bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radiological features of extraskeletal Ewing sarcoma
Authors: O'Keeffe Francis , Lorigan James G. , Wallace Sidney 
Published: July 2009

Abstract
The radiological features of extraskeletal Ewing sarcoma were reviewed in 22 patients whose average age was 22 years. Tumours were located in the extremities (11 patients), abdomen or pelvis (six patients) and the chest (five patients). The tumours ranged in size from 2 cm to 20 cm, were mainly well circumscribed and showed no evidence of calcification prior to treatment. Most tumours (13 out of 14) were of low attenuation or contained areas of lower attenuation than muscle on computed tomographic examination, and in six out of seven patients studied by ultrasound the tumours were hypoechoic or partly anechoic. No distinctive post-contrast medium enhancement pattern on CT examination (11 patients) or angiographic features (three patients) were evident. Tumour haemorrhage was a frequent microscopic finding and changes consistent with this were present in one patient on magnetic resonance imaging examination. Distant metastases or local recurrence developed in 13 patients with lung being the most frequent metastatic site (eight patients). Although its radiological features are non-specific, extraskeletal Ewing sarcoma should be included in the differential diagnosis of noncalcified soft-tissue tumours especially in a young age group and where located in an extremity or paravertebral region of the chest.
Further studies on selective radioprotection by organic zinc salts and synergism of zinc aspartate with WR 2721
Authors: Floersheim G. L. , Bieri A. 
Published: July 2009

Abstract
The organic zinc salts zinc aspartate, zinc histidine, zinc orotate and zinc acetate reduced the fall of the haematocrit, thrombocytes, erythrocytes and leucocytes in irradiated mice. In general, zinc aspartate was more effective than the other organic zinc salts. Protection of the haematocrit and thrombocytes by small doses of the aminothiol radioprotector WR2721 was markedly improved by the concomitant administration of small doses of zinc aspartate. Zinc aspartate was the only one of the four tested organic zinc salts that did not inhibit in any instance the regression induced by radiotherapy of human tumours grown as xenografts in immunosuppressed mice. This also applied to the combination of zinc aspartate with WR2721. In an experiment performed to determine the toxicity of the combined regimen, a dose of zinc aspartate which afforded synergistic haematological protection did not enhance the toxicity of WR2721. The synergism of zinc aspartate with WR2721 and the differential radioprotection of the combined protocol may make it possible in clinical cancer radiotherapy to obtain selective radioprotection at a lower toxicity giving an improved therapeutic ratio compared with WR2721 alone.
Pelvic haematoma following orchidectomy: a pitfall in the staging of non-seminomatous germ cell tumour
Authors: Russell S. A. , Johnson R. J. , Russell J. M. 
Published: July 2009

Treatment of non-seminomatous germ cell tumour (NSGCT) is critically dependent on the stage of disease at presentation. Staging is by clinical examination, estimation of tumour markers (serum human chorionic gonadotrophin, HCG, and alpha-fetoprotein, AFP) and imaging; the latter comprising chest radiography and thoraco-abdominal computed tomographic (CT) scan.
Three cases are presented whose staging CT scan showed abnormality confined to the external and common iliac region ipsilateral to orchidectomy, subsequently diagnosed as resulting from a post-operative haematoma. The importance in considering this differential diagnosis and its effect on treatment are stressed.
Radiological anatomy of the kidney revisited
Authors: Palma L. Dalla , Bazzocchi M. , Cressa C. , Tommasini G. 
Published: July 2009

Abstract
In recent years some structures or features such as the “inter-renuncular septum”, the “echogenic triangle” and the “echogenic line” have been described to support the concept of a kidney resulting from the fusion of two masses or renunculi. To clarify this concept and to understand the meaning of the above echographic features better, the authors have examined prospectively by sonography the kidneys of 50 children, 200 adults with a single collecting system, 25 adults with a duplicated collecting system and 32 cadavers. Furthermore, to help explain the sonographic features, we have examined 32 cadaver kidneys with sonography and 10 cadaver kidneys with magnetic resonance imaging (MRI). The sonographic, MRI and anatomical correlations have shown that the “echogenic triangle” and the “echogenic line” are not renuncular residuals, but simply an extension of the hilar fat visible when the renal sinus is rather deep. The intermediate cortical mass is not a septum dividing the kidney into an upper and lower renunculus, but a column of parenchymal tissue crossing the renal sinus, which, from an anatomical point of view, is an accessory renal lobe. The presence of two renunculi, suggested in a previous study with cortical nephrotomography, has not been confirmed.
Stereotactic multiple arc radiotherapy
Authors: Thomson E. S. , Gill S. S. , Doughty D. 
Published: July 2009

