bluuebunny/crossref_metadata_2025_split huggingface dataset:
Doppler ultrasound scanning in the detection of renal artery stenosis in hypertensive patients
Authors: Postma Cornelis T. , van Aalen Joost , de Boo Theo , Rosenbusch Gerd , Thien Theo 
Published: July 2009

Abstract
The diagnostic accuracy of Doppler ultrasound in the detection of renal arterial disease has been assessed in a prospective study of 61 hypertensive patients. The findings of Doppler ultrasound were compared with the results of renal angiography. In 15 patients (24.5%) no accurate Doppler signs could be obtained and the Doppler ultrasound examination was considered a technical failure. Of the remaining 46 patients, 24 had renal artery stenosis. Nine of the stenoses were not detected by Doppler ultrasound and in three patients a false positive diagnosis of renal artery stenosis was made. The sensitivity of Doppler ultrasound was 62.5%, the specificity 86.4% and the overall diagnostic acccuracy was 73.9%. By comparing the 15 patients in whom Doppler ultrasound failed with the 46 in whom it was successful, age appeared to be higher and creatinine clearance lower in the failure group. By comparing the 34 patients with true positive and true negative results with the 12 patients with false results, no significant differences were found. In a multivariate analysis, higher age showed a significant relation to failure of Doppler ultrasound. Doppler ultrasound has limited value in the screening of hypertensive patients for renal artery stenosis.
Impact of hydration status on body composition as measured by dual energy X-ray absorptiometry in normal volunteers and patients on haemodialysis
Authors: Horber F. F. , Thomi F. , Casez J. P. , Fonteille J. , Jaeger Ph. 
Published: July 2009

Abstract
To evaluate the influence of hydration status on the estimation of body composition using dual-energy X-ray absorptiometry (DXA), six normal volunteers and seven patients on maintenance haemodialysis were investigated using two different DXA machines (Lunar DPX, Hologic QDR 1000/W). Normal volunteers were studied (Hologic QDR 1000/W) before and 1 h after ingestion of breakfast, lunch and dinner (drinking various amounts of liquids at each meal, 0.5–2.4 kg). Whereas bone mineral content and body fat mass did not change, lean body mass of the trunk increased as a consequence of the meals. Conversely in patients on haemodialysis (Lunar DPX), lean body mass decreased in all segments of the body as a consequence of removal of 0.9–4.4 kg of salt-containing fluid by haemodialysis (trunk 61%, legs 30%, arms 5.5% and rest of the body 3.5%), whereas bone mineral content and body fat mass remained unchanged. However, this finding(s) did not hold true in one particular patient with bilateral hip prostheses. Measurement of body composition in eight normal volunteers on the same day with both machines showed similar results for lean and fat mass, whereas bone mineral content was found to be 17% higher using the Lunar DPX. In summary, in centres where both machines are available, follow-up of one individual patient should always be performed using the same equipment. In addition, hydration status and food intake must be taken into account when repetitive measurements of lean body mass are performed in the same patient.
Retrospective analysis of nasopharyngeal carcinoma treated during 1976–1985: late complications following megavoltage irradiation
Authors: Lee Anne W. M. , Law Stephen C. K. , Ng S. H. , Chan David K. K. , Poon Y. F. , Foo William , S. K. O  , Tung Stewart Y. , Cheung Fred K. , Ho John H. C. 
Published: July 2009

Abstract
A retrospective analysis was undertaken of the late complications observed in 4527 patients with nasopharyngeal carcinoma treated by megavoltage radiotherapy during the years 1976–1985. Unconventional fractionation schedules were used because of serious resource limitations. The median equivalent doses were 65 Gy to the nasopharyngeal region and 53 Gy to the cervical region. 707 patients had reirradiation for local recurrences and 250 for regional relapses. The 10-year actuarial cancerspecific survival was 47%, and the corresponding all-complication-free and neurological-complication-free rates were 40% and 72%, respectively. Altogether, 1395 (31%) patients developed one or more late irradiation sequelae. The majority were mild softtissue damages, but 322 (7%) had significant functional disturbances, from which 62 (1%) died. Neurological damage that occurred in 450 (10%) patients constituted the major morbidity and accounted for all but three of the treatment mortalities. The cumulative incidence of the various complications is summarized, and the data recorded in the literature reviewed in order to give a proper perspective of the problem. Patients treated during 1981–1985 had a significantly higher actuarial encephalomyelopathyfree rate than those treated during 1976–1980, but the incidence-free rates for the other neurological complications remained unimproved, suggesting that the improvement could be mainly attributed to additional shielding for the brainstem rather than the reduction of dose from 3.8–4.2 Gy to 2.5 Gy per fraction.
Demonstration by computed tomography of a case of internal small bowel herniation
Authors: Hoeffel J. C. , Zimberger J. , Pocard B. , Hoeffel C. 
Published: July 2009

