bluuebunny/crossref_metadata_2025_split huggingface dataset:
Detection of inflammation/infection with human polyclonal immunoglobulin G labelled with 99Tcm
Authors: Jiménez-Heffernan A , Villanueva J L , Moral A , Rebollo A , González F M , Ureña M , López-Ruiz J M , Llamas-Elvira J M , Mateo A 
Published: July 2009

Abstract
Radiolabelled human polyclonal immunoglobulin G (IgG) has been successful in identifying inflammatory/ infectious processes in human and animal models. We studied 71 patients with suspicion of inflammation of varied origin and location (44 of musculoskeletal location and 27 other) using 99Tcm. IgG images correctly identified 21/22 inflammatory sites of musculoskeletal origin and only 4/14 sites of soft-tissue location. Five false negative studies corresponded to granulomatous processes, three of them tuberculosis. Four false positive studies were obtained in the musculoskeletal group corresponding to three synovial tumours and a Charcot joint. No false positive results were seen in the soft tissue group. 99Tcm-IgG performs well in the identification of bone–joint lesions and rules out non-inflammatory conditions (with the important exception of tumours). The role of 99Tcm-IgG in soft-tissue inflammatory sites, especially in highly vascular organs is inferior, with a high yield of false negative studies. Granulomatous lesions probably represent situations of low or absent IgG uptake.
Comparison of hand injection with mechanical injection for digital subtraction selective cerebral angiography
Authors: Hughes D G , Patel U , Forbes W ST C , Jones A P 
Published: July 2009

Abstract
100 patients undergoing digital subtraction cerebral angiography were randomized to have contrast delivered by either hand or mechanical injection. We compared the two modes of injection for image quality, the presence of vertebral reflux, possible complications and radiation exposure to the radiologist. There was no statistical difference between the two modes of contrast delivery for image quality and vertebral reflux. Only one definite temporary neurological complication was recorded. However, radiation exposure to the radiologist's hand and body were reduced by up to 70% by using a mechanical injector for contrast delivery during selective cerebral angiography with digital subtraction. We advocate use of the mechanical injector by radiologists who perform regular angiography to reduce their exposure to radiation.
A mathematical model of intraluminal and intracavitary brachytherapy
Authors: Jones B , Dale R G , Bleasdale C , Tan L T , Davies M 
Published: July 2009

Abstract
The adaptation of the linear-quadratic model to allow for the effect of tumour regression and clonogen repopulation between initial teletherapy and subsequent brachytherapy has been extended to include the geometrical conditions encountered in intraluminal and intracavitary brachytherapy. For a radiation line source placed at the centre of a lumen or cavity, regression of any endoluminal tumour towards its mural origin will not result in any change in the minimum brachytherapy–tumour dose with time. In contrast, regression of transmural tumour will cause a potentially advantageous increase in the minimum brachytherapy–tumour dose with time. The latter effect will be opposed by tumour clonogen repopulation. The loge cell kill due to brachytherapy has been calculated for tumours of diameters 2, 4 and 6 cm at completion of teletherapy. The centres of the tumours were assumed to be at distances of 0, 1 and 2 cm from the radiation source. Tumour linear regression rates (λ) ranging from 0.025 to 0.25 per week and tumour clonogen doubling times (T p) of 2.5, 5 and 15 days were used in the calculations. The results demonstrate the critical importance of the distance of the tumour centre from the line source as well as the influence of tumour diameter, λ and T p. In some instances, both maximum and minimum values of loge, cell kill occur. Calculations of tumour cure probabilities reveal that these variations in loge cell kill predicted by the model can produce highly significant differences in tumour control rates. Where the relevant parameters can be assessed directly or estimated from previous experience, the model provides a basis for the design of future intraluminal or intracavitary brachytherapy protocols.
Complete photopenia of the femoral head on radionuclide bone scanning in septic arthritis of the hip
Authors: Gash A , Walker C R , Carty H 
Published: July 2009

