are optimized, mean doses for barium examinations could be reduced to 20% of current reference levels.
Precision and accuracy of measurements of whole-body bone mineral: comparisons between Hologic, Lunar and Norland dual-energy X-ray absorptiometers
Authors: Tothill P , Avenell A , Reid D M 
Published: July 2009

Abstract
Measurements of whole-body bone mineral made by Hologic, Lunar and Norland dual-energy X-ray absorptiometers have been compared. It was found that in each case the results were changed by new software protocols introduced by the manufacturers during the course of the study. With a moderately anthropomorphic model, the later software corrected some anomalies of regional bone mineral content (BMC) observed earlier. There was some slight dependence of total BMC on thickness and fat proportion and up to 15% difference between instruments. Measurements on volunteers showed good precision, but there were differences between instruments made by different manufacturers. There were high correlations, but the slopes of regression lines suggested differences of calibration of up to 8%; the standard errors of the estimates were 110 to 190 g, with maximum deviations from regression of 17%. There were regional disparities in BMC, particularly in the trunk, which arise (in part at least) from the imposition of a higher bone threshold by Hologic. From the pattern of results it was concluded that different assumptions were made by the manufacturers, particularly concerning the fat distribution model, which preclude the interchangeability of results from different instruments.
Book reviews
Authors: Banerjee A K 
Published: July 2009

There can be very few radiologists who are unaware that 1995 is the centenary of Röntgen's discovery of X-rays. This anniversary has led to a sudden resurgence of interest in the history of radiology.
Dr Mould's scholarly monograph is a timely contribution to the radiological history literature. The book is a fascinating read. The introductory chapters are on the discovery of X-rays by Röntgen and radioactivity by Becquerel.
Angiographic contrast media relax isolated rabbit aorta through an endothelium-independent mechanism that may not depend on the presence of the iodine atom
Authors: Pugh N D , Hutcheson I R , Edwards D H , Nossen J Ø , Karlsson J O G , Griffith T M 
Published: July 2009

AbstractSystemically administered iodinated angiographic contrast media evoke vasodilatation through mechanisms that are at present poorly understood. In the current investigation we have evaluated the role of the vascular endothelium in responses to an iso-osmolar formation of the non-ionic dimer iodixanol and a hyperosmolar formulation of the non-ionic monomer iopromide. Isolated rabbit aortic ring preparations with endothelium intact or removed by gentle abrasion were mounted in organ baths containing oxygenated Holman's solution, and cumulative concentration–response curves for relaxation to the contrast media were constructed after pre-constriction by phenylephrine (300 nM) in the presence of indomethacin to inhibit prostaglandin synthesis. Endothelial denudation did not influence the ability of either iodixanol or iopromide to relax the aortic ring preparations. Iopromide was significantly more potent than iodixanol when expressed in terms of iodine concentration (mg I ml−1), but both agents were equipotent when expressed in terms of molarity (mM). We conclude that relaxation of isolated rabbit aortic rings to iodixanol and iopromide under conditions where there is no fluid flow is endothelium-independent, and therefore not mediated by release of the potent endogeneous nitrovasodilator endothelium-derived relaxing factor (EDRF). Furthermore, their relaxant activity under the in vitro experimental conditions employed is attributable to a direct action on vascular smooth muscle by factors in addition to osmolality, and may depend on features that are not specifically associated with the presence of the iodine atom.
Organized chaos? Computed tomographic evaluation of the neuropathic diabetic foot
Authors: Griffith J , Davies A M , Close C F , Nattrass M 
Published: July 2009

Abstract
Accurate radiographic evaluation of diabetic neuroarthropathy is increasingly difficult as the disease becomes more florid. 22 patients with a known diabetic neuroarthropathy of one or both feet were prospectively examined by computed tomography (CT) in the axial and coronal planes. Bilateral changes of a neuroarthropathy were present in 75% of cases. Distinct patterns of disease were seen and categorized into five types in order of increasing severity. Changes at the medial tarsometatarsal joints and adjacent intercuneiform joints were seen in all affected feet. More extensive disease involved the medial arch more commonly than the lateral. Fractures of the tarsal bones were found in 32% of cases and were associated with neuroarthropathic changes in adjacent joints. Calcaneal fractures were seen in four feet. A Lisfranc fracture–dislocation was present in 41% of cases and a bilateral in only 21%. A single CT examination of the foot, while an accurate method of demonstrating the extent of the disease, is an insensitive indicator of disease activity.
Idiopathic isosexual central precocious puberty: magnetic resonance findings in 30 patients
Authors: Robben S G F , Oostdijk W , Drop S L S , Tanghe H L J , Vielvoye G J , Meradji M 
Published: July 2009

