bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radiation dose to neonates on a Special Care Baby Unit
Authors: Faulkner K. , Barry J. L. , Smalley P. 
Published: July 2009

Abstract
Neonates on a Special Care Baby Unit often require radiography to monitor the progress of their treatment and as a result can have a large number of radiographs taken during their stay in hospital. The skin entrance dose was estimated from a knowledge of the technique factors, X-ray tube output and backscatter factors. Normalized organ dose data were employed to estimate the radiation dose to a number of critical organs. A number of methods of reducing the radiation dose to neonates were investigated. Initially, this involved changing the radiographic technique factors and introducing a lead rubber adjustable collimator, placed on top of the incubator, in addition to the light beam diaphragms on the X-ray tube. It was deduced from the results of calculations that these modifications to the radiographic examination technique had reduced the average entrance dose per radiograph from 92 μGy to 58 μGy, a reduction of 37%. Later, a rare-earth film-screen combination was introduced to replace the existing fast calcium tungstate screens. This enabled the average entrance dose per radiograph to be reduced to 39 μGy, a further reduction of 33%. The mean radiation dose to a neonate is mainly determined by the number of radiographs taken and this is dependent on the clinical symptoms.
A comparison of two different T-grain films in rare-earth screens with a standard film–screen combination for intravenous pyelography and bone examinations
Authors: Logan Hugh , Daly Lesley , Masterson James 
Published: July 2009

Abstract
T-grain film is claimed to give significantly improved image quality, allowing the use of faster screens without loss of quality and thus reducing radiation dose. We tested this claim for two systems. In each case comparison was made with our usual screen–film combination, Agfa Curix RP1 film with Kodak Xomatic Regular screens (a nominally 200 speed system). The systems tested were Kodak TMatG in Kodak Lanex Medium screens (300 speed) and Agfa STG in Kodak Lanex Regular screens (400 speed). The Agfa STG–Lanex Regular system performed less well than the standard system for intravenous pyelograms (IVPs), bones and soft-tissue detail. Its speed advantage was not apparent below 70 kV. The Kodak TMatG-Lanex Medium system was better than the standard system for IVPs but not as good for bones. It gave virtually no speed advantage below 90 kV. Kodak T-grain film in a medium-speed, rare-earth screen was found to be better than the standard system for IVPs. Agfa T-grain film in a fast rare-earth screeen was unsatisfactory for IVPs. Neither combination was as good as the standard system for bones.
Radiological appearances of colonic ring staple anastomoses
Authors: Daly B. D. , Crowley B. M. 
Published: July 2009

Abstract
The radiographic appearances of colonic staple ring anastomoses are presented. Staple ring disruption on plain abdominal radiographs in the early post-operative period suggests dehiscence of the bowel anastomosis and is an indication for urgent water-soluble contrast medium enema to confirm the diagnosis. Rectal stenosis can develop as a late complication of staple anastomosis and may be detected on barium enema.
An iodine-125 applicator designed for irradiating blood vessels growing into the cornea of the eye
Authors: Hering E. R. , Sealy R. , Korrubel J. B. , Hill J. 
Published: July 2009

The invasion of the traumatized cornea by blood vessels is a well known complication and is often associated with graft rejection. Graft acceptance may be improved by the induction of endarteritis with β radiation but the corneal stroma may be so changed by the necessary dose of radiation (commonly 4500–5000 cGy in three or four fractions) as to significantly increase the risk of sloughing (Macfaul & Bedford, 1970). To overcome this problem, we have designed and made an 125I eye applicator to produce an extremely narrow radiation field for treating the vascularization at the base of the cornea only. The anterior part of the cornea receives a very small dose of about 11% of that given to the base and is sufficiently large to receive a 6 mm corneal transplant.
The use of 125I seeds in gold applicators for treating malignant conditions of the eye has been well documented (Sealy et al, 1980). Our applicator is designed to achieve a field width of 0.4 mm at the base of the cornea. Seeds were positioned in a gold applicator, a cross-section of which is shown schematically in Fig. 1.
Ultrasound diagnosis of gallbladder perforation in a case of xanthogranulomatous cholecystitis
Authors: Houston J. P. , Sampson M. A. , Collins M. C. 
Published: July 2009