Abstract
Three cases of septic arthritis of the hip are presented. In each case, radionuclide bone scanning, using 99Tcm diphosphonate (MDP), demonstrated complete photopenia of the femoral head. All three cases resulted in avascular necrosis and subsequently had a poor clinical outcome with a reduced range of movement and radiographic epiphyseal deformity. Complete photopenia in the presence of suspected sepsis requires urgent referral with a view to exploration and decompression.
Bone SPECT of the wrist
Authors: Dubowitz D J , Miles K A 
Published: July 2009

Abstract
A technique for single photon emission computed tomography (SPECT) during bone scintigraphy of the wrist is described. The technique has been developed as a means to improve localization of abnormalities observed on 99Tcm-MDP planar bone scintigraphy. A wrist phantom and 15 wrists in 13 symptomatic patients were examined. Good spatial detail was achieved, with the pisiform readily identifiable as a separate bone in six wrists. In seven cases the tomograms permitted better localization of planar image abnormalities and in four cases additional lesions were visible which were missed on planar scintigraphy. This technique can be applied to all patients with suspected carpal injury and allows better anatomical localization and greater sensitivity than planar scintigraphy alone.
Book reviews
Authors: Faulkner K 
Published: July 2009

This book has been written as an introductory text on the use of dual energy X-ray absorptiometry in medicine. It covers all aspects of the subject, ranging from an introduction to the clinical problem of osteoporosis and a description of measurement techniques to the measurement of bone mineral and body composition in practice.
The first two chapters briefly review metabolic bone disease and bone structure. These chapters are then followed by a group of chapters which describe bone mineral absorptiometry equipment and techniques. This group of chapters represents a wide ranging review of all methods of assessing bone mineralization but with particular emphasis on dual photon absorptiometry and dual energy X-ray absorptiometry.
Magnetic resonance image synthesis using a flexible model
Authors: Zhu X P , Hutchinson C E , Hawnaur J M , Cootes T F , Taylor C J , Isherwood I 
Published: July 2009

Abstract
Image synthesis methods are based on the hypothesis that a magnetic resonance (MR) image with optimized contrast can be reproduced by synthesis from three calculated basic images of T 1, T 2 and spin density. This method, however, is limited by noise due to uncertainties in the initial measurements. The principal component analysis (PCA) method is based on an information theory approach that decomposes MR images into a small set of characteristic feature images. PCA images, or eigenimages, show morphology by condensing the structural information from the source images. Eigenimages have also been shown to improve contrast-to-noise ratio (CNR) compared with source images. In this study we have developed a method of synthesizing MR images using a flexible model, comprising a set of eigenimages derived from PCA. A matching process has been carried out to find the best fit between the model and a synthetic image calculated from the Bloch equations. The method has been applied to MR images obtained from a group of patients with intracranial lesions. The images derived from the flexible model show increased lesion conspicuity, reduced artefact and comparable CNR to the directly acquired images while maintaining the MR characteristic information for diagnosis.
Saccular aneurysm of the intraorbital ophthalmic artery
Authors: Kikuchi K , Kowada M 
Published: July 2009

Abstract
A saccular aneurysm of the intraorbital portion of the ophthalmic artery is extremely rare. We report this entity in a 54-year-old man who also had a dural arteriovenous malformation (AVM) at the base of the anterior cranial fossa. The aneurysmal formation at this unusual site may be explained by a haemodynamic stress that derived from the presence of the dural AVM.
Results of a questionnaire regarding the practice of radiotherapy for carcinoma of the cervix in the UK
Authors: Jones B , Tan L T , Blake P R , Dale R G 
Published: July 2009

Abstract
A questionnaire was sent to 50 departments of clinical oncology in the UK in September 1991. The aim was to determine the range of external beam and brachytherapy techniques employed at that time in the radical treatment of carcinoma of the cervix. Replies were received from 35 centres. This paper summarizes the preliminary findings of the study. Low dose rate (LDR) brachytherapy techniques predominated (34/35 = 97%) but 41% of departments (13/32) had future plans for the use of high dose rate (HDR) equipment. For low bulk (Stage I–II) carcinoma of the cervix, there was no detectable association between the total brachytherapy dose prescribed and the brachytherapy dose rate. In bulky (Stage I–III) carcinoma of the cervix treated by initial open teletherapy (without shielding), there was a statistically significant reduction in the prescribed brachytherapy dose with increasing dose rate. There was considerable variation between centres in the measurement or estimation of normal tissue doses during brachytherapy. The range of techniques used and the variation in expected complication rates should be closely monitored via medical audit and a further follow-up questionnaire may reveal important changes.
A moderately sized resonator/surface coil for radiofrequency electron paramagnetic resonance spectroscopy and imaging in vivo
Authors: Stevens A D 
Published: July 2009

