bluuebunny/crossref_metadata_2025_split huggingface dataset:
Testing a policy for skull radiography (and admission) following mild head injury
Authors: de Lacey Gerald , McCabe Michael , Constant Olivia , Welch Theo , Spinks Christopher , McNally Eugene 
Published: July 2009

Abstract
There has been, and continues to be, conflicting advice regarding skull radiography following an apparently uncomplicated head injury. Policies on admission are often ill defined. In 1983, representatives of the Royal College of Radiologists met neurosurgeons at a seminar in Harrogate organized by the DHSS and laid down clear, but little publicized, joint recommendations: “The Harrogate Criteria”. The survey described here evaluated an existing liberal policy for skull radiography (and a loose policy for admissions) against these recommendations, and it was concluded that the number of patients having skull radiography (74% of head injury attenders) was excessive. Measured against the “Harrogate Criteria”, requests for 36% of the adult and 47% of children's skull radiographs did not fulfil these criteria. As a corollary, it was also concluded that loose admissions policies could usefully be altered to comply more closely with the Harrogate recommendations. This would not necessarily reduce the numbers admitted, but would provide casualty officers with a framework on which to base this crucial aspect of clinical decision making, where presently there is often very little structure at all. The authors suggest that all the options have not been fully explored, and that a simple but important alteration to the Harrogate guidelines would provide an even closer link between policy on skull radiography and patient admission. Specifically, most patients who are to be admitted do not need skull radiographs.
Nasopharyngeal carcinoma: the significance of neck node involvement in relation to the pattern of distant failure
Authors: Sham Jonathan S. T. , Choy D. , Choi P. H. K. 
Published: July 2009

AbstractThe pattern of distant failure of 759 Stage I–IV cases of nasopharyngeal carcinoma was studied. The most common sites of distant metastasis were, in descending order, bone, lung and liver. The N stage, T stage and the characteristics (size and degree of fixation) of the neck nodes involved were found to be significant prognostic factors determining the development of distant metastasis. The bilaterality of neck node involvement, sex, age, haemoglobin and white blood count at diagnosis were not significant. The discriminating effect of N stage holds true in patient groups stratified for the node size and degree of fixation. The superiority of the Ho stage classification was confirmed. The high incidence of distant failure in patients with T3, N3, or bulky or fixed neck node involvement warrants further clinical trials to explore the role of adjuvant chemotherapy.
Book reviews
Authors: Roberts G. M. 
Published: July 2009

This paperback has seven contributors, six from the George Washington University Medical Centre in Washington DC. Professor W. L. Olmsted states in his foreword that the book is written for medical students, first-year residents or general medical practitioners “who desire to get a thorough and basic introduction to the specialty of radiology”.
The initial chapters discuss the physical processes involved in producing images, radiographic positioning and some aspects of the cost of imaging techniques (with a distinct North American bias). These are followed by a sequence of chapters describing the imaging of body systems. Finally, there is a chapter devoted to the future of imaging in which MRI is mentioned briefly.
Book reviews
Authors: Rezvani Mohi 
Published: July 2009

This book is intended primarily for medical science readers such as medical physicists and doctors studying for their FRCR or MCRP. However, it will also prove valuable for a wider group of readers such as biologists, health administrators and, as stated in the preface, any amateur “would-be statistician”.
The book explains most of the essential points of medical statistics. Although the earlier chapters are very concise they are easy to follow and a sufficient number of references are listed for every topic explained.
Vasopressin release in response to intravenously injected contrast media
Authors: Trewhella Matthew , Dawson Peter , Forsling Mary , McCarthy Peter , O'Donnell Christopher 
Published: July 2009

Abstract
We have previously reported that intravenously administered contrast media produce a rise in plasma vasopressin (antidiuretic hormone) concentrations. We have now shown that this occurs both when contrast medium is injected into a peripheral vein and when it is centrally injected into the right atrium. The peak vasopressin concentration recorded varies with the osmolality of the contrast medium. The vasopressin response was greater when contrast agent was centrally injected.
Final Report of the general clinical results of the British Institute of Radiology fractionation study of 3F/wk versus 5F/wk in radiotherapy of carcinoma of the laryngo-pharynx
Authors: Wiernik G. , Bates T. D. , Bleehen N. M. , Brindle J. M. , Bullimore J. , Fowler J. F. , Haybittle J. L. , Howard N. , Laing A. H. , Lindup R. , McGurk F. , Phillips D. L. , Rezvani M. 
Published: July 2009

