bluuebunny/crossref_metadata_2025_split huggingface dataset:
A pain in the rear
Authors: Suarez Richard , Morrison Douglas , Suarez Valerie 
Published: July 2009

A 79-year-old, non-insulin-dependent diabetic woman presented with severe pain in the rectum and urgency. A year previously she had been seen because of alternating constipation and diarrhoea. Rectal examination and sigmoidoscopy were normal, but she had a distended bladder and was subsequently catheterized. and this had become permanent. She had had a hysterectomy and bilateral salpingo-oöphorectomy after intracavity radium for carcinoma of the body of the uterus 13 years before.
Examination revealed a lax anus, soft stool, and a soft mass behind the rectum. Sigmoidoscopy was again normal.
Pelvic ultrasound was performed after filling the bladder with saline (Fig. 1). This was followed by a barium enema (Fig. 2). A plain radiograph of the pelvis after barium had cleared is also shown (Fig. 3).
Fractionation sensitivity and the oxygen effect
Authors: Hendry J. H. , Thames H. D. 
Published: July 2009

Many normal tissues in natural conditions exhibit slight radiobiological hypoxia (Hendry, 1979). Examples of this in man, which necessitated reductions in dose when the oxygenation status of the tissue was increased, are the skin (van den Brenk et al, 1965), the spinal cord (Coy & Dolman, 1971) and laryngeal cartilage (Churchill-Davidson, 1968; Henk et al, 1977). The expected effect of oxygenation status on fractionation sensitivity has not yet been considered in detail.
Fractionation sensitivity can be quantified by the ratio of the parameters α and β in the following equation, which describes the probability (P) of a given level of radiation injury in a tissue following a schedule of doses (x) delivered to a total dose (D).
where K is the number of tissue-rescuing units (TRU) (Hendry & Thames, 1986).
An assessment of the sensitivity of in vivo 31P nuclear magnetic resonance spectroscopy as a means of detecting pH heterogeneity in tumours: a simulation study
Authors: Madden A. , Glaholm J. , Leach M. O. 
Published: July 2009

Abstract
The presence of hypoxia and low pH in tumours is known to influence several treatment modalities including radiotherapy, chemotherapy and hyperthermia. Hypoxic and acidic regions have been demonstrated in tumours using pH and pO2 microelectrodes. The technique has shown marked heterogeneity within individual tumours. A non-invasive measure of intracellular pH is provided by 31P nuclear magnetic resonance (NMR) spectroscopy from determination of the chemical shift of inorganic phosphate, and is being increasingly applied to the study of human tumours in vivo. Based upon the assumption that hypoxic cells are also acidic, we have assessed the ability of a whole-body NMR spectrometer to detect acidic subpopulations within a tumour using simulated tumour spectra. In these simulations the size of the acidic subpopulation, assigned pH values from 5.0 to 7.0, was varied between 5% and 50% of the neutral “control” population. Gaussian noise was added to the simulated spectra giving signal-to-noise ratios for the neutral control inorganic phosphate peak of 3, 5 and 7, which are typical of values encountered in human tumour measurements. From the results of the simulations it seems unlikely that human hypoxic, and presumably acidic, cell fractions, typically 1–15%, will be detected by this method in the presence of signal-to-noise levels characteristic of current equipment. Therefore, whole-body in vivo 31P NMR spectroscopy may fail to identify significant pH heterogeneity within human tumours. Improvements in signal-to-noise and line separation owing to improvements in technique and higher field strength instruments may improve sensitivity to heterogeneous populations.
Further comparisons of films, screens and cassettes for mammography
Authors: Law J. , Kirkpatrick A. E. 
Published: July 2009