Internal hernia is a rare condition. We report a case where computed tomography (CT) demonstrated a saclike encapsulation of small bowel loops which suggested a diagnosis of internal hernia.
A 76-year-old woman presented with abdominal pain and vomiting. Ultrasound examination revealed a 10 cm heterogenous mass posterior to the bladder, close to the ovaries, associated with bilateral hydronephrosis affecting mainly the left side. Contrast-enhanced CT showed a large pelvic mass Fig. 1), behind the bladder, of fluid density and containing septations. The appearance suggested dilated loops of small bowel. Both ureters were dilated, and a plain film of the abdomen 24 h after injection of contrast medium (Fig. 2) showed marked left hydronephrosis and less severe dilatation the right renal tract. Forty-eight hours after injection Fig. 3) the left ureter was still opacified.
At laparotomy a cluster of dilated and congested loops of small bowel were found posterior to the bladder and these were strangulated in the pouch of Douglas. Resection of 50 cm of ileum was necessary, following which the patient made a full recovery.
Caecal herniation through the foramen of Winslow: diagnosis by computed tomography
Authors: Schuster M. R. , Tu R. K. , Scanlan K. A. 
Published: July 2009

Herniation of viscera through the foramen of Winslow comprises 0.08% of all hernias, with caecal involvement in nearly a third (Valenziano et al, 1987). Due to the difficulty in diagnosis, only 10% are diagnosed on plain films prior to surgery (Okhuma & Miyazake, 1977); therefore, other imaging methods are being utilized to assist in the diagnosis. This example of caecal herniation through the foramen of Winslow was diagnosed by dynamic abdominal computed tomography (CT) and its important diagnostic points are reviewed.
A 64-year-old woman presented with 12-hour history of shortness of breath and chest pain. Vital signs and laboratory studies were normal.
Dense bones
Authors: Vinnicombe Sarah , Heron Christine , Wansbrough-Jones Mark 
Published: July 2009

A 39-year-old Asian woman was investigated for a 4 year history of generalized aches and pains and more recent malaise, fevers and cervical adenopathy. On admission, her erythrocyte sedimentation rate (ESR) was 62 and there was a mild polyclonal gammopathy. Mantoux and Kveim tests were negative and screening cultures of urine and sputum (including for acid and alcohol fast bacilli) were also negative. The chest radiograph is shown in Fig. 1. At this time, radiographs of the skull, pelvis and hands were normal.The patient received a 6 month trial of antituberculous chemotherapy, but this resulted in minimal symptomatic improvement and her lymphadenopathy persisted.
Enlarged mediastinal lymph nodes in the fibrosing alveolitis of systemic sclerosis
Authors: Garber S. J. , Wells A. U. , duBois R. M. , Hansell D. M. 
Published: July 2009

Abstract
The aim of this study was to determine the prevalence of enlarged mediastinal lymph nodes in systemic sclerosis (SSc) and relate this to the extent of pulmonary disease and disease activity as judged by high resolution computed tomography HRCT). The HRCT scans of 78 patients with SSc were reviewed. The extent of lung disease and HRCT pattern were analysed and CT scans examined on soft tissue window settings for evidence of mediastinal lymph node enlargement. Sixty six (85%) patients had evidence of lung involvement on CT. Enlarged mediastinal lymph nodes were present in 21 (32%) patients with lung involvement but in only 1 (8%) patient without. The prevalence of enlarged mediastinal nodes increased with more extensive lung involvement on CT (p &lt; 0.025), but correlated poorly with the type of CT appearance and concurrent erythrocyte sedimentation rate. Mediastinal lymph node enlargement occurs frequently in patients with SSc, particularly if lung involvement is extensive.
The effect of thin K-edge filters on radiation dose in dental radiography
Authors: MacDonald-Jankowski D. S. , Lawinski C. P. 
Published: July 2009

