bluuebunny/crossref_metadata_2025_split huggingface dataset:
Computer assisted determination of the dose-area product in retrograde urethrography
Authors: Merkle E , Aschoff A J , Muller M , Merk J , Brambs H-J 
Published: July 2009

Abstract
Retrograde urethrography (RUG) is a dynamic radiological procedure in which the cumulative dose–area product (DAP) comprises radiation doses derived from both fluoroscopy and radiography. In the present prospective study, digital retrograde urethrographs (Prestilix 1600X/DRS, General Electric) were obtained in 40 consecutive male patients (mean age 60.6 years, range 23–88 years) presenting for evaluation of urinary pathology. The radiation dose was recorded as the dose–area product. From these data, a computer program (Diasoft 2 0, PTW, Freiburg, Germany) then determined the respective proportions of the total radiation dose deriving from fluoroscopy and radiography, as well as the number of radiographic exposures. The average total radiation dose was 316 cGy cm2. In five of the 40 patients examined (12 5%), the number of radiographic exposures registered by the program and, hence, the calculated DAPs were erroneous. In the remaining 35 patients, the average proportion of the cumulative DAP resulting from fluoroscopy was 81%, while that deriving from radiography was 19%. The computer program utilized in this study makes possible an intelligent evaluation of the DAP in dynamic procedures such as RUG. Since fluoroscopy is responsible for 81% of the cumulative DAP at RUG, a significant decrease in applied radiation dose may be achieved by reducing fluoroscopy time or by using pulsed fluoroscopy.
MRI appearances of left sided Morgagni hernia containing liver
Authors: Collie D A , Turnbull C M , Shaw T R D , Price W H 
Published: July 2009

Abstract
Morgagni hernias most commonly present in infancy or childhood with gastrointestinal or respiratory symptoms, resulting from visceral herniation into the thorax. They are much rarer in the adult, and may be misdiagnosed as pericardial masses. We report a case of a Morgagni hernia containing liver, which hindered cardiac imaging with echocardiography and angiography, and was best demonstrated with MRI.
Ultrasound diagnosis of portocaval anastomosis in infants—a report of eight cases
Authors: Farrant P , Meire H B , Karani J 
Published: July 2009

Abstract
We report eight cases of portocaval anastomosis in infants diagnosed by ultrasound. Anatomically we believe this represents continuing patency of the ductus venosus, either as a primary developmental abnormality or secondary to established liver cell failure.
The influence of the number of fractions and bi-exponential repair kinetics on biological equivalence in pulsed brachytherapy
Authors: Millar W T , Hendry J H , Canney P A 
Published: July 2009

Abstract
A linear-quadratic radiobiological model incorporating single or bi-exponential repair kinetics has been used to show the following and other features when a continuous low dose rate (CLDR) 70 Gy/140 h brachytherapy protocol is replaced by a radiobiologically equivalent pulsed dose rate (PDR) system using 140 fractions for reasons of dosage homogeneity. (1) For equivalent effects in late-reacting tissues, the PDR dose (at 5 or 0.05 Gy min−1) × 1 h intervals needs to be reduced by up to only 3%. Progressively further reductions in dose are required when fewer larger fractions are used. (2) When equivalence using pulsed doses is achieved for one normal tissue type, and extrapolated response doses (ERD) are calculated for other tissue types in the irradiated volume, values of the ERD remain within 5% of each other using the above PDR protocol and associated parameters. (3) For tumours with α/β=10 Gy and a single repair halftime of 0.1–1.0 h, there is no significant loss of therapeutic benefit using the PDR protocol equivalenced for late normal tissue reactions. The strategy of replacing an LDR boost protocol of about 24 Gy by a PDR protocol gives similar levels to the 70 Gy PDR protocol for the expected percentage increase in the biological dose to normal tissues (due to the PDR protocol alone). These calculations also highlight the importance of the values assumed for the conventional α/β ratio and the repair kinetics when estimating equivalent PDR protocols. The use of an inappropriate radiobiological parameterization will lead to erroneous conclusions with the potential to advocate PDR protocols which will, in practice, lead to an increase in late complications.
Transrectal ultrasound in the evaluation of cervical carcinoma and comparison with spiral computed tomography and magnetic resonance imaging
Authors: Yang W T , Walkden S B , Ho S , Cheung T H , Lam S K , Teo J , Metreweli C 
Published: July 2009

