bluuebunny/crossref_metadata_2025_split huggingface dataset:
Residual radiation-induced injury in dermal tissue: implications for retreatment
Authors: Simmonds R. H. , Hopewell J. W. , Robbins M. E. C. 
Published: July 2009

Abstract
The evidence for residual radiation-induced injury has been investigated in the dermal vascular/connective tissue of pig skin at intervals of 17–52 weeks after irradiation. The primary irradiation was a single dose of 18 Gy, which represents the upper limit of “tolerance” to X irradiation of pig dermal tissue. Re-irradiation was with graded single doses of X rays in order to establish dose–effect relationships for the incidence of late ischaemic dermal necrosis of the skin; dose–effect curves obtained for previously irradiated skin were compared with those obtained using previously unirradiated skin in the same group of animals. At intervals of 17, 35 and 52 weeks after the primary treatment the resulting ED50 values for dermal necrosis were not significantly different from those obtained for previously unirradiated skin. This suggests little or no effective residual injury at these time intervals after a primary full “tolerance” dose. This conclusion was supported by the findings for the latency time for the development of dermal necrosis, which were similar in re-irradiated and previously unirradiated skin. Epithelial desquamation was not induced by the doses used in these studies, either after the primary treatment or after re-irradiation; however, the early erythema reactions seen in re-irradiated skin were markedly reduced, particularly when this was carried out after 35 and 52 weeks, when compared with skin that had not previously been irradiated. This suggests that the early erythema reaction may be a particularly poor predictor of late effects after the re-irradiation of the skin. Although the present results suggest that dermal and subcutaneous tissues may safely be retreated with a full tolerance dose at relatively early times after an initial radical treatment, caution is recommended in extrapolating these results to other late-responding normal tissues. In other tissues some persistent injury may be present even at very long time intervals after the primary treatment.
Total abdominal and pelvic ultrasound: incidental findings and a comparison between outpatient and general practice referrals in 1000 cases
Authors: Mills P. , Joseph A. E. A. , Adam E. J. 
Published: July 2009

Abstract
Ultrasound examination is a rapid and non-invasive method of examing the abdomen. Opinions differ as to whether the entire abdomen and pelvis should be examined in all cases or whether examination can be confined to the region of suspected pathology. The aim of this study was to evaluate the diagnostic yield of total abdominal and pelvic ultrasound examination in patients referred for primary diagnostic ultrasound and with particular reference to specific symptoms. The results of 1000 examinations were analysed. In 25% of patients, a significant abnormality was found and almost one-third of these were incidental findings. The incidence of abnormalities was not significantly different between patients referred via their general practitioners and those referred via the hospital outpatients department. We recommend total abdominal and pelvic examination in all cases regardless of the presenting symptoms.
Can ultrasound replace the intravenous urogram in preliminary investigation of renal tract disease? A prospective study
Authors: Lewis-Jones H. G. , Lamb G. H. R. , Hughes P. L. 
Published: July 2009

Abstract
The intravenous urogram has long been the mainstay of urinary tract imaging in adult practice. It has been shown recently that in many clinical situations the routine use of intravenous urography is no longer justified and in some situations avoidance of adverse contrast reactions, reduced examination time and significant cost reduction. In order to assess the clinical and financial aspects of a change in practice in our department, a prospective study was undertaken over a total of 10 weeks when 328 patients who were referred for intravenous urography were also examined independently by ultrasound combined with the plain abdominal radiograph. The results were compared and in 81.4% of cases the two techniques yielded identical information. Ultrasound plus a plain abdominal radiograph provided more diagnostic information in a further 12.5% of cases, whilst intravenous urography was more informative in only 6.1%. The findings of the study are discussed by considering the main clinical groups and comparing the relative yields of ultrasound and urography. A scheme of routine urinary tract investigations using ultrasound and the plain abdominal radiograph is proposed. We estimate a 58% reduction in number of urographic examinations while retaining diagnostic accuracy. The financial and planning implications for our department are discussed.
Double-contrast computed tomographic arthrography of the shoulder joint
Authors: Cook J. V. , Tayar R. 
Published: July 2009