Abstract
A radiotherapy technique is presented for delivering a concentrated pattern of absorbed dose to intracranial lesions. Treatment takes place on a conventional, isocentrically mounted linear accelerator, rotated in several planes around a single target site. A new, relocatable sterotactic frame is used which enables fractionated radiotherapy to be administered if required. Calculations of the absorbed dose distribution in three orthogonal planes are performed using specially prepared software on a computer used for standard treatment planning. In this way, the need for excessive computing power is avoided.
Quantitative γ-ray computed tomography of the radius in normal subjects and osteoporotic patients
Authors: Smith D. A. S. , Hosie C. J. , Deacon A. D. , Hamblen D. L. 
Published: July 2009

Abstract
A new design of γ-ray computed tomography (CT) scanner was used to measure bone density in 516 normal adults and in 116 female patients with osteoporotic fractures. Trabecular bone density (TBD) was measured for a core of the ultradistal radius; cortical bone mass per unit length (MLS) and mass per unit volume (MVS) were computed for the radius shaft. TBD, MLS and MVS peaked at the age of about 40 in females and fell by 32%, 15% and 24%, respectively, by the age of 65. In males, TBD decreased from the third decade and MLS and MVS peaked in the fourth decade. The corresponding falls by 65 years were 20%,6% and 7%. In patients with Colles' fracture TBD and MLS were reduced by 13% and 10%, respectively, relative to age matched normal female subjects. For patients with vertebral crush fracture the reductions relative to age matched normal females were 36%, 17% and 16% for TBD, MLS and MVS. In fracture patients the deficit in TBD was significantly greater than that for cortical bone but TBD was no better at discriminating normal and osteoporotic individuals because of its larger normal range. We conclude that γray CT may best be used for monitoring changes in bone rather than as a diagnostic screening tool.
Sedation in children scanned with high-field magnetic resonance; the experience at The Hospital for Sick Children, Great Ormond Street
Authors: Shepherd J. K. , Hall-Craggs M. A. , Finn J. P. , Bingham R. M. 
Published: July 2009

Abstract
Patient movement is the most common cause of image degradation when performing magnetic resonance scans in children. This is a particular problem scanning at high field, as noise levels of up to 90 dB may be reached. Movement can be reduced by adequate sedation. We present the results of two sedation protocols when scanning with a 1.5T Magnetom scanner. Optimal scan quality can be achieved in up to 85% of scans using Pethco combined with triclofos in children aged 1 month–2 years, and trimeprazine combined with papaveretum in children over 2 years. When heavy sedation is used, patient selection must be cautious, and there is a minimum acceptable level of monitoring including close physical observation, electrocardiographic and apnoea monitoring.
Progressive systemic sclerosis (diffuse scleroderma) and radiotherapy
Authors: Cooper Stephen G. , Denham James W. 
Published: July 2009

The rheumatological manifestations of cancer are many and varied. Progressive systemic sclerosis has been reported both as an initial manifestation of malignancy (Caldwell & McCallum, 1986) and, of course, as coexisting with malignant disease. Surprisingly, only one case report is to be found in the literature reporting on the interaction between radiotherapy and scleroderma (Ransom & Cameron, 1987), the consequences of which may carry significant morbidity.
Our patient was 49 years old in May 1987 when referred for the management of a mass in the right neck. This right cervical node measured 6 × 5 cm, was fungating through the skin, with biopsy confirming metastatic squamous cell carcinoma. No primary site was identified either on direct ear, nose and throat examination or with computed tomography.
Unusual presentation of non-Hodgkin's lymphoma of the small bowel
Authors: Nicholson D. A. 
Published: July 2009

