bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radiological manifestation of elastofibroma: a case report and review of the literature
Authors: Nakano Takashi , Tsutsumi Zenta , Hada Toshikazu , Higashino Kazuya 
Published: July 2009

Elastofibroma is a very rare benign tumour of connective tissue, whose features are distinguished by the presence of abundant elastinophilic polymorphic structures and characteristic location. The lesion usually appears in elderly women (50–80 years) characteristically arising from connective tissue in the subscapular region. There are few reports of elastofibroma in the radiological literature (Berthoty et al, 1986; Marin et al, 1987).We report a case of elastofibroma dorsi presenting with chest radiographic abnormalities and its radiological manifestation is reviewed.An 84-year-old Japanese female with no significant medical history was referred to hospital for evaluation of an abnormal chest X ray and a feeling of fullness in the upper abdomen. 6 months earlier she began to experience an occasional feeling of fullness in the upper abdomen. Initial evaluation revealed a gastric polyp, 1.5 × 1.5 cm in diameter, and a mass on the chest radiograph. The polyp was biopsied and histologic examination showed no malignancy. On physical examination, the right scapula was displaced slightly, both laterally and upwardly, and a non-tender hard mass was apparent beneath it. The mass was obvious when the patient raised her arms and rotated them anteriorly but was not adherent to the overlying skin. She had no perisubscapular pain, discomfort, or restriction of movement. She had noticed a swelling at that site 5 years earlier and although the mass had increased in size, it was otherwise unremarkable. There was no lymph node enlargement and otherwise the physical examination was normal.
The radiological (CT) and clinical sequelae of primary intracerebral haemorrhage
Authors: Kreel Louis , Kay Richard , Woo Jean , Wong H. Y. , Nicholls M. Gary 
Published: July 2009

Abstract
To determine the radiological and clinical outcome of primary intracerebral haemorrhage, a prospective study was carried out involving computed tomography (CT) of 388 consecutive Chinese patients admitted with acute stroke to a large public hospital in Hong Kong. Further CT and functional assessment were performed 3 months later in 71% of survivors. The patients were admitted over a 6 month period. 120 (31%) were found to have had presumed primary intracerebral haemorrhage. Of these, 64 patients (53%) died within 3 months. From 40 of the 56 survivors who returned for a follow-up study at 3 months, 30 were functionally independent and five mildly disabled; only five were significantly disabled. Follow-up CT showed no residual lesion in 27%, low attenuation areas in 37%, slit-like lesions in 25% and calcification in 10% of patients. The size of residual lesions correlated statistically with the degree of residual disability, although the association was not close. It is concluded that primary intracerebral haemorrhage accounts for a high percentage of strokes among Hong Kong Chinese with more than half of the patients dying within 3 months. Many survivors, in whom follow-up CT appearances are variable, show good functional recovery.
Time-related changes in lymphatic clearance in pig skin after a single dose of 18 Gy of X rays
Authors: Mortimer P. S. , Simmonds R. H. , Rezvani M. , Robbins M. E. C. , Ryan T. J. , Hopewell J. W. 
Published: July 2009

Abstract
The early and late effects of X rays on lymphatic microcirculatory function have been investigated in pig skin. Paired estimates of lymph clearance were performed in irradiated and unirradiated sites on the flank skin of anaesthetized Large White pigs at 3, 6, 9, 12, 26, 39, 52, 64 and 78 weeks after a single dose of 18 Gy of X rays. The dermal clearance of 99Tcm-colloid was used to assess lymph flow. The results demonstrated two waves of impaired lymphatic clearance which correlated well with the gross morphological changes observed. The first wave occurred between 6 and 12 weeks after irradiation and corresponded to a period of ischaemia and oedema. The second wave, at 52 weeks, corresponded with dermal thinning and subcutaneous atrophy. X irradiation resulted in an impairment of lymph drainage both within and outside the field of irradiation. Impaired lymphatic drainage probably contributes to the gross and histological changes observed in the skin after X irradiation.
Striking a balance: benefit and risk in man's exposure to man-made radiations
Authors: Berry R. J. 
Published: July 2009