Abstract
The use of thin K-edge filters has been found to reduce considerably the radiation dose in intra-oral radiography. The aim of this study was to investigate the effect of nitration on the skin entrance dose and several sites (representing organs or areas of interest within the head) along the central beam axis, at other points within the primary beam and at two points just outside the primary beam. The subject was a sliced head phantom (a human skull embedded in tissue-equivalent material) which was exposed to X rays from a conventional dental X-ray unit in the range of tube voltage 55–85 kVp for each of four filter systems. These were 2.7 mm of aluminium alone (the existing total filtration) or with an added 0.1 mm erbium, 0.1 mm yttrium or 0.05 mm niobium metal foils. Measurements of radiation dose were made using thermoluminescent dosemeters (TLD rods) and were adjusted to simulate the exposure resulting from a typical dental radiograph of a maxillary molar. The results suggest that the use of thin K-edge filters significantly reduces the entrance skin dose and to a certain extent reduces the total dose imparted to the head. However, the dose to the ipsilateral orbit at higher tube voltages may be increased.
The distribution of medical X-ray doses amongst individuals in the British population
Authors: Hart D. , Le Heron J. C. 
Published: July 2009

Abstract
This study has estimated the distribution of diagnostic X-ray doses amongst individuals in the British population by sampling the records kept by general practitioners (GPs) on their patients and the records held by the radiology department of a district general hospital. Deceased patients were chosen in the former case in order to evaluate the dose acquired over a complete lifetime. In each case, several hundred records were sampled. The GP data obtained have enabled an estimate to be made of the likelihood of reaching various dose levels in a lifetime. It is estimated that about 1% of the population has received a lifetime effective dose-equivalent of more than 100 mSv. The largest cumulative dose revealed by the samples of GP and radiology department records was about 200 mSv. The GP data have also shown that the last year of life sees a four-fold increase in the number of X-ray examinations experienced compared with the previous 9 years. The hospital data have allowed an estimate to be made of current rates of dose acquisition amongst the population of a District Health Authority.
Comparison of a subjective and a quantitative assessment of the neonatal chest radiograph
Authors: Yuksel B. , Greenough A. , Karani J. 
Published: July 2009

AbstractThe aim of this study was to assess if quantitative classification of the chest radiograph appearance at 7 days predicted chronic oxygen dependency (oxygen dependency beyond 8 weeks of age) more accurately than did subjective classification at 28 days of age. Thirty preterm infants, median gestational age 27 weeks, who had chest radiographs taken for clinical purposes at 7 and 28 days of age, were recruited into the study. The 7-day chest radiograph was scored according to the lung volume, presence of opacification, interstitial changes, pulmonary interstitial emphysema and cystic elements. The range of chest radiograph scores was from 0–18, a score of 18 indicating the most abnormal appearance. The 28-day chest radiograph was classified as Type I or Type II chronic lung disease (CLD), according to the presence or absence, respectively, of coarse reticulation. The median chest radiograph score at 7 days of the 30 infants was 5 (range 2–14). In predicting chronic oxygen dependency, a chest radiograph score of 5 at 7 days had 83% sensitivity and 75% specificity, but a diagnosis of Type II CLD at 28 days of age had only 67% sensitivity and 67% specificity. We conclude that a quantitative assessment of the chest radiograph appearance at 7 days is more useful than a subjective assessment at 28 days of age.
Kinetic considerations in the choice of treatment schedules for neuraxis radiotherapy
Authors: Wheldon T E , O'Donoghue J A , Barrett A 
Published: July 2009

Abstract
Neuraxis radiotherapy of radiosensitive tumours such as medulloblastoma is usually carried out using conventionally sized fractions and a shrinking field technique. Plowman and Doughty (Br. J. Radiol., 64 (1991) 603–607) have proposed a partial transmission block (PTB) technique which entails the use of small daily doses over a conventional time period. Radiobiological analysis suggests that, although the PTB technique may be adequate for slowly growing tumours, therapeutic efficacy is likely to be compromised where the tumour doubling time is short. Accelerated hyperfractionation (twice daily fractions) provides a possible alternative to both conventional scheduling and the PTB technique. Direct measurement of the kinetics of tumour cells in CSF, where possible, may provide useful guidance in the choice of regimes.
The role of radiography and computed tomography in the diagnosis of acute dislocation of the proximal tibiof ibular joint
Authors: Keogh P , Masterson E , Murphy B , McCoy C T , Gibney R G , Kelly E 
Published: July 2009