Small bowel non-Hodgkins lymphoma (NHL) usually present with abdominal pain (72%), vomiting and diarrhoea (28%); however, gastrointestinal (GI) bleeding is an uncommon mode of presentation (4%) (Makepeace et al, 1987). A case is presented where a patient with coexisting small bowel NHL and an abdominal aortic aneurysm presented with clinical symptoms suggestive of an aortoenteric fistula.
The mode of presentation for NHL is unusual, with computed tomography (CT) playing a significant role in the diagnosis and management.
A 75-year-old man presented with a 1-month history of intermittent episodes of non-colicky upper abdominal pain, mild weight loss, malaise, and black stools. Past medical history was unremarkable.
On examination he was anaemic with a pulsatile abdominal mass. Investigation revealed a haemoglobin of 4.9 g/dl, with normal urea, electrolytes, liver function tests and white count. Severe melaena with positive occult bloods was confirmed.
An abdominal ultrasound scan showed the presence of an 8 cm abdominal aortic aneurysm, with no evidence of leakage. Initially the patient was transfused with 6 units of blood. An urgent fibre-optic gastroscopy revealed no gastric or proximal duodenal abnormality. A presumptive diagnosis of aortoenteric fistula was made, on the clinical triad of upper GI bleeding, abdominal pain and abdominal aortic aneurysm (Ferguson & Arden, 1966).
Gallbladder wall thickening (congestive cholecystopathy) in chronic liver disease: a sign of portal hypertension
Authors: Saverymuttu S. H. , Grammatopoulos A. , Meanock C. I. , Maxwell J. D. , Joseph A. E. A. 
Published: July 2009

Abstract
A thickened gallbladder wall is often seen with ultrasound in alcoholic cirrhosis. Hypoalbuminaemia is thought to be the cause since there is a strong association between bowel wall thickening and low serum albumin. To determine the role of portal hypertension in producing gallbladder wall thickening we studied 40 consecutive stable patients—37 with cirrhosis and three with portal hypertension due to primary biliary cirrhosis. Ultrasound assessment of the gallbladder wall was made after an overnight fast using a Technicare autosector. Wall thickness 4 mm or greater was considered abnormal. Twenty-seven patients had a thickened gallbladder wall and all had evidence of portal hypertension. Hypoalbuminaemia was not an important factor since it was only present in six cases with thickened walls. In two cases reduction in portal pressure with oral propranolol was associated with a decrease in gallbladder wall thickness. These results suggest that portal hypertension, not hypoalbuminaemia, is the dominant factor causing gallbladder wall thickening in cirrhosis. Ultrasound demonstration of gallbladder wall thickening in chronic liver disease should suggest the presence of portal hypertension.
The prognostic significance of radiologically detected knee joint effusions in the absence of associated fracture
Authors: Maskell T. W. , Finlay D. B. L. 
Published: July 2009

Abstract
The significance of radiologically detected knee joint effusion as a marker of soft tissue injury following trauma is uncertain. In this study 100 patients presenting to the casualty department following acute injury, with effusions but no fracture, were assessed. Of those available for follow-up, 20% required further investigation and 11% proceeded to surgery for significant soft tissue injury. It is concluded that radiologically detected knee joint effusions are a useful marker for underlying soft tissue injury.
Determinations of organ doses and effective dose equivalents from computed tomographic examination
Authors: Nishizawa Kanae , Maruyama Takashi , Takayama Makoto , Okada Minoru , Hachiya Jun-ichi , Furuya Yoshiro 
Published: July 2009

Abstract
The organ or tissue doses were determined with a phantom measurement for 12 types of CT scanners widely used in Japan. Two types of thermoluminescent dosimeters were used for the dose determinations in a Rando woman phantom. The effective dose equivalents recommended by the International Commission on Radiological Protection were calculated using the measured organ or tissue doses. It was found that the CT scanners currently available give quite different organ or tissue doses. When selecting the optimum technical factors for scanning, therefore, it is important to take into consideration the balance of the image quality and the radiation exposure to patients.
Carcinoma of the breast: measurement and the management of treatment. I. The value of the data
Authors: Cheung C. W. D. , Johnson A. E. 
Published: July 2009

