bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lymphoproliterative disorders of the thyroid gland: radiological appearances
Authors: Kasagi K. , Hatabu H. , Tokuda Y. , Yamabe H. , Hidaka A. , Yamamoto K. , lida Y. , Misaki T. , Mori T. , Endo K. , Konishi J. 
Published: July 2009

Abstract
Images of lymphoproliferative disorders of the thyroid by ultrasonography (US), computed tomography (CT), 99Tcm and 67Ga scintigraphy were analysed in eight patients (two men and six women, aged 42–83 years). Seven patients were diagnosed as having primary lymphoma and one plasmacytoma. Ultrasound revealed a solid mass with homogeneous and very low echogenicity clearly distinguishable from residual thyroid tissue in five patients, diffuse hypoechoic goitre in one and multiple irregular hypoechoic nodules in both lobes in the patient with plasmacytoma (Case 8). Computed tomography demonstrated a focal low-density area in six cases of lymphoma and decreased density throughout the gland in the other two patients. 99Tcm scintigraphy showed hemilobar enlargement with decreased and uneven trapping, cold area or complete lobar defect in six patients with lymphoma and no trapping in the case of plasmacytoma. 67Ga scintigraphy demonstrated high accumulation in lymphoma and faint accumulation in the case of plasmacytoma. Radiological manifestations with a focal lesion were considered typical and diagnostic of primary thyroid lymphoma, while in one case with diffuse infiltration through the whole gland, the differential diagnosis from Hashimoto's thyroiditis could not be made. In the final case, cells infiltrated diffusely to form islands with patchy distribution among well preserved follicles, correlating with the multiple hypoechoic areas observed by US.
Clinical application of an electronic imaging device for assisting patient set-up in radiotherapy
Authors: Wade J. Penelope , Nicholas David 
Published: July 2009

Abstract
As radiotherapy treatment set-ups are becoming more complicated and a greater emphasis is placed on accuracy, there is an increasing need to verify and record the actual treatments being given. A direct electronic imaging device is currently marketed by Varian (the DYNARAY ID), which uses the latest technology in detection and image processing to obtain digital images of the patient's anatomy using the actual treatment beam. At Norwich we have been using a prototype machine in a busy district radiotherapy centre and have examined over 50 patients. We have found the images easy to obtain and the technique superior to the standard practice of using verification radiographs. The role of this device lies in aiding quality assurance of treatments whilst generating a permanent record of the actual treatment given.
The role of the single photon emission computed tomography (SPECT) in detection of ossific mediastinal and pulmonary metastases
Authors: Goddard P. R. , Davies E. Rhys 
Published: July 2009

We have read with considerable interest the case report on the scintigraphic detection of ossific mediastinal and pulmonary metastases in osteosarcoma (Brady & Ennis, 1990).
Our recently reported experience of two cases of osteosarcoma (Goddard et al, 1990) has been similar. In one case the pulmonary uptake of 99Tcm MDP demonstrated a metastatic deposit from osteosarcoma that had previously been missed by computed tomography (CT). In the other case, however. CT demonstrated more metastases tha scintigraphy.
Non-specific aorto-arteritis (Takayasu's disease) in children
Authors: Sharma Sandiv , Rajani Mira , Shrivastava Savitri , Kaul Upendra , Kamalakar Takkellapati , Talwar K. K. , Saxena Anita 
Published: July 2009

Abstract
Digital subtraction panaorto-arteriography was performed in 32 consecutive children (21 females, mean age 10.8 years) with non-specific aorto-arteritis to assess digital subtraction angiography (DSA) in imaging these children and to study the patterns of involvement in the Indian sub-continent. Diagnostic quality DSA images were obtained in 21 out of 27 intravenous and nine out of 11 intra-arterial studies. Obstructive lesions were present in all the patients and commonly involved the abdominal aorta (24 patients) and renal arteries (20 patients). Aneurysms were seen in five patients and predominantly involved the descending thoracic aorta. Pulmonary artery involvement was uncommon (five out of 20 patients) and clinically silent. Based on clinical and angiographic features, percutaneous transluminal angioplasty was performed for the management of uncontrolled hypertension in eight patients (10 lesions). Initial success was obtained in eight procedures (80%). Re-stenosis occurred after 5.5 months in one patient, but was successfully re-dilated. The follow-up period ranged between 5 and 16 months (mean 9 months). Long-term efficacy of transluminal angioplasty in the management of these children is awaited.
A new coaxial needle for pre-operative localization of breast abnormalities
Authors: Schoenberger S. G. , Bamber J. C. , Rank W. , Sutherland C. M. , Nichols R. L. 
Published: July 2009

