bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does Myodil introduced for ventriculography lead to symptomatic lumbar arachnoiditis?
Authors: Hill C. A. Rowland , Hunter J. V. , Moseley I. F. , Kendall B. E. 
Published: July 2009

Abstract
Although there is a substantial body of evidence implicating Myodil or Pantopaque as a cause of lumbar arachnoiditis, assessment of the clinically based evidence is complicated by the additional potentially causative factors present in a high proportion of cases. These include pre-existing spinal pathology, traumatic lumbar puncture and surgery. The aim of this retrospective study was to attempt to ascertain whether Myodil introduced via ventricular catheter was associated with subsequent development of symptomatic lumbar arachnoiditis. In 222 patients in whom clinical records were reviewed there was no excess of back pain following ventriculography compared to the general population. Myodil ventriculography does not appear to be a major cause of symptomatic lumbar arachnoiditis. Several unavoidable problems with the methodology of this study are discussed.
Influence of radiologist grade on fluoroscopic patient dose
Authors: Hoskins P. R. , Williams J. R. 
Published: July 2009

Abstract
The effect of radiologist grade on patient dose during fluoroscopic barium studies was assessed over a one-year period in a large teaching hospital using area–kerma measurements made with a Diamentor M2 system. The number of studies investigated was 164 for barium swallows, 274 for barium meals and 1288 for barium enemas. The patient's AP thickness was assessed at the abdominal level from a formula combining the patient's estimated height and weight. For each study there was significant change in AP thickness as a function of radiologist grade. For all barium studies there was a trend for both the screening time and the patient dose to fall to a minimum for the grades third-year registrar/first-year senior registrar. From this group to consultant level the dose and screening time rose.
Primary leiomyosarcoma of the superior vena cava with massive thrombosis treated by local fibrinolysis
Authors: Marini M. , Tovar E. , López-Fernández M. F. , Pombo F. , Rodriguez E. 
Published: July 2009

Occlusion of the superior vena cava (SVC) is usually related to malignant or benign disease involving the mediastinum (Putnam et al, 1988) or secondary to central venous catheters and pacemakers (Capek & Cope, 1989). Acute superior vena cava syndrome (SVCS) caused by massive thrombosis secondary to leiomyosarcoma is a very rare event. Primary leiomyosarcoma of the SVC has been reported in only a few cases and special attention to radiological findings has been described in only two cases (Vogel et al, 1981; Lupetin et al, 1986).
We report a case of massive thrombosis of the SVC and its branches treated by local thrombolytic therapy that achieved complete lysis. Subsequently an intraluminal tumour mass was demonstrated on an enhanced computed tomographic (CT) study. Local fibrinolytic treatment should be given in SVCS due to thrombosis. The CT studies are of value in the search for the aetiology of SVCS. To our knowledge, this case is the first one in which the CT findings of leiomyosarcoma of the SVC are reported.
Bowel preparation before intravenous urography: is it necessary?
Authors: George C D , Vinnicombe S J , Balkissoon A R A , Heron C W 
Published: July 2009

Abstract
Whether or not bowel preparation should be used before intravenous urography (IVU) remains a controversial issue. Despite strongly held views on both sides there is little scientific evidence to support either viewpoint. We have conducted a prospective randomized study designed to test the hypothesis that adequate bowel preparation before IVU facilitates better quality studies requiring fewer films and consequently less time and a lower radiation exposure. Data on 188 patients were analysed; 90 patients received bowel preparation and 98 received no bowel preparation. There was no difference between the groups in terms of the number of films taken, the duration of the procedure, the visibility of the renal tracts or the overall quality of the studies. The prepared group did have significantly less faecal residue than the unprepared group. However, the renal tract visibility was no greater, as the combination of gas and haustral folds seen after bowel preparation obscured fine detail of the urinary tract as effectively as faecal residue. The hypothesis that adequate bowel preparation before IVU facilitates better quality studies must therefore be rejected.
Detection of significant abnormalities on lumbar spine radiographs
Authors: Davies A M , Fowler J , Tyrrell P N M , Millar J S , Leahy J F , Patel K , Hill J S 
Published: July 2009

Abstract
The purpose of this study was to determine the proportion of significant abnormalities detected on anteroposterior (AP) and lateral radiographs of the lumbar spine when viewed separately, in a series of cases where the prevalence of abnormalities had been artificially increased. Five radiologists of varying experience were required to report separately on the AP and lateral films of 300 cases in which randomly included were 30 cases with metastatic disease, a disc infection or an inflammatory spondylitis. At a later date, unaware of their initial observations, the radiologists repeated the exercise reviewing all the films together. As might be expected the false positive rate was relatively high, particularly in the least experienced radiologists' responses. Nevertheless the overall results indicate that the majority of early inflammatory spondylitis cases will be missed on a solitary lateral film as will many of the metastases. Conversely, fractionally more of the disc infections were observed on the lateral film than on the AP. Further analyses in terms of sensitivity, specificity, positive and negative predictive values are presented. The authors conclude that it is preferable to reduce the overall number of lumbar spine examinations performed, by adherence to accepted guidelines, than to prejudice the detection of significant, albeit rare, abnormalities by restricting the routine series of radiographs.
Measurement of focal spot size in mammography X-ray tubes
Authors: Law J 
Published: July 2009

