bluuebunny/crossref_metadata_2025_split huggingface dataset:
Percutaneous femoral artery puncture: practice and anatomy
Authors: Grier D. , Hartnell G. 
Published: July 2009

Abstract
In a survey of the superficial landmarks used to select the site of puncture of the femoral artery for angiography, the inguinal skin crease was most popular, preferred by 39.2% of angiographers. The maximal femoral pulse irrespective of the position of the skin crease was the next most popular landmark (24.7%). Bony landmarks were least popular (13.0%). The majority (73.7%) of those using the skin crease punctured at the same level or distal to it. The relationship of these superficial landmarks to the common femoral artery (CFA) and its bifurcation were investigated. The inguinal skin crease was distal to the bifurcation of the CFA in 71.9% of limbs (mean, 0.61 cm). The maximal femoral pulse was over the CFA in 92.7% of limbs, and the CFA was projected over the medial aspect of the femoral head in 77.9% of limbs. The use of the inguinal skin crease is a popular though unreliable guide for puncture of the CFA. Use of the maximal femoral pulse will enable more constant puncture of the CFA.
Transforming growth factor beta: a promotor of late connective tissue injury following radiotherapy?
Authors: Canney Peter A. , Dean Stephen 
Published: July 2009

Abstract
Transforming growth factor beta (TGF-β) is a peptide which has a fundamental role in controlling proliferation of many cell types. Its main effect upon connective tissues in vivo is to stimulate growth. It can result in endothelial cell proliferation but tends to inhibit epithelial cell growth. Damage to the connective tissues and the vasculature are the principal findings in late radiotherapy damage. Following the initial cellular depletion after radiotherapy, an abnormal proliferation of these tissues occurs, which does not respond to normal feedback mechanisms. Immunocytochemical staining for TGF-β has been performed upon six patients who had received pre-operative radiotherapy and three patients who had surgery alone for large bowel tumours. Transforming growth factor beta was found in relation to the pathological changes of late radiation damage in the non-tumourbearing tissues of four out of six previously irradiated patients, but in none of the non-irradiated patients. This paper proposes that TGF-β activity may modulate late post-radiation changes.
An instance of clinical radiation morbidity and cellular radiosensitivity, not associated with ataxia-telangiectasia
Authors: Plowman P. N. , Bridges B. A. , Arlett C. F. , Hinney A. , Kingston J. E. 
Published: July 2009

Abstract
A 14-year-old boy received standard induction chemotherapy for acute lymphoblastic leukaemia followed by standard dose cranial radiation prophylaxis (18 Gy). Severe chemosensitivity and acute radiation reactions occurred and he died at 8 months from late radiation damage. In vitro radiobiological studies of the boy's fibroblasts in culture demonstrated an enhanced radiosensitivity indistinguishable from ataxia-telangiectasia (A-T) cells. However, unlike A-T cells, DNA synthesis following irradiation was inhibited in a normal manner. This patient represents yet another example of extreme radiosensitivity, and the possibility of clinical prediction in the future is discussed.
Ultrasound appearances of extramedullary haematopoiesis in the liver and spleen
Authors: Bradley M. J. , Metreweli C. 
Published: July 2009

Extramedullary haematopoiesis is an uncommon finding in the adult patient. Many sites have been described, the liver and spleen being more common. The ultrasound appearances have not been well documented. Two cases of extramedullary haematopoiesis in the liver and spleen are presented.
A 58-year-old man presented with a history of a cough, haemoptysis, dyspnoea and weight loss. On examination he had finger clubbing, no significant chest signs and hepatomegaly. A bronchial neoplasm was suspected clinically and the initial chest radiograph demonstrated a right lung mass adjacent to the hilum. Full blood count was normal and the erythrocyte sedimentation rate was raised at 52 mm/h. Bronchoscopy revealed extrinsic compression of the right upper lobe bronchus but biopsy was unsuccessful. Ultrasound examination of the abdomen demonstrated multiple echogenic lesions in an enlarged liver (Fig. 1). Some of these lesions contained central echo-poor areas. The spleen was of normal size, and contained one echogenic mass similar to those in the liver. No other abnormality was shown in the remainder of the abdomen and pelvis.
The most likely diagnosis for these lesions was metastatic carcinoma. Ultrasound-guided Trucut biopsy was performed. The lesion chosen was peripheral and without any central echopoor area.
Histology revealed immature and mature cells of the myeloid and erythroid series with occasional megakaryocytes. Dilated sinusoids and portal tracts contained pleomorphic infiltrate. These are the features of hepatic extramedullary haematopoiesis. An isotope bone scintigram using 99Tcm MDP revealed multiple hot spots in the femora, ribs, skull and spine, interpreted as being metastases.
The relationship of “high risk” mammographic patterns to histological risk factors for development of cancer in the human breast
Authors: Arthur Justine E. , Ellis I. O. , Flowers C. , Roebuck E. , Elston C. W. , Blarney R. W. 
Published: July 2009

