bluuebunny/crossref_metadata_2025_split huggingface dataset:
Peripheral neuropathy simulating lymphoma
Authors: Swingler R. J. , Cull R. E. , Kean D. , Turnbull L. 
Published: July 2009

Nerve hypertrophy occurs in some types of Charcot-Marie-Tooth syndrome (hereditary motor and sensory neuropathy (HMSN) type I), Dejerine-Sottas disease (HMSN type III), Refsum's disease (HMSN type IV), neurofibromatosis, amyloidosis, sarcoidosis, leprosy, diabetes mellitus, chronic relapsing neuropathies, acromegaly, hypothyroidism, isolated peripheral nerve lesions and, very rarely, multiple sclerosis (Dyck, 1984; Walton, 1985). We report a case of HMSN type I with marked intercostal, splanchnic and peripheral nerve hypertrophy producing radiological appearances of pleural lesions and mediastinal widening, which, together with systemic symptoms, simulated lymphoma.
An 18-year-old man (A.P., RIE 110264–1100) had ingrowing toe nails removed in 1982 and subsequently noticed numbness of the big toes, extending onto the dorsum of both feet, and a tendency to lift the feet high when walking.
On general examination he had mild pectus excavatum, bilateral pes cavus and paronychiae affecting both great toes. The peripheral nerves in the upper limbs and intercostal nerves over the chest wall were thickened with diameters of up to 2–3 cm. On neurological examination, tone was reduced in the hands and feet and there was distal wasting and weakness in all limbs with reduced sensation for all modalities in a stocking distribution to mid calf. Tendon reflexes were preserved in the upper limbs and knees but ankle reflexes and plantar responses were absent. Examination of the family revealed no neurological deficits.
On investigation the level of protein in the cerebrospinal fluid was elevated at 2.72 g/1 but other indices were normal. Neurophysiological studies were performed using an MS91 Medelec system and, although normal responses were recorded from the upper limbs, no compound muscle action potential could be recorded from the left common peroneal nerve when the recording electrode was placed on the extensor digitorum brevis; a velocity of 31 m/s (normal &gt; 44 m/s) was observed in tibialis anterior. Sensory nerve action potentials could not be detected in the sural nerves bilaterally.
The spine deformity index in osteoporosis is not related to bone mineral and ultrasound measurements
Authors: Bernecker Peter , Pietschmann Peter , Winkelbauer Friedrich , Krexner Elisabeth , Resch Heinrich , Willvonseder Robert 
Published: July 2009

AbstractIn 34 female patients suffering from osteroporotic vertebral compression fractures, the spine deformity index (SDIM) was determined, according to the method of Minne et al (1988), to reflect the radiological severity of established osteoporosis. Peripheral (single-photon absorptiometry (SPA) of the non-dominant distal forearm) and axial (quantitative computed tomography (QCT) of the lumbar spine) bone mineral measurements, as well as the broadband ultrasound attenuation of the os calcis, were performed in the osteoporotic patients and in a control group of 20 age-matched women. No correlation could be found between bone mineral measurements and radiological severity of osteoporosis, expressed as SDIM. All three densitometry methods showed clearly reduced values in patients with vertebral crush fractures. Correlations established in the control group between peripheral and axial bone mass (SPA versus QCT) could no longer be found in the osteoporotic group, thus indicating changes in bone mineral density of the spine after the occurrence of osteoporotic fractures. Our data show that SDIM is an additional parameter of osteoporotic change in the spine, independent from bone mass measurements. In the management of osteoporotic patients, quantitative radiological methods (i.e. SDIM) in addition to densitometry might be of value for grading and monitoring the progress of disease.
The incidence and severity of hypoxia associated with 99Tcm Technegas ventilation scintigraphy and 99Tcm MAA perfusion scintigraphy
Authors: James J. M. , Lloyd J. J. , Leahy B. C. , Shields R. A. , Prescott M. C. , Testa H. J. 
Published: July 2009