Abstract
The purpose of this prospective study was to define the incidence of magnetic resonance imaging (MRI) abnormalities in the brain in patients with idiopathic central precocious puberty without any additional neurological signs and symptoms, and to evaluate the routine use of gadolinium contrast in these patients. 30 patients (29 girls, one boy; age range 1.9–11.9 years) with idiopathic central precocious puberty were studied. MRI of the brain in axial, coronal and sagittal planes was performed before and after administration of gadopentetate dimeglumine, with special attention to the region of the third ventricle. There are three major findings: (1) the height of the pituitary gland is increased up to adult size compared with normal individuals; (2) in four patients (13%) major structural abnormalities were found; three hamartomas of the tuber cinereum and one gliomatous process extending from the chiasm to the optic tract; and (3) the routine use of gadopentetate dimeglumine did not reveal new abnormalities although the lack of enhancement made a positive contribution to diagnostic certainty. We conclude that contrast enhanced MR examination is a safe and reliable method for the exclusion of abnormalities in children with precocious puberty and for the follow-up of those patients in whom abnormalities are present.
A hamartoma presenting as a giant oesophageal polyp
Authors: Halfhide B C , Ginai A Z , Spoelstra H A A , Dees J , Vuzevski V D 
Published: July 2009

Abstract
Giant oesophageal polyp (GOP) is a very rare intraluminal tumour. It is usually a benign, fibrovascular polyp arising from the proximal third of the oesophagus. We describe a patient with such a polyp but with a histological diagnosis of hamartoma. Regurgitation of the polyp into the mouth, which can lead to asphyxia, is a feared complication. A barium swallow and oesophagoscopy are the common diagnostic procedures. The site of the polyp and its volume often define the method of resection.
Archives of Clinical Skiagraphy (1896)
Authors: Rowland S 
Published: July 2009

The object of this publication is to put on record in permanent form some of the most striking applications of the New Photography to the needs of Medicine and Surgery.
The progress of this new Art has been so rapid that, although Prof. Rontgen's discovery is only a thing of yesterday, it has already taken its place among the approved and accepted aids to diagnosis. At the first moment, the statement that it had been found possible to penetrate the fleshy coverings of the bones, and to photograph their substance and contour, seemed the realization of almost an impossible scientific dream. The first essays were of a rough and imperfect character; week after week, however, improvements have been made in the practical application of the Art, which I venture to call Skiagraphy; and, at the present time, we are in a position to obtain a visible image of every bone and joint in the body.
MBS: a model for risk benefit analysis of breast cancer screening
Authors: Jansen J Th M , Zoetelief J 
Published: July 2009

Abstract
Breast cancer screening programmes employing mammography are being implemented in various European countries. Different screening protocols are used in demonstration projects and nationwide programmes. To evaluate and improve protocols, a computer model for the evaluation of breast cancer screening has been developed. The availability of such a model can be of great importance in obtaining a better insight into the influence of various parameters. The Monte Carlo computer model is based on random selection from distributions of relevant parameters including tumour onset, tumour growth rate, lifetime expectancy, tumour detection size for screening and spontaneous observation. The radiation risk is calculated for various screening protocols employing multiplicative and additive risk models combined with lifetime expectancy, number of females screened and absorbed dose per screening session. The benefit is calculated on the basis of the reduction in tumour size at detection due to screening compared with spontaneous observation and the survival as a function of tumour diameter. Data from the Swedish two-county study are used to validate the model in terms of prevalence, interval tumour rates and interval tumour diameter distributions. Except for the spontaneous tumour diameter distribution, the model can describe the Swedish two-county study. Specific information is presented on the distributions of relevant parameters.
Computer planning of stereotactic iodine-125 seed brachytherapy for recurrent malignant gliomas
Authors: Hughes S W , Sofat A , Kitchen N D , Brown A , Beaney R P , Timothy A R , Saunders J E , Thomas D G T 
Published: July 2009

Abstract
At St Thomas' Hospital, we have developed a computer program on a Titan graphics supercomputer to plan the stereotactic implantation of iodine-125 seeds for the palliative treatment of recurrent malignant gliomas. Use of the Gill–Thomas–Cosman relocatable frame allows planning and surgery to be carried out at different hospitals on different days. Stereotactic computed tomography (CT) and positron emission tomography (PET) scans are performed and the images transferred to the planning computer. The head, tumour and frame fiducials are outlined on the relevant images, and a three-dimensional model generated. Structures which could interfere with the surgery or radiotherapy, such as major vessels, shunt tubing etc., can also be outlined and included in the display. Catheter target and entry points are set using a three-dimensional cursor controlled by a set of dials attached to the computer. The program calculates and displays the radiation dose distribution within the target volume for various catheter and seed arrangements. The CT co-ordinates of the fiducial rods are used to convert catheter co-ordinates from CT space to frame space and to calculate the catheter insertion angles and depths. The surgically implanted catheters are after-loaded the next day and the seeds left in place for between 4 and 6 days, giving a nominal dose of 50 Gy to the edge of the target volume. 25 patients have been treated so far.
Chest radiograph appearance at 24 h of age—prediction of chronic oxygen dependency
Authors: Giffin F , Greenough A , Karani J 
Published: July 2009