Cholelithiasis is a common disease and perforation and carcinoma of the gallbladder are well recognized complications. Xanthogranulomatous cholecystitis is an uncommon form of cholecystitis which is being recognized with increasing frequency. We report a case in which gallbladder perforation was diagnosed by ultrasound in a patient in whom all four conditions coexisted.
A 73-year-old woman presented with a 1-month history of rapidly worsening dementia following an episode of abdominal pain. Nine days before admission to hospital an abdominal swelling had been noticed. On examination she was pyrexial with a neutrophilia; there was a large, tender, fluctuant epigastric mass, pointing through erythematous skin.
Submarine escape training, lung cysts and tension pneumothorax
Authors: Saywell W. R. 
Published: July 2009

Submariners in the Royal Navy are required to undergo escape training, which is performed in a water-filled tower. Entry is gained via air-locks at depths of 9, 18 and 27 m. The subjects ascend to the surface exhaling continuously to compensate for the increased gas volume in the lungs as the pressure decreases. Divers are in the water as safety attendants, and a medical team including a doctor is on standby. Prior to escape training, chest radiography is performed in full inspiration and full expiration. Particular attention is paid to areas of reduced compliance (e.g. scarring) and evidence of airtrapping, either of which may pre-dispose to pulmonary barotrauma (Liebow et al, 1959; Campbell-Golding et al, 1960; Calder, 1985).
The subject of this report is a 21-year-old man who had an apparently normal chest radiograph (Fig. 1) and no significant previous medical history. He made an initial ascent from 9 m, during which he experienced transient right-sided chest pain. Examination by the Medical Officer revealed no abnormality and a further ascent from 9 m was made. On completion of this ascent he emerged from the water pale and unsteady, complaining of dizziness and diplopia, but with no evidence of chest pain or dyspnoea. He was immediately recompressed to 50 m. A Medical Officer entered the compression chamber and found evidence of barotrauma to the ears, but no other abnormalities.
The misleading pre-operative chest radiograph
Authors: Ipinyomi Janet , Watt Iain 
Published: July 2009

A 66-year-old man presented to the Accident and Emergency Department with pain in the right hip and difficulty in weight bearing after falling in the street that morning. He smoked about 15 cigarettes a day and had a wheeze which was relieved by Salbutamol. No other relevant history was elicited, apart from a vague story of ill defined upper chest pain in the past.
On examination he was observed to walk with a limp. His right hip was externally rotated, with limitation of movement because of pain. His right lower limb was 2 cm shorter than the left. Radiographs of the pelvis and chest and an apical view are shown in Figs 1 and 2 and frontal tomography of the chest was subsequently performed (Fig. 3).
What are the abnormalities demonstrated? What differential diagnosis should be considered and what might skeletal scintigraphy reveal?
A bone scintigram was performed a few days after admission to hospital. The right femoral head was imaged to assess vascularity (Fig. 4).
The relation of radionuclide uptake by bone to the rate of calcium mineralization. I: Experimental studies using 45Ca, 32P and 99Tcm-MDP
Authors: Budd R. S. , Hodgson G. S. , Hare W. S. C. 
Published: July 2009

Abstract
The study of the uptake of radionuclides by bone has been undertaken in a mouse tail graft model using 45Ca, 32P and a routine bone scanning agent 99Tcm-MDP, together with serial calcium determinations. The model provided an experimental system in which the calcium mineral content and the rate of mineralization both changed progressively throughout its development. A significant linear correlation was found between 45Ca and 32P uptake and the rate of calcium mineralization, which held for all stages of the graft's growth. Both radiotracers therefore accurately reflected the calcium mineral deposition. In the case of 99Tcm-MDP, the correlation with mineralization rate only applied for the most active growth period of the graft when the rate was increasing. For all radiotracers, the peak in bone uptake corresponded to the maximum in mineralization rate.
The relation of radionuclide uptake by bone to the rate of calcium mineralization. II: Patient studies using 99Tcm-MDP
Authors: Budd R. S. , Hodgson G. S. , Hare W. S. C. 
Published: July 2009

