bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intestinal perforation—an unusual complication of endoscopic biliary stenting
Authors: D'Costa H , Toy E , Dennis M J S , Brown C 
Published: July 2009

Abstract
The endoscopic placement of stents to decompress biliary obstruction is accepted practice in the management of malignant biliary strictures. In our patient, a 73-year-old man with a presumed malignant common hepatic duct stricture, palliation of his obstructive jaundice has been achieved. However, his clinical course was complicated by a colonic perforation—a previously unreported complication of distal stent migration.
The application of dose–volume histograms to the Paris and Manchester systems of brachytherapy dosimetry
Authors: Langmack K A , Thomas S J 
Published: July 2009

Abstract
When the geometry of an implant does not exactly follow a system of dosimetry problems arise in choosing a treatment dose rate. This study has investigated the use of natural dose–volume histograms (DVHs) as a means for choosing the treatment dose level in these cases. A number of ideal geometrical cases have been investigated. For these, where appropriate, the Paris or Manchester dose rates have been calculated and compared with the peak position of the natural DVH. The dose rate at the peak of the DVH was found to agree with the basal dose rate calculated according to the Paris rules. For implants that completely obeyed the Paris rules the mean ratio was 1.009 ± 4%. A series of clinical implants was also examined. For these the mean ratio was 1.002 ± 2.5%. It is concluded that the peak position of a DVH can be used to predict the Paris basal dose rate of an implant. There was no systematic relationship found between the Manchester dose rate and the peak position of the DVH. The mean ratio between the Manchester dose rate and the peak dose rate position of the DVH was 0.82 ± 13% for a series of implants.
Improved image quality utilizing dual plate computed radiography
Authors: Workman A , Cowen A R 
Published: July 2009

Abstract
A method of improving image quality in computed radiography (CR) using dual plate exposure has been developed. Two CR image plates are used to increase the fraction of X-ray quanta absorbed from the beam. Spatial registration and combination of images from the two plates leads to an image with improved signalto-noise ratio characteristics. A cross correlation technique is used to register spatially the images from the front and rear plates. The modulation transfer function and noise power spectrum were measured for the single plate and combined dual plate images. Results indicate a potential increase of approximately 60% in the detective quantum efficiency (DQE) of the dual plate combined image compared with the single plate image. The improvement of DQE at high spatial frequencies is dependent on the accuracy of the registration of the two images. The actual improvement in imaging performance was measured using a contrast detail test piece. A computerized method was used to measure the imaged detail signal-to-noise ratio of the details of different dimension. Results indicate an improvement of 21% in the signal-to-noise ratio of the details imaged with the dual plate arrangement compared with the single plate. This indicates that this technique can result in a significant increase in image quality for the same exposure level. Alternatively this technique could allow reduction in exposure while maintaining the same image quality achievable with the single plate system.
Lipoma arborescens of the sub-deltoid bursa
Authors: Dawson J S , Dowling F , Preston B J , Neumann L 
Published: July 2009

Abstract
Lipoma arborescens is a rare synovial disorder which principally affects the knee joint. We describe an unusual case of lipoma arborescens arising within the sub-deltoid bursa in association with a rotator cuff tear. Pre-operative diagnosis was made by magnetic resonance imaging.
Paediatric intramuscular haemangiomata—don't overlook the phlebolith!
Authors: Morris S J , Adams H 
Published: July 2009

Abstract
Three children presented with soft tissue masses which were clinically suspected to be soft tissue sarcomas. The identification of phleboliths on initial radiological studies should have suggested the correct diagnosis of benign intramuscular haemangiomata. Subsequent referral to a paediatric oncological unit, and the unnecessary parental anxiety so generated, could have been avoided.
The addition of carbogen and nicotinamide to a palliative fractionation schedule for locally advanced breast cancer
Authors: Pigott K , Dische S , Saunders M I 
Published: July 2009

Abstract
Tumour cell hypoxia is a recognized cause of resistance to radiotherapy. Using clinically relevant dose-fractionation schedules in a mouse tumour model, the addition of carbogen and nicotinamide to overcome chronic and acute hypoxia results in a marked increase in radioresponsiveness with a lower degree of sensitization in normal tissue. Carbogen and nicotinamide were added to the palliative radiation treatment given to six patients with locally advanced breast cancer. The aim of the pilot study was to determine if patients tolerated the addition of carbogen and nicotinamide and to assess if there was any increase in radiosensitivity of the skin. Patients received 30 Gy prescribed to the intersection dose in six fractions over 17/18 days with full skin bolus to the tumour. All patients were given 6 g of nicotinamide orally 90 min before radiation treatment. Carbogen breathing was started 5 min prior to treatment and continued during it. Patients tolerated the treatment well, with vomiting in one patient being the only side effect that could be related to the nicotinamide, and this settled with an anti-emetic. No increase in skin reaction was noted with the addition of carbogen and nicotinamide, and good tumour regression was achieved.
Identifying and aspirating hip effusions
Authors: Berman L , Fink A M , Wilson D , McNally E 
Published: July 2009