In two previous papers (Kirkpatrick & Law, 1987, Law & Kirkpatrick, 1989), films and screens for mammography have been compared, primarily for image quality and secondarily for dose. The rate at which new products become commercially available makes identification of the better films and screens a never-ending task, although the combination found to be still the best in 1987 had been available since before 1980. At the time of the work for the 1989 paper (late 1987) certain newer products did offer some improvement over previous ones, but further products were known to be imminent. That series of comparisons could not be continued because the processor was changed making it impossible to maintain complete comparability of test conditions.
This paper reports on new films and screens, using essentially the same experimental technique as before, but on a new processor and a new X-ray set. Certain of the better films and screens from the previous paper were included to form a base line against which to compare newer products. Only a direct comparison under a single set of experimental conditions can be considered valid.
All films were obtained on a single X-ray set and a single processor. These were a CGR 600t maramographic X-ray set installed as the assessment unit in the Edinburgh Breast Screening Centre, and a Dupont T5A processor using Kodak chemistry. The X-ray set has Molybdenum target and filtration and broad and fine foci.
Unusual appearances of an adrenal mass on computed tomography
Authors: Hughes David , Golding Stephen 
Published: July 2009

When patients undergo imaging investigations to stage malignant disease the finding of a mass in the adrenal gland may not necessarily represent metastasis. Incidental non-functioning adrenal masses have been reported in 0.6% of examinations of the abdomen by computed tomography (CT) (Glazer et al, 1982). We report a patient with such a finding, whose CT scans showed unusual appearances.
A 64-year-old Caucasian man with histologically proven adenocarcinoma of the prostate was referred for CT for staging purposes. There were no clinical signs to suggest spread of the disease and no symptoms referable to the abdomen. Prior to this he had been well.
Magnetic resonance imaging of the chest in infectious mononucleosis
Authors: Goddard P. , Kinsella D. , Duncan A. W. , Hamilton A. , Carswell F. 
Published: July 2009

Infectious mononucleosis is a disease of young adults, typically presenting with malaise, fever, sore throat and cervical adenopathy (Juel-Jensen, 1983). Non-specific respiratory symptoms may also be present. The diagnosis is confirmed by serological tests for the virus.
A case is reported in which the presence of lymphadenopathy as demonstrated by a magnetic resonance imaging (MRI) scan led to the diagnosis of infectious mononucleosis.
Book reviews
Authors: Plant Graham 
Published: July 2009

There are very few books on operative (otherwise known as intraoperative) ultrasound. This book covers most of the subject well, but it is not really orientated towards radiologists.
The stated aim of the book is “to inform surgeons and their radiologic (sic) colleagues in the use of ultrasound imaging in the operating room”. The Editor is Professor of Surgery at the Medical College of Pennsylvania and the contributors are mainly surgeons.
The contents include chapters on instrumentation and techniques as well as one on the basics of ultrasound, an inclusion that seems reasonable in a book aimed at non-radiologists. There are chapters devoted to the use of operative ultrasound in the surgery of various areas of the body and, not surprisingly, these are mainly concerned with the uppergastrointestinal tract (liver, bilary system and pancreas). The use of ultrasound in procedures on the brain and spinal cord and in renal and vascular surgery are also covered.
Computers in radiology departments
Authors: Sutherland G. R. 
Published: July 2009

It is only a few years since computers were essentially regarded by the public as complicated machines used only by banks, major industrial concerns and research establishments. But the situation is changing rapidly to one where in every household the computer will sit alongside the video tape recorder and the television set. Every schoolchild is now taught how to use computers and elementary keyboard operation skills. They are pervasive throughout our society. A tremendous development of their use by small businesses has occurred where this would not have been considered cost effective only a few years ago. However, it is only with the publication of the “White Paper” on the most recent reorganization of the Health Service that the importance of introducing computers for information management has ultimately been recognized as central to the effective management of the Health Service. It appears that the financial implications of such developments have also been accepted.
Radiologists in this country have been trying to acquire computing systems for their departments for many years now, and many have been effective, but there is still a large core of individuals who remain to be convinced of the effectiveness of such systems in the running of their departments, and it is with the objective of convincing them of the applications and usefulness of computer systems that this article has been written (Sutherland, 1983).
Unfortunately, like many specialties, the computer world is full of jargon that the uninitiated find difficult to understand.
An analysis of personnel dose records which justifies the application of cost-benefit analysis techniques in the design of an afterloading facility and the use of controlled areas and systems of work within suite to control occupational exposure
Authors: Gifford D. , Godden T. J. , Kear D. 
Published: July 2009