Abstract
38 women with biopsy proven untreated cervical carcinoma were prospectively studied with transrectal ultrasound (TRUS), spiral computed tomography (SCT) and magnetic resonance imaging (MRI). 20 women had radical hysterectomy and pelvic lymphadenectomy with detailed histological evaluation of the parametra. The echographic features of cervical carcinoma on TRUS are a hypoechoic (60%) or isoechoic (40%) (relative to normal uterine muscle/cervical stroma), poorly defined mass lesion with indistinct margins in an enlarged cervix. This relatively high percentage of isoechoic tumours and relative lack of contrast resolution may pose a problem in the identification of some tumours, and to our knowledge has not been previously reported. Further limitations of TRUS are in the evaluation of advanced cervical cancer, due to bulky tumours rendering poor access to the parametrium and pelvic sidewall. The overall accuracy in staging of early cervical cancer (less than stage 2b) was 85% for examination under anaesthesia (EUA), 75% for TRUS, 65% for MRI and 50% for SCT. The positive predictive value in evaluating the parametra in this group of patients was also lower for SCT (14%) and MRI (33%) compared with TRUS (100%). In the evaluation of advanced cervical cancer (stage 2b or higher), there was poor correlation between TRUS and EUA, with MRI showing the best correlation with EUA. We conclude that SCT is inferior to both TRUS and MRI in the staging of early stage cervical cancer.
Flat and curved crystal spectrography for mammographic X-ray sources
Authors: Chantler C T , Deslattes R D , Henins A , Hudson L T 
Published: July 2009

Abstract
The demand for improved spectral understanding of mammographic X-ray sources and non-invasive voltage calibration of such sources has led to research into applications using curved crystal spectroscopy. Recent developments and the promise of improved precision and control are described. Analytical equations are presented to indicate effects of errors and alignment problems in the flat and curved crystal systems. These are appropriate for all detection systems. Application to and testing of spectrographic detection (using standard X-ray film) is presented. Suitable arrangements exist which can be used to measure X-ray tube voltages well below 1 kV precision in the operating range of 20–35 kV.
Colour Doppler ultrasound in renal artery stenosis: intrarenal waveform analysis
Authors: Baxter G M , Aitchison F , Sheppard D , Moss J G , McLeod M J , Harden P N , Love J G , Robertson M , Taylor G 
Published: July 2009

Abstract
Renal artery stenosis (RAS) is the commonest secondary cause of hypertension and may result in renal ischaemia with resultant renal failure. Recent studies have suggested that colour Doppler ultrasound, with spectral analysis of the intrarenal waveforms, can identify those patients with a significant RAS. A prospective study was performed in which colour Doppler ultrasound was compared with angiography in 73 patients (143 kidneys) presenting for renal angiography. Colour Doppler ultrasound was unsuccessful in 16% of kidneys due to a combination of technical failures and small kidney size. Accessory renal vessels were present in 14% of kidneys on angiography but none was detected by ultrasound. Of the 120 kidneys that had both examinations, no significant difference in intrarenal pulsatility or resistive index was noted between the angiographically stenosed and normal arteries. There were significant differences for intrarenal peak and end diastolic velocities, and acceleration time and index. Of these measurements, acceleration time was the best indicator of RAS. The probability of detecting a high grade RAS in an individual patient did not reach 90% until the acceleration time was prolonged to more than 0.12 s. Intrarenal colour Doppler ultrasound is not a general screening test for RAS and it should be reserved for selected patient groups where the incidence of disease is high Patients with prolonged acceleration times of more than 0.12 s have a high likelihood of at least 70% RAS and should proceed directly to angiography.
Endovascular treatments for intracranial aneurysms
Authors: Byrne J 
Published: July 2009

Abstract
During the last 10 years, the development of flexible microcatheters which can navigate cerebral vessels to lesions deep within the brain, has allowed the treatment of an increasing range of intracranial pathologies, including aneurysms. Techniques to embolize aneurysms, either by occlusion of their parent artery or endosaccular packing with its preservation, have evolved largely in order to treat inoperable aneurysms. Endosaccular packing with thrombogenic coils has recently allowed embolization of smaller aneurysms to be performed in patients acutely ill after subarachnoid haemorrhage. The procedural morbidity associated with these endovascular treatments are less dependent on aneurysm site than conventional neurosurgical clipping and initial results are comparable. These developments are challenging current thinking on the surgical management of patients with intracranial aneurysms. This review describes the evolution and practice of current endovascular treatments and their possible implications for the future of neuroradiology.
Hysterosalpingo-contrast sonography (HyCoSy) using Echovist®-200 in the outpatient investigation of infertility patients
Authors: Ayida G , Harris P , Kennedy S , Seif M , Barlow D , Chamberlain P 
Published: July 2009