Abstract
Dislocation of the shoulder joint can cause post-traumatic injury to certain anatomical structures, which may lead to recurrent dislocation. The operative visualization of some of these abnormalities may be difficult and their identification preoperatively allows selection of the appropriate surgical approach and avoids the necessity for lengthy surgery. Fifty-one patients with a history of recurrent dislocation, single dislocation or suspected recurrent subluxation as a cause of pain were examined over a 3-year period by double-contrast computed tomographic (CT) arthrography. Thirty-five patients had a demonstrable abnormality and 13 were considered suitable for surgical intervention on radiological criteria. A further 12 patients were advised to have surgery on a combination of clinical and radiological grounds. Eleven of these have so far had surgery, eight of which required an arthrotomy and the CT findings have been confirmed in all these cases. The results of CT arthrography in the patients examined are reported and the technique, normal anatomy and pathological findings are described. The technique is suggested as the imaging method of choice in recurrent dislocation.
Demonstration of osteochondritis dissecans of the talus by coronal computed tomographic arthrography
Authors: Davies A. M. , Cassar-Pullicino V. N. 
Published: July 2009

Abstract
Ten cases of osteochondritis dissecans of the talus are reviewed. Coronal computed tomographic arthrography identified the precise location in each case and consistently revealed the extent of the lesion to be greater than that apparent on the plain radiographs. The talar cartilage over the lesion was shown to be thinned in four cases, deficient in two, and fissuring of the cartilage was demonstrated in four. Subarticular cysts were identified in all but two cases and contrast medium was shown to enter the cysts in two cases indicating a communication with the ankle joint. The aetiology and relevance of these findings to treatment are discussed.
Sublethal damage repair and radiosensitivity of human squamous cell carcinoma cells grown with different culture techniques
Authors: Schwachöfer J. H. M. , Crooijmans R. P. M. A. , van Gasteren J. , Hoogenhout J. , Jerusalem C. R. , Kal H. B. 
Published: July 2009

AbstractIn this study, cells of a human squamous cell carcinoma line, HN-1, were grown in monolayers and as multicellular tumour spheroids (MTS). Repair of radiation-induced damage was studied by irradiation with single and split doses of X rays (4–8 Gy). It was shown that the amount of sublethal damage that was repaired in this dose range was equal in cells growing in monolayers and as MTS. The radiosensitivity of spheroids, as expressed by spheroid “cure” dose, increased with increasing MTS diameter. It is postulated that, in MTS with no signs of hypoxia, radioresistance diminishes when MTS increase in diameter.
Asymmetrical pulmonary changes in premature infants with surgical closure of a persistent ductus arteriosus
Authors: Steinberg J. D. J. , Oetomo S. Bambang , Martijn A. 
Published: July 2009

AbstractThe chest radiographs of 57 premature infants admitted consecutively with hyaline membrane disease and receiving respirator therapy were reviewed, comparing right and left pulmonary abnormalities. Fifteen infants (Group I) did not develop a persistent ductus arteriosus (PDA). Forty-two infants developed a PDA, which was successfully treated with indomethacin in 17 infants (Group II), while in 25 infants (Group III) the ductus was closed surgically. Analysis of the three groups showed that infants who had undergone surgical closure of their PDA developed significantly more asymmetrical broncho-pulmonary damage. Statistically significant fewer radiological findings of broncho-pulmonary damage were found on the left side in comparison with the right side in the group treated surgically.
Calcification of the intrathoracic trachea demonstrated by computed tomography
Authors: Lloyd D. C. , Taylor P. M. 
Published: July 2009

Abstract
The presence of intrathoracic tracheal calcification was assessed on computed tomographic (CT) scans of 90 consecutive male and female patients. The presence of calcification was demonstrated to be common and to increase with age. No female preponderance was shown.
The radiology of Coffin–Lowry syndrome
Authors: Padley S. , Hodgson S. V. , Sherwood T. 
Published: July 2009