Abstract
Three different measurement techniques for estimating the size of focal spots in X-ray tubes are described. These are the pin-hole, the slit and the star pattern or resolution pattern, and all are well known. Results are reported for a number of modern mammography X-ray tubes employed in a screening programme, using all three techniques. The results are compared with each other and with makers' specifications, IEC tolerances and UK Department of Health guidelines. Agreement between slit and star pattern results is generally within a few per cent, while pin-hole results are usually appreciably smaller. Although the slit technique is the most reliable for estimating focal spot size, both the others have a useful role, especially in revealing focal spot condition. Compliance with makers' specifications is usually demonstrated, but compliance with Department of Health guidelines is only found on the width of broad foci.
Calibration of ion chambers for use in mammography
Authors: Law J 
Published: July 2009

Abstract
There is at present no UK calibration service for ion chambers for mammography, where X-ray beams are produced from tubes having molybdenum targets and filters. This paper reports calibrations against a radiotherapy secondary standard (calibrated for beams from tungsten targets with aluminium filters) using beams from both types of target and filter. Two examples of the Radcal mammography dosemeter were found to have calibration factors which varied by less than 1% in molybdenum target beams from 30 to 40 kV. Differences between calibrations using the two types of X-ray beam did not exceed about 2%. All calibration factors were within about ±2% of 1.0. Errors are thought to be within ±3%. The results of an independent calibration of one of these dosemeters against a similar chamber calibrated by CEC are also reported. Calibrations of this kind can only be temporary expedients until adequate calibration facilities for mammography beams become available, but are nevertheless useful.
Agenesis of the corpus callosum
Authors: Warren M E , Cook J V 
Published: July 2009

Agenesis of the corpus callosum is an uncommon congenital anomaly which causes dilatation of the posterior horns of the lateral ventricles and a falsely high ventricular/hemispheric ratio on antenatal ultrasound scans with an incidence on studies of air encephalograms of 0.7% (Grogono, 1968). It may be confused with hydrocephalus and lead to unnecessary intervention.
The characteristic features on both ante- and postnatal ultrasound are:
(1) Absence of the corpus callosum.
(2) Marked separation of the slit-like anterior horns of the lateral ventricles and dilatation of the posterior and inferior horns creating the typical “rabbit's ear” or “devil's horn” appearance.
(3) Visualization of both medial and lateral walls of the anterior horns of the lateral ventricles which are displaced from the midline.
(4) Variable dorsal and superior displacement of the third ventricle.
(5) Loss of the normal parallel sulcal pattern above the third ventricle.
A case of congenital absence of the corpus callosum is described and the ante-natal ultrasound, post-natal ultrasound and computed tomography (CT) appearances are demonstrated.
Ultrasound diagnosis of duodenal atresia combined with isolated oesophageal atresia
Authors: Kessel D , De Bruyn R , Drake D 
Published: July 2009

Duodenal atresia associated with isolated oesophageal atresia is very rare. The combination has distinctive ultrasound appearances. We report a case in which ultrasound was able to establish the diagnosis and thus influence the surgical management.
A 28 year primigravida was investigated for polyhydramnios at 30 weeks of gestation. Ultrasound snowed the typical “double bubble” appearances of duodenal atresia. Chromosomal analysis was normal. The baby was born prematurely at 32 weeks gestation after the spontaneous onset of labour. The umbilical cord had only 2 vessels. Examination revealed a morphologically normal baby. The baby's abdomen was distended with palpable masses in each flank. It was not possible to pass a nasogastric tube.
The chest radiograph (Figure 1) and plain abdominal film revealed oesophageal atresia and a gasless abdomen. A soft tissue mass was seen behind the cardiac silhouette. Six lumbar vertebrae and 12 pairs of ribs were present.
Patients' perception of the hysterosalpingogram: the initial stages of the audit cycle
Authors: Tyrrell P N M , McHugo J M , Hale M 
Published: July 2009