Abstract
This study describes the introduction of hysterosalpingo-contrast sonography (HyCoSy) as a first line outpatient investigation of uterine and tubal factors in two fertility units. 136 infertile women had transvaginal scanning before and during the intrauterine injection of contrast medium (Echovist®-200). HyCoSy was successfully completed in 132 cases (97%) within a mean time of 12.6 ± 8.4 (4–50) min. The uterus and its cavity appeared normal in 108 (82%) women. Uterine abnormalities in the remaining 24 women (18%) included structural abnormality (n = 7), fibroids (n = 12) and endometrial polyps (n = 5). A total of 261 fallopian tubes in 132 women were assessed: 186 (71%) appeared patent and 55 (21%) blocked. The remaining 20 (8%) could not be assessed for technical reasons. Polycystic ovaries and ovarian cysts were diagnosed in eight women. The most common adverse effect was mild/moderate pain, similar to period pain, with 24 (18%) women requiring simple analgesia. HyCoSy is a simple and well tolerated outpatient procedure. The technique provides clinically valuable information about tubal patency, ovarian and uterine abnormalities.
Foot axes and angles
Authors: Gentili A , Masih S , Yao L , Seeger L L 
Published: July 2009

AbstractUsing radiographs and diagrams, this article reviews the most commonly used axes and angles of the foot, including: longitudinal axis of the rearfoot, collum tali axis, talocalcaneal angle, cuboid abduction angle, longitudinal axis of the lesser tarsus, lesser tarsus angle, talonavicular angle, longitudinal axis of the metatarsus, forefoot adductus angle, metatarsus adductus angle, first intermetatarsal angle, hallux valgus angle, proximal and distal articular set angles, and hallux interphalangeal angle, plane of support, collum tali axis, talar declination angle, calcaneal inclination axis, lateral talocalcaneal angle, first metatarsal declination axis and calcaneal inclination angle.
Observer variability in the interpretation of contrast enhanced MRI of the breast
Authors: Mussurakis S , Buckley D L , Coady A M , Turnbull L W , Horsman A 
Published: July 2009

Abstract
The purpose of this study was to determine observer variability in the interpretation of contrast enhanced breast MRI and to evaluate its effect on the detection and differentiation of breast cancer. 57 women underwent breast MRI using spin echo and dynamic spoiled gradient-recalled sequences. Images were independently reviewed by three radiologists, two experienced and one newly trained in breast MRI interpretation. One of the experienced readers reviewed all examinations twice. Interpretation was based on lesion conspicuity, signal intensity, contour and enhancement pattern. Contrast uptake was assessed using region of interest (ROI) analysis of the dynamic images and calculation of a maximum enhancement index. Sensitivity and specificity in the diagnosis of malignancy irrespective of disease extent, and in the diagnosis of multifocal malignancy were estimated. 113 lesions were reported. Kappa coefficient estimations showed only a moderate agreement between the two experienced readers in rating morphological characteristics; the agreement between the newly trained reader and the experienced readers was even worse. Moreover, there was significant interobserver and intraobserver variation in the enhancement index measurements. Weighted kappa values indicated good agreement between the experienced readers in lesion and overall interpretation, excellent intraobserver agreement, but substantial disagreement between the newly trained reader and both experienced readers. All readers showed good sensitivity in cancer detection, but specificity was substantially lower. There is significant observer variability and a substantial learning curve in the interpretation of breast MRI, and variability in the ROI analysis of dynamic data. Further efforts to improve the reliability of ROI analysis and image interpretation are needed to help MRI realise its full potential in the clinical management of breast cancer.
Scatter dose estimation based on dose–area product and the specification of radiation barriers
Authors: Williams J R 
Published: July 2009