Abstract
Inhalation of the ventilatory radiopharmaceutical 99Tcm Technegas leads, in some patients, to symptoms that may be attributed to temporary lowering of oxygen saturation. In order to evaluate this, oxygen saturation was measured by pulse oximetry in a series of patients undergoing Technegas ventilation scintigraphy. A decrease in oxygen saturation was recorded in 87% of the patient group. The mean change, as a percentage of the initial value, was 8.3% (range 1–24%). Hypoxia arising in association with Technegas administration may be reduced by pre-oxygenation. In patients who were pre-oxygenated, oxygen saturation did not fall below 85% (PaO2: 50 mmHg) but in 39% of those not pre-oxygenated the value fell below this level. Oxygen saturation was also monitored in a series of patients undergoing perfusion scintigraphy. In 17% of patients a decrease was recorded (range 2–11%). In view of the large number of perfusion scans performed annually in this department and elsewhere without untoward effect, such temporary decreases in oxygen saturation presumably present no hazard to the patient.
The Reference Man in diagnostic radiology dosimetry
Authors: Lindskoug Bengt A. 
Published: July 2009

Abstract
Following the legislation for radiation protection in Europe, increasing interest has been given to patient dosimetry indiagnostic radiology. Dose comparisons between groups of patients have demonstrated considerable discrepancies. Theequipment, as well as the procedures used, have been scrutinized in order to find the reasons for the variation and to reduce it. Inthis work, patient size and shape are considered in patient dose evaluations in diagnostic radiology. The size, shape and constitution of the patients are shown to relate exponentially to the energy imparted during examination of the trunk. Theequivalent cylindrical diameter of the patient body is used as the independent variable. Exponential functions are created by linearregression. The ICRP Reference Man with an equivalent diameter of 22.9 cm is used as a body-size standard. A method issuggested by which coordinate transformations reduce data to a base line defined by the Reference Man. It is shown that themethod reduces the range of energy imparted by between 30% and 60% for six common X-ray examinations of the trunk. Resulting data constitute a finer instrument for intercomparisons between hospitals for the same examination. Further, it issuggested that adipose tissues should not be included when detrimental effects of radiologic exposure are determined. TheReference Man, stripped of 10 kg subcutaneous adipose tissue, is used as the non-fat standard dimension corresponding to theequivalent cylindrical diameter 21.2 cm. The suggested method is used to estimate the fraction of energy imparted to vital organsonly. The results show that the energy imparted is reduced by between 30% and 60% according to this model. Consequently,predicted deaths are reduced by the same amount.
Diagnosis and treatment of an oesophageal stricture due to lichen planus
Authors: Holder P. D. , Wong W. L. , Pemberton J. , Thompson R. P. H. , Parker S. C. 
Published: July 2009

Involvement of the oral mucous membranes occurs commonly in lichen planus. Oesophageal involvement is less common and may result in pain, dysphagia and strictures. We present a case of an oesophageal stricture in a patient with lichen planus.
A 44-year-old woman with a 24 year history of oral lichen planus and a 9 year history of anogenital involvement gave a 2 year history of dysphagia. An endoscopy performed when she first noticed dysphagia showed oropharyngeal ulceration and the pharynx was narrowed with a friable mucosa. A further endoscopy in December 1990 showed an ulcerated nasopharynx but no abnormality in the oesophagus.
Increasing patient throughput in magnetic resonance imaging: a practical approach
Authors: Moore N. R. , Golding S. J. 
Published: July 2009

Abstract
A major factor governing the throughput of patients in a magnetic resonance imaging (MRI) service is the number length of sequences employed. This study investigated the feasibility of prospectively selecting patients for whom a pre-planned examination of the brain, spine or knee could be applied with a high chance of success. The implications on throughput of using these pre-planned examinations were determined. 173 patients were studied. A successful outcome was defined as an examination in which a diagnosis could be made with 100% confidence and without the need for further sequences. Examinations of the brain (n = 113), knee (n = 23) and lumbar spine (for disc degeneration, n = 14) were performed with success rates of 96%, 87% 64%, respectively. Examinations of the lumbar spine (for radicular symptoms, n = 20) and cervical spine (n = 3) were performed with success rates of 85% and 66%, respectively. The examinations of the brain, knee and lumbar spine (for disc degeneration) were completed within the target time of 20 min in 92%, 95% and 69% of cases, respectively. Examinations of the lumbar spine (for radicular symptoms) and cervical spine were completed within 30 min in 75% and 33% of cases, respectively. Analysis of our results suggests that success rates could be improved by minor changes in sequence design. Carefully selected patients can be successfully examined in short examination times. Instituting these practices would increase the efficiency of MR machine time and improve patient throughput by 80–125%. This would have a marked effect on the length of waiting lists, and would increase the general availability of MRI.
Radiological features during and following treatment of spinal tuberculosis
Authors: Boxer D. I. , Pratt C. , Hine A. L. , McNicol M. 
Published: July 2009

