bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outpatient lumbar radiculography: comparison of iopamidol and iohexol and a literature review
Authors: Davies A. M. , Evans N. , Chandy J. 
Published: July 2009

Abstract
A prospective study of 261 patients undergoing lumbar radiculography using 12 ml iopamidol (200 mgl/ml) was undertaken to determine whether the procedure could be performed safely on an outpatient basis. No statistically significant differences in the incidence and severity of side-effects were found between the 132 outpatients and 129 inpatient controls. Nine outpatients had to be kept in hospital at the end of a 4-h observation period and a further two outpatients were re-admitted to hospital because of severe side-effects. The current study was compared with a preceding study of identical design, already published, in which 200 patients underwent lumbar radiculography with 10 ml iohexol (240mgI/ml). No statistically significant differences in the incidence and severity of side-effects between the two contrast media were evident up to 24 h after the examination. In the period between 24 h and 7 days, the incidence and severity of headache, nausea and dizziness were all significantly greater in the iopamidol group. Although outpatient radiculography can be performed safely with both contrast media, the higher incidence of delayed side-effects in the iopamidol patients prompts the authors to express a preference for iohexol for intrathecal use. The increased incidence of adverse reactions in female patients and the literature comparing iopamidol and iohexol for myelography are discussed.
Aneurysm of the inferior pancreaticoduodenal artery diagnosed by real-time ultrasound and pulsed Doppler
Authors: Grech Paul , Rowlands Peter , Crofton Mary 
Published: July 2009

Aneurysms of the superior mesenteric artery are rare, being noted in only 1 of 12 000 autopsies (Lucke & Rae, 1921). Aneurysms of branch arteries are even less common. Presentation is most commonly at the time of rupture, which often results in catastrophic and usually fatal haemorrhage. The incidental finding of such aneurysms and their recognition thus assumes an importance out of proportion to their frequency. A case is presented in which an incidental finding of an asymptomatic aneurysm of the inferior pancreaticoduodenal artery was made by ultrasound and pulsed Doppler. The diagnosis and exact anatomy was confirmed by angiography.
A 50-year-old woman presented to a gynaecologist complaining of vaginal bleeding and was referred for ultrasound examination of the pelvis. The patient was a normotensive non-smoker and, on direct questioning, revealed no symptoms referable to the gastrointestinal tract or upper abdomen.
Late radiation injury of the rectum and sigmoid colon: barium enema findings in 92 patients
Authors: den Hartog Jager F. C. A. , Cohen P. , van Haastert M. 
Published: July 2009

Abstract
We reviewed the findings on 169 contrast enema examinations in 92 patients with late radiation injury of the rectum and sigmoid colon, encountered over an 11-year period. The diagnosis was made by rectosigmoidoscopy in all patients. The limitations and pitfalls of both examinations were studied. The mean interval between radiotherapy and diagnosis was 1.7 years and the mean follow-up period was 3.5 years. The main radiological features varied from normal findings (15% of the initial examinations) to decreased distensibility of the bowel wall, intestinal fixation, mucosal and contour abnormalities, ulceration, stenoses and fistula formation. During follow-up, the number of all pathological findings increased. Pre-stenotic dilatation of the descending colon was always absent. The contrast enema examinations and endoscopies were found to be complementary. The barium enema showed the extent of the disease and accurately identified stenoses and fistulas, but underdiagnosed ulceration and overdiagnosed malignancy. Endoscopy allowed unequivocal detection of mucosal damage, especially ulceration, and was accurate in showing stenoses but sometimes failed to demonstrate fistulas. Moreover, in 25% of examinations it was impossible to examine the entire abnormal area.
The effects of single doses of X rays on the mechanical properties of pig skin in vivo
Authors: Baker M. R. , Bader D. , Hopewell J. W. 
Published: July 2009