Abstract
The relation of radionuclide uptake by bone and rate of calcification has been studied in normal vertebrae and in vertebral metastases from cancer of the prostate. Specifically, the determination of 99Tcm-MDP uptake by radionuclide scanning and the estimation of calcium concentration of trabecular bone by dual-energy computed tomography have provided the means of obtaining a relation between these parameters which was similar to that found in an animal model, in which the dependence of radionuclide uptake on the rate of mineralization was established. This relationship has enabled the experimental findings to be extrapolated to those in patient studies and has shown that in sclerotic bone lesions, the increase in 99Tcm-MDP uptake accompanying the progression of the metastases was proportional to the rate of calcification.
Treatment of persistent and recurrent nasopharyngeal carcinoma by brachytherapy
Authors: Sham J. S. T. , Wei W. I. , Choy D. , Ho C. M. , Tai P. T. H. , Choi P. H. K. 
Published: July 2009

Abstract
The early results of brachytherapy for persistent and recurrent nasopharyngeal carcinoma in 30 patients is presented. Fifteen patients were treated by intracavitary caesium, 12 patients were treated by interstitial gold grain implant using the splitpalate approach and three patients were treated by both intracavitary caesium and interstitial gold grain implant for the first and second relapse in the nasopharynx, respectively. The overall tumour control rate for intracavitary caesium was 5/18 (28%) with median follow-up of 25.2 months, and for interstitial gold grain implant it was 9/14 (64%) with median follow-up of 16.5 months. Interstitial gold grain implantation appears to be effective in the treatment of persistent and recurrent nasopharyngeal carcinoma.
Dysplastic cortical hyperostosis: a new form of lethal neonatal dwarfism
Authors: Kozlowski K. , Tsuruta T. 
Published: July 2009

A new form of lethal neonatal dwarfism is reported. The name of dysplastic cortical hyperostosis is proposed for this entity. A Japanese, stillborn, male infant was delivered by a 28-year-old mother by a caesarean section after 28 weeks gestation. The pregnancy was complicated by polyhydramnios (2000 ml).
The mother was not exposed to any teratogenic agent. There was no parental consanguinity nor was there a family history of short stature or bone disease. No details of the father's age or the number of siblings were available.
At autopsy, it was found that the infant weighed 2900 g, crown-heel length was 37.7 cm and head circumference 37.4 cm. There was shortening of both the trunk and extremities and there was considerable oedema (Fig. 1).
The lungs were hypoplastic (left 2.7 g, right 3.0 g) with incomplete lobulation of the right lung. The cerebral sulci were poorly developed (? lissencephaly). There was complete renal duplication on the left and the orifice of the right coronary artery was high in position. Hepatosplenomegaly was noted.
The most striking radiographic finding was the generalized, symmetrical cortical thickening throughout the skeleton. This was most marked in the long bones and ribs, where the cortical thickening was wavy in outline. The medullary cavity was markedly narrowed. Similar sclerosis was seen in the clavicles and scapulae. The metacarpals and metatarsals had milder cortical sclerosis but in addition showed proximal tapering of the bones.
Haemoptysis in a laundry worker
Authors: Jackson J. E. , Allison D. J. 
Published: July 2009

A 39-year-old man of Philipino origin, who moved to England in April 1986, presented in January 1987 to his local hospital, as an emergency, following a massive haemoptysis. He had suffered four smaller haemoptyses during the preceding 4 months. The patient denied any history of cough, sputum, chest pain or wheezing although he had noted mild dyspnoea on exertion and had smoked until about 1 year previously. Bronchoscopy on admission revealed friable mucosa but no actual bleeding. He was subsequently referred to this hospital for further investigation.
Physical examination was unremarkable. Baseline laboratory investigations revealed only a mild microcytic anaemia and his arterial blood gases were normal. The chest radiograph on admission (Fig. 1) and a ventilation/ perfusion lung scan (Fig. 2) are shown below.
Book reviews
Authors: Owen Philip 
Published: July 2009

The first edition of this work was called X-ray Diagnosis and, in the words of the authors, “covered the subject of conventional radiology in reasonable detail but provided only a few pages on the imaging modalities”. I confess that I never read it, but feel confident that this new edition fully justifies the title Diagnostic Imaging.
Aimed at medical students and young doctors in training, it is destined to achieve a pre-eminent position on their bookshelves. I am amazed that a hard-backed book, so lavishly illustrated, can be offered at a price of only £19.80.
Doppler ultrasound in medical diagnosis
Authors: Wells P. N. T. 
Published: July 2009

