bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cholangiography in liver transplantation: a comparison of two types of biliary reconstruction
Authors: Holland P. , Morris E. , Buckels J. 
Published: July 2009

Abstract
Orthotopic liver transplantation has been performed in Birmingham since 1982. Two types of biliary reconstruction have been used, the choledocho-choledochostomy and the choledocho-cholecysto-choledochostomy (gallbladder (GB) conduit). A retrospective study was undertaken to compare the biliary tract complications encountered at cholangiography in these two groups to assess which reconstruction is safest. In the gallbladder (GB) conduit reconstruction, the incidence of biliary leakage (20.4%) and stricture formation (14.4%), the two most serious complications, was higher than in end-to-end duct anastomosis (11% and 10%, respectively), though these differences did not reach statistical significance. This supports evidence from other centres that the choledocho-choledochostomy is the procedure of choice to minimize biliary complications. Biliary debris (14.2%) presented additional problems and was strongly associated with biliary strictures. T-tube related problems were least troublesome. The close relationship between hepatic artery occlusion and biliary complications, particularly leakage, noted in other studies is also emphasized.
Is a short femur length a useful ultrasound marker for Down's syndrome?
Authors: Twining P. , Whalley D. R. , Lewin E. , Foulkes K. 
Published: July 2009

Abstract
To assess the significance of a short femur in the antenatal diagnosis of Down's syndrome a retrospective analysis was made of all Down's syndrome fetuses diagnosed over a 3 year period. 11 fetuses were found to have had a biparietal diameter and femur length measurement taken between 15 and 24 weeks gestation. Normal graphs were plotted for femur length against gestational age, femur length against biparietal diameter and biparietal diameter/femur length against gestational age. When the Down's syndrome measurements were plotted on the normal graphs there were four abnormal measurements. These four measurements, however, represented two fetuses both of which demonstrated other abnormalities, one cystic hygroma and one duodenal atresia with choroid plexus cysts. We do not feel that the femur length measurement is useful in the antenatal diagnosis of Down's syndrome.
Sonographic evaluation of the parotid ducts: its use in tumour localization
Authors: Bradley M. J. , Ahuja A. , Metreweli C. 
Published: July 2009

Abstract
The previously unreported sonographic anatomy of the intraglandular parotid ducts is described, and how this aids tumour localization is illustrated. Forty patients underwent ultrasonography and computed tomography (CT) sialography for the evaluation of parotid tumours. Ultrasound identified two extra unsuspected 5 mm tumours in the superficial lobe, which could not be seen at CT. Both techniques produced similar results for deep and mixed lobe lesions. Ultrasound had one false positive mixed lesion, which surgery subsequently found to be confined to the deep lobe. The full extent of invasion in three deep lobe tumours was revealed only by CT to be parotid invasion by nasopharyngeal carcinomas. We conclude that parotid sonography with reference to the intraglandular ducts is highly accurate in localizing parotid tumours and should probably be the first-line imaging technique. Computed tomography should only be necessary for visualization of deep lobe tumour extent and in those cases where the complete tumour boundary cannot be seen by ultrasound alone.
Normal tissue reactions in the British Institute of Radiology Study of 3 fractions per week versus 5 fractions per week in the treatment of carcinoma of the laryngo-pharynx by radiotherapy
Authors: Rezvani M. , Alcock C. J. , Fowler J. F. , Haybittle J. L. , Hopewell J. W. , Wiernik G. 
Published: July 2009

Abstract
The radiobiological data obtained from a multicentre clinical trial of the British Institute of Radiology, which compared the treatment of carcinoma of the laryngo-pharynx by 3 fractions per week (3F/wk) with 5 fractions per week (5F/wk) radiotherapy, have been studied. The trial involved an intake of 734 patients between 1966 and 1975. The number of fractions, overall treatment time and total doses used by different treatment centres ranges from 9 to 40 fractions, 18 to 70 days and 3880 to 7800 cGy, respectively. An 11–13% reduction in the total radiation dose was applied for treatments with 3F/wk as compared with 5F/wk in centres treating over 6 weeks and 3 weeks, respectively. All patients were followed for 10 years from the start of treatment. Different types of early and late normal-tissue reactions were investigated, ranging from a low percentage incidence of perichondritis to 95% for slight early reactions. Greater than 80% of the late normal-tissue reactions seen were observed within the first year after the start of treatment, and 96% were observed within the first 5 years. There was no statistically significant difference in the normal-tissue event-free rates between the 3F/wk and 5F/wk treatment groups. This finding did not differ when different major treatment centres were studied separately. For a number of end-points, α/β ratios and N- and T-exponents of a modified nominal standard dose (NSD) formula have been calculated.
99Tcm-mercapto acetyl triglycine in paediatric renal tract disease
Authors: Pickworth F. E. , Vivian G. C. , Franklin K. , Brown E. F. 
Published: July 2009