Abstract
A new coaxial needle, containing a retractable anchoring wire with a helical tip, has been developed for purposes of mammographic and sonographic localization of non-palpable suspicious breast abnormalities before surgical excision. The helically shaped tip provides the needle with a number of potential advantages over other currently available localization needles. During in vitro comparisons with other needles quantitative and qualitative evidence was obtained to suggest that the new needle can be expected to have improved anchoring capability, be deflected less by tough fibrous tissue interfaces and be more visible sonographically. The anchoring wire can also be retracted and repositioned. Preliminary clinical experience with the needle was consistent with these expectations.
Calibration of a Microselectron HDR iridium 192 source
Authors: Flynn A. , Workman G. 
Published: July 2009

Abstract
A method for the calibration of the output, in terms of an air kerma rate, of the high activity miniature iridium 192 sources used in the Microselectron HDR afterloading unit is described. An air kerma rate is measured using a calibrated thimble chamber in an “in-air” calibration jig. The results are compared with an air kerma rate derived from the manufacturer's test certificate. In some cases, the ionization chamber measurements have been followed by a further calibration check using thermoluminescent dosimetry. Other checks carried out when a new source is received are also briefly described.
Extensive calcification in the breast in chronic renal failure
Authors: Evans S. E. , Whitehouse G. H. 
Published: July 2009

Although soft tissue calcification is a frequent finding in chronic renal failure, extensive calcification in the breast is a very rare feature in this condition. It may present as a non-tender mass or be found incidentally on a chest radiograph or mammogram. We report a case of extensive bilateral breast calcification occurring in a woman with chronic renal failure.
A 43-year-old female with a long history of chronic renal failure was referred for mammography, having discovered a lump in her breast on self examination. Renal insufficiency was diagnosed 12 years previously when bilateral staghorn calculi had been removed. Renal transplantation, performed 6 years later, was complicated by multiple post-operative problems including uretero-vesical stenosis and acute rejection. On examination, she had a firm, non-tender mass, 4×5 cm in size, in the upper outer quadrant of the left breast.
Effect of radiological iodinated contrast media on acetylcholinesterase activity
Authors: Tamura Akira , Suzuki Teruyasu , Yamasaki Toshie , Morita Rikushi , Sato Takashi , Fujii Tatsuzo 
Published: July 2009

The inhibitory effects of several contrast media on acetylcholinesterase (AchE) activity were studied in vitro. Their inhibiting power was in the order: iothalamate &gt; ioxaglate &gt; iopamidol &gt; iohexol. Because both the Km and maximal velocity (V max) values of the enzyme were altered on adding ioxaglate, the inhibition mode seemed to be of a mixed type. Complete recovery from such inhibition was observed by removing the contrast media from the enzyme. Adding albumin (1%) to the reaction mixture led to a decrease in the inhibitory effect of ioxaglate. These results suggest that the contrast media, which have an inhibitory effect on AchE activity in vitro, may have no influence on its activity in blood which contains 4–5% of albumin under physiological conditions.
Radiological iodinated contrast media are relatively non-toxic, but they are employed in such large doses that mild toxic effects are common in clinical practice, and severe reactions sometimes occur (Labbe & Peyroux, 1984; Dawson, 1983, 1985). Since some symptoms of their toxicity such as peripheral vasodilation, bronchospasm and disturbances of cardiac rhythm are similar to those produced by acetylcholine, their inhibitory effects on AchE (acetylcholine acetylhydrolase, EC 3117) have been studied (Lasser & Lang, 1966; Dawson & Edgerton, 1983; Howell & Dawson, 1985; Guidollet et al, 1988). The published studies, however, have yielded conflicting results. In this short communication, we report more precisely the nature of the inhibition of AchE by some representative ionic and non-ionic contrast media.
The relative biological effectiveness of fractionated doses of fast neutrons (42 MeVd→Be) for normal tissues in the pig
Authors: Robbins M. E. C. , Barnes D. W. H. , Campling D. , Hopewell J. W. , Knowles J. F. , Sansom J. M. , Simmonds R. H. 
Published: July 2009