It is indeed an honour to be invited to give the Silvanus Thompson Memorial Lecture, and awesome when one considers the Hall of Fame represented by one's predecessors, starting with Lord Rutherford in 1918. Silvanus Thompson was the first President of the Roentgen Society, the forerunner of the BIR. Well ahead of his time, he would have today been labelled a “communicator”. Born in York in 1851 he took his first degree in London in 1869 and returned to York as a Science Master. In 1876 he was appointed Professor of Experimental Physics in Bristol and in 1885 moved to the post of Principal Professor of Physics at the City and Guilds Technical College, Finsbury, which he held until his death in 1916. Elected a Fellow of the Royal Society in 1891, he followed his Presidency of the Roentgen Society in 1897, for the first year of its life, by the Presidency of the Institute of Electrical Engineers in 1899, the Physical Society in 1901 and the Optical Society in 1905. His was a key role in founding the multidisciplinary and broadly based organization that the British Institute of Radiology remains to this day.
Despite the euphoria that surrounded Roentgen's description of X rays, some of the risks of exposure to these novel radiations became apparent very early. The first publication of Roentgen's discovery in the English language in January 1896 was followed by the first description of “deterministic” effects only 3 months later.
The dependence of the scattered radiation dose to personnel on technique factors in diagnostic radiology
Authors: Marshall N. W. , Faulkner K. 
Published: July 2009

Abstract
The measurement and prediction of scattered radiation dose to staff in diagnostic radiology is particularly important, owing to the increased use and complexity of interventional radiology. The air kerma-area product and scattered radiation dose in the vicinity of the patient couch, for both overcouch and undercouch X-ray tube geometries, were simultaneously monitored. The scattered radiation distribution at the couchside was deduced at a range of tube potentials for both overcouch and undercouch X-ray tube geometries. The variation of scattered radiation with field size on both geometries was investigated, as well as the variation with focus–table distance on an overcouch tube geometry. It was discovered that the scattered radiation dose at a point correlated with the air kerma–area product and the result may be used for radiation protection purposes. A method of predicting the scattered radiation dose at a given position is described.
Improved image quality for dense breasts in mammography
Authors: Law J. 
Published: July 2009

Abstract
Within the UK breast scanning age range of 50–65 years, about 15% of breasts show a dense structure that is underexposed in conventional mammography. This gives rise to a severe reduction in contrast. Methods of improving this contrast by variation of exposure factors are explored, using a Dupont phantom that has a simulated dense breast structure. Results are assessed by considering measured contrast from a Perspex stepwedge, and by obtaining relative scores, on a scale of 1–10, from 15 radiologists involved in mammography. It is concluded from both these methods that approximately doubling the mAs at the normal kV is preferable to increasing the kV by more than a small amount. A modified mammographic technique on these lines could be valuable in selected cases where a previous conventional mammogram was available, i.e. assessment stage or repeat screening in a screening programme, or symptomatic patients. Practical problems in choosing exposure factors and the magnitude and implications of the increased dose are discussed.
99Tcm-HMPAO SPECT and magnetic resonance studies in L-asparaginase induced cerebrovascular accident
Authors: Foreman Nicholas K. , Mahmoud Hazem H. , Lanqston James W. 
Published: July 2009

Symptoms including malaise and fever over an 8 week period prompted the parents of their 14-year-old daughter to seek medical attention. She was found to be pancytopenic and, after a bone marrow aspirate suggested a diagnosis of acute leukaemia, she was referred to St Jude Children's Research Hospital. Her initial white cell count was 1.4 × 109/1. Examination of the cerebral spinal fluid (CSF) showed no white cells or blasts in a cytospin preparation. She was entered on the current front-line protocol for the treatment of children with acute lymphoblastic leukaemia (St Jude total therapy study XII). Induction therapy comprised of daunorubicin, prednisone, vincristine and L-asparaginase, followed by tenoposide (VM-26) and cytosine arabinoside (Ara-C) on Day 22. Triple intrathecal chemotherapy with methotrexate, hydrocortisone and cytosine arabinoside was given on Day 2. The patient received six doses of Escherichia coli L-asparaginase (Days 3, 4, 6, 8, 10 and 12). After a gynaecology consultation on Day 10, she was started on medroxyprogesterone acetate (Provera) 2.5 mg/day to suppress menstruation during chemotherapy.
On Day 14 of induction therapy the patient had two brief focal seizures, characterized by jerking of the left arm with deviation of the eyes and the head to the left. There was no loss of consciousness. Physical examination revealed a left facial (VII) nerve palsy and weakness of the left arm, but no other abnormalities.
A persistent offender
Authors: Kinsella D. , Norman P. 
Published: July 2009