Abstract
The use of 99Tcm-mercapto acetyl triglycine (99Tcm-MAG3), a new hippuran substitute, has been reported widely in adults but not in children. Our experience of its use in 100 infants and children for renography and indirect micturating cystography (IMC) is reported. The average age was 5.6 years. 65 patients completed IMC studies and nine patients had 99Tcm-dimercaptosuccinic acid (99Tcm-DMSA) scans performed on the same day. The majority of patients were referred for the investigation of urinary tract infection. 32 kidneys were found to be scarred on 99Tcm-MAG3 scans, 17 kidneys and ureters refluxed on IMC and 14 kidneys were obstructed. The results of 99Tcm-MAG3 scans were compared with those of other urinary tract investigations including ultrasound, micturating cystography (MCUG), intravenous urography (IVU) and 99Tcm-DMSA scintigraphy. No kidney which was scarred had a normal 99Tcm-MAG3 scan. All significant degrees of dilatation or obstruction on IVU or ultrasound were also detected by 99Tcm-MAG3. 99Tcm-MAG3 gave more information than any other single imaging modality and we believe it represents an ideal initial screening test in the investigation of urinary tract infection in older toilet-trained children.
Choledochal cyst and congenital anomalies of the pancreatico-biliary junction: the clinical findings, radiology and outcome in nine cases
Authors: Young W. T. , Thomas G. V. , Blethyn A. J. , Lawrie B. W. 
Published: July 2009

Abstract
Nine patients with choledochal cyst have been reviewed. There was a 6:3 preponderance of females. Four patients presented in adulthood. Cholangiocarcinoma developed in three patients with an interval ranging from 2 to 35 years following surgery. The predominant complaint was of abdominal pain and symptoms had been present from weeks up to 28 years. Imaging by sonography may be all that is required in the paediatric age group, but in adults further confirmation of the choledochal cyst and the associated anomalous junction of the pancreatico-biliary duct (AJPB) by direct cholangiography is recommended.
Magnetization transfer contrast (MTC) imaging of skeletal muscle at 0.26 Tesla — changes in signal intensity following exercise
Authors: Zhu X. P. , Zhao S. , Isherwood I. 
Published: July 2009

Abstract
Magnetization transfer contrast (MTC) imaging of skeletal muscle before and after exercise has been studied in normal volunteers at 0.26 Tesla. A saturation pulse was applied over a range of offset frequencies immediately before a gradient recall echo sequence. Substantial signal loss was observed in all muscles. After exercise, selective saturation resulted in a significant increase of contrast between active and less active muscle, a phenomenon attributable to an increase in extracellular water content. MTC imaging provides a more sensitive method to detect changes in water distribution in human skeletal muscle.
A standardized multifield irradiation technique for breast tumours using asymmetrical collimators and beam angulation
Authors: Lagendijk J. J. W. , Hofman P. 
Published: July 2009

Abstract
Combined angulation and asymmetrical collimator matching techniques are used for field alignment in breast irradiation. A local regional irradiation technique has been developed that allows a uniform dose distribution to the entire target volume. The localization is characterized by simple measurement of a few patient co-ordinates. The equipment settings to produce a theoretical exact field alignment are calculated by a special computer program. These settings guide the simulation. We have designed the method such that the technique is standardized for all patients receiving breast and lymph node irradiation. This allows an easy, accurate and fast patient throughput at the simulator and accelerators.
What to do with the biopsy specimen — practice in an oncology setting
Authors: Tung K. T. , Fisher C. , Parsons C. A. 
Published: July 2009