Abstract
A retrospective study was performed in order to document the sequence and time scale of radiological changes occurring during the healing of spinal tuberculosis. 28 episodes occurred in 26 patients, of whom only two were Caucasian. All demonstrated good response to conventional chemotherapy. Soft-tissue masses increased in size for up to 1.5 months and took about 12 months to resolve. Bone destruction was seen in all cases and progressed in 70% of patients, whilst on treatment. There was loss of vertebral body height in 79%, which progressed for up to 14 months; any recovery of height was a very late feature. Sclerosis was seen at presentation in 52% and developed in most of the remaining patients within 5 months of instigating treatment. It progressed for up to 14 months and took, on average, 31 months to return to normal. Reduction in disc height was commonly seen and the vertebrae fused in three-quarters of those affected, the time of onset of fusion being very variable. To manage patients with spinal tuberculosis, an appreciation of the variability of radiological changes that can occur during treatment is necessary.
Use of ultrasound in osteomyelitis
Authors: Nath Ashok Kumar , Sethu Arunchala U. 
Published: July 2009

Abstract
The use of ultrasound in osteomyelitis has been studied in 25 patients clinically suspected of osteomyelitis. A sonographic diagnosis of osteomyelitis was made if fluid was present in direct contact with the bone, without intervening soft tissues. This was thought to represent an inflammatory exudate dissecting in a subperiosteal and/or extraperiosteal location. Ultrasonographically 15 patients were found to have osteomyelitis, proved either by surgical drainage or needle aspiration. Seven patients had soft-tissue abscesses, one had cellulitis and two patients had no abnormality.
Intracardiac metastases from germ cell tumours—an unusual but important site of metastasis
Authors: Pickuth Dirk , Eeles Rosalind , Mason Malcolm , Pumphrey Charles , Goldstraw Peter , Horwich Alan 
Published: July 2009

Abstract
Two cases of intracardiac deposits from testicular teratomas diagnosed by echocardiography and angiocardiography, respectively, are described. The importance of recognizing this as an uncommon site of metastasis from germ cell tumours is discussed.
Low oxygen extraction fraction in tumours measured with the oxygen-15 steady state technique: effect of tissue heterogeneity
Authors: Lammertsma Adriaan A. , Jones Terry 
Published: July 2009

Abstract
Several reports have described decreased oxygen extraction fractions in tumours relative to those in normal tissues as measured with the oxygen-15 steady state technique and positron emission tomography. The present simulation study was carried out to assess the influence of tissue heterogeneity on these measured values. It was found that, within the range analyzed, tissue heterogeneity always resulted in underestimations of mean values of oxygen extraction fraction. It must, therefore, be concluded that the oxygen-15 steady state technique is not an accurate method for the assessment of the oxygen status of tumours. This finding should also apply to other pathological conditions, where a significant degree of tissue heterogeneity can not be excluded. More generally, this study demonstrates the need for detailed analyses of sensitivities of tracer kinetic procedures to tissue heterogeneity.
Asymptomatic temporal lobe injury after radiotherapy for nasopharyngeal carcinoma: incidence and determinants
Authors: Leung S. F. , Kreel Louis , Tsao S. Y. 
Published: July 2009

Abstract
Computed tomography (CT) scans were performed on a cohort of 60 patients for detection of temporal lobe injury (TLI) at 1–3.5 years after radiation therapy for nasopharyngeal carcinoma. Nine cases of TLI were identified, five of which were asymptomatic. The earliest case of asymptomatic TLI was found at 2.2 years after radiation therapy and the earliest symptomatic case at 2.3 years. A significantly higher incidence of TLI was found in patients with decreased temporal lobe shielding consequent to omitted eyeshield to the anterior photon beam and in patients treated with a hyperfractionation schedule giving 67.2 Gy in 42 fractions in 6 weeks. The incidence in these subgroups at 2–3.5 years after radiation therapy was 56% (5/9 patients) and 35% (8/23 patients), respectively. No patient in this study had TLI in the absence of these two factors. The implications of the results are discussed.
Treatment planning for 131I-mIBG radiotherapy of neural crest tumours using 124I-mIBG positron emission tomography
Authors: Ott R. J. , Tait D. , Flower M. A. , Babich J. W. , Lambrecht R. M. 
Published: July 2009