Abstract
This is the first of a series of papers in which we shall explore some insights into the biological changes which accompany the treatment of human tumours which may be obtained through estimation of volume changes in relation to treatment. We have adopted a working hypothesis that regression slopes reflect the composition of individual tumours and, indirectly, their intrinsic growth rate rather than the effectiveness of treatment. The breast has proved to be a suitable site for measurement and our interpretation of the results has led to the development of a new style of management for carcinoma of the breast: measurement based sequential therapy (MBST). In this paper the method of measurement and detailed statistical evaluation of the quality of the data from 262 patients (263 tumours) is presented. Exponential regression lines have been fitted to describe volume changes in relation to treatment by radiation, chemotherapy and hormones. A simple classification of steepness of slopes is introduced.
Selective uptake of toxic nucleoside (125IUdR) by resistant cancer
Authors: Bagshawe Kenneth D. , Sharma K. , Southall Peter J. , Boden Joan A. , Boxer Geoffrey M. , Patridge Terence A. , Antoniw Pari , Pedley Rosamond B. 
Published: July 2009

Abstract
We report uptake of a thymidine analogue 125-Iodine-5-iodo-2′-deoxyuridine (125IUdR) by nude mice bearing human xenografts of choriocarcinoma or colonic cancer. When 125IUdR was given alone, uptake by intestinal tissues was 5–10 times greater than by the tumours as measured by tissue γ counting. This ratio was reversed when hydroxyurea or cytosine arabinoside were used as inhibitors of ribonucleotide reductase and were given in combination with 5-fluorouracil or methotrexate to inhibit thymidine synthesis shortly before injecting 125IUdR. Counting the radioactivity in tissues removed 24 hours after 125IUdR gave tumour to highest normal tissue ratios of up to 15:1, but the corresponding nuclear grain counts, which is probably a more reliable indicator of selective uptake into DNA, were in excess of 100: 1. The addition of unlabelled IUdR to the regimen only reduced the uptake of l25IUdR when given in relatively large amounts. For this approach to be exploited it is concluded that the tumour must be resistant at the cell level to the inhibitor of DNA synthesis either de novo or as a result of prior exposure to it. This inhibitor can then be used to block uptake of the potentially toxic nucleoside analogue by normal renewal tissues while it is taken up by the resistant cancer cells. By inhibiting synthesis of the corresponding normal nucleosides with inhibitors to which the cancer cells are not resistant, incorporation of the toxic analogues into tumour DNA was enhanced. Although 125IUdR is a convenient agent for exploring this approach and is highly cytotoxic when incorporated in DNA, the clinical potential of reverse role chemotherapy probably lies with the development of toxic non-radioactive nucleoside analogues.
Tissue dose estimates following the selective uptake of 125IUdR and other radiolabelled thymidine precursors in resistant tumours
Authors: Humm J. L. , Bagshawe K. D. , Sharma S. K. , Boxer G. 
Published: July 2009

Abstract
For the purposes of evaluation of the therapeutic potential of the radiohalogenated thymidine analogue 125IUdR, estimation of the radiation dose to the tumour cells and normal tissues is important. To determine the dose to any tissue from the radionuclide 125I is not simple, since the major emissions are very short-range Auger electrons. The cytotoxicity of 125I is strongly dependent on the position of the decay relative to the DNA, the principal target for cell sterilization. Estimates of the cytotoxicity of 125I based on the traditional MIRD recommended formulation (ICRU Report 32, 1979) may produce gross underestimates if it is incorporated into the DNA via the thymidine precursor 125IUdR. In this work, tissue count and autoradiography (ARG) data from studies by Bagshawe et al were used to estimate tissue doses following the administration of 125IUdR to LS174/T (a colorectal carcinoma) and CC3 (a choriocarcinoma) tumour-bearing animals, after a hydroxyurea block of the normal tissue turnover. The tumour cell toxicity is estimated from ARG data on the degree of 125I incorporation into the cell nucleus. Major drawbacks with 125I for this type of therapy are the long 60-day half-life, leading to radiological and waste disposal problems and the extreme short range of the radiotoxic effects. Possible alternative radiohalogens, 123I, 77Br, 131I and 211At, are suggested in place of 125I in the thymidine analog iododeoxyuridine. Dose calculations are performed and cytotoxicities estimated on the assumption that their biological retention characteristics are the same as for 125IUdR.
Cranio-facial melorheostosis: case report and review of the literature
Authors: Williams J. W. , Monaghan D. , Barrington N. A. 
Published: July 2009