The technique of image-guided biopsy using either fluoroscopy, ultrasound or computerized tomography (CT) has become well established in recent years. It is. now routine practice in most radiology departments having been shown to have an accuracy of greater than 90–95% (Gazelle & Haaga, 1989; Jennings et al, 1989; Charboneau et al, 1990) and using biopsy needles of 18 gauge or smaller, has a complication rate of less than 1% in many series (Welch et al, 1989; Nolsoe et al, 1990). It makes an important impact on clinical management (Jaeger et al, 1990), allowing diagnosis and treatment planning without recourse to more invasive methods. The automated spring-loaded biopsy gun has simplified the procedure (Parker et al, 1989; Bernardino, 1990) producing adequate specimens without crush artefact and with minimal trauma to the patient.
While most series have concentrated on the technique of image-guided biopsy, little emphasis has been placed on the importance of optimal preparation of tissue specimens once obtained.
Is the coned lateral lumbosacral junction radiograph necessary for radiological diagnosis?
Authors: Lamb G. , Davies S. 
Published: July 2009

We read with interest the article by Lipton et al (1991). A number of points are worthy of mention.
The authors do not state the centring point for the lateral lumbar view. Eisenberg et al (1979) make the comment that this can vary by up to 10 cm in relation to the iliac crest. Lipton et al (1991) indicate that the lumbosacral junction was visualized adequately in 79% of patients and if the coned view is performed in everyone, then 79% of patients will be unnecessarily exposed to additional radiation.
Duplex Doppler ultrasound in the investigation of occult nephropathy following haemolytic uraemic syndrome
Authors: Gleeson F. V. , Fitzpatrick M. M. , Somers J. , Kennedy C. , De Bruyn R. , Barratt T. M. 
Published: July 2009

Abstract
Duplex doppler ultrasound has been reported to be of value in the detection of raised vascular resistance, particularly in the renal tract. A prospective single blind study investigating the use of duplex Doppler ultrasound to measure resistive index (RI) in patients with impaired renal function and a history of diarrhoea-associated haemolytic uraemic syndrome (D+ HUS) was performed. There was considerable overlap in the range of RIs, with RIs greater than 70% in children with normal renal function and in those with renal impairment following D+ HUS. There was no significant difference in the mean RI between the groups studied. We feel that the RI is not of value in predicting the presence of occult nephropathy following haemolytic uraemic syndrome.
Mitomycin C, 5-fluorouracil and radiation in advanced, locally recurrent rectal cancer
Authors: Dobrowsky W. 
Published: July 2009

Abstract
15 patients with inoperable presacral recurrent rectal cancer following surgery were treated with combined radiation and chemotherapy. Treatment consisted of split-course radiotherapy with 50 Gy in 25 fractions over 5 weeks and, after 4 weeks, an additional 20 Gy in 10 fractions over 2 weeks. At the start of treatment and following the split course, chemotherapy was administered. Mitomycin C was given on Day 1 (dose: 15 mg/m2 i.v. bolus) and 5-fluorouracil from Day 1 to Day 5 (dose: 750 mg/m2/24 h, continuous i.v. infusion). Owing to considerable, predominantly haematological and gastrointestinal toxicity, only six out of 15 patients received treatment according to the protocol. The symptomatic relief of symptoms was good. Pain was controlled in seven of eight symptomatic patients. Seven of the patients showed response according to computed tomography, but in none of these cases was a complete remission seen. After a follow-up of at least 30 months, only three patients are alive. The 1-, 2- and 3-year survival rates are 9/15, 6/15 and 3/12, respectively. The median survival is 14 months (range 4–60+ months). In comparison with historical data from the same institution, combined radio-chemotherapy did not show any prolongation of survival or increased response rate, but increased toxicity excessively, when compared with radiation alone.
The use of 123I-Hippuran renography in the management of synchronous bilateral upper urinary tract transitional cell carcinomata
Authors: Sandhu D. P. S. , Sambrook P. , George N. J. R. 
Published: July 2009