Abstract
A prospective study of 98 consecutive hysterosalpingogram examinations was undertaken to evaluate patients' understanding of the examination, to assess their anxiety levels and to identify any factors where improvements might alleviate this anxiety. This was achieved by employing three simple questionnaires, two being completed by the patient (before and after the examination), the third being completed by the radiologist who recorded clinical and technical details. In this study the majority of patients knew why the examination was being performed, although only 50% had received an explanation of the technique prior to their arrival in the department. Anxiety levels associated with the examination were high. The importance of a sympathetic approach by the radiologist prior to the examination was highlighted, and it was found that time delays contributed to the anxiety level.
Pyogenic sacroiliitis, the missed diagnosis?
Authors: Abbott G T , Carty H 
Published: July 2009

AbstractPyogenic sacroiliitis is considered to be an uncommon infection, which is often diagnosed late because of poor localization of symptoms and normal plain radiographs at presentation. Nine cases aged between 20 months and 14 years who presented with sacroiliitis over a 7 year period are reviewed retrospectively. Isotope bone scanning is a useful technique in establishing early diagnosis and its relationship to other diagnostic imaging modalities is discussed. By routinely obtaining views of the entire pelvis in children presenting with hip pain and a limp, pyogenic sacroiliitis may be detected more frequently.
An audit of comparative views in elbow trauma in children
Authors: Rickett A B , Finlay D B L 
Published: July 2009

Abstract
A comparative radiograph of the contralateral elbow was obtained in only 30 (2.5%) of children examined after elbow trauma. Interpretation by junior clinical staff was changed in only three children (0.25%). Radiological review of the ipsilateral elbow alone altered diagnosis in six (20%) of the 30 children referred for comparative views and agreed with the final clinical diagnosis in 29 (97%). Comparative views were requested by inexperienced clinical staff in 28 (95%) of cases and were unnecessary in all patients. A senior radiological or clinical opinion would have resolved problems at interpretation.
The efficacy of lead shielding in megavoltage radiotherapy
Authors: Marrs J E , Hounsell A R , Wilkinson J M 
Published: July 2009

Abstract
The dose received by anatomical structures which are apparently shielded by lead blocks during a course of megavoltage radiotherapy may not be negligible. The dose has three main components; there is that due to radiation transmitted through the shielding block, that due to radiation scattered within the patient and that due to radiation scattered prior to reaching the patient and so circumventing the shield. A calculation method which separates the three components has been investigated and the results have been compared with measurements in a wide range of test situations for both cobalt-60 and 6 MV photon beams. The method of calculation predicts the dose behind the shielding block with acceptable accuracy in all the conditions investigated.
Modification of late dermal necrosis in the pig by treatment with multi-wavelength light
Authors: Rezvani M , Robbins M E C , Hopewell J W , Whitehouse E M 
Published: July 2009

Abstract
Low-level light from a multi-wavelength light source has been used to prevent late X-ray-induced dermal necrosis in the pig. Skin fields, measuring 4 cm × 4 cm on the flank, were irradiated with graded doses of X rays and the incidence of late dermal necrosis at 10–16 weeks after irradiation was scored. The control skin sites were irradiated only with 250 kV X rays but the test skin sites were subsequently exposed to low-level light. Local light exposure was from an array of gallium aluminium arsenide diodes, which produced wavelengths of 660, 820, 880 and 950 nm, pulsating at 5 kHz. Light treatment was given three times a week, from 6–16 weeks after X irradiation. Each treatment session was 1 min, which was equivalent to energy density of 1.08 Jem−2. Light treatment increased the ED50, the dose which causes dermal necrosis in 50% of the irradiated skin fields, from 20.10 ± 0.12 Gy to 21.94 ± 0.30 Gy. This difference, although small, was highly significant (p &lt; 0.001) and was equivalent to a dose modification factor (DMF) of 1.09. The effect of light treatment was minimal at incidence levels of less than the 50% but greater at higher levels of effect. These findings suggest that low-level light, when applied appropriately, may be useful in the prevention of late X-ray-induced damage to the dermis.
Assessment of X-ray field alignment in mammography
Authors: Kotre C J , Robson K J , Faulkner K 
Published: July 2009

In mammography it is important that the chest wall edge of the X-ray field is accurately aligned with the edge of the film in the film cassette. Too small an X-ray field (which may result in the loss of clinical information) is easily seen on the resulting image, but too large a field is less easy to detect and is potentially a source of unnecessary patient dose. This is of particular concern when mammography is being used for the screening of asymptomatic women. If the X-ray field is oversized, the scattered radiation dose to the thymus, lungs and to the fraction of the red bone marrow in the chest region will be higher. It is also possible for these organs to be partially irradiated by the primary beam if the field size is excessively large. These organs are recognized as being particularly radiosensitive and are included in the list of tissues considered when calculating effective dose (ICRP, 1990).
Tests of beam alignment have been suggested (IPSM, 1989) which involve the use of films or fluorescent screens overlapping the front edge of the support table together with markers for the field edge and a steel rule. In practice, this approach has been found to be difficult to reproduce on different designs of mammographic unit and, more importantly, found not to give a measurement easily referenced to the actual film position.
Squamous cell carcinoma of the nail bed
Authors: Conill C , Verger E , Vilalta A , Palou J 
Published: July 2009