Abstract
The sealed source operational policies employed at the Bristol Radiotherapy and Oncology Centre were originally designed to meet the requirements of the 1972 Code of Practice by ensuring that individual personnel doses were kept below the relevant quarterly and annual dose limits. In 1982–1983, measures were taken to improve personnel radiation safety within the brachytherapy treatment facility by (a) making preparations for the introduction of Selectron medium-dose-rate (MDR) afterloading systems at the centre for intracavitary brachytherapy and (b) reviewing the operational policies to ensure that they meet the more stringent requirements of the ALARA (as low as reasonably achievable) principle, a principle subsequently embodied in the 1985 UK Ionising Radiations Regulations (IRR 85). When considering the implications of making existing singlebedded side wards, originally designed for low-dose-rate brachytherapy and suitable for the new systems, the cost of the extra protection required to reduce the instantaneous dose rate in the ward corridors adjacent to the treatment room to less than 7.5 μSv h1 had to be determined. On the basis of the cost-benefit analysis, it was decided not to provide additional shielding but rather to introduce administrative controls based on local rules which contained systems of work and the operational policies for the afterloading systems. After using the MDR afterloading systems for 2 years, a period in which there has also been a marked increase in interstitial brachytherapy, an analysis was made of the doses received by nursing staff over the past 8 years. This has shown that, in spite of higher dose rates in the corridor areas because of the use of an MDR system and the increase in interstitial techniques, the doses to ward nurses have been significantly reduced by encouraging staff to comply with the ALARA principle and the introduction of afterloading systems.
Giant mid-oesophageal diverticulum: a rare cause of dysphagia
Authors: Etherington R. J. , Clements D. 
Published: July 2009

Mid-oesophageal diverticula are usually small, asymptomatic and rarely result in complications (Meshkinpour, 1985). We report a case of a giant mid-oesophageal diverticulum which caused dysphagia. The aetiology of these diverticula is discussed.
A 91-year-old man presented with a long history of dysphagia and weight loss of over 20 kg. More recently he had developed vomiting and symptoms of nocturnal aspiration. The dysphagia had become severe and he required intravenous fluids to maintain his hydration.
The chest radiograph demonstrated an irregular gas lucency inferior to the carina (Fig. 1). There was no evidence of previous tuberculous infection. Barium swallow examination revealed a huge sac arising from the mid-part of the oesophagus and extending to the left and anterior to it. Initially, the sac appeared thick walled (Fig. 2), but on delayed radiographs barium penetrated the food residue within it revealing a thin walled diverticulum.
Iliopsoas abscess: an unusual complication of femoral artery catheterization
Authors: Loveday E. J. , Tonge K. A. , du Peloux Menage H. G. 
Published: July 2009

We report a case of iliopsoas abscess following percutaneous transfemoral carotid angiography. To our knowledge there are no previous reports of this complication.
The patient, a woman aged 49, was admitted for investigation of occlusive cerebrovascular disease. She was a smoker and had a history of exopthalmic Graves' disease and thyrotoxicosis, previously treated with Iodine 131. Current medications were thyroxine, Voltarol Retard and Nifedipine Retard. Prior to the procedure, haemoglobin level was 14.2 g/dl, white cell count was 8400 × 103/ml and platelet count was 283 000 × 103/ml. Full clotting studies were normal.
Carotid arteriography was performed using a modified Seldinger technique. Full aseptic precautions were taken including groin shave, cleansing with chlorhexidine, povidone iodine skin preparation and sterile drapes and gowns. A 5 F Mani catheter (William Cook Europe ApS) and a 0.035 inch straight guidewire were used during the procedure which was protracted owing to inability to catheterize the left common carotid artery. A subsequent arteriogram using a 5 F pigtail catheter revealed complete occlusion of this vessel at its origin. Compression was applied to the puncture site for 20 min. The patient was well following the procedure and was discharged home shortly thereafter. Minor bruising only was seen at the puncture site.
She presented again 22 days post-investigation complaining of increasing pain in the right groin and difficulty with walking. On examination she was pyrexial; and greenish, offensivesmelling fluid was oozing from the puncture site in the right groin.
The effect of secondary electron spread on the penumbra in high energy photon beam therapy
Authors: Day M. J. , Lambert G. D. , Locks S. M. 
Published: July 2009

