bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fatigue fractures of the proximal tibia simulating malignancy
Authors: Davies A. M. , Evans N. , Grimer R. J. 
Published: July 2009

Abstract
The clinical and radiological features of nine fatigue fractures developing along the soleal line of the posteromedial cortex of the proximal tibia are described. Seven patients were referred with the diagnosis of a probable malignant sarcoma of bone. All nine patients were male and all but one were 18 years of age or less. Only two gave a history of a recent increase in physical activity. The plain radiographic findings consisted of an uninterrupted, lamellar, periosteal reaction arising medially and posteriorly in the proximal tibia with the fracture seen through the thickened posterior cortex. Bone scan revealed a fusiform focus of increased uptake in the posteromedial cortex of the tibia with varying degrees of activity in the adjacent metaphysis. Computed tomography, on a soft-tissue window, showed perifracture oedema and the absence of a soft-tissue mass. The attenuation of the underlying medulla was increased as a result of fibrosis and hyperaemia. On an extended window setting, both periosteal and endosteal callus was identified, maximal in the posteromedial tibia, and the fractures, multiple in two cases, were best demonstrated on a cortical window. Clinical and radiological features that differentiate a fatigue fracture of the tibia from a sarcoma are discussed.
The Clatterbridge high-energy neutron facility: dosimetry intercomparisons
Authors: Blake S. W. , Bonnett D. E. , Shaw J. E. , Eenmaa J. , Otte V. , Awschalom M. , Tatcher M. , Vynckier S. 
Published: July 2009

Abstract
Dosimetry intercomparisons have been performed between the Clatterbridge high-energy neutron facility and the following institutions, all employing beams with similar neutron energies: Université Catholique de Louvain, Belgium; University of Washington, Seattle, USA; MD Anderson Hospital, Houston, USA; and Fermi National Accelerator Laboratory, Batavia, USA. The purpose of the intercomparison was to provide a basis for the exchange of dose–response data and to facilitate the involvement of Clatterbridge in collaborative clinical trials. Tissue-equivalent ionization chambers were used by the participants in each intercomparison to compare measurements of total (neutron plus γ) absorbed dose in the host institution's neutron beam, following calibration of the chambers in a reference photon beam. The effects of differences in exposure standards, chamber responses in the neutron beams and protocol-dependent dosimetry factors were all investigated. It was concluded that the overall difference in the measurement of absorbed dose relative to that determined by the Clatterbridge group was less than 2%.
Splenic accumulation of technetium 99m in chronic lymphocytic leukaemia
Authors: McHugh K. , Lee D. M. , Batty V. B. 
Published: July 2009

Splenic accumulation of bone-seeking radiopharmaceuticals is a rare phenomenon. It has, however, been previously described in a number of neoplastic disorders, including lymphoma but only once previously in leukaemia. Here we report a case of intense splenic uptake of bone agent in a patient with chronic lymphocytic leukaemia and discuss possible aetiological mechanisms.
A 77-year-old man, with a 4-year history of chronic lymphocytic leukaemia, was admitted to hospital as a result of a syncopal episode. His medication on admission was cyclophosphamide 50 mg daily. Clinical examination revealed marked pallor, moderate icterus and hepatosplenomegaly. His haemoglobin on admission was 3.2 g/dl, with a reticulocyte count of 18.8%. Further laboratory investigations confirmed the diagnosis of chronic lymphocytic leukaemia complicated by a Coombs-positive haemolytic anaemia.
Antagonism between radiosensitizing agents
Authors: Berenbaum M. C. 
Published: July 2009

Watts et al (1987) examined various combinations of the radiosensitizing agents Ro 13–8799 and SR-2508 and concluded that their effects were additive. The term “additivism”, by which is generally meant lack of interaction between agents, has been defined in at least five different ways (Dewey et al, 1971; Valeriote & Lin, 1975; Han & Elkind, 1978; Berenbaum, 1981; Potemesil et al, 1986; Streffer & Muller, 1987). However, Watts et al (1987) give a particular example which shows that they mean the following. If a combination of dose d a of agent A and dose d b of agent B is additive, its effect will be the same as that of the “combination” of d a of A plus that dose of A isoeffective with d b of B.
Digital subtraction angiography of the left ventricle
Authors: Foster C. J. , Butler P. , Freer C. E. L. 
Published: July 2009