The Coffin–Lowry syndrome is a rare disorder inherited as an X-linked condition, affecting men much more severely than women. The characteristics are mental retardation, skeletal abnormalities with short stature, hypermobile joints, loose skin, tapering fingers and dysmorphic facial features.
The proband was referred for genetic assessment at the age of 15 years because of developmental delay with dysmorphic features. He was the first child of unrelated parents, and had a younger sister. His mother was said to be mildly educationally subnormal, but she came from a family of highly educated people, and there was no other family history of retardation (Fig. 1). His sister (aged 16 years) was of normal intelligence and had no dysmorphic features.
The proband was induced at 36 weeks gestation because of placenta praevia in an otherwise normal pregnancy, and was healthy at birth (birth weight 5 lb 2 oz). His milestones were delayed, sitting at 18 months and only walking at 3 years of age, and making no meaningful sounds until the age of 2 years. He went into residential care for the moderately to severely retarded from 5 years of age, at which time he only had two or three words of speech.
In his early teens he developed epilepsy in the form of “drop attacks”, which caused him to fall backwards to the ground; he would rise immediately afterwards.
The development and use of digital subtraction angiography
Authors: Jeans W. D. 
Published: July 2009

The technique of radiographic subtraction was first described in 1935 (Ziedses des Plantes, 1935), although the first English language paper on the subject did not appear until 27 years later (Hanafee & Stout, 1962). This commented that the technique provided an economical photographic method of reducing the confusion of overlapping bony structures in angiographic studies. The advantages of radiographic subtraction can be summarized as (a) providing image enhancement and (b) improving and bringing out detail in areas hidden by overlying bone or poor contrast. These features may therefore save the situation when the density of contrast medium is insufficient to show a lesion (Leeds, 1974). Previously, intravenous injections of contrast medium had been used to show the aorta and other arteries (Steinberg et al, 1959).Digitization of images was introduced experimentally (Meyers et al, 1963), with the aim of automating the reading of radiographs. Manipulation of digitized information became widely used when computerized tomographic (CT) scanners were introduced, and an early use of computerized subtraction was for the assessment of regional cerebral blood flow (Zilkha et al, 1976) in which pre-injection scans were subtracted from postinjection scans to allow analysis of areas of the scan sections. A series of papers then appeared from workers at the University of Wisconsin describing “computerized fluorography” in which images from an image intensifier were collected, amplified logarithmically and digitized, before being integrated, processed and redisplayed on a monitor (Kruger et al, 1979).
Anatomical variations of the carotid bifurcation: implications for digital subtraction angiography and ultrasonography
Authors: Trigaux J. P. , Delchambre F. , Van Beers B. 
Published: July 2009

Abstract
Intravenous digital subtraction angiography was used to determine prospectively the positional variations of the common carotid bifurcation in 100 consecutive patients with clinically suspected arteriosclerotic disease. The most common position (97/200, 48.5%) of the external carotid artery was anteromedial to the internal carotid artery. Position of the external carotid artery anterolateral to the internal carotid artery was noted in 26/200 (13%) bifurcations, but this anatomical variant was more common on the right (21/100) than on the left (5/100) (p&lt;0.0l). Practical implications may be drawn from this study. For digital subtraction angiography, the left anterior oblique view has to be considered the projection of choice and the right common carotid bifurcation is less likely to be adequately displayed than the left one; for duplex ultrasonography, optimal visualization is obtained from a posterolateral orientation of the transducer.
The use of combined transoesophageal echocardiography and fluroscopy in the biopsy of a right atrial mass
Authors: Scott P. J. , Ettles D. F. , Rees M. R. , Williams G. J. 
Published: July 2009