Abstract
In photon beam therapy, the geometric penumbra width is determined by the source-size and the collimator design. The width of the physical (i.e. dosimetric) penumbra involves an additional contribution from secondary electron spread. Using a suitably defined measure of penumbra width, the separate widths due to photons and secondary electrons are additive in quadrature. Secondary electron spread functions were measured using photographic dosimetry for 60Co γ rays and for 4, 8 and 16 MV X rays. The results suggest that, under typical treatment conditions, secondary electron spread may be the predominant contributor to the penumbra at effective generating voltages exceeding 10 MV. The implications for selection of beam energy in precision small-field radiotherapy are discussed briefly.
Neutron and gamma ray measurements carried out around a Varian Clinac 2500 linear accelerator
Authors: Beckham W. A. 
Published: July 2009

Auckland Hospital, New Zealand, has recently installed a Varian Clinac2500 linear accelerator. This unit is capable of producing 24 MV peak photon energies. It is well known (Fox et al, 1977; Ing et al, 1982; Palta et al, 1984) that such photons are capable of producing neutrons via a photonuclear reaction. The sources of such neutrons from this accelerator have been described (LaRiviere, 1985). In this study a survey was carried out around this new installation to observe some of the characteristics of the neutrons produced, and to assess likely radiological hazards to radiotherapy staff.
Equipment and methods Equivalent neutron dose was measured using an Alnor neutron dose rate meter (rem-meter) model 2202D. Remote pulse counting was carried out using an Elscint model INS-30 nuclear spectrometer.
The manufacturer of this unit claims that the detector exhibits 200 R/h gamma ray discrimination. Initially this would appear satisfactory for carrying out a survey, but owing to the fact that linear accelerators are operatedin pulsed mode, peak leakage and scatter photon dose rates within the treatment room could well exceed 200 R/h. This was confirmed by operating the accelerator in 6 MV photon mode (i.e. producing no expected neutrons) and showing that the neutron meter did in fact respond. However, in the entrance maze to the treatment room the scattered X-ray dose rate was attenuated sufficiently so that it was not contributing to detector response.
Final Report of the BIR fractionation study
Authors: Fletcher Gilbert H. 
Published: July 2009

Wiernik et al (1990) have reported on the BIR multicentre trial of 3 versus 5 days per week treatment of tumours of the larynx and pyriform sinus. No statistically significant differences were found between the two arms with respect to survival and complication rates.
The purpose of choosing irradiation over surgery in the tumours of the laryngopharynx is to preserve the larynx. Salvage surgery is highly successful, primarily for failures in patients with mobile cord tumours, but it also has been successful in other sites where, in addition to laryngectomy, radical neck dissection can be curative. Therefore, survival rates do not reflect the effectiveness of the radiation treatment, yet survival analysis makes up the bulk of their report. The brief analysis of the incidence of laryngectomies is lost in an extensive text on statistical methods and a large number of tables and graphs relating to survival rates.
Book reviews
Authors: Kingsley D. 
Published: July 2009

Craniospinal Magnetic Resonance Imaging is a multiauthor book under the general editorship of Stephen Pomeranz. It is aimed at a wide readership of both trainees and practising radiologists and consists of 22 chapters including those on the orbit, nasopharynx and temporomandibular joint. Rather surprisingly for such a comprehensive text book there is no chapter on the paranasal air sinuses.
The first four chapters are concerned with the principles of MRI including a very complete overview of the fast scanning techniques currently used.
Thyroid imaging using positron emission tomography—a comparison with ultrasound imaging and conventional scintigraphy in thyrotoxicosis
Authors: Flower M. A. , Irvine A. T. , Ott R. J. , Kabir F. , McCready V. R. , Harmer C. L. , Sharma H. L. , Smith A. G. 
Published: July 2009

