bluuebunny/crossref_metadata_2025_split huggingface dataset:
The case of the missing calcified disc
Authors: Wardlaw J , Beggs I 
Published: July 2009

A 39-year-old male, with chronic renal failure following a failed renal transplant, presented with acute back pain. His previous history included crystal arthropathy, tertiary hyperparathyroidism and parathyroidectomy.
He had initially presented with tuberculosis of the L5 region and associated psoas and gluteal abcesses 1 year previously. The abcesses had been drained and he had been on apparently adequate chemotherapy ever since. Radiographs of the lower lumbar spine at the time of the original presentation (Figure 1) showed well-defined calcification of the nucleus of the D12/L1 disc.
Book reviews
Authors: Venables H K 
Published: July 2009

This American book is essentially a set of lecture notes on ultrasound physics and instrumentation for complete beginners.
The first few chapters on the fundamentals assume very little prior learning. In particular the section on mathematics is aimed well below GCSE standards. This continues throughout the book with many examples of simple calculations worked out in full. A little insulting to the average intelligence, but very useful for those with an inherent aversion to anything remotely resembling an equation! (Will definitely appeal to my DMU students!)
The following chapters cover the interaction of sound with matter, transducers, resolution etc. through to image processing and display.
The efficacy of a single posteroanterior radiograph in the assessment of metastatic pulmonary melanoma
Authors: Collins C D , Padley S P , Greenwell F , Phelan M 
Published: July 2009

Abstract
Posteroanterior (PA) and lateral chest radiographs are performed as part of the routine staging and follow-up investigation of patients with malignant melanoma. We have assessed the contribution of the lateral chest radiograph in the follow-up of 227 consecutive patients with proven malignant melanoma. In only once case was an abnormality evident on the lateral radiograph which was not previously detected on the PA films. Our department, as a result of this study, has discontinued the routine use of lateral chest radiography in the follow-up of patients with malignant melanoma.
Impaired rectal emptying caused by perineal herniation of the rectum: defaecographic demonstration using oblique projections
Authors: Kaasbøl Mari-Anne , Hauge Christina , Nielsen Michael Bachmann 
Published: July 2009

Abstract
Defaecography is usually performed in the lateral projection alone. We present a case of perineal herniation of the rectum, previously unreported, demonstrated by defaecography in oblique projections.
A new afterloading applicator for primary brachytherapy of endometrial cancer
Authors: Bauer M , Schulz-Wendtland R 
Published: July 2009

Surgery is the treatment of choice for carcinoma of the endometrium. If the patient is not eligible for surgery because of advanced age or internal problems, primary irradiation—in most cases a combination of external beam radiation with brachytherapy—is indicated. In the following we present a new applicator used for intrauterine brachytherapy.
In 1936 Heyman showed that the packing technique—which was later modified by Ries (1944), who introduced the so-called radium tamponade method, and by Becker and Scheer (1952)—was superior to the radium tandem method. This was documented by the 20–25% improvement in survival rates (Heyman et al, 1941). Radiation protection regulations have forced us to abandon the radium method in favour of the afterloading technique (Henschke, 1960; Waltstam, 1962). With the afterloading technique the results for cervical cancer are just as good as those of the radium method.
Several afterloading methods have been described to treat cancer of the endometrium. However, to date there has been no satisfactory simulation (Simon et al, 1971; Rotte et al, 1973; Busch et al, 1977; Pernot, 1977; Bauer et al, 1981; Nori et al, 1982). Irradiation using a single applicator is only suitable for brachytherapy of small uteri. Radiation treatment using curved tubes to reach into the corners of the uterus results in a very inhomogenous dose distribution in the uterine mucosa, the tumour, and the target volume of the entire uterus.
Multiple myeloma presenting as bilateral orbital masses: CT and MR appearances
Authors: Jackson A , Kwartz J , Noble J L , Reagan M J 
Published: July 2009