A 28-year-old lady presented with a 12 hour history of severe occipital headache. The onset of the headache was sudden. On examination there was mild neck stiffness with no focal neurological signs. The initial radiological examination was a head computed tomography (CT) scan which demonstrated a recent subarachnoid haemorrhage. The following day cerebral angiography was performed (Fig. 1).
What abnormalities are shown and what is the diagnosis?
The right common carotid arteriogram demonstrates a communication between the right internal carotid and the basilar arteries. This is caused by a persistent hypoglossal artery. The hypoglossal artery has a large aneurysmal sac close to its termination in the basilar artery. The sac is projected behind the terminal portion of the right internal carotid artery in Fig. lb. It can be identified clearly following a selective hypoglossal artery injection (Fig. 2). There is no retrograde filling of the distal portions of the vertebral arteries following this injection. The origins of the vertebral arteries could not be determined following selective injections into the innominate and left subclavian vessels.
Percutaneous removal of retained intrahepatic stones with a pre-shaped angulated catheter: review of 96 patients
Authors: Han Joon Koo , Choi Byung Ihn , Park Jae Hyung , Han Man Chung 
Published: July 2009

Abstract
Intrahepatic biliary stone disease is prevalent in East Asia and there is a high frequency of retained intrahepatic stones after surgical treatment. Percutaneous removal of retained intrahepatic stones with a pre-shaped angulated catheter and a Dormier basket was attempted in a group of 96 patients who had a T-tube. Seventy-six had multiple intrahepatic stones, confined to one hepatic lobe in 52 patients. Stones were exclusively intrahepatic in 68 cases. Biliary strictures were present in 92 cases (95.8%). A combination of techniques was used including pre-shaped angulated catheters, irrigation suction, balloon dilatation of strictures, crushing of large stones and extracorporeal Shockwave lithotripsy. Retained stones were completely removed in 48 cases, and incompletely removed in 22 cases. The overall success rate was 72.9%. There were only minor complications. No mortality or significant morbidity requiring hospitalization occurred. Angular deformity, stricture of bile ducts and impacted stones were the most frequent factors responsible for failure or incomplete removal of retained stones. Fluoroscopically guided percutaneous interventional procedures with a pre-shaped angulated catheter are useful complementary procedures to surgery for patients with intrahepatic stones. The major benefits of an individually angulated catheter are safety and easy access to small peripheral bile ducts.
The reduction in radiation dose for intra-oral radiographs by the use of thin K-edge filters
Authors: Macdonald-Jankowski D. S. , Lawinski C. P. 
Published: July 2009

In reply to the letter by R. Wilks regarding our paper (MacDonald-Jankowski & Lawinski, 1991) we would like to make the following comments.
We do not infer that K-edge filters have some special property that reduces radiation dose.
Measurement of forearm bone mineral density in normal women by dual-energy X-ray absorptiometry
Authors: Ryan P. J. , Blake G. M. , Fogelman I. 
Published: July 2009

AbstractWe report the results of forearm measurements, without the use of a water bath, using dual-energy X-ray absorptiometry (DEXA) in 100 normal women aged 29–69 years (average age, 52 years). Studies were performed using the Hologic QDR-1000, with bone mineral density (BMD) measured at three sites in the non-dominant forearm: ultradistal, distal one-third and a region between these two. The precision of the technique was 0.74%, 0.55% and 0.58%, respectively. The normal range for forearm BMD and variation with age was established. BMD was also measured in the lumbar spine (L1-L4) and femoral neck. Linear regression analysis gave a range of correlation coefficients between forearm and axial sites of r = 0.49–0.67. Standard errors of the estimate (SEE) in predicting axial from peripheral measurements gave average values from the three forearm sites of 0.085 g/cm2 for the femoral neck and 0.118 g/cm2 for the spine. Forearm measurements using DEXA can now be reliably performed in air. DEXA produces a high-resolution image, is fast and simple to perform, and enables both cortical and trabecular sites to be examined in one measurement. Forearm and axial measurements can be performed using the same equipment, where centres possess a suitable DEXA system.
The application of microdosimetry to the metrology of low-energy X rays used in mammography
Authors: Waker A. J. , Marco M. 
Published: July 2009