Abstract
In the UK Trial for the Early Detection of Breast Cancer in Nottingham, 119 women were identified as having fibrocystic change with epithelial hyperplasia or in situ carcinoma. Their mammograms were classified according to Wolfe's criteria and the corresponding histology for each patient was classified for degrees of epithelial hyperplasia, atypia and in situ neoplasia using Page's criteria. A control population of patients presenting for breast screening was used to represent the general population. No correlation was found between the four mammographic Wolfe patterns, Nl, P1, P2 and DY and histological evidence of epithelial hyperplasia, atypia or in situ carcinoma. A further study was carried out to determine histological features of Wolfe pattern, using radiological examination of resected breast tissue. The variation in Wolfe pattern was related to the distribution of fibrous and adipose tissue in the breast interlobular stroma and appeared to have no relationship to epithelial parenchymal content. This information does not support the hypothesis that radiographic densities of P2 and DY patterns correspond to high risk epithelial proliferation.
A survey of the radiation exposures received by the staff at two cardiac catheterization laboratories
Authors: McParland Brian J. , Nosil Josip , Burry Brian 
Published: July 2009

Staff working in cardiac catheterization laboratories receive radiation exposures from primary radiation (if any part of their body is placed within the X-ray beam) or from secondary radiation due to scatter from the patient and image intensifier and to leakage from the X-ray tube. As a result, the radiation exposure distribution over a staff member's body is expected to be non-uniform. In order to evaluate the radiation somatic risk to be assigned to an individual, and to assess the efficacy of the personal shielding used, radiation exposures must be measured at specific anatomical locations.
In the study described here, radiation exposures received by catheterization laboratory personnel were measured at various body locations in two separate laboratories over 3–5 day periods. This study was initiated as a consequence of conventional radiation monitoring by the federal regulatory agency (Bureau of Radiation and Monitoring Devices, Health and Welfare Canada), which had indicated that occasional high exposures were received by some individuals.
A case of colonic defection
Authors: Butterworth Rosalind , Adams H. 
Published: July 2009

A 76-year-old woman presented with a 6-month history of left iliac fossa pain, associated with alternating constipation and diarrhoea.
For 30 years she had suffered from severe, generalized osteoarthritis. A left knee arthroplasty had been performed 8 years previously but this subsequently failed. Arthrodesis was therefore undertaken with internal fixation using an intramedullary nail. The nail later fractured and the patient underwent further surgery to the left knee with bone grafting.
Magnetic resonance imaging of primary skeletal muscle diseases: patterns of distribution and severity of involvement
Authors: Lamminen Antti E. 
Published: July 2009

Abstract
Magnetic resonance imaging of the lower extremities was performed with a low field system in 51 patients representing three different categories of biopsy-proven primary skeletal muscle disease: muscular dystrophies, congenital myopathies and polymyositis. The intermuscular distribution of abnormal signal intensity and the grade of involvement of individual muscles were assessed. Large differences in the degree of pathological signal intensity between individual muscles were found in all categories. In the muscular dystrophy and polymyositis patients, the overall involvement was significantly more severe than in patients with congenital myopathy. Definite patterns of selective involvement were seen. Statistical evidence of selective muscle sparing was found; the gracilis muscle was significantly less affected than the other muscles in all three disease groups. Other muscles with significant sparing include the rectus femoris and sartorius muscles of the thigh and the tibialis posterior muscle of the leg. Common anatomical and functional characteristics of muscles may be related to the distribution of muscular disease.
Book reviews
Authors: Reidy J. F. 
Published: July 2009