AbstractChronic oxygen dependence is associated with immaturity, male sex and low birthweight, but amongst that high risk group further criteria are necessary to predict those most at risk. We previously developed a chest radiograph scoring system which, when used at 1 month of age, proved useful in predicting chronic oxygen dependency at 36 weeks post-conceptional age (PCA). We have now assessed whether the scoring system, if applied at 24 h of age, added predictive value to readily available demographic and ventilatory data. 50 infants, birthweight less than 1200 g and ventilated from birth, were examined. They had a median gestational age of 27 weeks (range 23–34), birthweight of 886 g (range 470–1172) and chest radiograph score of 7 (range 2–13). Univariate analysis revealed that oxygen dependency at 28 days and 36 weeks PCA was significantly associated with low gestational age, male sex and high ventilatory requirements, in addition to a high chest radiograph score. Stepwise regression analysis, however, demonstrated that a high chest radiograph score predicted oxygen dependence at 28 days, independent of immaturity, low birthweight, male sex and high ventilatory requirements. A chest radiograph score of more than 5 rendered an infant four times more likely to be oxygen dependent at 28 days than those with lower scores. We conclude the chest radiograph appearance at 24 h of age could be used as a criterion to institute interventional strategies aimed at reducing chronic oxygen dependence.
Cervical lymphadenopathy: ratio of long- to short-axis diameter as a predictor of malignancy
Authors: Steinkamp H J , Cornehl M , Hosten N , Pegios W , Vogl T , Felix R 
Published: July 2009

Abstract
The purpose of this study was to evaluate short- and long-axis diameters of enlarged cervical lymph nodes with ultrasonography and to determine whether the long-to-short axis (1/s) ratio is a valid diagnostic parameter in the differentiation between benign and malignant nodal disease. 730 enlarged cervical lymph nodes in 285 patients were examined with ultrasound. The short- and the long-axis diameters of each enlarged node were measured and the 1/s ratio calculated. Definite diagnoses of the nodes were obtained by histological examination following neck dissection. 95% of enlarged cervical nodes shown on ultrasound to have a 1/s ratio of more than 2 were correctly diagnosed as benign. Nodes presenting with a more circular shape and a 1/s ratio of less than 2 were diagnosed correctly as metastases with 95% accuracy. The 1/s ratio of lymph nodes thus provides an excellent criterion for differentiation between benign and malignant enlargement in cervical lymphadenopathy.
The role of flow cytometry in non-resected cervical carcinoma
Authors: Tang G-J S , Sun C-F , Lin F-J , Tsao K-C 
Published: July 2009

Abstract
Flow cytometry (FCM) has a prognostic value for many malignant neoplasms in terms of treatment response rate and survival. However, its role in non-resected cervical carcinoma remains uncertain. We have collected 96 paraffin-embedded specimens taken from non-resected cervical cancer patients treated by radiotherapy (RT) alone between 1984 and 1986. Our data revealed that FCM has little correlation with patients' age, pathological grade and clinical stage. Ploidy pattern and clinical stage correlate significantly with complete remission (CR) rate (p = 0.001 and 0.03). Most diploid or low-stage tumours (IB to IIA) obtained CR after RT alone. The application of an intravaginal extension electron cone (IVEC) (p = 0.019) and CR status (p = 0.0001) yield significant better overall survival (OS) rates than their alternative groups. The Cox regression model has confirmed these two variables as having an independent influence on OS. We thus conclude that both ploidy pattern and S-phase fraction (SPF) predict neither pre-treatment biological behaviour of the tumours nor overall survival. However, ploidy pattern has an independent influence on CR rate.
Radiation doses to paediatric patients undergoing micturating cystourethrography examinations and potential reduction by radiation protection optimization
Authors: González L , Vañó E , Ruiz M J 
Published: July 2009

Abstract
Dose–area product values were measured in paediatric micturating cystourethrography examinations in two dedicated facilities. The results are compared, taking into account features of the X-ray rooms and differences in examination protocol. Several optimization procedures were simulated or implemented, in order to estimate the dose savings which could be attained. Potential savings identified in the dose–area values reach about 85% for both centres.
Normal tissue injury after cancer therapy is a local response exacerbated by an endocrine effect of TGFβ
Authors: Anscher M S , Kong F-M , Murase T , Jirtle R L 
Published: July 2009