Abstract
Scatter dose as a function of dose–area product (DAP) has been studied over a range of tube potentials and scattering angles. Data are presented to permit the calculation of scatter dose from DAP at distances of 1 m or more from the patient. This method has been used to calculate absorbed dose to the walls of six existing X-ray rooms which are used for interventional radiology, angiography or barium contrast studies. These calculations have been compared with measurements using thermoluminescent dosemeters. The median ratio of measured to calculated dose was 0.50 and the maximum value was 1.26. It was concluded that the calculation of scatter dose from DAP using the factors derived in this report can be used as the basis for the specification of radiation protection barriers. The busiest room in this study in terms of DAP had a DAP rate of 224 Gy cm2 per day. From the scatter factors presented here, it was shown that the room walls did not need to have more than 1.2 mm of lead equivalence.
Vaginal endosonography to diagnose enterocoele
Authors: Halligan S , Northover J , Bartram C I 
Published: July 2009

Abstract
Radiological diagnosis of enterocoele is possible using evacuation proctography, but the standard technique must be modified to reveal the small bowel. Since prolapsed bowel is interposed between the vagina and rectum, diagnosis may be possible using vaginal endosonography. We describe a simple ultrasound technique to diagnose enterocoele, which has been validated by comparison with proctography. 17 women were examined with vaginal endosonography, and a diagnosis of enterocoele made if bowel was visualized in the rectovaginal space when bearing down. The findings were compared with subsequent proctography. In eight cases (47%) bowel prolapsed into the rectogenital space during straining, obscuring the rectum, while this did not occur in the remaining nine subjects (53%). Proctography confirmed an enterocoele in six of the eight cases in whom it had been diagnosed on endosonography, and confirmed the absence of enterocoele in all of the nine cases negative on endosonography. These values gave vaginal endosonography a sensitivity of 100% and specificity of 82%, with a positive predictive value of 75%, and negative predictive value of 100% for a prevalence of abnormality of 0.35. Vaginal endosonography is a quick, easy and convenient alternative to evacuation proctography for the radiological diagnosis of enterocoele.
Spectral pulsed Doppler sonography of renal vascular resistance in sickle cell disease: clinical implications
Authors: Aikimbaev K S , Oǧuz M , Güvenç B , Başlamişli F , Koçak R 
Published: July 2009

Abstract
The major complications in sickle cell disease (SCD) are microcirculation lesions and impairment of renal function. The aim of this study was the evaluation of renal vascular resistance by means of spectral pulsed Doppler sonography and its relationships with haematological and clinical features in patients with SCD. 40 patients with SCD (mean age 22.4±7.0) and 14 age and sex matched healthy subjects (mean age 25.7±9.5) were included into the study. Spectral Doppler sonography of main renal, segmental and interlobar arteries were performed on both kidneys in all patients and controls. Peak systolic, end diastolic and mean velocities through the entire cardiac cycle were obtained, with calculation of the resistive (RI) and pulsatility (PI) indices. All the patients were investigated in stable state conditions and had not been transfused within a month before investigation. Patients were followed for up to 6 months. Patients with SCD had higher values of RIs and PIs than control subjects (p&lt;0.0001, p&lt;0.0001, respectively). Patients with high value of RIs (RI&gt;0.70) had more pronounced disturbances of blood parameters (all p&lt;0.05), than patients with normal RIs (RI&lt;0.70). Significant positive correlation existed between RIs and ISC number, MCHC level (r=0.52, p&lt;0.001 and r=0.42, p&lt;0.01), while RBC count and Hb level correlated inversely with RIs (r=−0.39, p&lt;0.01 and r=−0.42, p&lt;0.01). During follow-up, nine patients (33.3%) with high RIs and only one patient (5.5%) with normal RI developed painful crises. In conclusion, renal vascular resistance, assessed by Doppler sonography was raised in SCD patients as compared with age matched apparently healthy persons. These changes were more pronounced in those with more severe manifestations of disease and correlated with haematological and clinical features of sickle cell disease.
Tuberculosis of the parotid gland—diagnosis by CT
Authors: Bhargava S , Watmough D J , Chisti F A , Sathar S A 
Published: July 2009