Abstract
Twenty-eight patients have been studied by left ventricular angiography and digital subtraction angiography, using either a peripheral venous injection (16) or a central venous injection (12) of contrast medium. Digital subtraction angiography compared favourably to angiography in the qualitative assessment of left ventricular size and function. Measurement of ejection fraction demonstrated a good correlation (r = 0.83) between digital subtraction angiography and left ventricular angiography. In the assessment of left ventricular segmental wall motion the use of a central venous injection, particularly in those patients with severely impaired ventricular function, proved superior to the use of a peripheral injection.
Professor W. V. Mayneord, CBE, DSc, FInstP, FRS
Authors: Lamerton L. F. 
Published: July 2009

Val Mayneord was a man who could have succeeded with great distinction in any of several fields. Throughout his life, in addition to his scientific work, he had great interests in literature and art, particularly of the Renaissance period, and in music. It is very fortunate for radiation medicine and medical physics that this was the field he chose for his profession. He brought to it a remarkable intelligence, great practical skill and wisdom. There are few areas in modern radiation medicine in which he did not make an outstanding contribution.
He played a large part in the establishment of radiation dose on the basis of energy absorption and did pioneer work on volume distribution of dose in the body. He carried out the first measurements of γ rays in roentgens in this country, and made some of the earliest mathematical studies of the distribution of dose around radioactive sources of varying shape. Very early on in the development of atomic energy he recognized the potential, for both therapy and diagnosis, of artificially produced radioactive materials and pioneered important techniques, including designing and building some of the first scanning equipment.
Book reviews
Authors: Hemingway Anne 
Published: July 2009

In his introduction, Dr Kadir states that this book was conceived with a two-fold purpose: to serve as a manual of current angiographic techniques and provide a didactic textbook of angiography. The author succeeds admirably with both of these aims.
The book, just over 700 pages long, is divided into eight major sections. The first, comprising seven chapters, covers the subject of equipment and basic techniques. Chapter one is essential reading for anyone thinking of setting up or replacing an angiographic suite. The second chapter covers the range of materials (needles, guidewires, catheters, etc) available for catheterization.
Book reviews
Authors: Kendall Brian 
Published: July 2009

This book has been written by a well proven team of North American teachers, all of whom have been fortunate enough to have acquired an extensive knowledge of magnetic resonance imaging (MRI), many being pioneers in the field, and all are actively involved in the continuing clinical applications of the technique.
Without presuming any prior knowledge of the subject or introducing any complex physics or mathematics, the contributors provide working concepts, which give sufficient insight to allow logical application of MRI to clinical problems. At the same time, all the important facts of the subject are covered and the book is extensively referenced, well indexed and illustrated with excellent magnetic resonance images and many diagrams.
Installation requirements for an argon laser angioplasty system
Authors: Smithson P. H. , Jeans W. D. , Murphy P. 
Published: July 2009

The installation and running of an argon laser for angioplasty is described, together with the costs and safety aspects.
We have acquired a unit for the purpose of producing a passage through occluded arteries, and report here the pre-installation work required, the safety requirements and initial measurements on an argon laser (Optilase 900 supplied by Nycomed (UK) Ltd).
Argon lasers are similar to X-ray tubes in that they generate large amounts of heat for relatively small output powers (Carruth & McKenzie, 1986). Argon lasers have been used in laser-assisted angioplasty because they are stable and the blue/green frequency is absorbed well by blood.
A good water supply and drainage system is necessary to cool the laser. Interlocks are provided that will turn off the laser if the water pressure falls, so the water supply should preferably not have many other users as this will cause pressure fluctuations.
Assessment of angioplasty balloon catheters: further studies
Authors: Jeans W. D. , Henson J. H. L. , Holloway T. M. A. , Forman A. G. G. , Blakeborough A. 
Published: July 2009