Abstract
Forty-six comparative studies were performed on 41 patients with hyperthyroidism. Clinically these comprised two groups: those with Graves' disease, and those with multinodular goitre. All patients underwent an ultrasound examination and positron emission tomography (PET) using 124I, then gamma camera pinhole imaging following their 131I therapy administration. Although the 131I pinhole imaging was not performed for diagnostic purposes, there was good correlation (78% agreement) between it and 124I PET in determining relative lobe size. Hence either imaging modality could be used as an indicator of the relative radiation dose delivered to each thyroid lobe at a macroscopic level. In terms of gland morphology the PET images corresponded well to the high resolution ultrasound images (78% agreement), unlike the pinhole images which correlated poorly (only 28% agreement). The results showed that PET imaging gives better anatomical and physiological detail than 131I pinhole imaging. In 77% of cases where the pinhole image showed a uniform distribution of radioisotope, the improved spatial resolution of the PET images revealed non-homogeneous distribution indicating a non-uniform distribution of radiation dose. Since all dosimetry calculations are based on the assumption of uniform distribution of radioiodine, this non-uniformity could possibly have important consequences in the outcome of radioiodine therapy in thyrotoxicosis.
Oropharynx carcinoma: irradiation alone versus induction chemotherapy plus irradiation—5 year results
Authors: Calais Gilles , Reynaud-Bougnoux Agnés , Garand Gérard , Beutter Patrice , Le Floch Olivier 
Published: July 2009

Abstract
Induction chemotherapy (CT) has demonstrated overall response rates of 80% for oropharynx carcinomas, but no overall survival benefit has been reported. In order to determine the value of induction CT for such patients, we conducted a retrospective study: 121 patients were treated with CT and radiotherapy (RT) (Group 1). This group was compared with a historical group of 84 patients treated by RT alone (Group 2). The CT used was Cisplatinum associated with Bleomycin and Vincristin or Vindesin and with 5 Fluoro-uracil. An objective response to CT was observed for 41% of patients. The 5 year actuarial survival rate was 19% for Group 1 and 24% for Group 2. Patterns of failure were identical in the two groups. The only difference observed was for patients with N3 nodes (26% of 5 year survival rate in Group 1 versus 9% in Group 2) (p = 0.05). The results did not depend on the histological differentiation, the tumour site or the type of CT. We conclude that this retrospective study failed to demonstrate an advantage for induction CT in oropharynx carcinoma except for patients with N3 nodes.
A Chinese puzzle
Authors: Williams J. W. , Collins M. C. 
Published: July 2009

A 39-year-old Chinese waiter presented with a 5 week history of intermittent epigastric pain, exacerbated after eating and increasing over the 3 days preceding admission with associated retching.
Previous medical history included a vagotomy and gastro-enterostomy for duodenal ulcer many years earlier, and similar symptoms had settled with conservative management in the past.
Examination revealed abdominal distension and highpitched bowel sounds. A plain abdominal radiograph was obtained (Fig. 1).
Book reviews
Authors: Keeling D. H. 
Published: July 2009

This small booklet of less than 50 pages packs in a great deal of useful information and advice about modern hospital radiopharmacy work. It is an update of the Hospital Physicists' Association Report No. 16, The Hospital Preparation of Radiopharmaceuticals.
The introduction usefully summarizes the legislative framework, regulations and various guidance notes which are relevant in the radiopharmacy, both from the pharmaceutical point of view and from that of radiation protection.
Bronchopulmonary dysplasia: a radiographic and clinical review of 20 patients
Authors: Fitzgerald Patricia , Donoghue Veronica , Gorman W. 
Published: July 2009

Abstract
This paper reviews the radiological features of 20 infants with bronchopulmonary dysplasia, with particular emphasis on the early radiological findings in these infants, the clinical findings and radiological progression. Of 20 infants, eight had idiopathic respiratory distress in the first week of life, two infants had early radiological abnormalities other than idiopathic respiratory distress and 10 infants had normal initial chest radiographs. The complicating features included lower respiratory infections (88%), patent ductus arteriosus (40%) and areas of atelectasis (40%). Areas of atelectasis were more common in infants with an intially normal chest radiograph than in those with idiopathic respiratory distress syndrome (p = 0.015). Mortality from severe bronchopulmonary dysplasia was 70% in this series.