Abstract
Changes in the mechanical properties of pig skin have been studied in vivo, using a dermal extensometer, after irradiation with a single dose of 18 Gy of X rays. There was no significant change in the stiffness of irradiated skin, when compared with unirradiated skin, until 9 weeks after irradiation when the irradiated skin was significantly stiffer This effect was also found at 12 and 15 weeks after irradiation. When the increase in skin thickness, as a consequence of oedema, was taken into account a significant increase in the unrelaxed elastic modulus of irradiated skin was only seen at 12 and 15 weeks after irradiation. There were no significant changes in force relaxation, after extension of the skin, over this time period. After the resolution of oedema, which was associated with a significant 20% reduction in the thickness of irradiated skin relative to unirradiated skin, the mechanical properties of irradiated skin were not markedly different from those of unirradiated skin. However, between 30 and 39 weeks after irradiation there was a further wave of dermal thinning, resulting in a total reduction in the thickness of irradiated skin relative to unirradiated skin of 26%. This was associated with a rapid rise in the skin stiffness and unrelaxed elastic modulus by ∼65 and ∼140%, respectively. It was only at these late times after irradiation that the force relaxation of the skin was modified significantly. At 9 and 12 weeks after irradiation the reduction in skin stiffness and the unrelaxed elastic modulus were dose related. Based on the percentage of fields showing a significant reduction in these biomechanical parameters, ED50 values of between 12 and 14.5 Gy were established. This would appear to be a sensitive method for assessing radiation-induced dermal changes since few gross changes are observed in this dose range.
Soft-tissue effects of biliary extracorporeal Shockwave lithotripsy in swine
Authors: Malone Dermot E. , Becker Christoph D. , Reich K. David , Quenville Noel F. , Burhenne H. Joachim 
Published: July 2009

Abstract
This study investigates the soft-tissue effects of biliary extracorporeal Shockwave lithotripsy (BESWL) using a recently developed lithotripter, which consists of an electromagnetic Shockwave generator and an integrated ultrasonic targeting system. Sixteen swine, evenly divided into four groups, underwent BESWL. One group had one BESWL session targeted on the gallbladder and another group had two BESWL sessions targeted on the gallbladder. The third group had one BESWL session targeted on implanted gallbladder stones and the fourth group had one BESWL session targeted on the region of the common bile duct (CBD). Half of each group were sacrificed on the day of lithotripsy and half 1 week later. Post-mortem examinations were performed. Each implanted gallstone had fragmented. There were no findings attributable to BESWL in 11 animals. Three animals had pulmonary haemorrhagic spots (the largest was 10 mm in diameter) and one had a submucosal CBD petechia; these findings were attributable to BESWL. In two animals, microscopic haemorrhage associated with bronchopneumonia (usually present in our pig population) was more prominent than usual. This was possibly attributable to BESWL. The swine's deep posterior costophrenic sulcus makes it difficult to avoid the lung base during BESWL in swine. We conclude that this BESWL device can fragment gallstones without causing clinically significant soft-tissue damage.
Spondylo-metaphyseal dysplasia of Sutcliffe type
Authors: Kozlowski K. , Bellemore M. C. 
Published: July 2009

In 1965, Sutcliffe presented to the European Society of Paediatric Radiology two cases of spondylometaphyseal dysplasia with a distinctive pattern of bone changes. The purpose of this paper is to report a third case and to describe the radiographic features of this rare entity.
The patient was the product of an uncomplicated, term pregnancy and normal vaginal delivery. The mother took benzodiazepine sedatives during the first and third trimesters of the pregnancy. At birth, the patient was noted to be a healthy female weighing 2650 g. The parents were unrelated and had two other children who were normal. There was no family history of short stature.
The patient's growth and development were thought to be normal during her first year of life. However, she did not walk until 18 months old. At 2 years of age, she was seen by a paediatrician because of frequent falls. Her gross motor development and neurological examination were found to be normal. Over the next 6 months she continued to have frequent falls and the patient was referred to the Orthopaedic Department at the Royal Alexandra Hospital for Children because she had an abnormal gait.
Book reviews
Authors: Dunn M. J. 
Published: July 2009