As the editor of this “state of the art” review points out, in the last 20 years there has been little change in invasive cardiology (angiography) but there have been considerable developments in non-invasive techniques so that now with the exception of coronary artery anatomy virtually every cardiac diagnosis can be made non-invasively.
This small volume aims to give an introduction and general account of these non-invasive cardiac imaging techniques to “anyone newly entering the field, either as a clinician or research worker”.
Book reviews
Authors: Wilson A. G. 
Published: July 2009

This is the second edition of The Mediastinum, the first having appeared over 10 years ago in 1977, and, for those familiar with the book, it closely resembles the first edition with identical chapter headings and format. The contention of the author — that accurate radiological diagnosis is based on a thorough understanding of correlated radiographic anatomy and pathology — also remains the same and the book is a brilliant expose of this philosophy.
There are 10 chapters in all mostly concerned with separate regions of the mediastinum.
Magnetic resonance angiography of abdominal vessels: early experience using the three-dimensional phase-contrast technique
Authors: Vock P. , Terrier F. , Wegmüller H. , Mahler F. , Gertsch Ph. , Souza S. P. , Dumoulin C. L. 
Published: July 2009

Abstract
Based on three-dimensional acquisition of three sequences sensitive to one flow-direction, abdominal magnetic resonance phase-contrast angiography (MRA) was performed in 13 volunteers and 20 patients. The subjects received no antiperistaltic medication and were allowed to breath normally during the three acquisition periods of 11 minutes. The frequency of demonstration of the normal aorta, superior mesenteric and right and left renal arteries was 100%/100%/91%/100%, and of the inferior vena cava, splenic, superior mesenteric and portal veins was 92%/67%/92%/100%, respectively, whereas other abdominal vessels were seen less constantly. In renal artery stenosis or occlusion, MRA detected eight out of nine pathological arteries, missed only a minimal stenosis and was never false positive. In all 10 cases of portal hypertension, MRA demonstrated the venous collaterals detected by conventional angiography and in six cases showed more collaterals, particularly paravertebral vessels. A Budd–Chiari syndrome was investigated as well. If the accuracy of MRA can be proved in larger studies, it may become an important diagnostic tool in evaluating abdominal vascular pathology, such as renal artery stenosis or portal hypertension.
The effect of sodium iothalamate on the vascular resistance of the isolated perfused rat kidney
Authors: Haylor J. L. , El Sayed A. A. , EI Nahas A. M. , Morcos S. K. 
Published: July 2009

AbstractThe direct effects of sodium iothalamate on renal vascular resistance (RVR) were examined using the isolated perfused rat kidney experimental model. A concentration-dependent biphasic change in RVR was produced with the hyperosmolar solution of sodium iothalamate [(Conray 420), 420 mgl/ml, 2500 mOsmol/kg/H2O]. The response characterized by an initial fall followed by a prolonged increase in RVR on discontinuation of the iothalamate infusion. No significant change in RVR was observed when iothalamate was infused as an iso-osmotic solution (60 mgl/ml, 280 mOsmol/kg/H2O) at a rate of 0.525 ml/min. to produce a concentration of 4.2 mgl/ml in the renal perfusate. We conclude that sodium iothalamate can exert direct biphasic effects on RVR which are mediated by its hyperosmolality rather than its chemical content.
Neuroblastoma of the tail of the pancreas in childhood
Authors: Hoeffel J. C. , Galloy M. A. , Schmitt C. , Schmitt M. 
Published: July 2009

We report a rare case of this condition in a child 4 years old, with the computed tomography and ultrasound findings.
A 4-year-old boy presented with a firm, non-tender left upper quadrant abdominal mass. There was mild fever and moderatee anaemia. Plain radiographs of the abdomen revealed an opacity in the left upper quadrant with calcification.
Measurement of time-averaged flow in the middle cerebral artery by magnetic resonance imaging
Authors: Tarnawski Maria , Padayachee Soundrie , Graves Martin J. , Taylor M. Graeme , Ayton Victoria T. , Smith Michael A. 
Published: July 2009