Abstract
The effects of fractionated doses of fast neutrons (42 MeVd→Be) on the radiation response of the pig kidney have been assessed and compared with those observed after X irradiation. Following X irradiation there was a marked increase in the total dose at which renal function was preserved with decreasing fraction size. The rate of this increase was dependent on the overall treatment time; for fractionated irradiation given over 18 or 39 days the exponents related to fraction number, N, were 0.36 ± 0.03 and 0.48 ± 0.003, respectively. In contrast, there was no significant change in the iso-effect dose for renal injury following fractionated irradiation with fast neutrons where there was also little effect of varying the overall treatment time. Analysing these data by means of the linear-quadratic (LQ) model, using both an Fe-plot and the Tucker test, gave α/β ratios of 2.42 ± 0.16 Gy and 2.99 ± 0.16 Gy, respectively, for X-ray doses given in 18 days. For fractionated doses of X rays given in 39 days the αβ ratios were 0.40 ± 0.01 Gy and 0.47 ± 0.02 Gy, respectively. The αβ ratios for renal tissue following fast neutron irradiation obtained bythe two methods were also similar, i.e. 15.00 ± 0.60 Gy and 15.72 ± 3.76 Gy, respectively. The pronounced fractionation effect seen with X irradiation, particularly for doses administered over 39 days as opposed to 18 days, coupled with the absence of any such effect with fast neutrons, resulted in a marked increase in relative biological effectiveness (RBE) with decreasing X-ray dose/fraction. The slopes of the resulting regression lines were −0.73 ± 0.05 and −0.33 ± 0.02, respectively. The lack of dose sparing associated with fractionation, or variation of the overall treatment time for fast neutron irradiation, suggests that doses administered to tumours adjacent to the kidney can be given as a few relatively large dose/fractions in a short overall treatment time without an increased risk of complications related to renal tissue. This may be of therapeutic advantage in the treatment of rapidly proliferating tumours where dose may be wasted using more conventional protracted fractionated irradiation schedules.
Melnick–Needles syndrome (osteodysplasty) in an older male–report of a case and a review of the literature
Authors: van der Lely H. , Robben S. G. F. , Meradji M. , Derksen-Lubsen G. 
Published: July 2009

In 1966 Melnick and Needles reported on a previously undiagnosed bone dysplasia. The diagnosis was based on characteristic radiographic findings: a delay in closure of the anterior fontanel, i.e. sclerosis of the skull base and mastoids. The long tubular bones are bowed with cortical irregularities and metaphyseal flaring. The ribs also show cortical irregularities and have a ribbonlike or wavy appearance. The vertebral bodies show an increase in height with a decrease in antero-posterior measurement and anterior scalloping. A decrease in disk space is also present. The pelvis has a typical constricted appearance with flaring of the iliac crest and tapering of the ischial and pubic bones. The clinical signs include exophthalmos, full prominent cheeks, mild hypertelorism, micrognatia, large ears and misaligned teeth. Females are affected almost exclusively and inheritance is in an X-linked dominant pattern. The condition is lethal in males born from Melnick–Needles syndrome (MNS) mothers (Donnenfeld, 1987). Three male patients (born from normal parents) are reported to have reached the age of 3 years.
We present the case of an 11-year-old boy, the oldest living male patient documented so far.
A retrospective comparison between different stage classifications for nasopharyngeal carcinoma
Authors: Teo P. , Leung S. F. , Yu P. , Lee W. Y. , Shiu W. 
Published: July 2009

Abstract
From 1984 to 1987, 659 patients with untreated nasopharyngeal carcinoma (NPC) were investigated by computed tomography of the nasopharynx and skull base, and fibreoptic nasopharyngoscopy. Thirty-one patients presenting with distant metastasis were treated palliatively; 628 were treated with intent to cure. Prospective staging was performed for the Ho's classification but since all T- and N-stage data required for staging according to the Huang's, the Changsha and the UICC classifications were recorded and stored in a computer database, retrospective staging according to these classifications could be accurately performed. Ho's classification was concluded to be the best in view of highly significant differences between the overall stages in survival and between N-stages in distant metastasis. The number of prognostically distinct overall stages and N-stages was greatest for Ho's classification. Huang's T-stage classification was superior, however, because it emphasized the significant adverse effect on local tumour control of cranial nerve(s) palsy (Tn) and intracranial tumour extension (Tc). Changsha and UICC classifications were demonstrably less powerful in predicting NPC prognosis. Multiple sites of involvement within the nasopharynx by NPC had no adverse influence on local tumour control. The grouping together of both soft-tissue and skull-base lesions into Changsha's T3 has been shown to be unjustified because of significant differences in local failure.
Small bowel vasculitis
Authors: Gleeson F. V. , Tidbury P. J. 
Published: July 2009