Abstract
A resonator for the radiofrequency (250 MHz) electron paramagnetic resonance spectroscopy (EPRS) and imaging (EPRI) of biological samples is described. It has been designed for use with a 0.5 m bore EPR spectrometer. It is of the double split-ring type, 65 mm in diameter and 100 mm in length, and is equipped with a tuning-lock mechanism for fixed frequency operation. It can be used in the whole-body mode for small animals and as a surface coil for larger samples. The extent of sensitivity in the latter mode is ca. 20 mm. Larger resonators are being developed for whole-body human studies. A phase-locked crystal oscillator frequency source with high spectral purity is used to minimize noise demodulation and automatic tuning; coupling and phase controls have been included to compensate for motional artefacts. For purely aqueous nitroxides, the minimum detectable concentration is ca. 4 × 10−7 M using an internal sample 100 ml in volume. Sensitivity in the surface coil mode is discussed and spectra from phantoms using both physiological saline and a human volunteer to induce realistic conduction losses are shown.
Reducing motion artifacts in in vivo magnetic resonance imaging measurements of relaxation times
Authors: Gowland P A , Leach M O , Tanner S F 
Published: July 2009

Abstract
Robust and accurate methods of measuring relaxation times on commercial scanners have recently been developed. Such methods overcome many machine and sequence dependent errors, but are still subject to errors arising from motion artifacts. This paper considers methods of decreasing the effect of motion artifacts in in vivo T 1 and T 2 measurements. Three conventional techniques for reducing such artifacts are assessed for their use with relaxation time measurement sequences. It is shown that these techniques do not adversely affect the accuracy of phantom T 1 measurements made with the spin echo/inversion recovery sequence, and of T 2 measurements made using the PHAPS sequence. For in vivo measurements of T 1 it is also shown that these techniques reduce the standard deviation of T 1 measurements in regions of interest and improve the reproducibility of such measurements overall. Two other techniques for reducing motion artifacts were found not to be compatible with the accurate measurement of relaxation times.
A lump in the throat
Authors: Guest P , Husband J 
Published: July 2009

A 46-year-old man previously treated for spinal cord compression complained of a painless swelling in his neck. He had no difficulty in breathing swallowing.
A plain radiograph of his neck and a chest radiographor are shown (Figures 1 and 2).
What is the abnormal structure in the neck and what diagnosis can you reach from the films? in the hyoid bone (not shown) consistent with metastasis. The dominant lesion appeared to be in the right humeral head. The diagnosis of osteosarcoma was confirmed on surgical decompression of the spinal cord from thoracic spine disease.
Eye splashes during invasive vascular procedures
Authors: Davidson I R , Crisp A J , Hinwood D C , Whitaker S C , Gregson R H S 
Published: July 2009

Abstract
In recent years there has been an increased awareness among health care workers regarding possible risk of nosocomial transmission of blood borne pathogens. The aim of this study is to document the risk of contamination of radiologists' eyes during invasive vascular procedures. Radiologists performing these examinations were asked to wear glasses throughout. After each examination the glasses were inspected for droplets. 150 procedures were performed on 123 patients (M = 80, F = 43). 10 procedures (6.7%) resulted in splashes to glasses. In four of these cases the radiologist was not aware of the “eye splash” nor was there a spray event to account for it. Radiologists were aware of 13 spray events (8.7% of all procedures). There was a significantly increased risk of spray events and eye splashes during thrombolysis (χ2 = 14.93, p &lt; 0.001) and of spray events during angioplasty when compared with perfemoral arteriography (χ2 = 8.816, p &lt; 0.01). Procedures lasting longer than 30 min were associated with a significantly increased risk of spray events (χ2 = 5.63, p &lt; 0.02). Significantly more eye splashes were associated with more than two catheter changes (χ2 = 8.912, p &lt; 0.01). It is suggested that protective eye wear should be used routinely during invasive vascular procedures.
The effects of sublethal damage recovery and cell cycle progression on the survival probability of cells exposed to radioactive sources
Authors: Zaider M , Wuu C S 
Published: July 2009