AbstractThe 10 year follow-up of a clinical trial involving the comparison of 3F/wk versus 5F/wk in radiotherapy of squamous cell carcinoma of the larynx and hypopharynx has now been completed. The trial involved an intake of 734 patients between 1966 and 1975. The classification of all patients has been revised to conform with the latest TNM publication. A reduction in total dose was made for 3F/wk compared with 5F/wk. This varied between 13% and 11% in centres treating over 3 weeks and 6 weeks, respectively. No statistically significant differences have been found between the two arms (3F/wk versus 5F/wk) of the trial in any of the main group analyses. A number of sub-group analyses relating to survival, tumour-free and laryngectomy-free rates and to the comparison of acute or late normal-tissue radiation damage have also been performed. No differences have been found that could be considered to be statistically significant in relation to the particular sub-group. Previous interim reports suggested minor differences in sub-group analyses between the 3F/wk and 5F/wk regimes in this trial; these have diminished now that the full follow-up data are available. This trial has provided evidence on which clinicians may base their choice between either a 3F/wk fractionation regime or a conventional 5F/wk treatment protocol in the treatment of carcinoma of the laryngo-pharynx.
“Diaphragm-like” structures of the small bowel in patients treated with non-steroidal anti-inflammatory drugs
Authors: Levi S. , de Lacey G. , Price A. B. , Gumpel M. J. , Levi A. J. , Bjarnason I. 
Published: July 2009

Abstract
The radiological findings are described in four patients who developed strictures of the small bowel, and who had received non-steroidal, anti-inflammatory drugs (NSAIDs) for 1.5–15 years. Clinical presentation was that of subacute small bowel obstruction. Small bowel barium studies showed multiple discrete strictures. Some strictures were indistinguishable from those of regional enteritis. Others however were narrow “diaphragm-like” septae encroaching on and markedly narrowing the ileal lumen, and shown histologically to be due to submucosal fibrosis. It is suggested that these strictures are likely to be consequent on NSAIDs administration and that radiologists and surgeons need to be aware of these “diaphragms” which can be very difficult to detect on barium examination, either small bowel follow-through or enteroclysis, and at laparotomy.
Salivary gland scintigraphy—a suitable substitute for sialography?
Authors: Pilbrow W. J. , Brownless S. M. , Cawood J. I. , Dynes A. , Hughes J. D. , Stockdale H. R. 
Published: July 2009

Abstract
By comparing 27 patients who had both scintigraphy and sialography in the assessment of salivary gland disease, scintigraphy has been shown to correlate well with abnormal sialograms. It is suggested that scintigraphy could become the initial screening procedure in the assessment of salivary gland disease. A normal scintiscan is unlikely to miss significant pathology (as demonstrated by sialography), but sialography must always be performed if there is a suspicion of duct obstruction on scintigraphy. Patients suspected of focal salivary gland pathology such as tumour have not been investigated. The series documents the findings in patients who presented with facial pain, swelling or xerostomia suggesting sialadenitis, duct occlusion or Sjögren's syndrome.
The role of the STIR sequence in magnetic resonance imaging examination of bone tumours
Authors: Golfieri Rita , Baddeley Hiram , Pringle Jean S. , Souhami Robert 
Published: July 2009