Abstract
A case of parenchymal and intraparotid lymph node tuberculosis is reported in a young Asian male. The diagnosis was suggested pre-operatively by the contrast enhanced CT (CECT) appearance. There were no systemic symptoms of tuberculosis and this is a characteristic feature of the 100 cases reported in the literature. The presence of thick walled rim enhancing lesions with a central lucency on CECT should suggest the diagnosis. Filling defects with or without thin walls are non-specific findings and are seen in tumours and other inflammatory processes. In an appropriate clinical setting, thick walled round rim enhancing lesions with a central lucency are characteristic of tuberculosis.
Prognostic Significance of CXCL12 Expression in Patients With Colorectal Carcinoma
Authors: Akishima-Fukasawa Yuri , Nakanishi Yukihiro , Ino Yoshinori , Moriya Yoshihiro , Kanai Yae , Hirohashi Setsuo 
Published: July 2009

Abstract
The present study investigated the protein expression level of CXCL12 in colorectal cancer and aimed to elucidate its association with prognosis. CXCL12 positivity in 50% or more of tumor cells was defined as high expression and that in less than 50% of the tumor cells as low expression. CXCL12+ tumor budding at the invasive front was divided into 2 grades: high with 10 or more budding foci per ×200 field of view and low grade with fewer than 10 budding foci. Patients with high expression (72.7%) and high grade CXCL12+ tumor budding (43.0%) had significantly shorter survival than patients with low expression (P = .014) and low grade (P = .003), respectively. Patients with a combination of high expression and high grade had the worst outcome (P &lt; .001). Our study demonstrated that CXCL12 expression in colorectal cancer cells and at sites of budding were significant prognostic factors. Furthermore, together with lymph node metastasis, a combination of both expression patterns was a more powerful independent prognostic factor.
Aberrant Expression of CD8 in B-Cell Non-Hodgkin Lymphoma
Authors: Carulli Giovanni , Stacchini Alessandra , Marini Alessandra , Ciriello Maria Matilde , Zucca Alessandra , Cannizzo Elisa , Aliberti Sabrina , Demurtas Anna , Novero Domenico , Calcagno Lara , Callegari Tiziana , Petrini Mario 
Published: July 2009

Abstract
T-cell antigen expression can be observed in B-cell non-Hodgkin lymphoma (B-NHL). Although CD5 is expressed in B-cell chronic lymphocytic leukemia (B-CLL) and mantle cell lymphoma, the presence of other T-cell antigens is less common. This article reports a retrospective multicenter analysis in which flow cytometry was used to evaluate aberrant CD8 expression on the pathologic B cells of 951 bone marrow samples from patients with various types of B-NHL.
In a total of 18 patients, CD8 was coexpressed: 10 had B-CLL; 1, small lymphocytic lymphoma (SLL); 1, marginal zone lymphoma; 1, lymphoplasmacytic lymphoma; 2, diffuse large B-cell lymphoma; and 3, follicular lymphoma. There was a 1.89% overall frequency of CD8 coexpression in which B-CLL/SLL had a higher frequency (3.03%) than did the other B-cell neoplasms (1.18%). Most cases were characterized by a favorable outcome.
Trends in the Postmortem Diagnosis of Opportunistic Invasive Fungal Infections in Patients With AIDS
Authors: Antinori Spinello , Nebuloni Manuela , Magni Carlo , Fasan Marco , Adorni Fulvio , Viola Anita , Corbellino Mario , Galli Massimo , Vago Gianluca , Parravicini Carlo , Ridolfo Anna Lisa 
Published: July 2009

Abstract
We retrospectively evaluated autopsy-proven invasive fungal infections (IFIs) in patients with AIDS who died between 1984 and 2002. IFIs were identified in 297 (18.2%) of 1,630 autopsies. Their prevalence significantly decreased over time (from 25.0% in 1984–1988 to 15% in 1998–2002; P = .004), mainly owing to a significant decrease in pneumocystosis (P = .017) and cryptococcosis (P = .003), whereas the prevalence of aspergillosis and histoplasmosis remained relatively stable and of candidiasis and zygomycosis tended to increase in the last years (P = .028 and P = .042, respectively). IFIs were suspected or confirmed during life in only 46.8% of the cases; this proportion did not vary significantly over time (P = .320). The infections contributed to the deaths of 103 patients (34.7%), and their global impact on mortality was 6.3%. Of fatal cases, 38 (36.9%) were characterized by missed antemortem diagnoses, 17 (45%) of which met Goldman criteria for class I errors.
The epidemiology of IFIs in patients with AIDS is evolving and not completely mirrored by clinical diagnoses or current diagnostic methods. Our results confirm the valuable role of autopsy data, even with highly effective therapies and advanced technologies.