Abstract
Ultrasound has become a routine investigation in the investigation of the painful hip in children. It has been recommended that all effusions demonstrated by sonography be drained. Based on the experience of 800 hip aspirations, the authors describe an approach to the demonstration and aspiration of hip effusions with some of the pitfalls that result in false positive and false negative diagnoses.
Radiotherapy for Stages I and II testicular seminoma: results and morbidity in 238 patients
Authors: Vallis K A , Howard G C W , Duncan W , Cornbleet M A , Kerr G R 
Published: July 2009

Abstract
We have undertaken a retrospective analysis of 238 patients with Stages I and II seminoma of the testis treated with radiotherapy in Edinburgh between 1974 and 1989. There were five deaths from seminoma. Cause-specific survival for the whole group at 2 and 5 years was 99.2% and 98.1%, respectively. Causespecific survival at 2 and 5 years by stage (Royal Marsden staging classification) was: Stage I, 99.5% and 98.7% and Stage II, 98.1% and 96.1%. Fourteen (5.9%) patients relapsed (one after treatment for his second testicular seminoma). Eight were given successful salvage treatment, five died of seminoma and one died of intercurrent disease. 13 (5.5%) patients developed World Health Organisation (WHO) grade 3 gastrointestinal or haematological toxicity and two developed grade 4 gastrointestinal toxicity as a result of abdominal radiotherapy. 22 patients (9.2%) developed problems ascribed to late morbidity of abdominal radiotherapy including 18 with peptic ulcer disease. Contralateral testicular tumours occurred in seven (2.9%) patients and five (2.1%) patients developed malignancies at other sites.
Intraventricular meningioma with cerebellopontine angle and drop metastases
Authors: Peh W C G , Fan Y W 
Published: July 2009

AbstractA 34-year-old Chinese woman underwent successful gross total excision of a benign fibroblastic meningioma, pre-operatively diagnosed by computed tomography (CT), arising from the left lateral ventricle of the brain. After a quiescent period of 5 years, CT and magnetic resonance imaging (MRI) demonstrated tumour recurrence at the same site. Despite two further excisions of progressively malignant intraventricular meningiomas and treatment with radiotherapy, the patient rapidly developed bilateral cerebellopontine angle and spinal drop metastases. CT and MRI were useful in demonstrating the location and extent of recurrent intraventricular meningiomas, as well as metastatic spread via the cerebrospinal fluid.
Mammographic features of invasive lobular and invasive ductal carcinoma of the breast: a comparative analysis
Authors: Cornford E J , Wilson A R M , Athanassiou E , Galea M , Ellis I O , Elston C W , Blamey R W 
Published: July 2009

Abstract
The mammographic appearances of 86 invasive lobular carcinomas were compared with those of 86 invasive ductal carcinomas of no special type matched for age, size and stage. There was no significant difference in the frequency of a mammographic abnormality consistent with malignancy between the lobular carcinoma (90%) and ductal carcinoma (96%) groups. A spiculate mass was the commonest feature in both groups (69% and 63%, respectively). There were no differences in the imaging features of masses in the two groups. In the lobular carcinoma group any mammographic abnormality was more likely to be seen on only one view and calcifications were less frequently observed. Multiple lesions were more frequent in the ductal carcinoma group. However, although these differences appeared to reach statistical significance, as they were only apparent in a study with a large number of comparisons, it is unlikely that these differences are practically significant. Analysis of the lobular invasive group failed to demonstrate any significant differences in the imaging features of the classical and mixed sub-types, a spiculate mass being the most common single abnormality in both. No mammographic differences of practical use to distinguish invasive lobular from invasive ductal carcinoma of no special type were demonstrated.
Dosimetric considerations in 131I-MIBG therapy for neuroblastoma in children
Authors: Bolster A A , Hilditch T E , Wheldon T E , Gaze M N , Barrett A 
Published: July 2009

