bluuebunny/crossref_metadata_2025_split huggingface dataset:
The value of repeated chest radiographs in the follow-up of patients with germ cell testicular tumours
Authors: Dunn W. K. , McMillan P. J. , Sokal M. , Wastie M. L. 
Published: July 2009

Abstract
Patients with germ cell testicular tumours customarily have repeated follow-up chest radiographs after treatment. This study assesses the contribution of chest radiography to the detection of recurrent disease in 162 patients. Six patients developed an intrathoracic recurrence, but in only one case was the chest radiograph the only indication of recurrence. Five had other evidence to suggest recurrence, such as raised serum markers or palpable masses. The yield from follow-up chest radiographs in patients with germ cell testicular tumours is very low and their use must be balanced against both the harmful effects of radiation and the financial cost.
Lung function and radiation response
Authors: Hong A. , Dische S. , Saunders M. I. , Lockwood P. , Crocombe K. 
Published: July 2009

Abstract
This study investigated whether impaired respiratory function affected the response to radiotherapy. A prospective study was performed in which lung function, arterial oxygen and haemoglobin concentration were examined, before treatment with radical radiotherapy, in 141 patients with advanced non-small cell lung cancer and head and neck cancer. The findings were considered to reflect the physiological conditions present at the time of radiotherapy and these were related to acute normal tissue reactions and tumour control. Although 53% of the patients showed some impairment of lung function and 47% demonstrated a haemoglobin oxygen saturation below the normal range, oxygen partial pressure was below expected levels in fewer patients (27%) and total arterial oxygen content was below normal in only 12% of patients. No correlation was found between the tests performed and the severity of acute morbidity or with local tumour control. In the patients with carcinoma of the bronchus, there was a trend for incomplete tumour control to be associated with a lower haemoglobin level, but this did not reach statistical significance. In patients selected for curative radiotherapy, lung function would not appear to be an important factor influencing the response of normal tissues or tumour to irradiation.
Afferent loop obstruction diagnosed by sonography and computed tomography
Authors: Hasuda Keitaro , Makino Yoshinari , Arata Toshihiko , Yamada Tsutomu 
Published: July 2009

Although obstruction of the afferent loop following Billroth II gastrectomy is uncommon, it causes a rapid onset of severe abdominal pain, non-bilious vomiting and at times may become lethal if complicated by perforation and peritonitis. However, the diagnosis is sometimes difficult to establish by conventional biochemical and radiological means. We present one case in which both sonography and computed tomography (CT) were very helpful in establishing the early and accurate detection of this life threatening condition before surgery.
A 69-year-old female, who had previously undergone a partial gastrectomy and Billroth II reconstruction, was admitted with a 2 week history of right upper quadrant pain associated with nausea. There was a palpable mass in the right upper quadrant. Laboratory data on admission revealed normal values for haemoglobin, haematocrit, serum amylase, total birilubin, lactate dehydrogenase (LDH) and serum glutamate oxaloacetate transaminase (SGOT).
CT of a unicameral bone cyst in a rib
Authors: Ian Marsh J. , Munk Peter L. , Muller Nestor L. 
Published: July 2009

Unicameral bone cysts are relatively common lesions in childhood but are distinctly unusual in the ribs; a single case having been reported previously (Shulman et al, 1977). They occur most frequently in the metaphysis of the proximal ends of the humerus or femur (Jaffe et al, 1942; Baker, 1970). There is an age dependency of the location of these lesions, the most common site after the age of 17 years being the pelvis and os calcis (Norman & Schiffman, 1977). The lesion shows a male predominance.
The computed tomographic (CT) appearance of unicameral bone cysts has been described infrequently. These lesions have a low attenuation value (0–20 Hounsfield Units (HU)) (Blumberg, 1981).
Renal arterial fibromuscular dysplasia: acute renal infarction in three patients with angiographic evidence of medial fibroplasia
Authors: Stinchcombe S. J. , Manhire A. R. , Bishop M. C. , Gregson R. H. S. 
Published: July 2009