This book is aimed at medical physicists wishing to make radiation dose measurements on patients undergoing diagnostic radiological examinations.
The book attempts to cover in some 60 pages of text, dose quantities, measurement strategies and suitable dosimetric techniques for use in a wide variety of clinical situations. Risk estimation and bone dosimetry each have a chapter devoted to them. The information is provided in a clear and concise manner.
Radiographic videodensitometry for quantitative monitoring of experimental bone healing
Authors: Kälebo Peter , Strid Karl-Gustav 
Published: July 2009

Abstract
A method for non-invasive assessment of experimental bone healing in animals is described. Optimized radiographs were analysed by digital processing using a computer-based image analysis system. Values of the total mass were expressed as the equivalent mass of a simultaneously exposed aluminium roentgen-density reference. In order to assess the potential of the method, measurements were initially performed on phantoms and bone specimens. The systematic error was negligible. An excellent correlation (r=0.999) was found between the densitometric weight (μ) and the corresponding dry weight (m) of the analysed bone samples and a calibration factor μ/m=1.38 was established. The total random error was low, the coefficient of variation (CV) amounting to &lt;5% or, if duplicate analyses were performed, &lt;3%. The accuracy was not impaired when radiography was carried out with addition of water to mimic overlying soft tissue in the model. The method was applied to the assessment of callus mass longitudinally in vivo in the healing of a bone defect in the rabbit radius, yielding reproducible values (CV &lt;5%) and a quantitative analysis of the healing sequence.
Small hepatocellular carcinoma: detection with sonography, computed tomography (CT), angiography and Lipiodol-CT
Authors: Choi Byung Ihn , Park Jae Hyun , Kim Bo Hyun , Kim Seung Hyup , Han Man Chung , Kim Chu-Wan 
Published: July 2009

Abstract
Seventy-three small hepatocellular carcinomas under 5 cm in diameter in 47 patients were examined by sonography, computed tomography (CT), hepatic angiography and CT after intra-arterial injection of iodized poppy-seed oil (Lipiodol-CT). The imaging techniques that first led to detection of small hepatocellular carcinomas were sonography in 53 cases (72.6%), CT in 10 (13.7%), angiography in eight (11%) and Lipiodol-CT in two (2.7%). Sensitivity for detecting small hepatocellular carcinomas was 73% with sonography, 82% with CT, 86% with angiography and 96% with Lipiodol-CT. As a screening method, sonographic and CT results in detecting small hepatocellular carcinomas were not significantly different (p&gt;0.05). Lipiodol-CT was superior to sonography (p&lt;0.01), CT (p&lt;0.01) and angiography (p&lt;0.05) in detecting small hepatocellular carcinomas. We believe that the combined use of Lipiodol-CT with screening methods such as sonography or CT is indispensable for the accurate detection of small hepatocellular carcinomas.
Enhanced risk from low-energy screen—film mammography X rays
Authors: Brenner D. J. , Amols H. I. 
Published: July 2009

Abstract
Modern screen–film mammography with molybdenum-anode X rays results in tissue doses being delivered primarily by photons with an energy of &lt;20 keV. Such photons interact with tissue predominantly through the photoelectric effect, producing low-energy electrons that have different patterns of energy deposition at the cellular level compared with those from higher-energy X rays. These differences result in low doses of typical molybdenum-based mammography X rays having an estimated radiobiological effectiveness of ∼1.3 compared with 80 kVp or 250 kVp X rays, and ∼2 compared with higher-energy γ rays. Thus the risk from mammography could be higher, by such factors, than previously estimated. This would result in the optimal age for beginning mammographic screening, derived from risk–benefit ratios, being increased by at least 1–2 years and possibly by as many as 10 years.
Radiation doses in extracorporeal shock wave lithotripsy
Authors: Huda W. , Bews J. , Saydak A. P. 
Published: July 2009