Abstract
Eight millimetre diameter angioplasty balloon catheters of both the Gruntzig and Olbert types from five manufacturers have been tested in vitro to establish bursting pressures and the changes in maximum and deflated diameters following repeated inflations, both when free and within a restraining sleeve. Maximum inflated diameters were within 10% of that stated and all types of balloon except one burst at a pressure greater than the recommended value. Deflated diameters were approximately 1 mm greater than insertion diameters, which are much smaller in the Olbert type. All balloons became a little larger with each of the first few distensions, and became stiffer. The maximum diameter was reached and remained constant after 10–15 distensions. Distension within a latex sleeve did not change bursting pressures, and it is considered that results from unconstrained testing can be extrapolated to behaviour in vivo. Computer modelling and calculation of maximum stress resultants also showed that calculated longitudinal and circumferential stresses are unaffected by applied restrictions. It is concluded that balloon technology is steadily improving and it is suggested that British Standards should be established for dilatation balloon catheters. Amongst other factors these Standards should include maximum recommended inflation pressures that are at least 2 atm less than bursting pressures, whilst the stated maximum diameter should be for fully extended balloons, and should have a tolerance of no more than ± 10%.
Changes in biological effectiveness of the neutron beam at Clatterbridge (62 MeV p on Be) measured with cells in vitro
Authors: Bewley D. K. , Cullen B. M. , Astor M. , Hall E. J. , Blake S. W. , Bonnett D. E. , Zaider M. 
Published: July 2009

Abstract
Chinese hamster V79 cells have been used to assess changes in RBE of the p(62)Be neutron beam at the Clatterbridge Hospital with depth in a phantom and with use of a hydrogenous filter. The cells were exposed at depths of 2 and 12 cm and at a depth of 2 cm with a hydrogenous filter. Two groups of experimenters each conducted two experiments. The ratios of relative biological effectiveness (RBE) at a depth of 12 cm to that at 2 cm were found by the two groups to be 0.99 ± 0.04 and 0.96 ± 0.02 (standard errors). The effect of a polythene filter 4.5 cm thick was measured at a depth of 2 cm and the ratio of RBE with and without the filter was found by both groups to be 0.99 ± 0.02. All the experiments suggest that there may be small effects of beam hardening by depth and filtration but these results are in marked contrast with those obtained using an in vivo system.
Radiotherapy simulators and independent field wire movement
Authors: Robertson G. 
Published: July 2009

When using the radiotherapy treatment simulator to determine a region to be treated, it is frequently required to move one field edge without altering the remainder. It is necessary both to change the field size and to reposition the field centre. This can be time consuming, particularly if the simulator operator is inexperienced, or if all edges of the field are not simultaneously displayed by the image intensifier. With the co-operation of simulator manufacturers, it may be possible to overcome this problem using the current generation of microcomputer-controlled simulators.
Varian have incorporated in their Ximatron CX series of radiotherapy treatment simulators a microcomputer for control and display purposes. The fielddefining crosswires can be moved either symmetrically or asymmetrically. In the symmetrical mode, the fielddefining crosswires are symmetrical about the beam centre, i.e. dxl = dx2 (Fig. 1), while the asymmetrical mode the four field-defining wires xl, x2, y1 and y2 can be moved independently. The jaws of the current generation of linear accelerators are capable of being set similarly. Situations exist where it is desirable to use asymmetrical fields, but in the great majority of cases it is more appropriate to use a symmetrical field arrangement.
Jekyll and Hyde chest radiographs
Authors: Cobby M. , Duncan A. , Hartnell G. 
Published: July 2009

A full-term, male infant was admitted to the Special Care Baby Unit immediately following birth with cyanosis and respiratory distress. The pregnancy had been uneventful and the mother had three other children who were all well. The baby was intubated and ventilated but remained persistently hypoxic with a respiratory acidosis. The chest radiograph on admission is shown in Fig. 1.
Treatment for a presumed streptococcal pneumonia was instituted but the baby remained unwell. Over the following days an expanding “cystic area” was noted in the right lower zone (Fig. 2) and, following increasing mediastinal shift, three chest drains were inserted (Fig. 3).
What abnormalities are shown on the three chest radiographs? What is your differential diagnosis and what further investigations would you perform?
On the initial chest radiograph the cardiac apex is shifted to the left as is the upper mediastinum, shown by the position of the endotracheal tube. There is diffuse shadowing throughout both lungs, compatible with retained fetal fluid, and more dense opacification of the right lower zone. The second radiograph (Fig. 2) shows marked overexpansion of the right lung, with emphysematous changes of the lower and middle lobes, and mediastinal shift to the left. This is even more severe on the third radiograph (Fig. 3) with considerable herniation of the hyperinflated right lung across the midline, inversion of the hemi-diaphragm and increased emphysematous changes in the right lower and middle lobes.
The chest drain tubes were inserted on the assumption that a pneumothorax was present.
Radiocontrast agents are contact activators of coagulation
Authors: Dawson P. , Bradshaw A. 
Published: July 2009