Christian Andreas Doppler (often erroneously called Johann Christian) was born in Salzburg on 29 November 1803. The paper that made his name famous, “On the coloured light of the double stars and certain other stars of the heavens”, was presented on 25 May 1842 and published in the following year (Doppler, 1843). At that time, Doppler was Professor of Mathematics and Practical Geometry at the Technical Institute in Prague; he subsequently held appointments in Schemnitz and Vienna, and died in Venice on 17 March 1853. A full account of these events can be found in an article by Eden (1986).
Even more intriguing than Doppler's paper is the fact that Doppler was wrong! An Englishman, James Bradley, one-time Vicar of Bridstow, near Ross-on-Wye in Monmouthshire, had earlier published an article concluding that “when the Eye is moving in different Directions, the apparent Place of the Object would be different.” (Bradley, 1729). Doppler used this as the starting-point for his explanation of the effect of relative motion between a source of white light and an observer—a shift towards the blue for an approaching source, and towards the red for a receding source—but he overlooked the then already known fact that the radiation from a visible star extends on each side of the visible spectrum into the ultraviolet and the infrared.
Platinum chemotherapy, radiotherapy and the inner ear: implications for “standard” radiation portals
Authors: Kirkbride P. , Plowman P. N. 
Published: July 2009

Abstract
In this centre, platinum chemotherapy precedes radiotherapy in several primary malignancies arising in structures adjacent to the mastoid bone. The augmented ototoxicity of platinum and radiotherapy to fields encompassing the inner ear is exemplified by a case report. The order of administration may not be critical. This important toxicity, particularly for young patients, may be reduced by careful shielding considerations during planning of radiation portals, as exemplified in two further cases, and by carboplatin chemotherapy.
In vivo viability of 111In-labelled granulocytes demonstrated in a sham-dialysis model
Authors: Becker W. , Schaefer R. M. , Börner W. 
Published: July 2009

Abstract
In seven febrile patients undergoing regular dialysis treatment, sham-dialysis with a dialyzer equipped with a cuprophane membrane was performed during a routine 111In-oxine white blood cell scan with “pure” granulocytes isolated on a discontinuous gradient (Percoll/plasma: n = 5; Metrizamide/plasma: n =2). The patients were in contact with the cuprophane membrane over 45 or 90 min. Twenty-five (±5) minutes after the start of the dialysis, the peripheral leucocyte count (59 ± 22%) and the 111 In activity in the peripheral blood decreased to a minimum of their initial range (64 + 21%) because of leucocyte activation. The activity over both lungs increased symmetrically (29+ 15%), the spleen activity decreased (14.8 + 8%) and the liver activity remained constant. At the end of the dialysis (45—90 min post-injection), the number of circulating neutrophils, peripheral 111In activity and activity distribution in the organs regained their initial level. In conclusion, these data confirm previously described data concerning the sequestration of neutrophils into the lung during dialysis treatment. The data demonstrate the origin of the activated neutrophils in the circulation and the spleen. The identical behaviour of 111In-oxine-labelled and unlabelled granulocytes is demonstrated. Additionally, the accumulation of activity in the spleen is due not to opsonized cells but to sequestrated neutrophils, which are able to migrate from the spleen after adequate activation. The migration of activated cells into the lung explains the diagnostic difficulties posed by diffuse lung uptake in leucocyte scans in patients with leucocyte-activating diseases.
An alignment test jig for measuring the effective focal-spot size of mammographic X-ray tubes
Authors: Ramsdale M. L. , Hiles P. A. , Lawinski C. P. 
Published: July 2009