Fibromuscular dysplasia of the renal arteries usually presents with hypertension but, rarely, it can present with acute renal infarction. Of the four types of fibromuscular dysplasia, medial fibroplasia has been said not to progress to renal arterial occlusion (Schreiber et al, 1984) and not to predispose to arterial thrombosis or dissection (Stewart et al, 1970).
We report on three patients who presented with acute renal infarction, whose renal angiographic features were more suggestive of the medial fibroplasia type of fibromuscular dysplasia.
A 33-year-old man was admitted with severe right loin pain. The right kidney was non-functioning on intravenous urography, but an ultrasound examination of both kidneys was normal. A right retrograde pyelogram was normal, but dynamic renography (99Tcm-DTPA) revealed that the right kidney was not perfused.
At angiography the right renal artery was completely occluded by thrombus 3 cm from its origin (Fig. 1). The left main renal artery was irregular and two stenoses were seen in one of the segmental vessels (Fig. 2). The thrombus in the right main renal artery was treated with intra-arterial streptokinase to reveal a 75% stenosis. This was treated with balloon angioplasty but peripheral perfusion could not be restored and the kidney remained non-functioning. The angiographic appearances were thought to represent the medial fibroplasia form of fibromuscular dysplasia. Subsequent investigations failed to reveal any other cause of arterial thrombosis or embolism.
Carbogen breathing: a system for use in man
Authors: Dische S. , Rojas A. , Rugg T. , Hong A. , Michael B. D. 
Published: July 2009

In the long history of the clinical application of laboratory knowledge concerned with the radioresistance of hypoxic tumour cells, carbogen (95%O2 + 5%CO2) was employed at an early time. In a randomized controlled trial of carbogen breathing in 254 patients with carcinoma of the upper aero-digestive system, initiated in 1972 and performed under the auspices of the radiation therapy oncology group (RTOG), a small margin of advantage to carbogen breathing in carcinoma of the larynx (total of 42 cases) and hypopharynx (total of 39 cases), which did not reach statistical significance, was reported by Rubin et al (1979). The method fell into disuse and in the 1960s and 1970s the clinical effort was concentrated on hyperbaric oxygen (HBO). Finally there was a move to chemical sensitizing agents.
Recently, using clinically relevant dose-fractionation regimes, it has been shown that both carbogen and 100% oxygen-breathing in mouse tumour models give a remarkable increase in radiosensitivity. The enhancement of radiation effect is greater than that achieved by any other system for sensitization of hypoxic cells in the laboratory, including the use of chemical sensitizers and hyperbaric oxygen (Rojas et al, 1990; Rojas, 1991).
The use of a chelating derivative of alpha melanocyte stimulating hormone for the clinical imaging of malignant melanoma
Authors: Wraight E. P. , Bard D. R. , Maughan T. S. , Knight C. G. , Page-Thomas D. P. 
Published: July 2009

Abstract
A novel chelating derivative of alpha melanocyte stimulating hormone, bisMSH-DTPA, has been used for the diagnostic targeting of malignant melanoma. 15 patients were investigated of whom nine were shown by other means to have active disease at the time of the scan. Tumours were imaged in all of these nine patients. Of a total of 46 lesions over 10 mm encountered, 41 (89%) were imaged. There were no false positives and in two cases bisMSH-DTPA was instrumental in reversing diagnoses made using ultrasound. Derivatives of melanocyte stimulating hormone may be of considerable value in targeting melanomas.
Fat suppression in magnetic resonance imaging at low field strength using binomial pulse sequences
Authors: Baudouin Christine J. , Bryant David J. , Young Ian R. 
Published: July 2009

Abstract
The use of binomial pulse sequences for fat suppression in MRI at low field strength (0.15 T) was investigated. Both spin-echo and inversion-recovery sequences were used and images obtained of the limbs, head and neck, and pelvis of volunteers and patients. Good fat suppression was seen particularly in small fields of view. Despite technical problems, chemical shift selective techniques can be applied at low field strength.
The influence of methotrexate on radiation-induced damage to different lengths of the rat spinal cord
Authors: Morris G. M. , Hopewell J. W. , Morris A. D. 
Published: July 2009