Abstract
A cadaveric study was undertaken to determine the best radiographic method of diagnosing dislocation of the proximal tibio-fibular (PTFJ) joint. Three pairs of cadaver knees were used, the right side serving as a control in each case. Plain radiographs, antero-posterior (AP) lateral and 45° oblique films, and axial computed tomography (CT) scans were obtained with the joints in each of three positions: (1) anatomical, (2) dislocated anteriorly and (3) dislocated posteriorly. Similar views were obtained in the control joints with the PTFJ undisturbed. The radiographs were assessed by eight independent observers and the results were analysed. The diagnostic accuracy with plain AP and lateral radiographs was 72.5%. This was unchanged with the addition of oblique views, but improved to 82% with the control films and 86% with the axial CT scans. The authors conclude that in the diagnosis of suspected dislocation of the PTFJ, axial CT scanning is the investigation of choice. Plain AP, lateral and comparison views are useful but less accurate, while oblique views are unhelpful and unnecessary.
A blood pressure independent index of aortic distensibility
Authors: Lehmann E D , Gosling R G , Parker J R , deSilva T , Taylor M G 
Published: July 2009

Abstract
A non-invasive Doppler ultrasound technique for the assessment of aortic compliance based on the in vivo measurement of pulse wave velocity along the thoraco-abdominal aortic pathway is described. An approach for correcting for the effect of blood pressure on aortic compliance is considered. The derivation of an index of distensibility, Cp, which is independent of blood pressure is provided and applied to data collected from 58 normal, healthy volunteers. Medical disorders such as atherosclerosis, diabetes mellitus and familial hypercholesterolaemia have all been shown to affect arterial distensibility. We suggest that the clinical measurement of Cp may be a useful, non-invasive tool for assessing such patients' susceptibility to atheromatous arterial disease as well as for monitoring their response to therapy.
Small cell carcinoma induced acute pancreatitis
Authors: Maclennan Alexander C , Macleod Iain A 
Published: July 2009

A 56-year-old lady presented with a 6 week history of increasing upper abdominal pain, vomiting and backache. She was jaundiced with reduced air entry over the right lung base and guarding of the upper abdomen. A chest radiograph showed elevation of the right hemidiaphragm; an abdominal radiograph was normal. The serum amylase was 1560 U I−1 (NR &lt; 100). A diagnosis of acute pancreatitis was made and intensive medical treatment started. The following day an ultrasound examination showed several hypoechoic areas within an enlarged pancreas (Figure 1). The biliary tree appeared normal.The patient's condition deteriorated over the next 10 days with the development of hypoproteinaemia, pleural effusions and oedema despite parenteral nutrition.
Asymptomatic deep venous thrombosis in the calf: accuracy and limitations of ultrasonography as a screening test after total knee arthroplasty
Authors: Vanninen R , Manninen H , Soimakallio S , Katila T , Suomalainen O 
Published: July 2009

Abstract
Patients who have recently undergone total knee arthroplasty are at high risk of developing deep venous thrombosis (DVT) in the calf. The clinical diagnosis of DVT is difficult in these patients owing to recent operation. A combination of compression ultrasonography (US) and colour flow imaging was used as a screening method of asymptomatic DVT in 51 patients who had undergone total knee replacement surgery. Both limbs were examined by US from the common femoral vein to the ankle approximately 7 days after operation and the results were compared with bilateral venography. 12 patients (24%) developed infrapopliteal DVT on the operated side, in two cases the thrombosis extended to the lower part of popliteal vein. One patient had bilateral thrombosis. US showed sensitivity of 77%, specificity of 96% and overall accuracy of 93%. US seems to be a useful screening method for DVT after knee replacement operation.
Quantitative image analysis of vertebral body architecture—improved diagnosis in osteoporosis based on high-resolution computed tomography
Authors: Mundinger A , Wiesmeier B , Dinkel E , Helwig A , Beck A , Moenting J Schulte 
Published: July 2009