In a relatively recent contribution to this journal, Brenner and Amols (1989) published an article concerning the application of microdosimetry to the assessment of the radiological risk of mammography. The ultimate value of their work depends on whether the basic response function referred to in the paper and given in ICRU Report 40 (ICRU, 1986) truly reflects the relative efficiency of low-LET radiation for cancer induction. However, provided the particular response function employed can be expressed in terms of microdosimetric quantities the method itself is independent of the actual function and the paper of Brenner and Amols is a good illustration of the power of this type of analysis.
Microdosimetry is, however, more than just an interesting but somewhat esoteric branch of radiation physics. The objective of this communication is to show, using some preliminary mammographic data, how experimental microdosimetry as a measuring technique can be used to provide, in a direct manner, information concerning the quality of a radiation field and values of basic quantities such as absorbed dose and dose-rate.
The mammographic set used for the measurements was a Soredex Mamex dc, which is fitted with a molybdenum tube operated at a fixed current of 40 mA and applied potentials from 25 kV to a maximum of 31 kV. Total filtration is listed as 0.5 mm A1.
Linear scleroderma and melorheostosis
Authors: Siegel Alan , Williams Hadyn 
Published: July 2009

Melorheostosis is an uncommon sclerosing bone dysplasia, which has been associated with other mesenchymal abnormalities. We present a patient with linear scleroderma who has radiographic and scintigraphic confirmation of melorheostosis. Bone scintigraphy in a patient with linear scleroderma and melorheostosis has not, to the best of our knowledge, been previously described.
A 65-year-old woman was admitted for treatment of bilateral plantar fasciitis.
Diagnosis of melorheostosis and linear scleroderma of the left leg was made in 1945 when the patient was 23 years of age. The disease process had reportedly been present since child-hood. Owing to pain and limitation of movement in the left leg, she underwent a fasciotomy in the 1950s. Associated abnormalities include oesophageal dysmotility and Raynaud's phenomenon, for which she underwent a lumbar sympathectomy in 1953.
Examination of the left leg revealed skin thickening on the medial aspect from the knee to the lower leg. Multiple scars were present, secondary to previous surgery.
Radiographs revealed cortical hyperostosis of the medial femoral condyle, which apparently crossed the joint space, extended into the medial aspects of the proximal tibial plateau and continued down the entire length of the medial tibial diaphysis. There was narrowing of the medial compartment of the left knee (Fig. 1).
Bone scintigraphy, performed 4 h following intravenous administration of 925 MBq (25 mCi) of technetium-99m methylene diphosphonate, demonstrated increased activity in the medial left femoral condyle, crossing the joint space into the medial aspect of the tibial plateau.
Impedance plethysmography and thrombo-embolic disease
Authors: Glew D. , Cooper T. , Mitchelmore A. E. , Parsons D. , Goddard P. R. , Hartog M. 
Published: July 2009

Abstract
This study compares the results of impedance plethysmography with lower limb venography in 68 patients referred for investigation of clinical deep vein thrombosis, and with the results of ventilation/perfusion isotope scans in 125 patients with suspected pulmonary embolism. Impedance plethysmography had a sensitivity of 100% and a specificity of 61% for the detection of thromboses involving popliteal or more proximal veins (30 patients), but a sensitivity of 90% and a specificity of 68% in the detection of thrombosis at any level, because of a low sensitivity in the detection of isolated calf vein thrombosis (60% in 10 patients). It is a non-invasive, portable and low-cost technique and, in centres where anticoagulation is only given to patients with popliteal or more proximal thrombosis, venography may only be necessary if impedance plethysmography is positive. It may also be of value in the assessment of patients with suspected pulmonary embolic disease and an indeterminate ventilation/perfusion lung scan.
The role of 99Tcm-HMPAO white cell imaging in suspected orthopaedic infection
Authors: Copping C. , Dalgliesh S. M. , Dudley N. J. , Griffiths P. A. , Harrington M. , Potter R. , Smith B. D. 
Published: July 2009