Magnetic resonance imaging (MRI) sequences have been developed specifically for the quantitative evaluation of blood flow in vessels. The most promising sequences are those utilizing gradient field echoes to produce two interleaved images with a velocity-induced phase difference between images (Firmin et al, 1987; Ridgeway & Smith, 1987). Velocity values within a pixel can be extracted by subtraction of the images, producing a phase map where the phase is directly proportional to velocity. It is generally accepted that there is a lower limit to the size of vessel in which flow can be measured owing to the resolution restriction imposed by the image pixel size. This constraint is due to the partial volume effect, in which a pixel covering a vessel edge may contain both stationary tissue and flowing blood, and as a consequence produces limitations in the accurate measurement of vessel cross-sectional area.
Conventional methods of flow calculation generally combine a measure of the vessel cross-sectional area with the mean velocity. In small vessels, where the pixel size is a significant proportion of the vessel diameter, significant errors can occur in both the measurement of the mean velocity and, more importantly, in the cross-sectional area. In the latter a 10% error results in a 20% error in the flow.
The problems posed by the measurement of time-averaged flow using MR in small vessels can be solved using a simple theoretical evaluation of the partial volume effect.
Acute spinal cord injury: magnetic resonance imaging correlated with myelopathy
Authors: Yamashita Yasuyuki , Takahashi Mutsumasa , Matsuno Yasuharu , Kojima Ryutaro , Sakamoto Yuji , Oguni Tasturo , Sakae Terumi , Kim E. Edmund 
Published: July 2009

Abstract
Thirty-one patients (29 males and two females, 13–87 years of age (mean, 46.7 years)) with acute spinal cord injury were studied by MR (magnetic resonance) imaging and the results were correlated with neurological findings. Magnetic resonance images were obtained with a 0.5 T superconductive MR scanner (Phillips Gyroscan S5). Initial imaging was performed within 24 hours after trauma in 13 patients, 1–7 days in 13 patients and 7–14 days in five patients. Twenty-six patients underwent follow-up examinations with MR imaging. Cord abnormalities including cord compression (23 patients), cord swelling (seven patients), and abnormal signal intensities on either T 1 or T 2 weighted images (26 patients) were observed on initial examination. Multivariate analysis showed that cord compression and abnormal intensities on T 1-weighted images were important prognostic indicators. Hyperintensity on T 2-weighted images was non-specific but correlated well with clinical recovery. Magnetic resonance imaging is useful in predicting the prognosis and for planning treatment following spinal cord injuries.
In vivo phosphorus-31 magnetic resonance spectroscopy of normal and pathological breast tissues
Authors: Redmond O. M. , Stack J. P. , O'Connor N. G. , Codd M. B. , Ennis J. T. 
Published: July 2009

Abstract
In vivo phosphorus-31 magnetic resonance spectroscopy, at 1.5 T, in addition to magnetic resonance imaging and mammography, was performed on the breast tissue of 59 subjects, using a 40 mm or 80 mm surface coil for spectral localization. The patients were divided into three groups: Group 1, 46 control subjects; Group 2, nine patients with breast carcinoma; Group 3, four patients with benign breast disease. The relationship of age, menopausal status, breast size and pattern, use of contraceptive pill and history of breast disease to spectral characteristics of breast tissue was examined for the control group. In multivariate analysis, only menopausal status and age were found to be significantly related to tissue biochemistry. Pre-menopausal women had reduced phosphocreatine (PCr) (%) (p = 0.02), and increased phosphomonoesters (PMEs) and β-nucleotide triphosphate (β-NTP) (%) (p = 0.05), while the fat-to-water ratio was higher in older women (p = 0.02). No significant differences were identified between the control subjects and the patients with benign breast disease. When spectra from patients with breast carcinoma were compared with an age-matched volunteer group, α- and γ-NTP (%) were found to be higher in the cancer tissue (p &lt; 0.01 and p = 0.01, respectively), while PCr (%) was reduced (p &lt; 0.01). The ratio β-NTP:PCr was higher in the carcinoma group of patients (p &lt; 0.05). In vivo phosphorus-31 magnetic resonance spectroscopy is a non-invasive examination which may prove useful in the early differentiation of malignant breast disease from normal and benign conditions.
Ultrasound of the pelvis and renal tract combined with a plain film of abdomen in young women with urinary tract infection: can it replace intravenous urography? A prospective study
Authors: McNicholas M. M. J. , Griffin J. F. , Cantwell D. F. 
Published: July 2009