Abstract
Patients undergoing lithotripsy on the Siemens Lithostar system are exposed to radiation in three modes: film radiography, electronic radiography and fluoroscopy. Radiation exposure techniques (kVp, field size, number of exposures and projection) were recorded for the first 125 patients undergoing treatment on a recently installed Lithostar unit at a Winnipeg hospital. These data were then used in conjunction with phantom-based radiation dose measurements to calculate entrance skin dose and total energy imparted for each patient. Values of 142mGy and 53 mJ, respectively, were found. In the case of energy imparted, 20% of the total arose from film radiography, 30% from electronic radiography and the remaining 50% from fluoroscopy. The estimated effective dose-equivalent, H E, to the average patient undergoing lithotripsy was 0.75 mSv. This corresponds to an estimated radiation risk for the induction of fatal cancers and genetic defects (in the first two generations of offspring) of between 5 and 11 per million.
Computed tomographic staging of testicular tumours: an unexpected source of error
Authors: Tran T. , Grech P. , Crofton M. E. 
Published: July 2009

Computed tomography (CT) is widely used in the staging and follow-up of testicular tumours. Errors of interpretation may arise because of unopacified loops of bowel or aberrant vascular structures, but attention to technique, the use of an intravenous contrast agent and awareness of these potential pitfalls should prevent confusion with intra-abdominal tumour spread in these cases.
We describe a case in which a retroperitoneal haematoma following orchiectomy closely mimicked an iliac lymph node secondary deposit. Such an appearance may result in erroneous staging of testicular tumours and lead to inappropriate treatment.
Acute toxic myopathy: a delayed adverse effect of intravenous urography with iopamidol 370
Authors: Stinchcombe Simon J. , Davies Peter 
Published: July 2009

We report the case of a patient who developed severe muscle pains due to acute toxic myopathy following intravenous urography. This is a previously unreported adverse reaction to intravenous contrast media and occurred with iopamidol 370, a low-osmolar, non-ionic agent.
A 55-year-old man was referred for intravenous urography (IVU) during investigation for poorly controlled hypertension. His only medication was atenolol (50 mg mane) and slow-release nifedipine (20 mg bi-daily); there was no other past medical history of note.
The influence of tube type and operator experience on performance of small bowel enema
Authors: Bisset Rob 
Published: July 2009

I read with interest the paper of Nicholson et al (1989) regarding the influence of tube type and operator experience on the performance of small bowel enemas. However, I was surprised that the paper gave scant description of the intubation technique and made no mention of the different techniques used by different operators. Am I to assume that all the radiologists involved used the same technique? If this were so, a description of the technique would be helpful.
I perform small bowel enemas on adults and children and use the same technique for intubation (a modification of the technique for the passage of a Crosby capsule in children) regardless of the patient's age. A child will tolerate only one attempt at small bowel intubation and thus an exacting routine is necessary.
Ten-year results of a post-operative prospective trial: NSD and LQ correspondence
Authors: Ellis Frank 
Published: July 2009

In a recent issue of the Journal, Dr Bates (1988) reported on the 10-year results of a prospective trial involving 411 patients.
From these results, certain conclusions were drawn on the assumption that the doses used produced equal effects based on clinical observations.
Three radiotherapy techniques were used and 12 fractions in 28 days were compared with six fractions in 18 days.
Book reviews
Authors: Kendall Brian 
Published: July 2009

Magnetic resonance imaging (MRI) has become an important neurodiagnostic modality during the 4 years since the first edition of this textbook of cranial computed tomography (CT), and the authors have attempted to integrate magnetic resonance imaging (MRI) into their second edition.
A very good simplified account of the physics of MRI and the normal appearances of MRI images of the brain and orbit are added to the descriptions of CT in the first two chapters.
Sequential imaging of post-operative thrombus using the In-111-labelled platelet-specific monoclonal antibody P256
Authors: Stuttle A. W. J. , Klosok J. , Peters A. M. , Lavender J. P. 
Published: July 2009