Abstract
An experimental model in the rat has been used to assess the possible enhancement of damage to the spinal cord when radiation is given in the presence of methotrexate (MTX). The dose of MTX used, 4 mg/kg, was the maximum dose that could be given to the rat, when administered into the cerebral spinal fluid circulation, without risk of serious neurological effects. Lengths of 4, 8 and 16 mm of the cervical spine were irradiated with single doses of X rays. For animals that developed paralysis within 30 weeks, caused predominantly by the presence of white matter necrosis, there was no evidence to indicate that MTX enhanced the radiation response of the rat spinal cord, at least at a more clinically relevant level of effect i.e. a low incidence of paralysis. However, for the doses associated with the 50% level of effect (ED50) to an 8 mm long field a significant (p &lt; 0.005) enhancement of the response was seen, suggesting a dose modification factor of 1.19 ± 0.07. This was interpreted in terms of an hypothesis to explain the well documented volume effect for very small fields in the rat spinal cord which is based on the migration of viable cells in the periphery of the irradiated site. The apparent smaller effect seen when only 4 mm of the spine was irradiated might be related to the nature of the lesion induced at doses required to produce paralysis in these small fields; the lesions were not restricted to white matter but were more severe and also involved the grey matter and nerve roots after a slightly shorter latent period.
Minimizing radiation dose to patient and staff during fluoroscopic, nasoenteral tube insertions
Authors: Rudin Stephen , Bednarek Daniel R. 
Published: July 2009

Abstract
It is possible to reduce greatly fluoroscopic radiation dose if some image degradation is acceptable. Since the fluoroscopic image during nasoenteral tube placements is used for guidance and not for diagnosis, a lower contrast image with increased quantum mottle can be easily tolerated. The three methods to reduce the radiation dose rate that were investigated consisted of removing the antiscatter grid, increasing the diameter of the optical aperture controlling the percentage of light reaching the television camera from the image intensifier output phosphor, and setting the fluoroscopic mA to the minimum value so that the kVp could be maximized. Fluoroscopic frozen video frames of a clinical tube insertion comparing the images with and without the dose-saving techniques are presented. Measurements of the radiation dose rates using a Plexiglas phantom show that the dose for patient and staff during fluoroscopic-guided nasoenteral tube placements can be reduced by over a factor of 10 without significantly adversely affecting the actual placement procedure.
Magnetic resonance imaging of Fricke-doped agarose gels for the visualization of radiotherapy dose distributions in a lung phantom
Authors: Thomas S. J. , Wilkinson I. D. , Dixon A. K. , Dendy P. P. 
Published: July 2009

When calculating a treatment plan for a radiation beam that passes through an inhomogeneity such as lung, the dose at each point needs to be modified to correct for the effect of the inhomogeneities. Many algorithms exist for making such corrections. Algorithms must be verified by measurements in phantoms. Measurements with an ionization chamber in a solid phantom can only be performed at a limited number of points, giving poor spatial resolution. Film dosimetry gives better spatial resolution, but the introduction of non-tissue equivalent photographic film represents a considerable perturbation of a tissue equivalent phantom.
Shultz et al (1990) and Olsson et al (1990) have recently described techniques for the measurement of absorbed dose using magnetic resonance imaging (MRI) of agarose gels doped with Fricke (iron (II) sulphate) solution. After Fe2+ has been oxidized by irradiation to Fe3+, the gel fixes the position of the ions, so that the distribution of Fe3+ in the gel corresponds to the dose distribution. The gel is then imaged to produce a map of the longitudinal proton relaxation time (T1). As a result of the paramagnetic properties of Fe3+, T1 is inversely proportional to Fe3+ concentration and hence to absorbed dose of radiation.
Thus, the technique provides a method of determining a continuous distribution of radiation dose within a phantom. This paper describes preliminary work using the technique on a phantom containing a volume of low density material designed to simulate lung.
The dose-rate effect in interstitial brachytherapy: a controversy resolved
Authors: Hall Eric J. , Brenner David J. 
Published: July 2009