The interactions between iodinated radiological contrast agents and various elements of the blood have been studied by a number of authors (Aspelin & Schmidt-Schonbein, 1978; Almen et al, 1980; Aspelin et al, 1980a, b; Dawson et al, 1983; Dawson, 1985; Dawson et al, 1986; Stormorken et al, 1986; Dawson et al, 1988). Although possible clinical correlates of some of the interactions have been indicated (Almén et al, 1980; Aspelin et al, 1980; Dawson et al, 1983, 1986; Stormorken et al, 1986), most of the work was in vitro and performed not so much with practical clinical effects in mind but more with the intention of assessing the absolute and relative chemotoxicities of contrast agents. Haematological effects parallel those of other systems and enzymes and therefore are useful in being relatively easily studied (Dawson, 1985).
Recently, interest in possible clinical sequelae of some aspects of contrast–blood interactions has been renewed (Raininko & Ylinen, 1987; Robertson, 1987). In particular, considerable attention has been focused on the occasional formation of clots in syringes and catheters, which, it has been claimed, is more likely to occur when these contain a non-ionic rather than an ionic agent (Robertson, 1987). This may be explained on the basis that the anticoagulant effects and inhibition of platelet aggregation with collagen of the non-ionic agents are less than those of the ionic agents, consistent with their known lesser chemotoxicity (Dawson & Edgerton, 1983; Dawson, 1985; Howell & Dawson, 1985; Dawson et al, 1986; Stormorken et al, 1986; Dawson et al, 1988).
Low-field (0.08 T) magnetic resonance imaging of the pancreas: comparison with computed tomography and ultrasound
Authors: Smith F. W. , Bayliss A. P. , Hussey J. K. , Robertson E. M. , Weir J. , Crosher G. A. 
Published: July 2009

Abstract
Seventy-four patients referred for computed tomography (CT) and ultrasound examination with a presumptive diagnosis of pancreatic disease have been studied using a low-field (0.08 T) magnetic resonance (MR) imaging instrument. A further 50 patients being examined for non-pancreatic disease were also examined to assess the appearances of the normal pancreas. All the MR examinations were performed using an interleaved saturation–recovery/short inversion time (TI) inversion–recovery sequence. Part or all of the pancreas was seen in 96% of normal cases. In inflammatory disease, MR was more accurate than either CT or ultrasound for diagnosis, whilst for the demonstration of pancreatic tumours, MR was found to be no better or worse than either CT or ultrasound. The use of specific T 1 measurement for soft-tissue characterization was not useful because of the large overlap in values between normal, inflamed and malignant pancreatic tissue. T 1 measurement was found to be useful in differentiating different pathological fluids.
Assessment of feature size abnormalities using receiver operating characteristic analysis
Authors: Warren R. C. , Darwin C. J. 
Published: July 2009

Abstract
The ability of an observer to detect variations in size of a geometrical image feature have been investigated using receiver operating characteristic (ROC) analysis. Three types of image were constructed using computer graphics: disc-shaped targets of variable radius, model chest radiographs showing a variable heart diameter and model arterial angiograms with variable vessel width. Five factors were investigated: observer experience, variation of detectability with theoretical signal-to-noise ratio, the prior probability of the presence of an abnormality, viewing distance, and uncertainty in the location of an abnormality. In all but one experiment, excellent agreement was found between measured detectabilities and the predictions of signal detection theory, providing an initial practice session was included for each observer. No significant variation in detectability was found using six different prior probabilities and two different viewing distances, and the reduction in detectability for a four-alternative location task was in good agreement with theoretical predictions. The high statistical efficiencies found for the detection of geometrical signals suggest that the levels of observer “internal” noise arising from decision-making processes during an ROC experiment are very low.
Soft-tissue sarcoma: neutrons versus photons for post-operative irradiation
Authors: Catterall Mary 
Published: July 2009