Orbital involvement in multiple myeloma is rare with less than 50 cases in the world literature (Mewis-Levin et al, 1981). The commonest form of orbital myeloma is a solitary soft tissue mass often arising from bone and associated with bone destruction. The finding of multiple bilateral orbital plasmacytomas is extremely rare and has been described in only two previous cases (Dufier et al, 1977; Hayes et al, 1980).
We present the findings on computed tomography (CT) and magnetic resonance imaging (MRI) in a patient with multiple myeloma who presented with visual impairment due to bilateral orbital plasmacytoma. The imaging appearances of this pattern of orbital involvement have not been described before and differ from cases presenting with a solitary orbital plasmacytoma.
A 65-year-old man was referred to Manchester Royal Eye Hospital with a 2 week history of blurred vision in both eyes. Visual acuity was reduced bilaterally (right eye 6/36, left eye 6/24) and examination demonstrated mild bilateral proptosis and conjunctival chemosis. Slit lamp biomicroscopy demonstrated full thickness corneal crystals and bilateral choroidal folds. Initial investigations revealed anaemia (Hb 10.9 g dl−1) and an elevated ESR (30 mm hr−1).
CT scan demonstrated bilateral soft tissue orbital masses. In the right orbit a large intraconal mass lesion was seen surrounding and distorting the posterior aspect of the globe and extending posteriorly in contact with the optic nerve.
Exploring the niches
Authors: Lillicrap S C 
Published: July 2009

Abstract
In his 1990 Presidential Address Professor C R Hill posed the question of whether, given the ethos of the late 20th century, there was a future for radiological science. To answer his question he reviewed the scientific basis of current major branches of radiology, demonstrating progress resulting from initial physical discovery, combined with engineering and medical inventiveness. In the process of the development of radiological science, small-scale speculative research, outside mainstream areas, has proved to be an important element. This address complements Professor Hill's by examining the role of a small-scale speculative research (the niches of the field). Examples are taken from the early pioneers of radiological science and the first British Institute of Radiology Congress. Finally some lesser known research activity in this category, being presented at the Golden Jubilee Congress, is reviewed.
Accuracy of lateral dual energy X-ray absorptiometry for the determination of bone mineral content in the thoracic and lumbar spine: an in vitro study
Authors: Edmondston Stephen J , Singer Kevin P , Price Roger I , Breidahl Peter D 
Published: July 2009

Abstract
Lateral scanning with dual energy X-ray absorptiometry (DXA) was undertaken on 153 thoracic and lumbar vertebral bodies from nine individuals (mean age 67; range 34–92 years) to establish their bone mineral content (BMC). All specimens were subsequently de-fatted and ashed to compare ash weight with BMC of the Tl to L5 segments. Linear regression analysis indicated a higher correlation between BMC and measured ash weights for each vertebral column (range: r = 0.97 0.99), with error analysis for all vertebrae tested showing a standard error of 0.40 g, or 10.8%. For the L2 4 segments the accuracy error was 0.50 g or 7.9%. In both cases there was a mean trend towards underestimation of ash weight. Mean BMC values of the T1 to T5 segments were similar before a progressive increase caudally. These data affirm the utility of DXA for determining bone mineral content in the vertebral column across wide ranges of age, and segmental and bone density.
Factors affecting the radiation dose to the lens of the eye during cardiac catheterization procedures
Authors: Pratt T A , Shaw A J 
Published: July 2009

Abstract
Concern has been expressed about the relatively high radiation doses to the lens of the eye received by the operator during cardiac catheterization studies. A study was undertaken to assess the occupational doses received by cardiologists and to examine the factors that affect the individual's eye dose. Eighteen cardiologists working in five catheterization laboratories at three centres were included in the study. Their eye doses, workload and individual study details were monitored at each centre. Operating dose rates and scattered radiation were also measured for each unit to compare equipment performance. The study demonstrated that the relationships between the cardiologist's eye dose and factors such as the dose efficiency of the X-ray equipment, scattered dose rates, examination protocols and workload are complex and vary from centre to centre. Because of these variations general workload limits may be inaccurate and should only be used for general guidance when no direct measurements are available. Such limits should be verified by local measurements as soon as is practical.
A simple solution to the problems of testing automatic exposure control in diagnostic radiology
Authors: Hunt A J , Plain S G 
Published: July 2009