Abstract
Low-dose-rate interstitial implants generally involve a range of dose rates varying from about 0.3 to 1.5 Gy/h. It has been a matter of some debate as to whether such a variation in dose rate has any impact on clinical results, i.e. whether implant treatment time needs to be taken into account when prescribing the treatment dose. In particular, Paterson and Ellis both published data based on clinical experience suggesting that the prescribed dose should vary with overall treatment time, whereas the Paris school suggested that isoeffect dose should not be varied for treatment times between 3 and 8 days. Experimental radiobiological data obtained in vitro and in vivo imply a significant change in biological effectiveness over this range of dose rates with a greater variation for normal-tissue late effects than for tumour control. We show, based on radiobiological considerations and model calculations, that the disagreement between the two schools in their recommendations for generating isoeffect doses for different treatment times was a result of two factors. First, the Paterson recommendation was unequivocally based on matching limiting late effects, whereas the Paris system recommendations were based on an analysis of a combination of late and early effects. Second, the Paterson recommendations were based on a dosimetry system in which the dose rate does not change greatly with tumour volume, whereas the Paris recommendations were based on a dosimetric system in which dose rate is correlated with tumour volume, which in turn is correlated with changes in both tumour control and, especially, necrosis.
Sonographic detection of neonatal hydrometrocolpos
Authors: Banerjee Arpan K. , Clarke O. , MacDonald L. M. 
Published: July 2009

Hydrometrocolpos is the result of an obstruction of the genital tract by an intact hymen, a midplane transverse septum, cloacal anomalies or vaginal atresia. This obstruction allows an accumulation of secretions from the infant cervical mucous glands in the vagina and uterus stimulated by maternal oestrogen (Wilson et al, 1978; Nyberg, 1990).
The incidence is reported to be between one in 16 000 births (Westerhout et al, 1964) and one in 30 000 births (Hill & Hirsch, 1985). Although several cases of hydrometrocolpos have been reported in the world literature (Mahoney & Chamberlain, 1940; Spencer & Levy, 1962; Reed & Griscom, 1973), there are very few reports of the ultrasonographic appearances of this condition (Sailer, 1979; Sawhney et al, 1990).
We present two cases of hydrometrocolpos which showed classical ultrasound features and review the literature on the subject.
A 1-day-old white girl, the product of a normal pregnancy and delivery, presented with a fluctuating mass protruding from the vagina. Clinical examination revealed a palpable abdominal mass and a swollen labia. An ultrasound of the abdomen and pelvis was performed using a 5 MHz probe. A 6 cm × 4 cm cystic left adnexal mass was demonstrated with no posterior acoustic enhancement. The mass contained several internal echoes (Fig. 1). The bladder was not distended and therefore not seen, but both kidneys were normal. The vaginal membrane was incised and 150 ml of milky white fluid was expelled.
An unusual osteochondral body in association with calcium pyrophosphate dihydrate crystal deposition disease
Authors: Jones A. C. , Preston B. J. , Doherty M. 
Published: July 2009

Chronic pyrophosphate arthropathy is a recognized subset of osteoarthritis (OA) characterized by deposition of calcium pyrophosphate dihydrate (CPPD) crystals (McCarty, 1976). Typically a disease of the elderly, there is symptomatic and radiographic involvement of characteristic sites, including the patellofemoral, radiocarpal and glenohumeral joints (McCarty & Haskin, 1963; Resnick & Resnick, 1983). CPPD deposition in cartilage (chondrocalcinosis) occurs particularly in the articular and the meniscal cartilages of the knee, the symphysis pubis and the triangular ligament of the wrist (McCarty & Haskin, 1963; Resnick & Resnick, 1983). It has been postulated that sporadic pyrophosphate arthropathy may represent a hypertrophic response to joint insult (Doherty et al, 1984), with CPPD crystal formation being a marker of high extra-cellular pyrophosphate production reflecting increased cellular biosynthetic activity (Caswell et al, 1983).
Osteochondral bodies, arising in synovium by enchondral ossification of islands of chondroid metaplasia, are a common accompaniment to OA and may be particularly florid in the subset of pyrophosphate arthropathy (McCarty & Haskin, 1963; Resnick & Resnick, 1983). Such bodies form by a process of layered growth (Milgram, 1977b), and possibly reflect a generalized hyperplastic response (i.e. attempted repair) by joint tissues. We present a patient with CPPD arthropathy who developed an osteochondral body that showed features both of ossification and chondrocalcinosis.
Three-dimensional imaging of dual isotope data-sets in a case of acute myocardial infarction
Authors: Dilhuydy Hugo P. , McNamara Daniel , Lemieux Raymond J. , Martel Yves , de Guise Jacques A. 
Published: July 2009