Abstract
Cell progression through the mitotic cycle during low dose rate irradiation may alter notably the survival probability, particularly when a fraction of the dose is delivered during a sensitive phase of the cycle. In this paper we indicate that the consequences of this phenomenon, commonly believed to lead to an “inverse dose rate effect”, may be significantly modulated (and even cancelled) as a result of (a) interactions among sublethal lesions produced in different phases of the mitotic cycle, and (b) variations in these lesions' production rates and repair ability from one phase of the cycle to another. The mathematical model presented (and accompanying numerical examples) takes into account the possibility of changes (e.g. radioactive decay) in the dose rate during exposure.
Oesophageal duplication cyst causing left lung collapse and hypoperfusion
Authors: Holemans J A , Rankin S C 
Published: July 2009

Abstract
Oesophageal duplication cysts are very rare congenital abnormalities. We report a case of one sited in the middle third of the oesophagus causing stenoses of both pulmonary arteries, with collapse of the left lung due to left main bronchus obstruction.
Off-resonance binomial composite pulses in 2D and 3D fat/water imaging at 0.5 T
Authors: Zhu X P , Hutchinson C E , Chilvers P B , Morris G A , Hawnaur J M , Taylor C J 
Published: July 2009

Abstract
A new method of acquiring two-dimensional (2D) and three-dimensional (3D) fat/water decomposed images on a 0.5 T magnetic resonance (MR) imaging system is described. The method uses a gradient-recalled echo (GRE) sequence incorporating a composite 121 pulse, originally used for magnetization transfer contrast (MTC) experiments, for frequency-selective pre-saturation. By applying the 121 pulse off resonance, a sharp discrimination between the chemically shifted water and fat signals may be obtained using a composite pulse as short as 4 ms. Phantom studies demonstrate that suppression ratios as high as 50:1 are achievable. The new method has been applied to volunteers and patients, and good fat/water images of limb, abdomen, head and neck obtained. The new method can be incorporated into other pulse sequences related to GRE, such as phase contrast (PC) and time-of-flight (TOF), and represents the first practical (i.e. rapid) method for 3D fat/water imaging at an operating field as low as 0.5 T.
Radiotherapy portal verification: an observer study
Authors: Bissett R , Boyko S , Leszczynski K , Cosby S , Dunscombe P , Lightfoot N 
Published: July 2009

Abstract
In many radiotherapy facilities radiotherapy portal verification is currently a subjective process based on the visual comparison of a treatment or portal image with a prescription or simulation image. The reliability of this process is unknown. We describe here a study in which 16 observers (oncologists, physicists and therapists) independently evaluated the geometric accuracy of 530 treatment fields on 45 patients. The treatment images were acquired by the BEAMVIEWTM on-line portal imaging system (Siemens Medical Laboratories, Concord, CA, USA). Illustrative examples of the large variation in observers' assessments of the same field are given. The kappa statistic is used to evaluate the degree of agreement between observers and between on-line (at the treatment unit) and off-line (in a quiet viewing room) assessments. The best interobserver agreement was between the four oncologists contributing to the study although this level of agreement was rated only as “fair”. Comparison of on-line and off-line decisions made by therapists exhibited “poor” agreement. This study has provided statistical confirmation of the suspicions of many workers in the field of radiotherapy portal verification, viz that the subjective evaluation of field accuracy is unreliable. However, the degree of unreliability is surprisingly large. The inconsistencies between observers documented in this study need to be clearly acknowledged in the development of protocols for the clinical use of on-line portal imaging systems. Acceptable reliability in radiotherapy portal verification will only be achieved when subjective decision making is eliminated.
Ultrasound-guided percutaneous fine needle puncture of the gallbladder for studies of bile composition
Authors: Hussaini S H , Kennedy C , Pereira S P , Wass J A H , Dowling R H 
Published: July 2009