Transoesophageal echocardiography has increasing application to the diagnosis of a wide range of cardiac disorders (Roelandt & Sutherland, 1988). Recently, simultaneous ultrasound imaging of the heart by the oesophageal route has been used during certain interventional cardiac procedures (Cryan et al, 1988; Neumann et al, 1988).
We report a case in which transoesophageal echocardiography was used in combination with fluroscopy to facilitate the biopsy of a right atrial mass.
A 14-year-old Asian boy presented with a short history of malaise, cough and haemoptysis associated with intermittent pleuritic chest pain. Physical examination revealed signs of bilateral pleural effusions and right-sided heart failure, with jugular venous pressure elevated 6 cm above the suprasternal notch and mild peripheral oedema. His pulse rate was 90 beats/ min and his blood pressure was 140/80 mmHg with no paradox. The pleural effusions were confirmed radiologically, but the chest radiograph and electrocardiogram (ECG) yielded no further diagnostic information. Pulmonary infarcts were suspected and, in the search for a source of emboli, praecordial cardiac ultrasound revealed distortion of the tricuspid valve annulus. This was further delineated by transoesophageal echocardiography which clearly showed a mass in the posterolateralwall of the right atrium causing displacement of the tricuspid valve (Fig. 1).
The patient's family were unwilling to allow cardiac surgery to be performed and so a biopsy of the mass was chosen as the next diagnostic approach. A Cordis bioptome was introduced via the right femoral vein and tip positioned at the junction of the inferior vena cava and the right atrium using radiological screening.
The ultrasound cystodynamogram—a new radiological technique
Authors: Boothroyd A. E. , Dixon P. J. , Christmas T. J. , Chappie C. R. , Rickards D. 
Published: July 2009

Abstract
Voiding dysfunction may be assessed using the intravenous urodynamogram (IVUD) or combined with pressure studies in the videocystometrogram (VCMG). However, VCMG requires bladder catheterization and voiding in public which often leads to inhibition of sphincter relaxation. For this reason the urinary flow rate measurement performed in private is more representative of the true voiding pattern. The ultrasound cystodynamogram (USCD) evaluates the bladder capacity, mean and maximum flow rates, flow pattern and post-micturition residual. The diagnostic capability of USCD was studied in 116 consecutive cases 46 of whom had also had VCMG. Comparison of the data obtained using both techniques revealed no significant difference. USCD has proved to be accurate, safe and reproducible and is of particular value in patient follow-up.
Malignant struma ovarii: presentation and management
Authors: O'Connell M. E. A. , Fisher C. , Harmer C. L. 
Published: July 2009

Struma ovarii are rare tumours and just over 400 cases are reported in the world literature (Gould et al, 1983). The incidence of malignancy is reported as 5–10% of all cases of struma ovarii (Marcus & Marcus, 1961) but has been reported as less (Gould et al, 1983). The metastasis rate is estimated to be 5–6% (Emge, 1940) and only 21 cases with metastases have so far been reported (Dalley, 1970; Pardo-Mindan & Vazquez, 1983; Willemse et al, 1987; Rosenblum et al, 1989). Owing to their rarity, there is no universal agreement as to management. Surgical excision continues to remain the initial definitive primary treatment. However, metastatic and recurrent malignant struma ovarii have been treated with radioactive 131I (Woodruff et al, 1966; Kempers et al, 1970; Willemse et al, 1987). Intra-peritoneal radiocolloids (Woodruff et al, 1966; Rosenblum et al, 1989) and external beam radiotherapy (Gonzalez-Angulo et al, 1963; Woodruff et al, 1966; Pardo-Mindan & Vazquez, 1983) have also found a useful role in palliation.This paper describes the presentation and management of two patients with malignant struma ovarii referred to the Royal Marsden Hospital between 1945 and 1989, during which time nearly 3000 other ovarian tumours were recorded.A 35-year-old married woman with no previous or family history of thyroid disease presented in 1951 with severe recurrent abdominal pain. Laparotomy was performed and both ovaries were found to be cystic.
Tuberculosis of the patella
Authors: Shah Priti , Ramakantan Ravi 
Published: July 2009

Tuberculosis causing an osteolytic lesion in the patella is very rare, having been reported on only four previous occasions. We present such a case and discuss the radiological features which help in differentiating tuberculosis from other similar lesions.
A 25-year-old man in good health presented with a 3 month history of pain, swelling and restriction of movement of the right knee. There were no systemic symptoms or other joint involvement. Examination of the knee revealed an effusion with minimal terminal restriction of flexion. Radiographs of the knee joint demonstrated swelling (Fig. 1) and an osteolytic lesion in the patella (Fig. 2). Radionuclide bone scans showed an area of increased uptake in the right patella; no other lesions were seen on the scan. A chest radiograph revealed no abnormality.
Discovertebral destruction in ankylosing spondylitis: the role of computed tomography and magnetic resonance imaging
Authors: Kenny J. B. , Hughes P. L. , Whitehouse G. H. 
Published: July 2009