Abstract
The sensitivity of normal tissues rather than of the tumour usually limits the effectiveness of cancer treatment. The normal tissue side effects from chemotherapy and/or radiotherapy result from both direct cellular loss and the extensive fibrosis that develops at the site of injury. Recent evidence suggests that the cytokine, transforming growth factor β (TGFβ), mediates this fibrogenic process. Herein, we provide evidence in support of the hypothesis that the fibrosis formation following therapy results not only from TGFβ produced locally in the injured normal tissue, but also from circulating TGFβ released by the tumour. Thus, therapy-induced normal tissue damage appears in part to be a local manifestation of a systemic condition.
Mediastinal lymph node size in an Asian population
Authors: Murray J G , O'Driscoll M , Curtin J J 
Published: July 2009

Abstract
There is a high incidence of respiratory tuberculosis in the British population of Indian subcontinent (Asian) ethnic origin. Granulomatous diseases can cause long term lymph node enlargement. Separate computed tomography (CT) criteria for normal nodal size could therefore be necessary when staging thoracic malignancy in Asian patients. The objective of this study was to measure mediastinal lymph node size in an Asian population, and to correlate nodal size with previous tuberculosis. Chest CT scans on all Asian patients over a 5 year period were reviewed and those with pulmonary disease, malignancy or grossly distorted anatomy were excluded. The study group consisted of 48 patients (26 male, 22 female) aged 10–75 years (mean 47 years). All nodes were measured and the site of those greater than 7 mm was recorded using the American Thoracic Society (ATS) lymph node map. 81.3% of patients had nodes less than or equal to 7 mm at all ATS stations, 10.4% had nodes of 8–10 mm and 8.3% had nodes greater than 10 mm. All nodes measuring more than 7 mm were in regions 4R, 10R and 7. Fourteen patients had signs of previous tuberculosis, and in this group 50% had nodes greater than 7 mm as compared with 6% in the group with no signs of previous tuberculosis (p &lt; 0.001, χ2 test). Despite these differences only four of the 48 patients (8.3%) had nodes greater than 10 mm, which is in keeping with other general population studies. Thus the generally accepted size criteria for mediastinal lymph node enlargement (greater than 10 mm) can reasonably be applied to all Asian patients when staging lymphoma or bronchogenic carcinoma.
Functional magnetic resonance imaging at 1 T: motor cortex, supplementary motor area and visual cortex activation
Authors: Santosh C G , Rimmington J E , Best J J K 
Published: July 2009

Abstract
Functional activation of the brain has been visualized using magnetic resonance imaging (MRI). Early studies used echo planar imaging and magnetic fields of 2 T and above. However, recent studies have successfully shown the activation of visual and motor areas of the brain using conventional clinical 1.5 T MRI systems. The purpose of the present study was to replicate these studies at a lower field strength. Eight motor and two visual activation studies were performed using a 1 T clinical scanner. Activation was seen in the contralateral motor cortex during motor stimulation in six of the eight volunteers. Activation was also documented within the contralateral supplementary motor area in four of the six volunteers with motor cortex activation. The supplementary motor area was located in the posteromedial aspect of the superior frontal gyrus. Both volunteers subjected to photic stimulation showed activation within the visual cortex. Results show that functional imaging can be successfully carried out with a 1 T clinical scanner. The size of the image intensity on activation change suggests that contrast may not be due solely to susceptibility changes.
A comparison of the effects of methotrexate and misonidazole on the germinal cells of the subependymal plate of the rat
Authors: Morris G M , Hopewell J W , Morris A D 
Published: July 2009

Abstract
The cytotoxic effects of the drugs methotrexate (MTX) and misonidazole have been assessed in the rat brain by quantifying changes in the constituent cell populations of a glial cell progenitor layer, the subependymal plate (SEP). Three distinct cell types can be identified in the SEP on the basis of their nuclear morphology: cells with small dark (SD), small light (SL) or large light (LL) nuclei. The cells with SD nuclei may represent pluripotential glial cell precursors. A reduction in the total nuclear density of the SEP, after the local ventricular administration of MTX, could be accounted for largely by a loss of cells with SD nuclei; to ∼45% of control values 2 days after MTX followed by a full recovery in numbers by day 5. A further decline in the number of cells with SD nuclei occurred at 12 weeks after MTX administration. The pattern of changes in the cellularity of the SEP, after misonidazole administration, were similar to those observed after MTX treatment, although the magnitude of the response was reduced. It was concluded that both drugs, but MTX in particular, could have a potential additive effect on glial progenitor cells when used in combination with other forms of cancer therapy including radiation.