Squamous cell carcinoma of the nail bed is an unusual malignancy often misdiagnosed as a benign condition. It has been suggested in previous papers that trauma, chronic paronychia, X radiation, arsenic exposure, actinic damage, dyskeratosis congenital and human papillomavirus infection (HPV) are risk factors for the development of this carcinoma (Silverman, 1959; Campbell & Klokarn, 1966; Albom, 1975; Attiyeh et al, 1979; Guitart et al, 1990).
A 62-year-old male presented with a history of subungual infection on the middle finger of the left hand, which had been drained 2 years earlier but an exophytic lesion persisted. It had been treated with various topical treatments by different dermatologists without success. When first seen in our institute no past history of exposure to irradiation, chemical carcinogens or obvious evidence of impaired immunity was given.
Clear cell adenocarcinoma of the vagina: MR features
Authors: Gilles R , Michel G , Chancelier M-D , Vanel D , Masselot J 
Published: July 2009

Abstract
Clear cell adenocarcinoma (CCA) of the vagina and the cervix is a rare tumour. Since 1971 its increased incidence has been ascribed to intrauterine exposure to diethylstilboestrol (DES) and as a consequence the US Food and Drug Administration has banned the use of all DES-type medications during pregnancy. We report a case of CCA demonstrated by magnetic resonance imaging.
A multisystem malabsorption
Authors: Mitchison H C , Loose H W C , Lendrum R 
Published: July 2009

A 57-year-old Caucasian man presented with a 5 month history of nausea and anorexia, diarrhoea, 19 kg weight loss, itching and loss of hair and nails. On examination he was cadaverous and pigmented with onycholysis (Figure 1), patchy alopecia and a red tongue. There was no relevant past medical, drug or family history. Investigations revealed hypoproteinaemia with abnormal absorption tests and, on gastroscopy, giant nodular folds were seen in the stomach. The duodenum was reddened and coarse with a mosaic pattern under the dissecting microscope. Representative illustrations from the barium meal (Figure 2) and barium enema (Figure 3) examinations are shown. What are the abnormalities and what is the differential diagnosis?
The barium meal shows extensive, largely sessile polyposis in both stomach and duodenum and similar changes are seen on the enema. Histology revealed hamartomatous changes compatible with a diagnosis of Cronkhite–Canada syndrome. A lesser number of polyps was seen in the small bowel (Figure 4).
Ultrasonographic placental grade and thickness: associations with early delivery and low birthweight
Authors: Dudley N J , Fagan D G , Lamb M P 
Published: July 2009

Ultrasonic imaging is widely used in antenatal care, both as a screening tool and as an aid to diagnosis. In the investigation of fetal well-being factors other than measurements of fetal size may be of value. For example, it is well known that placental morphology changes as pregnancy progresses. These changes were investigated by Grannum et al (1979) who assigned grades 0, 1, 2 and 3 to the different appearances and associated grade 3 placentae with fetal pulmonary maturity. The clinical value of placental grading has been assessed by several authors. Proud & Grant (1987) found that patients with a grade 3 placenta were at increased risk of problems during labour and that their babies had an increased risk of being of low birthweight, in poor condition at birth or of perinatal death. They suggested that their results should form a basis for the reporting of placental grade when ultrasound examination is performed in the third trimester. Kazzi et al (1983) found the fetus with a small biparietal diameter and a grade 3 placenta to be more likely to be small for gestational age at delivery in a high risk group of 224 patients.
Recent local perinatal deaths have raised the question of whether a grade 3 placenta is an indicator of potential early parturition, where at 40 weeks gestation the pregnancy is in fact postmature.
The use of carbon dioxide as an insufflation agent in barium enema—does it have a role?
Authors: Robson N K , Lloyd M , Regan F 
Published: July 2009

Abstract
A double blind prospective study was undertaken to evaluate the benefit of using carbon dioxide in double contrast barium enema (DCBE). 142 consecutive patients referred for DCBE were randomly allocated to receive either air or carbon dioxide (CO2) as the insufflation agent. The use of CO2 reduced the incidence of immediate and delayed severe pain from 31% to 12.5% and from 12.9% to 4.2% respectively. There was a statistically significant higher incidence of delayed severe pain in the younger age group as found in previous studies. Post-evacuation films showed that there was less residual gas after CO2. The quality of the DCBE was unchanged. We urge the more widespread use of CO2 as insufflation agent in DCBE.