A paper in BJR by Glaholm and Harmer (1988) describes five of my patients. The data on four of them are wrong and misleading. These are serious inaccuracies and I drew attention to them when I was sent a draft of the first paper. I was not sent a further draft and did not know the paper had been revised and resubmitted to your journal.
I would draw your attention to the following wrong data (Tables I, II).
Drs Glaholm and Harmer state that, “in one case excision was incomplete, there being a small-volume macroscopic residium prior to neutron therapy”.
Book reviews
Authors: Graves M. J. 
Published: July 2009

This monograph is the proceedings of an American Association of Physicists in Medicine (AAPM) symposium in co-operation with the Bowman Gray School of Medicine held in April 1988, with contributions from a number of academic and commercial magnetic resonance imaging (MRI) scientists and engineers.
Image quality in MRI is dependent upon a highly complex inter-relationship between a number of subsystems each requiring optimal adjustment. The book addresses the criteria for objective evaluation of image quality and system performance and is aimed at the clinical physicist with the responsibility for making such measurements. The first chapter provides a brief overview of the influence of particular MRI system components on image quality, whilst the next four chapters describe the main image parameters required for adequate monitoring of the sensitivity and geometric characteristics of a clinical MR imaging system.
Fatigue fractures of the femoral diaphysis in the skeletally immature simulating malignancy
Authors: Davies A. M. , Carter S. R. , Grimer R. J. , Sneath R. S. 
Published: July 2009

Abstract
The clinical and radiological features of three fatigue fractures developing along the medial aspect of the distal femoral diaphysis are described. All three patients were skeletally immature and were referred with the radiographic diagnosis of a probable sarcoma of bone. The plain radiographic findings consisted of an uninterrupted single lamella of periosteal new bone arising medially from the distal femoral diaphysis. Bone scans showed no evidence of hyperaemia on the vascular phase and revealed a fusiform focus of increased uptake in the postero-medial cortex of the lower femoral diaphysis on the 3-h images. Computed tomography showed increased attenuation of the medulla due to fibrosis and an absence of a soft-tissue mass. Periosteal callus was present and a cortical fracture through the medial femoral cortex was identified in two cases. The features that distinguish a fatigue fracture of the femur from a sarcoma are discussed.
Book reviews
Authors: Sherwood Thomas 
Published: July 2009

The publishers are inserting an erratum slip in this work; the cover and title page should have read “Edited by”.
The introduction says that, this book “is not intended to be all embracing, but rather an overview of the uses and problems associated with contrast media”. There are 19 chapters by 26 authors, making up a collection of interesting, varied essays on parenteral contrast media. Barium and other enteral agents are not considered.
Ultrasound-guided, histological, fine-needle biopsy from suspect parathyroid tumours: success-rate and reliability of histological diagnosis
Authors: Karstrup S. , Glenthøj A. , Hainau B. , Hegedüs L. , Torp-Pedersen S. , Holm H. H. 
Published: July 2009

Abstract
Ultrasound-guided, fine-needle tissue biopsies were performed in 60 suspected parathyroid tumours in 55 consecutive patients with biochemically proven hyperparathyroidism. The specimens were randomly arranged and re-read “blind” by two pathologists. The interobserver agreement, corrected for chance agreement, was 0.92 (= kappa coefficient). Twenty-three of the 60 suspect parathyroid tumours were verified histologically following surgery. No diagnostic errors were seen but the percentage of insufficient biopsies from suspect parathyroid tumours or surgically verified parathyroid tumours was high (45 and 47%, respectively). We conclude that a reliable tissue diagnosis can be made by ultrasound-guided, fine-needle tissue biopsy. However, when the material is insufficient for histological diagnosis, we recommend the additional use of ultrasound-guided, fine-needle aspiration for cytology or parathyroid hormone determination.