Abstract
Patients designated to receive 131I-meta-iodobenzylguanadine (mIBG) for the treatment of neural crest tumours have been scanned with 124I-mIBG using the MUP-PET positron camera. Uptake was detected in tumour sites in lung, liver and abdomen. The tomographic images produced have allowed estimates to be made of the concentration of mlBG in both tumour and normal tissue. From these data it is possible to predict the radiation doses that would be achieved using therapy levels (up to 11 GBq) of 131I-mIBG. The levels of tumour uptake are between 0.5 and 2.0 kBq/g indicating that the radiation doses to tumour would be in the range 3 Gy to 7.5 Gy.
Errors due to non-uniform distribution of fat in dual X-ray absorptiometry of the lumbar spine
Authors: Tothill Peter , Pye David W. 
Published: July 2009

Abstract
Errors in spinal dual X-ray absorptiometry (DXA) were studied by analysing X-ray CT scans taken for diagnostic purposes on 20 patients representing a wide range of fat content. The mean difference between the fat thickness over the vertebral bodies and that over a background area in antero-posterior (AP) scanning was 6.7 ± 8.1 mm for men and 13.4 ± 4.7 mm for women. For lateral scanning the mean fat thickness difference was only 4 mm for both sexes, but the dispersion was greater, with a standard deviation of 15 mm. To relate these differences to errors in bone mineral, measurements were made of the bone mineral equivalence of fat-equivalent materials on DXA machines from three manufacturers. 10 mm of adipose tissue was equivalent to –0.043 g/cm2 of hydroxyapatite. For AP scanning a non-uniform fat distribution leads to a mean overestimate of 0.029 g/cm2 for men and 0.057 g/cm2 for women. The error exceeded 0.1 g/cm2 in 10% of slices. For lateral scanning the error exceeded 0.1 g/cm2 (about 15% of normal) in a quarter of slices.
Pelvic phleboliths: is there an association with diverticulitis?
Authors: de Vries E. H. , Ginai A. Z. , Robben S. G. F. , Hop W. C. J. 
Published: July 2009

Abstract
Pelvic phleboliths are familiar structures to radiologists although their pathogenesis is not fully understood. The literature suggests a relationship between the prevalence of phleboliths and diverticular disease, and with a low-fibre diet. Phleboliths are said to be seen more frequently in women and on the left side in the pelvis. Their number seems to increase with advancing age. We have attempted to establish relations of phleboliths with diverticulitis, diverticulosis, sex, age and pelvic location. In this study the only statistically significant relation was an increase of the number of phleboliths with advancing age.
Staging of hilar cholangiocarcinoma by ultrasound and duplex sonography: a comparison with angiography and operative findings
Authors: Looser Christian , Stain Steven C. , Baer Hans U. , Triller Jürgen , Blumgart Leslie H. 
Published: July 2009

Abstract
The pre-operative radiological assessment of proximal bile duct tumours is clinically important as resection may be limited by tumour extension along the bile ducts, into hepatic parenchyma or the adjacent vascular structures. Demonstration of the extent of biliary and vascular involvement can direct additional investigations and definitive treatment. 22 patients with hilar cholangiocarcinoma were studied pre-operatively by conventional ultrasound (US) and duplex sonography (DS). The extent of tumour infiltration and vascular involvement was compared with arteriography and operative findings. Bile duct dilatation and the level of obstruction was documented by US in 22 (100%), and the tumour was shown by US in 19 (86%). In these 19 patients, the extent of extraductal extension compared with operative findings was correct in 13, underestimated in two, and in four infiltration was massed. Vascular patency or involvement was correctly determined by DS in 19 (86%), and by arteriography in 18 (82%). In two of the three incorrect DS interpretations, lobar atrophy and contralateral hypertrophy distorted the hilar anatomy. US with DS is valuable in the pre-operative staging of proximal bile duct tumours in predicting ductal and vascular involvement.
Direct coronal computed tomography of the temporomandibular joint in patients with rheumatoid arthritis
Authors: Goupille P. , Fouquet B. , Cotty P. , Goga D. , Valat J.-P. 
Published: July 2009