Abstract
Dosimetric calculations have been made for organ doses in patients receiving 131I-MIBG therapy as treatment for neuroblastoma. As well as whole body and liver dose, consideration has been given to dosimetry of organs (lung, urinary bladder) whose tolerance may become treatment limiting when 131I-MIBG is given as part of combined modality therapy. Data from both adults and children receiving radiolabelled MIBG for diagnostic or therapeutic purposes have been compared in constructing dosimetry models for children. A recently published urodynamic model has been used in the estimation of radiation dose to the bladder. The results show that liver and lung may receive doses greater than the average total body dose (0.58 mGy MBq−1 and 0.35 mGy MBq−1, respectively, as compared with 0.25 mGy MBq−1 to the whole body). The organ dose estimates do not differ greatly from previous analyses except in the case of the bladder for which the new modelling studies have resulted in lower dose estimates (0.76 mGy MBq−1 administered, for dose to bladder surface from bladder contents) than in some published series. This may result from differing assumptions regarding parameters such as bladder content and urine flow rate, an enhanced fluid intake being assumed in the present bladder dose estimates. Average doses to the bladder wall from the contents were estimated to be 7.4–11.3% of the surface doses. The urodynamic modelling analysis shows that the bladder could receive a much greater dose (by an order of magnitude) in patients who were inadequately hydrated or had impaired renal function.
Patient and staff dosimetry in neuroradiological procedures
Authors: Marshall N W , Noble J , Faulkner K 
Published: July 2009

Abstract
Cerebral angiography provides valuable information for use in the clinical management of patients but can result in relatively high radiation doses to patients and staff due to the extended fluoroscopy time and number of images acquired during an examination. In this study, extremity doses to radiologists and scrub nurses working in a neuroradiological centre were monitored during a 3 month period using thermoluminescent dosemeters (TLDs). Electronic personal dosemeters were also used to monitor doses above the lead apron at chest height to the radiologists, radiographers and the scrub nurses. Patient doses were recorded using a dose–area product meter whilst patient thyroid dose was measured using TLDs. Two types of examination were studied: cerebral angiography and arterial embolization. It was deduced from the results of the study that the radiologist may expect to receive a mean dose above the lead apron at chest height of 11 μSv and 25 μSv per examination when performing cerebral angiography and arterial embolization, respectively. A radiologist mean hand dose of 19.3 μSv per examination was found, whilst the average eye dose for both radiologist and scrub nurse was 13.4 μSv per examination. The patient dosimetry results revealed a mean thyroid dose of 1.7 mSv and a dose–area product of 48.5 Gy cm2 for cerebral angiography. Average dose–area product for arterial embolization was 122.2 Gy cm2 along with a mean patient thyroid dose of 3.3 mSv.
More detailed patient dosimetry was also performed using a Rando anthropomorphic phantom loaded with TLDs to measure organ doses and hence estimate effective dose. A typical four vessel angiogram was found to result in a patient effective dose of 3.6 mSv.
Compression stockings and posture: a comparative study of their effects on the proximal deep veins of the leg at rest
Authors: Macklon N S , Greer I A 
Published: July 2009

Abstract
Graduated compression stockings have been shown to reduce the incidence of deep venous thrombosis. While they are thought to act primarily by increasing venous flow velocity, their mode of action remains uncertain. Doppler ultrasound was employed to study the relative effects of three types of support stocking on the deep venous diameter, flow velocity and pulsatility in 10 non-pregnant female subjects. In addition, the effect of altered posture on the same parameters was assessed. Significant effects of the graduated stockings were found at the level of the popliteal vein, where a reduction in both the diameter and the amplitude of respiratory phasicity was recorded (p&lt;0.05). No significant increase in flow velocities was recorded. Adopting the left lateral position significantly increased flow velocity in the right common femoral vein (p&lt;0.05). The application of stockings in this position produced no additional increase in flow velocities, but did alter the amplitude of respiratory phasicity. These data do not support the widely held view that graduated compression stockings increase flow velocities at rest. Adopting a lateral recumbent position significantly increases flow velocity in the non-dependent leg.
Digital radiographic pelvimetry—a novel, low dose, accurate technique
Authors: Wright D J , Godding L , Kirkpatrick C 
Published: July 2009

Abstract
A technique is described for lateral pelvimetry which results in a lower radiation dose than that resulting from conventional film–screen pelvimetry and computed tomography (CT) pelvimetry. It uses digital radiographic imaging thereby closely matching conventional techniques yet additionally providing post-processing facilities including distance measurement and contrast adjustment. The digital technique was evaluated with an anthropomorphic phantom and compared with the conventional technique by measuring entrance surface doses on two groups of post-natal patients. Digital radiography gave radiation doses 10 times lower than those using conventional techniques.
Variable imaging appearances of angiomyolipomas of the liver
Authors: Peh W C G , Ngan H , FAN S T , NG I O L 
Published: July 2009

Abstract
Angiomyolipomas of the liver are rare benign tumours. We describe the variable imaging appearances of these tumours in three women. The first two patients underwent ultrasound, computed tomography (CT) and angiography, which demonstrated lesions resembling focal nodular hyperplasia and hepatocellular carcinoma, respectively. Both had histologically-proven liver angiomyolipomas surgically resected. The third patient was incidentally found to have typical features of multicomponented liver angiomyolipoma on CT. Variable proportions of fatty tissue in these tumours are the most likely explanation for their different imaging appearances on CT.
Model based calculation for effective cancer radioimmunotherapy
Authors: Attard A R , Chappell M J , Bradwell A R 
Published: July 2009