Systemic vasculitis affecting the gastrointestinal tract is uncommon. We report a case affecting only the small bowel. The gastrointestinal manifestations and diagnosis of vasculitis are discussed.
A 55-year-old normotensive man with a past history of a leftnephrectomy in 1970 for nephrolithiasis, presented with a 3-month history of upper abdominal pain after food, whichoccasionally radiated through to his back. The pain lasted upto 2 hours, and was sometimes relieved by vomiting. There wasno history of haematemesis or melaena. Initial haematologicalinvestigation was normal and endoscopy demonstrated onlymild oesophagitis. Treatment with cimetidine failed to relievehis symptoms.
Inflammatory back pain
Authors: Renowden S. A. , Hayward M. W. J. 
Published: July 2009

A 57-year-old male was admitted as an emergency with a 3 day history of thirst, frequency and severe low back pain radiating to his right flank for 24 h. He was apyrexial and examination was normal. An elevated plasma glucose confirmed late onset diabetes. Urinalysis did not show any evidence of infection.
He developed a temperature of 39°C 24 h later and his erythrocyte sedimentation rate (ESR) was raised at 133. Blood cultures demonstrated Gram negative (G-ve) bacilli, later confirmed as Salmonella enteritidis. Appropriate intravenous antibiotics were commenced, stool cultures, ultrasound of his renal tract, gallbladder and plain films of the lumbar spine were normal.
Radiotherapy to the mediastinum in chronic myeloid leukaemia
Authors: Davis S. R. , Wolf M. M. , Ball D. L. 
Published: July 2009

We would like to report on the effect on the white cell and platelet counts of a patient with chronic myeloid leukaemia (CML) who received radiotherapy to her mediastinum for a carcinoma of the bronchus.
A 64-year-old female presented with a 6 week history of hoarseness, pain in the left arm, tiredness and dyspnoea on mild exertion. The patient had an ECOG performance status of 2 and had lost approximately 5% of her body weight. Examination confirmed a left upper zone lung lesion and no demonstrable neurological deficit in the left arm. Chest radiograph and computed tomography (CT) scan of the thorax showed a 10 cm mass in the left upper lobe, an enlarged para-aortic lymph node and sputum cytological examination revealed squamous carcinoma. The patient was thus diagnosed as having a T2N2 squamous carcinoma of the lung.
Quantitative computed tomography: comparative study using different scanners with two calibration phantoms
Authors: Suzuki Satoshi , Yamamuro Takao , Okumura Hideo , Yamamoto Itsuo 
Published: July 2009

Abstract
To assess computed tomography (CT) scanners in vertebral quantitative computed tomography (QCT) measurement, five cadaveric vertebrae fixed in a water phantom were measured using 16 CT scanners of 10 different models using two types (CaCO3 and K2HPO4) of reference phantom. Although the same reference phantoms were used, the QCT values varied markedly depending on the CT scanner employed. The differences in QCT values were greater in the equivalent amount of CaCO3 than in that of K2HPO4. The largest difference between CT scanners was 40 mg/cm3 in the equivalent amount of CaCO3 and 28 mg/cm3 in that of K2HPO4. These differences were reflected among CT scanners by different slopes and intercepts of the reference lines of CaCO3, K2HPO4 and ash density depending on the CT scanner used. However, good correlations (r &gt; 0.97) were observed for the QCT values obtained by various CT scanners. These results show that QCT values on one machine can be compared more closely with those of another machine if conversion formulae, determined by using materials equivalent to human vertebral bone, are employed.
Oesophageal ruptures complicating balloon dilatation of strictures: a report of two cases
Authors: Mucci B. 
Published: July 2009