Abstract
Ultrasound-guided percutaneous fine needle puncture of the gallbladder (PFNP-GB) is invaluable for diagnostic and research purposes, but there are few reports about its safety. We therefore describe the efficacy and side-effects of 43 consecutive gallbladder punctures in 39 patients. PFNP-GB was successful in 40/43 (93%), but failed in three. Bile was completely aspirated in 28 of the 40 (70%) successful procedures. After 36 of the 43 punctures (84%), the patients remained asymptomatic, although on seven occasions (16%) the patients complained of right upper quadrant pain 0.5–12 h after the procedure. In six of these, the pain resolved in 2–24 h, although one developed a leucocytosis (22×l091−1). The seventh patient developed pyrexia and signs of generalized peritonism, which settled with conservative therapy. Ultrasonographic abnormalities of the gallbladder wall were seen in five of the seven symptomatic patients, consisting of: (i) an increase in the thickness of the gallbladder wall (n = 5) from less than 2 mm to 4–14 mm; (ii) peri-cholecystic collections (n = 2) measuring 5 and 11 mm in diameter; (iii) an intraluminal mucosal flap (n = 1); (iv) an intraluminal echogenic layer (n =1); and (v) a 12 cm intraabdominal haematoma in the patient with generalized peritonism. Predictors of pain were: (i) the number of needle “passes” (3.7 ±0.8, range 2–8, in patients with pain vs 2.0 ± 0.2, range 1–6, in pain-free patients, p&lt;0.02); (ii) the absence of gallbladder stones (p&lt;0.03); and (iii) incomplete aspiration of bile from the gallbladder (p&lt;0.02). PFNP-GB is an effective way of sampling fresh gallbladder bile, although there is a 16% risk of inducing pain and/or ultrasonographic changes in the gallbladder.
Audit of the value of double reading magnetic resonance imaging films
Authors: Wakeley C J , Jones A M , Kabala J E , Prince D , Goddard P R 
Published: July 2009

Abstract
100 consecutive magnetic resonance imaging (MRI) examinations were reviewed independently by two radiologists. Patients were selected so that the anatomical areas of clinical interest coincided with the special interests of the reviewers. The reviewers were both consultant radiologists, one with 3 years' and the other with 6 years' experience of MRI. Hard copy images from the MRI examinations were reported independently by both reviewers. Of the 100 MRI examinations, there was full concordance of opinion in 61/100. Of the remaining 39 cases, four (10%) were considered “minor unrelated” differences, 12 (31%) “minor related” differences and 23 (59%) “major related” differences resulting in a significant change in patient management.
The diagnostic implication of falcine calcification on plain skull radiographs of patients with basal cell naevus syndrome and the incidence of falcine calcification in their relatives and two control groups
Authors: Ratcliffe J F , Shanley S , Ferguson J , Chenevix-Trench G 
Published: July 2009

Abstract
The purpose of our study was to identify the incidence of falcine calcification shown on plain skull radiographs in people with basal cell naevus syndrome (BCNS) and in their relatives compared with a normal population. A population of people with BCNS and their relatives was identified on non-radiological grounds and the incidence of falcine calcification on skull radiographs in each of these two groups was compared with the incidence of falcine calcification in a control group of people and of a larger group who attended casualty departments. Falcine calcification was graded into dense, fine but definite, and faint. 85 people with BCNS had nearly 100% incidence of falcine calcification in adults. 83 first degree unaffected relatives showed no excess over “normal” incidence of falcine calcification. In the 970 casualty patients some falcine calcification was common (&gt;20%) in males over 30 and in females over 50 years of age. It occurred earlier and was more common in males than in females. Dense calcification occurred in 5–7% of females and males over 60 years of age. Dense calcification was rare (&lt;2%) under the age of 40 years. In conclusion, falcine calcification should be regarded as the fourth major feature and a very important diagnostic feature of BCNS. An adult labelled as a BCNS sufferer without falcine calcification probably has not got the syndrome. The genetic defect responsible for the metabolic defect resulting in dural calcification is probably the same as, or in close linkage disequilibrium to, that responsible for the major clinical features of the syndrome. The age and sex distribution of falcine calcification in a general hospital casualty population is described.