Abstract
The major problem of tumour radioimmunotherapy remains the low tumour antibody uptake and this leads to inadequate tumour irradiation. The antibody characteristics which influence uptake have been identified and quantified previously using a non-linear compartmental model that simulates antibody distribution to tumour and body after intravenous injection. The model has now been extended, in combination with MIRD dosimetry tables, to calculate the integral tumour/body radiation dose for a range of antibody masses (1, 10 and 50 mg), sizes (binding site fragments and whole molecules) and affinities (K = 109–1013 mo1−1). Antibody requirements for delivering 60 Gy to the tumour over 11.6 days were calculated for 131I and 90Y-labelled antibodies and included the effect of widely varying dose rates. The model predicted that intact antibodies of high affinity (1011–1013mo1−1) produced effective tumour radiation doses with acceptable whole body radiation levels. By contrast, antibody fragments gave higher body radiation levels and required larger injected activity because of renal excretion. The model predicted higher therapeutic indices for 90Y-labelled antibody compared with 131I.
Mesenteric mixed haemangioma and lymphangioma; report of a case with 10 year follow-up after radiation treatment
Authors: Tai P T H , Jewell L D 
Published: July 2009

AbstractA patient with massive mixed haemangioma and lymphangioma of the mesentery first presented in childhood with ascites which subsided spontaneously and, subsequently, at 21 years of age, presented with gastrointestinal bleeding. At laparotomy, the lesion was found to involve 90% of the mesentery and was unresectable due to its bulk. Hence he was treated by radiotherapy (15 Gy/15 fractions/3 weeks followed by a boost of 5 Gy/4 fractions/4 days). He responded to the treatment. 10 years later he again experienced mild gastrointestinal bleeding which subsided spontaneously. This case illustrates the efficacy of radiotherapy in massive mesenteric haemolymphangiomas. Review of the literature revealed that surgical excision, embolization, and radiotherapy have been used in the treatment of haemangiomas and lymphangiomas. In unresectable cases, radiotherapy has a definite role in the management. A variety of doses has been employed in the literature. No definite dose–response relationship was identified.
Are moving junctions in craniospinal irradiation for medulloblastoma really necessary?
Authors: Tinkler S D , Lucraft H H 
Published: July 2009

Abstract
The case notes of 35 patients treated for medulloblastoma using a standard technique of craniospinal irradiation (CSI) from 1978 to 1992 were reviewed. Two large opposed lateral fields to the whole brain and an orthogonal posterior spinal field were used. The position of the junction between the fields was constant throughout treatment with no feathering and no gap. We present our results, review the literature and discuss the need for feathering. The junction between the cranial and spinal fields produces an area of dose inhomogeneity but the clinical significance of this and the effect of feathering is uncertain.
An estimate of the margin required when defining blocks around the prostate
Authors: Jones D , Hafermann M D , Rieke J W , Vermeulen S S 
Published: July 2009

Abstract
The portal films of 54 consecutive patients treated for primary prostate cancer have been compared to the simulation films. The systematic and random uncertainty in the set-up, defined by the couch movement required to move the patient to the simulated position, was determined to be 1.6 mm UP (SD 3.3 mm), 0.3 mm RT (SD 2.6 mm) and 1.3 mm IN (SD 2.4 mm). The area of fields defined on simulation films was compared with that on portal films to determine the error in block production which was –0.7 mm (SD = 0.9 mm). Five sources of uncertainty in the radiotherapy have been identified, three occur before and two during the course of treatment. A method for combining these uncertainties is proposed and used on the data obtained in this study. This provides estimates of the margin required when drawing blocks so that the minimum dose to the target is 95% of the prescription in 95% of treatments. The block margins are not uniform and range from 21 mm, when drawing the block outline to the posterior on a lateral film, to 13 mm when drawing laterally on an anterior film.
Air versus carbon dioxide insufflation in double contrast barium enemas: the role of active gaseous drainage
Authors: Farrow R , Jones A M M , Wallace D A , Virjee J P 
Published: July 2009

Abstract
Air has been traditionally used as the negative contrast agent in double contrast barium enema (DCBE) examinations, but causes abdominal pain in the 24 h following the procedure. The frequency of post-procedural pain is less when carbon dioxide (CO2) is used as the negative contrast agent. We evaluated patients following DCBE examinations (using either air or CO2) by means of a questionnaire, to determine whether active drainage of gas altered the post-procedural pain. There was no difference in the pain experienced in the groups receiving CO2 with either active or passive drainage, or in the group receiving air with active drainage. Compared with the other groups there was a significantly higher incidence and severity of pain in the group receiving air and passive drainage. We conclude that active drainage of air following a DCBE examination is as effective as using CO2 in reducing post-procedural pain and swelling.