The complete testing of the automatic exposure control (AEC) in radiographic systems usually involves measurement of the optical density of films exposed under well controlled conditions. This can mean typically 30 exposures per unit tested. Until recently the technique adopted locally followed that recommended in TGR 32 Part IV (Hospital Physicists' Association, 1980). A slab of tissue-equivalent material 30 × 30 × 20 cm thick is placed in the position normally occupied by the patient. The X-ray beam is centred on the phantom with an incident field size of 25 × 25 cm. The focus–film distance should be set such that the tube and grid foci coincide (Figure 1).
The consistency of optical density produced while varying the equipment parameters and chambers is then assessed by exposing a film with an L-shaped 2.5 mm mask placed over the cassette (behind the AEC chambers). The use of the current mask means that approximately eight films may be exposed per Bucky assembly, and since two Buckies are commonly included in a typical X-ray room this can mean 16 films must be exposed. The preferred technique is to use the same cassette for each exposure during the testing of each AEC, to use the same film dispenser and the same processor throughout. This avoids screen speed, processing and film batch variations respectively. However the use of this technique can be tedious and expensive in terms of both time and film.
Dynamic forces influencing vertebral fracture risk
Authors: Ammann M E , Winkelbauer F W , Hittmair K , Thurnher S 
Published: July 2009

The risk of fracture of human vertebrae in vivo in relation to densitometric data has been reported (Buchanan et al, 1987; Cullum et al, 1989). Densitometric measurements alone do not, however, correlate well with actual structural failure (McBroom et al, 1985). Compressive strength characteristics and modes of fracture of human vertebrae have been determined with single load cycles in vitro (Kazarian & Graves, 1977).
Bone, however, is subjected to mechanical fatigue. Its apparent strength is reduced by multiple load cycles as opposed to a single load cycle. Static methods do not take into account the cyclic dynamic axial loading of the lumbar spine that occurs during everyday life (Brinckmann et al, 1987). We simulated the effect of these changing forces on isolated lumbar vertebrae and on lumbar motion segments consisting of two adjacent vertebrae with the connective tissue joining them left in place (Schmorl & Junghanns, 1968). Elasticity and deformation behaviour were analysed.
Intubaation dacryocystography in patients with a clinical diagnosis of chronic canaliculitis (“streptothrix”)
Authors: Sathananthan N , Sullivan T J , Rose G E , Moseley I F 
Published: July 2009

Abstract
Magnification dacryocystography in 18 patients with chronic infective canaliculitis showed dilatation and irregularity of the affected lacrimal canaliculi, with prominent filling defects in almost all cases. Filling defects are uncommon in other diseases of the canaliculi and serve to confirm the diagnosis.
The radiological features of calcifying odontogenic cyst
Authors: Devlin H , Horner K 
Published: July 2009

Abstract
Calcifying odontogenic cyst is a rare benign lesion of the jaws, with no particular specificity for age, sex or site. Three new cases are presented together with a review of the radiological literature. There appear to be no pathognomonic radiological features, although a superficial location on the affected bone and the presence of internal calcification may be useful signs. The role of radiology appears to be limited to determining lesion extent prior to surgery.
Superparamagnetic particles as oral contrast medium in magnetic resonance imaging of patients with treated ovarian cancer—comparison with plain MRI
Authors: Prayer L , Stiglbauer R , Kramer J , Wimberger D , Poelzleitner D , Schima W , Kainz C , Koelbl H , Haugen I , Imhof H 
Published: July 2009

Abstract
In 23 patients with treated ovarian cancer, 24 magnetic resonance (MR) examinations of the abdomen and pelvis were performed before and after administration of an oral superparamagnetic contrast medium. Depiction of bowel loops was judged sufficient in 47% with plain scans and in 85% with enhanced scans. Minor artefacts attributed to the agent were noted in 32% of examinations and were classified as disturbing in 8%. The diagnostic information obtained after contrast enhancement was estimated to be superior to that from plain MRI in 20% of patients. The use of oral contrast medium did not alter the MR diagnosis of “tumour recurrence” or “disease-free” in any patient. Our results suggest that superparamagnetic iron oxide is an effective and reliable approach to negative bowel contrast enhancement, increasing the confidence level when distinguishing intestines from solid structures.
Accurate measurement of surface areas of anatomical structures by computer-assisted triangulation of computed tomography images
Authors: Allardice J T , Jacomb-Hood J , Cookson J , Dykes E , Holman J , Abulafi A M , Williams N S 
Published: July 2009