Abstract
Direct coronal computed tomography (CT) of the temporomandibular joint (TMJ) was performed in 26 patients with rheumatoid arthritis (RA) and 26 control subjects. Erosions and cysts of the mandibular condyle had a significantly higher frequency in the RA group than in the control group (p &lt; 0.05) but there was no significant difference in the incidence of other abnormalities. Bone changes were bilateral in RA. A wide range of CT abnormalities was present in patients with RA and in the control group. There are no CT abnormalities specific for RA, but the incidence of erosions and cysts of the mandibular condyle was significantly higher in the RA group and should suggest the diagnosis.
Sonography in thyroid carcinoma in children
Authors: Garcia Cristiant J. , Daneman Alan , McHugh Kieran , Chan Helen , Daneman Denis 
Published: July 2009

Abstract
This paper reviews the clinical, sonographic and pathological findings of 20 children with thyroid carcinoma in an attempt to determine the value and limitations of sonography in thyroid neoplasms in this age group. Although sonography is an excellent technique for the evaluation of thyroid disorders and masses, certain limitations must be kept in mind. Microscopic foci of tumour might be missed and sonography cannot predictably differentiate benign from malignant disease. Previous radiation exposure should increase the level of suspicion for malignancy.
99TcmTechnegas and krypton-81m ventilation scintigraphy: a comparison in known respiratory disease
Authors: James J. M. , Lloyd J. J. , Leahy B. C. , Church S. , Hardy C. C. , Shields R. A. , Prescott M. C. , Testa H. J. 
Published: July 2009

Abstract
Krypton-81m gas, by virtue of its imaging characteristics, is often considered the “gold standard” for ventilation scintigraphy but its use is restricted by its high cost and limited availability. The new radiopharmaceutical 99Tcm-Technegas, a suspension of ultrafine technetium-99m labelled carbon particles, produces high-quality images of ventilation and has the advantage of continuous availability. As part of our evaluation of Technegas the two were compared in 40 patients with a variety of established respiratory diseases. Disparities were seen in five patients in five diagnostic groups and may be a consequence of the differing physical properties of the two agents and the different inhalation techniques used. In addition two interesting features were noted on the Technegas images. (1) Hot spots were seen in 50% of patients, particularly in those with a degree of airways obstruction; (2) preferential basal deposition of activity was seen in 30%, particularly in patients with idiopathic pulmonary fibrosis. Both features were significantly associated with parameters of pulmonary function indicating obstructive lung disease in the former case and restrictive lung disease in the latter.
Computed tomographic appearances of the pelvis following hindquarter amputation
Authors: Fowler J. , Davies A. M. , Carter S. R. , Grimer R. J. , Sneath R. S. 
Published: July 2009

Abstract
Bilateral and midline symmetry of the normal pelvic anatomy is an aid to the interpretation of computed tomographic (CT) examinations. Following hindquarter amputation (HQA) or partial hemipelvectomy (PHP) the normal anatomical relationships are disturbed. The CT examinations of 15 patients who had undergone either an HQA or a PHP for an advanced musculoskeletal malignancy are reviewed. The new “normal” anatomy revealed displacement of the bladder and small bowel to the side of surgery in one third of patients, more commonly in the PHP cases. There were varying degrees of wasting of the ipsilateral musculature, gluteus maximus muscle flap, erector spinae and psoas muscles, etc., because of partial denervation and disruption of their origin or insertion. Recurrent tumour was identified in eight of 10 cases in which it was clinically suspected prior to the CT examination. Invariably the recurrence arose within the muscle flap at the resection margin. Bone involvement by direct tumour spread was present in three cases. Pitfalls in differentiating recurrent tumour from scar tissue are discussed.
Comparison of the effect of different reference data on Lunar DPX and Hologic QDR-1000 dual-energy X-ray absorptiometers
Authors: Laskey M. A. , Crisp A. J. , Cole T. J. , Compston J. E. 
Published: July 2009

AbstractWe have investigated whether the Lunar DPX (software 3.4) and Hologic QDR-1000 dual-energy X-ray absorptiometers have comparable normal reference databases for the spine and femur of white UK and USA subjects. After conversion for systematic differences in absolute bone density values between the two systems, the reference databases were very similar for the spine in young subjects, but there were clear differences in the femur databases of young females and males of all ages. These differences were confirmed by comparing the percent age-matched and young values determined by the two systems for subjects scanned on both systems. Thus the diagnosis and management of a patient could differ, depending on the system used for the bone density measurements.