Abstract
Eleven patients undergoing total hip replacement were studied by radioimmunoscintigraph for development of postoperative thrombus. Images were obtained using the 111In-labelled Fab′ fragment of a monoclonal antibody (P256) directed against human platelets. Six patients showed focal accumulation of radioactivity in the lower limbs. Three of these had coritrast venograms that were all positive for thrombus. Two of these six patients showed evidence of pulmonary localization of P256-Fab′ and this correlated with positive ventilation/perfusion scintigraphy in one of the patients. Sequential imaging with 111In-P256 not′ Fab only established a diagnosis of deep venous thrombus but also provided useful information regarding its natural history.
Modulation in the radiosensitivity of MCF-7 human breast carcinoma cells by 17B-estradiol and tamoxifen
Authors: Wazer David E. , Tercilla Oscar F. , Lin Peck-Sun , Schmidt-Ullrich Rupert 
Published: July 2009

Abstract
Colony-forming ability after exposure to ionizing irradiation was compared for proliferating hormone response MCF-7 breast carcinoma cells and cells whose growth was inhibited by tamoxifen or 17B-estradiol. As compared with controls (D o = 1.20Gy, n = 3.1), cells in 1 μM or 5 μM tamoxifen were less radiosensitive (D o = 1.20Gy, n = 7.0; D o = 1.22Gy, n = 7.0, respectively) with the predominant effect being a widened shoulder on the survival curve. This protective effect could be abolished by co-incubation of 5 μM tamoxifen with 100 nM or 5 μM 17B-estradiol (D o = 1.30Gy, n = 2.6; D o = 1.20Gy, n = 2.6, respectively). The decrease in radiosensitivity induced by tamoxifen was similar to that seen when replating of irradiated plateau-phase cultures was delayed for 24 h (D o = 1.30Gy, n = 6.0). In contrast, when proliferation of MCF-7 cultures was inhibited by 10 μM 17Bestradiol, radiosensitivity was increased with a markedly diminished survival curve shoulder (D o = 1.40Gy, n = 1.0). Different hormonal manipulations of cycling human breast carcinoma cells may have profound but disparate efects on radiosensitivity such that tamoxifen and estrogens may serve as useful agents with which to study the biochemical mechanisms of repair.
Burkitt's lymphoma following treatment for Hodgkin's disease
Authors: Robinson A. C. R. , Khoury G. G. , Carney D. 
Published: July 2009

Treatment advances in Hodgkin's disease have resulted in many patients achieving long-term survival, and the late complication of second malignancies is being increasingly recognized. The occurrence of Burkitt's lymphoma following chemotherapy or combined-modality treatment for Hodgkin's disease has previously been documented. Its development has not, to the best of our knowledge, been described following irradiation alone. We report a male patient with Hodgkin's disease treated by mantle irradiation who subsequently died from Burkitt's lymphoma. Theories of pathogenesis are presented.
A 21-year-old Caucasian male presented with pathological Stage IIA (Ann Arbor) lymphocyte-predominant Hodgkin's disease. He was treated with mantle irradiation, a mid-plane dose of 3500 cGy in 16 fractions in 20 days being delivered to the mediastinum. Complete remission occurred and the patient remained well until 6 years later when he developed intestinal obstruction. Laparotomy revealed extensive malignancy involving the small bowel, mesentery and retroperitoneum, histology being Burkitt's lymphoma (Fig. 1). Bone marrow aspirate showed replacement with immature cells of Burkitt type and cytological findings on examination of cerebrospinal fluid showed malignant cells. The patient was commenced on systemic chemotherapy and intrathecal methotrexate, but died 2 days later of progressive disease. Autopsy confirmed the presence of Burkitt's lymphoma. There was no evidence of Hodgkin's disease.
Book reviews
Authors: Cochrane T. 
Published: July 2009

This book is based on the proceedings of a conference on blood flow in artificial organs and cardiovascular prostheses. As such, it suffers from the problem often associated with this type of publication: the subject matter of individual chapters appears disjointed, author styles are disparate and there is inevitably some repetition. Some considerable time has elapsed since the conference took place, with the result that most of the contents of the book are readily available from other sources.
The title itself is not a fair reflection of the contents of the book. Indeed only a few of the chapters specifically mention blood flow. Thirty-one chapters are crammed into 260 pages. The chapters are of two types: those which review a particular topic and those which report research work. The first chapter is intended to be a “scene-setter” and gives a review of the haemodynamic factors of importance in improving design of vascular prostheses.