Abstract
Sixty patients with primary bone tumours were evaluated with magnetic resonance imaging (MRI) at 0.5 T with both conventional spin–echo (SE) and short inversion time inversion recovery (STIR) sequences. The results have been reviewed in order to evaluate the accuracy of STIR and conventional SE sequences in the detection of tumours, the definition of intramedullary extent and soft-tissue involvement. The intraosseous neoplastic extent has been compared with macroslides of surgical specimens in 24 cases. The role of the STIR sequence in detection of recurrences in the post-surgical follow-up was also evaluated. The STIR sequence, designed to suppress signal from fat, also enhances the signal from tissue with long T 1 and T 2 relaxation times, such as neoplastic and inflammatory tissue. The STIR sequence with T 1 of 120–130 ms in all cases suppressed the high signal from fatty bone marrow, giving a clear depiction of tumour extent, in both its intramedullary and soft-tissue components, and is superior to conventional SE images. The high sensitivity (100% of our cases) of this technique is counterbalanced by its lack of specificity: on STIR sequences both tumour and peritumorous oedema give an increase of signal intensity, limiting assessment of tumour extent. Peritumoral oedema, only present in our series in malignant neoplasms, may however be differentiated on the basis of the configuration of the abnormal areas, and by comparing STIR images with short repetition time/echo time sequence results.
Congenital indifference to pain mistaken for non-accidental injury
Authors: Spencer J. A. , Grieve D. K. 
Published: July 2009

Congenital indifference to pain is a rare autosomal recessive inherited condition with cutaneous and skeletal lesions that mimic non-accidental injury(NAI). We present this case to illustrate the difficulty in differentiatingthe two conditions in early childhood and to demonstrate discriminatory features in the older child.
The affected boy, born in the UK to Pakistani parents, first came to medical attention aged 6 months. (He had escaped the obstetric profession having been delivered by his father in the family car in the hospital car park!) When admitted to investigate recurrent chest infections, he was noted to have burns on his left hand. His parents explained that he had touched anelectric heater while crawling. He was underweight, but his parents claimedthat he was a poor feeder. Over a 6 month period there were several furtheradmissions with chest infections, mainly affecting the right upper lobe. Nounderlying cause was found. The pneumonias resolved and were retrospectively attributed to episodes of aspiration. A further unexplained feature was recurrent oral and labial ulceration including one deep lesion on the tongue.
At 18 months of age he was taken to the Accident Department by his parents who had noticed a boggy mass over his occiput. An occipital fracture was present (Fig. 1). No explana-tion was offered by his parents. Further suspicion of nonaccidental injury (NAI) was raised by burns on the fingers of the right hand, deep cuts to both index fingers and a number of bruises about the trunk and limbs (Fig. 2). One revealing note by the admitting physician was his father's comment that the child was always running into things but never cried. This admission was following by a case conference under the Child Abuse Procedures at which close supervision by his GP and community services were urged.
Alterations in body and skin temperatures caused by MRI
Authors: Shellock Frank G. , Schaefer Daniel J. , Crues John V. 
Published: July 2009

Thank you for allowing us to respond to the letter from J. A. Dennis and R. D. Saunders concerning our recent article (Shellock et al, 1989).
We would like to indicate that the United States Food and rug Administration (FDA) has relaxed the guidelines for exposure to radiofrequency (RF) electromagnetic fields during clinical magnetic resonance imaging (MRI) based, in part, on our recent publications as well as those from other investigators.
The role of dacryocystography in the management of patients with epiphora
Authors: Nixon J. , Birchall I. W. J. , Virjee J. 
Published: July 2009

Abstract
A retrospective study has been carried out on 114 patients who have undergone dacryocystography (DCG) for epiphora, to assess the role of DCG in their management. It was found that 16/66 (24%) patients who were offered surgery after DCG refused it or were assessed as unfit for surgery, demonstrating the need for careful counselling and assessment of patients prior to investigation. The presence of lacrimal system obstruction on DCG was an important factor in determining whether a patient underwent lacrimal surgery. However, the actual level of the obstruction influenced neither the likelihood of a patient undergoing lacrimal surgery nor the form of lacrimal surgery undertaken. This suggests that, unless the surgical approach will be modified in the light of the anatomical information furnished by DCG, DCG is not necessary. Lacrimal scintigraphy would provide sufficient information for the practical management of epiphora. Syringing of the lacrimal system correlates poorly with DCG in detecting obstruction.
Comparison of 99Tcm dimercaptosuccinic acid scans and intravenous urography in children
Authors: Whitear Patrick , Shaw Penny , Gordon Isky 
Published: July 2009