Melorheostosis is a rare condition principally affecting the bones of the appendicular skeleton, producing characteristic radiographic features of flowing “candle wax” subperiosteal bone and streaky endosteal bone formation in the diaphysis and epiphysis, which may affect only one side of long bones within a limb. Radiographic appearances form the basis of the diagnosis, as clinical and histological findings are non-specific.
Our patient, an elderly woman, was admitted from the Casualty Department following a fall. Radiographs of her pelvis and left elbow were obtained (Figs 1 and 2) showing the typical longitudinal distribution of flowing subperiosteal and endosteal new bone. The left wrist and right elbow were similarly affected, but to a lesser extent. Skull radiographs showed (Fig. 3) bony obliteration of the left maxillary antrum without expansion of its outline, thought to be due to melorheostosis and similar in appearance to a previously described case. Thickening of the vault may be partially due to hyperostosis frontalis interna, but is asymmetrical, and melorheostosis was suspected in addition.
Examination revealed no skin changes, vascular abnormalities or joint deformity and the patient had experienced no pain in the affected areas.
Over 200 cases have now been reported. The classic pattern of subperiosteal bone deposition may be monostotic, polyostotic, monomelic or affect multiple limbs and the trunk (Morris et al, 1963). Extra-osseous bone deposition can occur.
Lymphangiohaemangioma of the mediastinum
Authors: Toye Rosemary , Armstrong Peter , Dacie Janet E. 
Published: July 2009

Lymphangiohaemangiomas are rare congenital malformations, which on histological examination show both vascular and lymphatic elements. Clinically they tend to behave as lymphangiomas. Conservative management is usually recommended, with intervention only if vital structures are affected or if required for cosmetic reasons (Bruce Williams, 1981). Mediastinal lymphangiohaemangiomas are exceedingly rare and may require treatment because of their position.
A case of benign lymphangiohaemangioma of the mediastinum is presented. Unlike the only previously reported case of computed tomography (CT) in this condition (Angtuaco et al, 1983), our case showed neither near-water density nor contrast enhancement following intravenous contrast medium administration.
A girl of 2 years and 8 months was admitted to Queen Elizabeth Hospital, Hackney, with a discharging cervical tuberculous fistula. She was incidentally found to have a superior mediastinal mass. After treatment of her tuberculosis, at the age of 2 years and 10 months, an exploratory thoracotomy was performed at Great Ormond Street Hospital. The operative findings were of an irresectible tumour densely adherent to the pericardium and to the great vessels in both thoracic cavities. Histological specimens showed a complex vascular malformation predominantly of lymphangiomatous tissue but containing abnormal blood vessels, appearances consistent with a diagnosis of benign lymphangiohaemangioma. A subtotal resection was performed at the age of 3 years 4 months. The left phrenic nerve was noted to pass through part of the tumour and had to be resected.
At 4 years and 7 months the patient presented with a persistent cough.
Acute response of mouse kidney clonogens to fractionated irradiation in situ and then assayed in primary culture
Authors: Jen Yee-Min , Hendry Jolyon H. 
Published: July 2009

Abstract
Although the difference in sensitivity to the changes in dose fraction size between early-responding and late-responding tissues is well established, the underlying mechanisms in terms of target-cell responses are not yet clearly identified for any tissue. The radiosensitivity of mouse kidney cells after in situ single-dose, 2, 8, and 16 fraction X-irradiations was measured in primary culture using a clonogenic assay. The assay was made 12 h after single doses or 12 h after the last dose of the multifraction regimens. When analysed using the linear-quadratic model, as predicted the individual α components for all the different fractionation schedules were not significantly different, and the changes in the β values were consistent with those expected on the basis of the reciprocal fraction numbers. When all four data sets were integrated to derive a common α/β ratio, the result was 4.4 ± 1.3 (1SE) Gy, or 2.8 ± 0.9 Gy (a better fit) if the single-dose data set was excluded. These values fall into the range reported for kidney using assays of tissue function at long times after irradiation. Hence, it has been shown for the first time that the fractionation sensitivity of a late-responding organ is mimicked by that of a clonogenic cell population in that organ. The evidence also suggests that the time available prior to fixation of potentially lethal damage does not influence the low α/β ratio observed for the kidney.