Abstract
The computed tomography and magnetic resonance imaging appearances are described in five cases of ankylosing spondylitis with discovertebral destruction. Computed tomography revealed erosions of the vertebral bodies not visible on plain radiographs. The different appearances of the involved disc spaces on magnetic resonance imaging are described and their significance in relation to the pathology of this condition is discussed.
Urinary tract infection in paediatrics: the role of diagnostic imaging
Authors: Gordon I. 
Published: July 2009

Infection of the urinary tract (UTI) has several clinical subgroups, each requiring different degrees of investigation. The most severe, acute pyelonephritis, is characterized by ill health, anorexia, pyrexia (&gt;38.5°C), an erythrocyte sedimentation rate greater than 20 mra/h or C-reactive protein greater than 10mg/l, pyuria, bacteruria and possible septicaemia. The child may well require hospitalization and parenteral antibiotics. The term cystitis is used to refer to children with lower urinary tract symptoms but without systemic illness who have more than 100000 bacteria per ml in the urine. They should be distinguished from children who are asymptomatic but nevertheless have positive urine cultures, i.e. asymptomatic bacteruria. This last group usually consists of girls over 5 years old and do not require much investigation. Clinically these three groups overlap to some extent, but nevertheless the presentation should be a guide to the choice of the appropriate imaging.
Urinary tract infection is common: the imaging that children undergo is important in terms of resource utilization as well as discomfort and radiation exposure. A conscious effort must be made not to over-investigate the child or to overburden the radiology department, yet treatable disorders or potential long-term complications must be detected (Saxena et al, 1975; Asscher, 1980).
A prospective study by Dickson (1979) found 3.1/ 1000 girls and 1.7/1000 boys presented annually with a first symptomatic UTI. The incidence of end-stage renal failure due to pyelonephritis in Europe in individuals under 40 years of age is 4–5 per million per year (Broyer et al, 1984).
Initial experience with percutaneous transluminal angioplasty in the management of Takayasu's arteritis
Authors: Sharma Sanjiv , Rajani Mira , Kaul Upendra , Talwar K. K. , Dev Vishwa , Shrivastava Savitri 
Published: July 2009

Abstract
We have performed percutaneous transluminal angioplasty (PTA) for 15 arterial stenoses in 11 patients with Takayasu's arteritis. The lesions included tight, proximally located renal artery stenosis (12 stenoses; nine patients), localized abdominal aortic stenosis (two patients) and occluded left common iliac artery (one patient). Clinically successful dilatation was achieved in seven patients (10 stenoses) with renal artery stenosis, in both the patients with abdominal aortic stenosis and in the only patient with an occluded left common iliac artery. No complications related to the procedure were encountered. The followup period (n = 7) ranged between 1 and 16 months, mean follow-up period after renal angioplasty was 5 months and after abdominal aortic angioplasty was 12.5 months. Initial success has been maintained in both the patients with abdominal aortic stenoses and in four out of five patients with renal artery stenosis. Percutaneous transluminal angioplasty offers an attractive alternative for the management of stenosing lesions in Takayasu's arteritis with good short term results.
Evaluation of response to chemotherapy of human cystic echinococcosis
Authors: Todorov T. , Vutova K. , Mechkov G. , Petkov D. , Nedelkov G. , Tonchev Z. 
Published: July 2009

Abstract
Fifty-five patients with echinococcosis were treated with mebendazole (30) and albendazole (25). To determine changes in cyst morphology and to evaluate the varying degree of response, progress during follow-up was shown by radiography, computerized tomography and ultrasonography. Persistence of cysts without any change in the morphology and cyst enlargement were taken as criteria for unsuccessful treatment. Development of echogenic foci and increase in density of cyst fluid were considered as a therapeutic effect. Changes in cyst wall such as thickening and deposition of calcium and detachment of the cyst membrane may also indicate response. An essential criterion, for a positive drug effect, was cyst size reduction as well as shape deformation. However, the most convincing and reliable criterion was the complete disappearance of hydatid cysts. Comparative assessment of the therapeutic effect of the two drugs favoured albendazole.