Abstract
A retrospective comparison of 99Tcm dimercaptosuccinic acid (DMSA) scans and intravenous urograms (IVUs) was performed on a large, unselected paediatric population to assess critically the relative merits of these two techniques. A total of 205 children were studied, providing 388 kidneys for comparison. The studies agreed in 81%, both being normal in 39%, and both abnormal in 42%. In 28 kidneys (7%), the IVU was abnormal when the 99Tcm DMSA was normal. There was a collecting system abnormality in 27 kidneys, but 10 kidneys also showed a parenchymal abnormality. In all these the parenchymal abnormality was global thinning on the IVU, and the contralateral kidney was small. In 40 kidneys (10%) the 99Tcm DMSA was abnormal when the IVU was normal: the abnormalities demonstrated were predominantly focal defects. After excluding IVUs of poor diagnostic quality, only 14 kidneys (3.6%) showed this disparity. The important clinical subgroups are infection, with or without reflux (27 kidneys), hypertension (4) and neonates with poor renal function (2). The one false positive 99Tcm DMSA was a result of an anatomical variant. Global thinning in a “normal” kidney on a 99Tcm DMSA scan may be overlooked when the contralateral kidney is poorly functioning and small.
A comparison of two methods of in vivo dosimetry for a high energy neutron beam
Authors: Blake S. W. , Bonnett D. E. , Finch J. 
Published: July 2009

Abstract
Two methods of in vivo dosimetry have been compared in a high energy neutron beam. These were activation dosimetry and thermoluminescence dosimetry (TLD). Their suitability was determined by comparison with estimates of total dose, obtained using a tissue equivalent ionization chamber. Measurements were made on the central axis and a profile of a 10 × 10 cm square field and also behind a shielding block in order to simulate conditions of clinical use. The TLD system was found to provide the best estimate of total dose.
A dedicated microcomputer for a superficial radiotherapy unit
Authors: Cassell K. J. , Gamble J. M. , Gerard-Martin S. 
Published: July 2009

A computer system has been developed for the purpose of calculating patient treatment times and output calibration measurements and monitoring set-up conditions on a Philips RT100 superficial radiotherapy unit. With minor modifications it could be used with other superficial therapy units.
The system has been developed around a Gemini Galaxy microcomputer wh
ich has a Z80 processor and 64K of RAM. The software is written in BCPL, a highlevel structured language which runs under the CP/M operating system but is also available on the latest 32 bit IBM-compatible microcomputers running under the MS-DOS operating system. All programs are menudriven with facilities for returning to the start of the previous section by means of the “ESC” key. All data validated at the time of entry according to the data type and expected length or magnitude.
A pROM-based system is used on the RT100 machine for calibration checks, treatment time calculations and set-up checks. This system has a safety feature in that contains two sets of identical data stored in two separate pROMs which are checked against each other before entry to the program is allowed. An additional safety feature is that the pROM data cannot be modified on this system by the system operator.
The full system which includes the editor and hard-copy sections, runs on a microcomputer with Winchester or floppy disk and can be used in place of the pROM-based system if required.
Retroperitoneal haematoma following orchidectomy: implications for staging computed tomography
Authors: Page J. E. , Prendergast C. M. , King D. M. 
Published: July 2009

Retroperitoneal haematoma, a rare complication of transinguinal orchidectomy, may be clinically silent. The discovery of a mass on staging-computed tomography (CT) is often the first and only sign of its presence. This may be misinterpreted as representing involved lymph nodes. Recognition of this benign complication is vital if the patient is to be correctly staged.
Correct management of testicular tumours depends on precise determination of the extent of dissemination, and to that end, most patients who are found to have a malignant testicular mass are staged by CT. These tumours have a predilection for metastasis to lungs and lymph nodes, hence most patients receive a CT examination of the thorax as well as the abdomen and pelvis. Abnormal masses discovered in the pelvic or para-aortic lymph node chain are usually the result of lymph node enlargement.
We present three cases where a retroperitoneal haematoma, consequent upon orchidectomy, mimicked lymph node enlargement. The literature contains only single previous report (Kullmann & Lien, 1987).
A 33-year-old man with a past medical history of bilateral orchidopexy at the age of 12 years, presented with a 4 month history of painful swelling of the left testis. Clinical examination indicated the presence of a testicular neoplasm and orchidectomy was performed through the previous incision. Histological examination of the resected specimen confirmed seminoma. Several days after surgery he was noted to be clinically anaemic and his haemoglobin had fallen from 14.2 g/dl pre-operatively to 7.2 g/dl. Accordingly he was transfused and further haemoglobin estimations showed no further diminution.
Book reviews
Authors: Taylor P. M. 
Published: July 2009