A patient with acute myocardial infarction was injected with indium 111 (111In)-antimyosin Fab. He then under-went planar imaging before receiving an additional dose of thallium 201 (2O1T1) so as to perform a dual isotope single photon emission computed tomography (SPECT) acquisition. Planar images showed vague myocardial uptake of antimyosin antibody. With tomographic slices, a more defined area of antimyosin uptake was seen but still with a low 111In signal-to-noise ratio. This area corresponded to a 2O1T1 defect. Two three-dimensional (3D) rendering methods showed a well matched 2O1T1 3D defect and 111In 3D hot spot and seemed to facilitate the localization of the infarct as well as the evaluation of its importance relative to the remaining viable tissue. This case study illustrates a situation where 3D imaging of dual isotope data-sets could be useful for direct visualization and localization of myocardial infarction.
A 61-year-old white male with a past history of occasional chest pain was admitted to the ICU for prolonged chest pain. He had multiple risk factors for coronary disease such as smoking (up to 40 cigarettes per day), essential hypertension, diabetes and a family history of coronary artery disease. Laboratory analysis showed elevated plasma enzyme levels of total creatine kinase (CK) (1289 U/l) and the electro-cardiogram showed an infarct in the anterior wall and a possible old inferior wall infarction (see Fig. 1). Five days after his admission coronary angiography revealed severe three-vessel disease.
Anatomy of percutaneous femoral artery puncture
Authors: Stubbs F. , Cumberland D. C. 
Published: July 2009

The paper by Grier and Hartnell (1990) discusses the use of the inguinal skin crease and the site of maximal pulsation in femoral artery puncture, but omits mention of the mid-inguinal point. Defined as being “midway between the anterior superior iliac spine and the symphysis pubis”, this point is traditionally held by anatomists to be the most accurate landmark in locating the common femoral artery (Williams & Warwick, 1980).
The anatomical accuracy of the mid-inguinal point was tested by studying 10 adult cadavers, using one side only on each. A tape measure was placed accurately between the two points and the exact mid-point marked on skin. (As the symphysis pubis was impossible to palpate through embalmed skin it was located by a limited dissection.)
Small bowel fistula secondary to endarteritis obliterans, complicating chemotherapy for small bowel lymphoma
Authors: Knowles S. , Smart H. E. , Al-Dawoud A. , Kerr D. J. 
Published: July 2009

Endarteritis obliterans, pathological thickening of the intima associated with luminal stenosis of small and medium sized arteries, is a relatively common late tissue effect following radiotherapy, but it is not associated with cytotoxic drug administration. We report a patient treated with chemotherapy for recurrent lymphoma of the sigmoid colon, who developed a fistula between the large and small bowel which was associated with severe endarteritis obliterans.
A 66-year-old man presented to the surgeons with intermittent abdominal pain and diarrhoea. A barium enema demonstrated an annular narrowing in the sigmoid colon and the patient had a laparotomy which revealed a large tumour of the sigmoid colon invading the bladder and retroperitoneal structures.
Chest radiograph scoring system for use in preterm infants
Authors: Greenough A. , Yuksel B. , Karani J. , Page A. 
Published: July 2009

We thank I. Hyde for this interest in our paper (Yuksel et al. 1991).
Two of our patients had undergone lobectomy for gross cystic degeneration following localized severe pulmonary interstitial emphysema. Both infants were ventilator-dependent at the time of lobectomy with deteriorating blood gases. As a consequence of this deterioration in respiratory status it was decided that they should undergo lobectomy following which their respiratory status improved and it was possible to extubate the infants.
Book reviews
Authors: Blngham J. B. 
Published: July 2009

Reviewing this textbook was a relatively simple task as it only comprises of images of the joints.
The book is divided into seven sections, covering the shoulder, elbow, wrist and hand, fingers, hip, knee, ankle and foot. Multiple sections are displayed through each joint in coronal, axial and sagittal planes using a T 1-weighted sequence and displayed on the same page as an anatomical section in precisely the same plane in colour.