Balloon dilatation of upper gastro-intestinal tract strictures is accepted as a safe and effective method of dealing with lesions of varying aetiology. Perforation of the oesophagus is a recognized, but rare complication. Two such cases are described and their management is discussed.
A 67-year-old man with a 10 year history of hiatus hernia associated with an oesophageal stricture presented with dysphagia and coughing after swallowing. Endoscopy revealed a benign oesophageal stricture at 35 cm.
Dilatation was performed using a 22 mm Lunderquist-Owman oesophageal dilatation kit (William Cook Europe) balloon under intravenous sedation (6 mg Midazolam Hydrochloride). The balloon was distended three times with ease under fluoroscopic control and no waisting of the balloon was visible on the final dilatation.
The patient complained of pain 4 h after the procedure and a chest radiograph was taken revealing no abnormality. The following morning a further chest radiograph revealed extensive consolidation in the left lower lobe.
A water soluble contrast swallow demonstrated a leak from the lower oesophagus. The patient was treated by bed rest and intravenous fluids for 1 week and no surgical intervention was required. The patient was discharged well on the seventh day following the procedure.
A 59-year-old lady presented with lower oesophageal dysphagia. At endoscopy there was an impassable area of narrowing in the lower oesophagus. Biopsies revealed no evidence of malignancy.
Relapsing polychondritis: report of an unusual case and a review of the literature
Authors: Goddard P. , Cook P. , Laszlo G. , Glover S. C. 
Published: July 2009

Relapsing polychondritis is an uncommon multisystem disorder, characterized by recurrent inflammation of cartilage at multiple sites, which can go unrecognized until classical signs of cartilage destruction occur. Destruction of the cartilage of the external ears and nose is easy to recognize. Central airway involvement is more difficult to recognize, but more important in terms of prognosis. Neurological symptoms and signs are uncommon, have been infrequently reported and may lead to incorrect diagnosis and delay in treatment.
A case of relapsing polychondritis presenting as an acute encephalitis is described. The use of computed tomography (CT) in determining the presence and severity of central airway involvement is discussed.
A 58-year-old man was admitted in June 1988 with a 6-week history of ear infection not responding to three courses of antibiotics. During this time he had been unwell with earache, headache, fatigue and lethargy and was sleeping for long periods. He also had fleeting arthralgia and intermittent fever with rigors. Two days before admission he deteriorated and became confused, uncooperative and drowsy.
He was known to have been under the care of an ophthalmologist with left episcleritis, for the previous 8 months. In 1972, mild asthma was treated with inhaled bronchodilators and in 1983 he experienced costochondral chest pain.
On admission he was found to be drowsy, confused and agitated. Bilateral conjunctivitis, swollen eyelids and tender pinnae were noted but the tympanic membranes were normal.
Thorium dioxide, forgotten but not gone
Authors: Kessel D. , Robbins K. F. , Wilkinson M. L. , Smith P. M. 
Published: July 2009

The recent report edited by Taylor et al (1989) reminds us of the continuing risk of morbidity in patients exposed to thorium. We present three cases, with hepatic sequelae, in which the radiological diagnosis was missed on initial presentation. They illustrate the need to be alert to the possibility of Thorotrast toxicity.
Thorotrast, a 25% colloidal solution of thorium dioxide, was a widely used contrast medium from 1928 (Blühbaum et al, 1928) until 1955, when its use was abandoned following a report (MacMahon et al, 1947) of hepatic angiosarcoma associated with exposure to Thorotrast and concern about the long term effects of internal irradiation.
A 69-year-old female was admitted in 1989 for investigation of malaise, right hypochondrial pain and anorexia. She had had a cholecystectomy 10 years previously at which abnormal liver texture was noted. A liver biopsy revealed cirrhosis. Examination was normal apart from tender, non-pulsatile hepatomegaly. Liver function revealed a markedly elevated alkaline phosphatase and gamma glutamyl transferase. The alpha-fetoprotein (AFP) was not raised. An abdominal X ray (Fig. 1) revealed metallic opacities in the spleen, periphery of the liver and coeliac axis lymph nodes. Abdominal ultrasound showed the liver to be enlarged with increased echogenicity. The spleen was noted to be very small. Further history revealed that the patient had received Thorotrast in 1938 during investigation of a “kidney problem”. A repeat liver biopsy showed multiple deposits of refractile brown material consistent with Thorotrast. There was macronodular cirrhosis with marked periductal fibrosis.