Bilateral simuitaneously occurring malignant tumours of the upper tracts are very rare, and present the difficult problem of preservation of renal function and adequate tumour clearance. We report such a case and discuss the difficulties and value of the modern methods of management, including ureteroscopy and 123I-Hippuran gamma camera renography with creatinine clearance to assess total and split renal function and recovery.
A 62-year-old housewife was referred with right loin and back ache associated with haematuria. Two years earlier she had been investigated for right loin pain without haematuria and had normal excretion urography at that time. A repeat urogram revealed a radiolucent filling defect in the upper pole calyx of the right kidney (Fig. la), with hydronephrosis and hydroureter on the left side resulting from probable tumour in the distal ureter (Fig. 1b). Serum creatinine was normal. A 123I-Hippuran renogram demonstrated the obstructed left kidney to contribute 36% of global function.
At initial cystoscopic assessment the urethra, bladder and ureteric orifices were normal. Ureteroscopy was not attempted on the left as the developing urographic appearances were considered to be pathognomonic of ureteric tumour (Fig. lb). Right ureteroscopy (9.5 FG) was successful in reaching the pelvis and tumour-like fronds were seen in the upper pole, but adequate biopsy material could not be obtained. Right retrograde ureteropyelogram appeared to confirm a right pole tumour, although pelvic urine draining from the catheter surprisingly did not subsequently provide positive cytological proof of malignancy.
Duplex pulsed Doppler sonography in the differential diagnosis of hepatocellular carcinoma and other common hepatic tumours
Authors: Lin Zu-Yau , Chang Wen-Yu , Wang Liang-Yen , Chen Shinn-Cherng , Chuang Wan-Long , Hsieh Ming-Yuh , Tsai Jung-Fa 
Published: July 2009

Abstract
180 previously untreated consecutive patients with liver tumours (308 lesions), including 104 hepatocellular carcinomas (148 lesions), 43 metastases (116 lesions) and 33 haemangiomas (44 lesions), were studied to determine the value of duplex sonography in the differentiation of hepatocellular carcinoma from other tumours. For lesions measuring ≤ 5 cm in diameter, hepatocellular carcinoma demonstrated the highest rate and haemangioma demonstrated the lowest rate of Doppler signals from within the lesions. To differentiate malignancy from haemangioma, the presence or absence of Doppler signals from these lesions were used as criteria. The specificity and positive predictive value were very high (100%, 100%), but the sensitivity, negative predictive value and accuracy were low (61.5%, 48.3%, 71.7%, respectively). With one exception, all lesions measuring &lt; 3 cm in diameter with detectable Doppler signals were hepatocellular carcinoma. Using these results it is possible to differentiate hepatocellular carcinoma from metastases and haemangioma with high sensitivity, specificity, positive and negative predictive value, and accuracy (80.8%, 96.4%, 95.5%, 84.4%, 88.9%, respectively, for metastases; 80.8%, 100%, 100%, 81.5%, 89.6%, respectively, for haemangioma). We conclude that Doppler signals from within a lesion in combination with its size can aid differentiation of hepatocellular carcinoma from two other kinds of common hepatic tumour.
Results of a survey of doses to paediatric patients undergoing common radiological examinations
Authors: Chapple C.-L. , Faulkner K. , Lee R. E. J. , Hunter E. W. 
Published: July 2009

Abstract
A survey has been performed to investigate typical radiation dose levels for children undergoing a number of common radiological examinations. Doses have been assessed using a Diamentor ionization chamber to measure dose–area product, and by attaching thermoluminescent dosemeters to the patient's skin to determine entrance and organ doses. The survey has been automated by using a personal computer for data collection and storage. Doses have been monitored for a large number of children, primarily in a dedicated paediatric X-ray room, and the results presented can be used as a baseline for making comparative measurements elsewhere. Entrance skin doses were found to range from 0.3 mGy to 5.7 mGy for radiographic examinations, and values of dose–area product from 3 to 225 cGy cm2. The corresponding dose ranges for fluoroscopic examinations are 7.4–26.2 mGy and 130–1241 cGy cm2.
Measurement of extrafocal radiation by computed radiography
Authors: Miettunen Risto H. 
Published: July 2009