Abstract71 women, 64 post-menopausal, were examined by single-energy quantitative computed tomography (SEQCT) and by high-resolution computed tomography (HRCT) scans through the middle of lumbar vertebral bodies. Computer-assisted image analysis of the high-resolution images assessed trabecular morphometry of the vertebral spongiosa texture. Texture parameters differed in women with and without age-reduced bone density, and in the former group also in patients with and without vertebral fractures. Discriminating parameters were the total number, diameter and variance of trabecular and intertrabecular spaces as well as the trabecular surface (p &lt; 0.05)). A texture index based on these statistically selected morphometric parameters identified a subgroup of patients suffering from fractures due to abnormal spongiosal architecture but with a bone mineral content not indicative for increased fracture risk. The combination of osteodensitometric and trabecular morphometry improves the diagnosis of osteoporosis and may contribute to the prediction of individual fracture risk.
Cyclosporin A-induced neurotoxicity
Authors: Monteiro L , Almeida-Pinto J , Rocha N , Lopes G , Rocha J 
Published: July 2009

Abstract
Acute encephalopathy is a recognized toxic effect of Cyclosporin A (CsA) in organ transplantation recipients. A 16-year-old girl presented with acute encephalopathy 2 weeks after CsA and methylprednisolone medication for idiopathic uveitis. Magnetic resonance imaging showed cortical and white matter occipital changes, which were not visible 2 months later. With expanding indication for CsA use, an increasing number of neurotoxic cases are to be expected.
Book reviews
Authors: Aktolun C 
Published: July 2009

This book is designed for physicians practising in and for residents who intend to practise nuclear medicine. It gives the main topics in clinical nuclear medicine.
The book consists of 15 chapters, three appendices and six colour plates. The first two chapters concentrate on the basic physical and chemical principles of nuclear medicine. Cardiovascular, genito-urinary, endocrine, haematological, pulmonary, central nervous, gastrointestinal and musculoskeletal system imaging are discussed in the subsequent chapters. Further chapters are devoted to radio-immunoscintigraphy and therapy, gallium-67 imaging and selected topics including radionuclide pallation of bone pain due to metastases, radiocolloid therapy and lymphoscintigraphy.
Total body studies in normal British women using dual energy X-ray absorptiometry
Authors: Herd R J M , Blake G M , Parker J C , Ryan P J , Fogelman I 
Published: July 2009

Abstract
We report dual energy X-ray absorptiometry (DXA) studies of total body bone mineral and body composition performed in 111 normal Caucasian women (aged 42–61). Conventional DXA scans of the lumbar spine and femoral neck were also obtained and each woman completed a detailed questionnaire. Significant correlations were found between total body BMD and BMD in the lumbar spine (r = 0.76) and femoral neck (r = 0.72). We present reference range data for BMD in the total body and in seven subregions of the skeleton. Multiple linear regressions of total body BMD and BMC on weight, height and age showed that the inclusion of height compared with weight and age alone was not statistically significant. The dependence of total body BMD on weight and age was: total body BMD (g cm−2) = 1.043 + 0.0042 × weight (kg) — 0.0039 × age (years) (R = 0.46, SEE = 0.074 g cm2). Body mass derived from DXA scans correlated well with weight measured on scales (r = 0.996, SEE = 0.77 kg). Body composition measurements agreed closely with % body fat estimated from skinfold measurements (r = 0.93), body fat mass estimated from a predictive equation based on weight, height and age (r = 0.91) and % body fat estimated from a predictive equation based on body mass index (r = 0.76). Study precision gave coefficients of varation of 0.6% for total body BMD and 0.7% for % body fat.
An optical system for measuring surface shapes for radiotherapy planning
Authors: Wilks R J 
Published: July 2009

Abstract
A system which uses two remote cameras to obtain surface contours for radiotherapy patients is described. Two variants are presented: one which requires couch movement to obtain multiple outlines, and one utilizing a special illumination method to achieve multiple outlines from one image per camera. In addition, a technique is discussed in which the grey-scale information from the skin surface (e.g., skin marks placed by the radiotherapist) may be utilized in displaying three-dimensional surface information. The system may also be used to monitor patient position in real time during each treatment.