Abstract
Urinary tract infection (UTI) is common in women and intravenous urography (IVU) is a frequently requested radiological investigation for recurrent UTI. The aim of this study was to assess whether pelvic and renal ultrasound combined with a plain film of the abdomen (KUB) could replace IVU as the initial radiological investigation in young women with recurrent UTI. Ninety-four young women with recurrent UTI who were referred for IVU were studied. Ultrasound of the pelvis and renal tract was performed, and information obtained from ultrasound and KUB was compared with that obtained from the IVU examination. Patient management was altered as a result of radiological investigation in eight cases. A case of staghorn calculus and a case of pelviureteric junction obstruction were diagnosed by both IVU and ultrasound with KUB. An intrarenal abscess was diagnosed by ultrasound in a patient with a normal IVU. In addition ultrasound demonstrated significant findings in the pelvis, including ovarian and uterine abnormalities and an ectopic and an intrauterine pregnancy. In all cases the patient had symptoms referable to the urinary tract and a history of documented UTI. The KUB did not yield any unsuspected finding not diagnosed by ultrasound, but did serve to delineate more clearly the extent of calculus disease in two patients. We suggest that ultrasound of the pelvis and renal tract combined with a KUB should be the radiological investigation of choice in young women with UTI.
Concomitant pelvic irradiation, 5-fluorouracil and mitomycin C in the treatment of advanced cervical carcinoma
Authors: Khoury G. G. , Bulman A. S. , Joslin C. A. F. , Rothwell R. I. 
Published: July 2009

Abstract
This was a Phase II study of 24 late (FIGO) Stage IIb and 39 Stage III patients. External beam radiotherapy was given daily, five days a week, using 15 × 15 cm parallel opposed pelvic fields. The first 20 patients had 45.00 Gy mid-plane dose in 20 fractions, Days 1–28, the last 43 patients had 50.40 Gy in 28 fractions, Days 1–43. This was followed by an intracavitary boost of 17.00 Gy to Point A in two fractions over seven days. The first seven patients had concomitant 5-fluorouracil (5FU) 1 g/m2day (maximum 1.5 g/day) Days 2·5, 30–33 and 57–60, with mitomycin C 10 mg/m2 (maximum 15 mg) Days 2 and 57. Two patients had WHO Grade 4 cytopenia, and only two were able to have full dose intensity. The 5FU dose was reduced to 0.8 g/m2/day, for Days 2–5 and 30–33; mitomycin C was given on Day 2 only. Treatment morbidity with the reduced chemotherapy intensity was comparable with that of radiotherapy alone. Median follow-up was 16 months (range 6–44). Median survival was 35 months. The results were compared with historical controls treated using the same radiation method alone. Two-year survival for late Stage IIb patients was 67% with the combination and 72% with radiotherapy alone; for Stage III, 67% and 49% respectively. Two-year pelvic control for late Stage IIb was 87% (combination) and 84% (radiotherapy alone) and for Stage III, 61% and 55% respectively. In contrast to reports from other centres, these results do not show an overall significant improvement on radiotherapy alone. A Phase III study may not be practicable.
Paediatric haemangiomas: the role of radiotherapy
Authors: Dutton S. C. , Plowman P. N. 
Published: July 2009

Abstract
Radiotherapy currently maintains an occasional place in the therapy of complicated haemangiomas of childhood. Eight such childhood benign lesions have been so treated at St Bartholomew's Hospital in the last 10 years. The case histories are presented before being discussed in the context of other therapies available (no treatment, steroids, embolism and surgery), radiation technique used and radiation dose prescription advised.
Imaging of neonatal pulmonary sequestration including Doppler ultrasound
Authors: Smart L. M. , Hendry G. M. A. 
Published: July 2009

Abstract
Seven cases of neonatal pulmonary sequestration are reviewed which illustrate the varied clinical presentations and radiological findings. In four patients, real time ultrasound scanning was used to image the chest and the features are described. In three cases, the systemic supplying artery was demonstrated by duplex Doppler scanning and further invasive investigations were avoided; after a chest radiograph, this should be the examination of choice in the investigation of a neonate with a possible pulmonary sequestration.