Abstract
Measurement of radiation differences from image data is made possible by computed radiography (CR) based on storage phosphor imaging plates. The photostimulable luminescence (PSL) response is linear in a range greater than four orders of magnitude. Pinhole radiographs of focal and extrafocal radiation obtained by CR were quantitatively analysed using the technique originally introduced in recent scatter studies. No films or hard copies were used in the analysis. The material consisted of 54 images for measurement of the focal peak intensity, and a corresponding set of 54 images obtained at a 250 times greater operating sensitivity for the imaging of the extrafocal emission. The extrafocal-to-focal emission ratio was in the range of 0.001–0.006 depending on the off-focus distance. Because of the relatively large area of origin, exposure resulting from extrafocal radiation is estimated to reach up to 20% of the total radiation dosage. The results are in agreement with previous reports using other techniques and show that CR can also be used in a quantitative manner in this kind of comparative measurement.
Accuracy of pelvimetry measurements on CT scanners
Authors: Wade J. P. 
Published: July 2009

There is an increasing awareness of radiation dose received by the patient and the use of low dose techniques is encouraged whenever possible. A low dose technique which is available is the use of the overview or scanogram facility on a computed tomography (CT) scanner to produce a digital radiograph for pelvimetry measurements instead of the conventional radiograph. Unfortunately ultrasound, which is the low dose technique, cannot be used for pelvimetry measurements because of the bone geometry. Several published papers discuss the dose reduction (of the order of 90%) which is received by the mother and the fetus by changing to CT pelvimetry examinations (Federle et al, 1982; Suramo et al, 1984; Dobson & Nelson, 1988), and the recent NRPB Report (1990) emphasized this dose reduction. As many district hospitals now have CT scanners, this technique is becoming more widely practised.
Whilst dose reduction is a major consideration when choosing a new technique, it is also important that the results obtained are as good or better than conventional techniques, since any inaccuracies may have serious repercussions and lead to complications during labour. For pelvimetries carried out on CT scanners, a lateral view or an antero-posterior (AP) scanogram, or both, is obtained of the pelvis and the required distances are measured on the viewing console using the distance measurement facilites provided in the software.
A fine needle aspiration technique using high negative pressure
Authors: Rhymer J. C. , McRobbie D. W. , Boultbee J. E. 
Published: July 2009

Ultrasound-guided aspiration for diagnostic or therapeutic purposes plays an important role in the management of thoracic, abdominal or pelvic fluid collections. The use of a fine needle is safe (Dewbury, 1990) having the advantages of minimal tissue trauma and minimal patient discomfort. The disadvantage of a small needle of 22 gauge is that its bore limits the rate of aspiration, which is significant in dealing with large or viscous collections. The use of a hand held syringe can be tiring for the operator and needle movement or displacement can occur during prolonged aspirations.
We describe a simple method of overcoming some of these disadvantages.
How good is ultrasound in the detection and evaluation of anterior abdominal wall defects?
Authors: Walkinshaw S. A. , Renwick M. , Hebisch G. , Hey E. N. 
Published: July 2009

Abstract
The ability of routine obstetric ultrasound to detect and accurately describe fetuses with anterior abdominal wall defects has been examined in an unselected population using data from a regional abnormality survey. Examination between 16 and 22 weeks gestation detected 60% of defects with a false positive rate of 5.3%. Fetuses with gastroschisis were incorrectly assigned as exomphalos in 14.7% of cases recognized before 22 weeks gestation. The diagnosis, including description of associated detectable anomalies, was completely accurate in 71.6% of cases. Some of the problems of diagnostic accuracy need to be considered when counselling couples with a fetal anomaly. Cross-referral between obstetric ultrasound units should be encouraged to improve diagnostic accuracy. These results form the basis for audit of obstetric ultrasound in the diagnosis of fetal abnormality within a geographically denned population.
Detection and evaluation of fetal goitre by ultrasound
Authors: Avni E. Fred , Rodesch Frederic , Vandemerckt Carine , Vermeylen Daniéle 
Published: July 2009

Abstract
Antenatal diagnosis of fetal goitre has been reported rarely. Once detected, however, it is important to evaluate fetal thyroid function so early treatment can be initiated if necessary. In reporting three new cases, the authors analyse the various methods of evaluation. The normal sequence of appearance of the various epiphyseal ossification centres is an indirect illustration of thyroid function and can be followed by ultrasound. Direct evaluation of hormone levels through cord blood sampling under sonographic guidance is a complementary method in doubtful cases. The mechanisms predisposing to the development of fetal goitres and the possible implications of these findings are also discussed.