Abstract
Accurate diagnosis is essential for the effective management of suspected bone infection. Current imaging techniques have had limited success and further work is required. Although white cell labelling techniques have been available for many years the radiopharmaceuticals employed have disadvantages, particularly in their availability and suitability for imaging. These problems have been overcome by the use of 99Tcm-HMPAO as an in vitro leukocyte labelling agent. The aims of this study were to assess retrospectively its role and accuracy in imaging orthopaedic infection and to compare the results with three-phase bone imaging. 30 patients with suspected bone infection underwent three-phase methylene diphosphonate (MDP) bone imaging and labelled leukocyte imaging on separate occasions. 16 bone scans were positive for infection, of which 14 were subsequently confirmed, and there were no false negatives. There were no false positive white cell studies and only one infection was not identified. 99Tcm-HMPAO white cell imaging has been shown to be an accurate technique for the diagnosis of bone infection but should be performed only following a positive finding on three-phase bone scanning, since the latter is highly sensitive but significantly less expensive, making it a more appropriate screening procedure.
An investigation of the dose equivalent to radiographers from a high-energy neutron therapy facility
Authors: Finch J. , Bonnett D. E. 
Published: July 2009

Abstract
The external radiation hazard to radiographers from the use of high-energy neutrons in radiotherapy has been investigated. The contributions from neutron-induced activity in the therapy gantry, the treatment room, the patient and ancillary equipment have been analysed as has the whole-body dose equivalent to radiographers. It was found that there are significant levels of gamma radiation throughout the treatment room, which increase both in the vicinity of the walls in line with the beam axis and in close proximity to the neutron therapy gantry. The mean dose equivalent to radiographers per field treated was found to be 5.1 ± 1.8 μSv. The dose per field also varied considerably with the particular site being treated but it was found that the dose equivalent per field per minute of set-up time was approximately constant. It was also found that the dose per field increased with the number of patients treated per day commensurate with a build-up of induced activity. The studies also showed that the dose equivalent to radiography staff was comparable to that at other high-energy neutron facilities but significantly greater than that recorded at facilities with low-energy beams.
Sonographic features in a case of Fitz-Hugh-Curtis syndrome masquerading as malignancy
Authors: Banerjee B. , Rennison A. , Boyes B. E. 
Published: July 2009

Pelvic inflammatory disease, associated with symptoms of pleuritic and upper abdominal pain, is characteristic of Fitz-Hugh-Curtis syndrome. The upper abdominal pain is due to perihepatitis. Gonococcal infection has previously been implicated almost exclusively as the cause of Fitz-Hugh-Curtis syndrome (Curtis, 1930; Fitz-Hugh, 1934). However, recent publications strongly indicate Chlamydia trachomatis as the causative organism in this syndrome. A case of Fitz-Hugh-Curtis syndrome is presented in which the sonographic demonstration of focal lesions in the liver, together with the presence of a pelvic mass led to an erroneous diagnosis of malignancy. Although Fitz-Hugh-Curtis syndrome was described over 50 years ago, it has not been widely publicized and to our knowledge the sonographic demonstration of focal hepatic lesions in Fitz-Hugh-Curtis syndrome has not previously been documented.
A 42-year-old divorced barmaid presented with anorexia, weight loss, upper abdominal pain, menorrhagia and pelvic discomfort. On examination the liver was palpated two fingers below the costal margin. There was tenderness over the right hypochondrium and epigastrium. Haematological investigations revealed a moderate hypochromic microcytic anaemia (haemoglobulin = 9 g/dl), elevated erythrocyte sedimentation rate (ESR) (36 mm/h) and abnormal liver function tests (alkaline phosphate = 184 i.u./l, gamma GT = 80 i.u./l).
Ultrasound examination of the abdomen and pelvis revealed multiple small abnormal foci within both lobes of a moderately enlarged liver. The focal lesions were both hypo- and hyperechoic in nature, but several target or “bull's eye” lesions were present (Fig. 1). There was irregular thickening of the liver capsule, particularly anteriorly (Fig. 2).