Following publication of the Forrest Report (Department of Health and Social Security (DHSS), 1986) and with the implementation of a breast cancer screening programme in the UK, there is considerable interest in the technical aspects of mammographic systems. The equipment requirements for mammographic X-ray screening units have been identified (DHSS, 1987) and guidance on the commissioning and routine testing of mammographic X-ray equipment is also expected (Institute of Physical Sciences in Medicine (IPSM), 1989). These documents relate to all aspects of the mammographic X-ray set including the specification and measurement of the size of the X-ray tube focal spot.
It is recommended (DHSS, 1987) that effective focalspot sizes are measured using a pair of slit radiograms in the manner described in BS 6530 (British Standards Institution (BSI), 1985). This standard provides details on the construction of the slit diaphragm and the geometry to be employed when performing focal-spot measurements. In particular, the method requires that the centre of the slit diaphragm and its axis of symmetry are aligned with the reference axis, which is defined as the line through the centre of the radiation source and parallel to the reference direction or that specified direction to which the characteristics such as target angle are referenced. The manufacturer should specify the reference axis when providing data on anode target angle and size of focal spot.
The production of chromosome structural changes by radiation: an update of Lea (1946), Chapter VI
Authors: Savage John R. K. 
Published: July 2009

No one can read the papers of the early radiation biologists without being impressed, almost awed, by the depth and thoroughness with which they tackled their topics. Every ounce of information is extracted from the results, every possible avenue of interpretation and implication is explored.
Douglas Lea's Actions of Radiations on Living Cells (first edition, 1946) is a classic example. It is a work that has had a profound influence on radiobiology and is still widely quoted today.
Many of Lea's fundamental concepts were based on the qualitative and quantitative production of visible chromosome structural changes, particularly in the plant Tradescantia. In accord with Sherlock Holmes' aphorism, before theorizing, he summarizes and evaluates in Chapter VI the experimental facts. In the intervening years an enormous amount of radiation cytogenetics has been done and it is fair to ask the question “How stands the foundation?”. I do not intend to review the whole field in this paper but, using the same section headings Lea used, to comment on and update, in the light of more recent work, some of the statements and ideas he developed. The format of the comments presupposes that the reader has a copy of Lea (1946) to hand.†
Before looking at the individual sections, it will be helpful to describe some of the conceptual changes that have occurred since Lea wrote his book and that influence current thinking.
Comparison of techniques for thallium-201–technetium-99m parathyroid imaging
Authors: Brownless S. M. , Gimlette T. M. D. 
Published: July 2009

Abstract
It is impracticable to compare the variety of techniques advocated for thallium–technetium (Tl–Tc) subtraction parathyroid imaging by repeated studies in patients. We therefore carried out studies using a phantom assembly to simulate thyroid and parathyroid in the neck, containing activities of 99Tcm and 201T1 similar to those likely to be present in patient imaging. An initial study of imaging protocol confirmed that correction for scatter from 99Tcm in the 201T1 window usefully improved the image. After making a preliminary selection of gamma cameras and collimators it was found that the GE Maxicamera 400T just visualized the 0.3 g “parathyroid” in a 5 min image with the pinhole collimator and 6 mm insert (A). It performed slightly less well with the HR converging collimator (B) and only marginally better with the 4 mm insert (C), but this is unduly slow unless it is placed close enough to limit the field of view unacceptably. The Siemens Orbiter 75 ZLC with special thyroid collimator (D) gave results similar to (A), is convenient for positioning the patient and is very suitable for parathyroid imaging.
Spontaneous abrupt changes in the distribution of ventilation: a cause for apparent mismatching on ventilation/perfusion scintigraphy
Authors: Peters A. M. , Gordon I. , Kaiser A. M. , Arnot R. N. , Lavender J. P. 
Published: July 2009

Abstract
A defect seen in the perfusion scan in a region of lung that is normally ventilated is usually interpreted as indicating pulmonary vascular disease. Since the distribution of 99Tcm macro-aggregated albumin (MAA) represents the distribution of perfusion (Q) only at the time of MAA injection, the assumption is required that the distribution of ventilation (V) remains unchanged between MAA injection and the commencement of imaging. We report the V/Q scintigraphic findings in six patients (including four children), in whom this assumption could not be sustained. Thus ventilation imaged with 81Krm was seen to change during image acquisition in lobes that showed perfusion abnormalities. In some, but not all, views the appearances were typical for pulmonary vascular disease, which might easily have been misdiagnosed if the changes in the distribution of ventilation had not announced themselves by occurring during image acquisition. A ventilation image obtained immediately before injection of 99Tcm-MAA may be useful.