When computed tomography (CT) imaging first became widely available a decade ago radiologists were stimulated to relearn their anatomy and many of us now see the body as a series of cross-sections. Several authors, realizing a demand, produced books correlating CT images with pathological sections, line drawings or both. Consequently many departments will have such a book for teaching, learning or reference. This new book is therefore the latest in a long line of cross-sectional anatomy books and is aimed, according to the author, at medical students. To be successful it must be as good if not better than the others and preferably contain some innovative material. How then does it compare?
The book contains a series of CT sections with correlative cross-sectional post-mortem photographs from the vertex to the symphysis pubis. Each pair is labelled and there is a short accompanying description.
Book reviews
Authors: Dendy P. P. 
Published: July 2009

Assessment of any release of radioactivity to the environment is important for the protection of public health, especially if the released radioactivity can enter the food chain. This technical report has therefore been published as a guide to the measurement of radionuclides in food and environmental samples, both for training courses and to help in the establishment of central and local environmental laboratories.
The book is divided into two parts. In the first part general issues are covered: pathways and samples of interest; radionuclides of interest; requirements for laboratories, equipment and personnel; collection and preparation of samples: analytical methods and analytical quality control.
Book reviews
Authors: Notley H. M. 
Published: July 2009

Ref 85–5 (F)
This tape/slide presentation is another in the series prepared by St Bartholomew's Hospital dealing with radiation safety in the medical environment. It is the first of two programmes for domestic staff (the second one being concerned with radiation safety in laboratories).
The programme covers all areas where radiation may be used in hospitals, from the diagnostic X-ray department through the radiotherapy department to the use of radioactive sealed sources on wards. No real mention is made of problems in operating theatres, although they are referred to in the text. is primarily intended for use in a radiotherapy centre.
The effect of ultrasound on the cytoxicity of adriamycin
Authors: Loverock Pam , ter Haar Gail , Ormerod M. G. , Imrie P. R. 
Published: July 2009

Abstract
The effect of continuous wave ultrasound exposures on the cytoxicity of adriamycin has been studied. It has been found that 2.6 MHz, 2.3 Wcm−2 (spatial average) ultrasound can enhance the cell killing potential of adriamycin both in suspensions of single V79 Chinese hamster fibroblast cells and in spheroids formed from these cells. The ratio of the slopes of the survival curves for single cell suspensions is 1.5. For spheroids, the growth delay is increased by 1.3 days by simultaneous ultrasound exposure. Flow cytometric studies of the intracellular concentration of adriamycin following ultrasound exposure reveals that this is increased when compared with that measured when the cells are only exposed to adriamycin. Evidence is presented to suggest that this is a non-thermal effect of ultrasound.
Pathological fracture of the femoral shaft in a case of Servelle–Martorell syndrome (phleboeclatic osteohypoplastic angiodysplasia with associated arterio-venous malformation)
Authors: Gibbon W. W. , Pooley J. 
Published: July 2009

A case is presented of a pathological femoral shaft fracture in a 47-year-old woman with a rare form of skeletal angiodysplasia (Servelle–Martorell syndrome). A simple classification of bony changes in congenital skeletal angiodysplasia is included with a literature review.
A 47-year-old woman presented to the Accident and Emergency Department having tripped and fallen in the street whilst shopping. The patient had walked with a limp since childhood because of a “short” left leg. A mole had been removed from her left thigh at the age of 9 years. Examination of the left lower limb demonstrated a clinical fracture of the left femoral shaft, 1.5 cm shortening of the left tibia and extensive varicosities with palpable fluid thrill.