Abstract
There is a need for accurate surface area measurement of internal irregular anatomical structures in order to define light dosimetry in adjunctive intraoperative photodynamic therapy (AIOPDT). No satisfactory preoperative method exists of measuring this parameter. We have investigated whether computer-assisted triangulation of serial sections generated by computed tomography (CT) scanning can give an accurate assessment of the surface area of the walls of the true pelvis after anterior resection and before colorectal anastomosis. We have shown that the technique of paper density tessellation is an acceptable method of measuring the surface areas of phantom objects, with a maximum error of 0.5%, and is used as the gold standard. Computer-assisted triangulation of CT images of standard geometric objects and accurately-constructed pelvic phantoms gives a surface area assessment with a maximum error of 2.5% compared with the gold standard. The CT images of 20 patients' pelves have been analysed by computer-assisted triangulation and this shows that the surface area of the walls varies from 143 cm2 to 392 cm2. Simple step-like analysis of images and approximation to geometric shapes with subsequent calculation give unacceptably high errors. The surface area of an internal, rigid, irregular surface area for illumination in AIOPDT can be accurately measured preoperatively by computer-assisted triangulation of CT images.
The influence of focal spot size on image resolution and test phantom scores in mammography
Authors: Law J 
Published: July 2009

Abstract
This paper reports an experimental investigation of the extent to which focal spot size influences image resolution in mammography. Films of two different phantoms, both containing high contrast bar patterns, were obtained using three different foci from 0.9 to 0.1 mm, and three degrees of magnification with the smallest of those foci. Some influence of focal spot size was detectable in all films except for the 0.1 mm focus at low magnification, where it was negligible in comparison with film-screen unsharpness, but effects attributed to the film-screen system were more important than focus size except with the 0.9 mm focus or at high magnification. However, a nominal 0.4 mm focus may have an effective size of 0.9 mm close to the chest wall side of the film. These two phantoms, and two others, were used to investigate the changes of perceptibility of “realistic” details, all of which depend on a combination of contrast, resolution and noise, with changes of focal spot size and magnification. As expected, when judged in this way image quality improved as focal spot size decreased. With the fine focus it also improved as magnification increased, unlike changes in high contrast resolution which decreased for high magnification. Thus conventional bar patterns are not always a good guide to detail perceptibility in mammograms, where the effects of noise may be as important as those of focal spot size.
Use of the linear quadratic model in order to accommodate a small reduction in the number of fractions of a standard radiotherapy treatment regime
Authors: Mills J A , Wayte S C 
Published: July 2009

Abstract
Use of the linear quadratic model is considered for reduction, by one or two fractions, of the number of fractions in a daily fractionated reference schedule while maintaining a continuous regime. The cases of maintaining late or early tumour reacting tissue are considered with the inclusion of time effects. The reduction of biologically effective dose (BED) to early-tumour type tissue is shown to be overestimated for both cases if time effects are not taken into account. A third option is outlined, which equates the magnitude of the fractional reduction of BED for early-tumour-reacting tissue to the fractional increase in BED for latereacting tissue without accounting for time effects. Using this option, the resulting variations in BED for lateand early-tumour tissue are compared with the accepted tolerances in physical dose delivery and some examples presented. The overestimated prediction of the variation in BED for early-tumour tissue still applies in this option, suggesting that this is the way the linear quadratic model should be applied to such a schedule change.
Interruption of the inferior vena cava with anomalous intrahepatic continuation
Authors: Balkanci F , Özmen M N 
Published: July 2009

Abstract
Infrahepatic interruption of the inferior vena cava (IVC) with azygos and hemiazygos substitution is a rare IVC anomaly which has been documented in the literature (Anderson et al, 1961; Chuang et al, 1974; Floyd & Nelson, 1976; Mayo et al, 1983). Recently Bercoffet al and Ghossain et al reported two cases with portal continuation of the interrupted IVC (Bercoffet al, 1985; Ghossain et al, 1988). In our case, we describe a left sided IVC with infrahepatic interruption which continues by both the azygos system and the hepatic veins via anomalous intrahepatic vessels. To our knowledge such a continuation with intrahepatic anomalous vessels has not been described before.
Adverse chronic effects of highdose irradiation on proximal bronchus in patients treated for bronchogenic carcinoma
Authors: Hayakawa K , Mitsuhashi N , Saito Y , Nakajima N , Niibe H 
Published: July 2009

Abstract
Of five patients with epidermoid carcinoma of the lung who were treated with small fields of 80 Gy in 40 fractions/8–11 weeks (TDF123–129) to the hilar region, four patients developed marked stenosis of the proximal bronchi without tumour progression and died of pulmonary insufficiency 1–3 years after radiotherapy. These results should serve as a warning against escalation of the radiation dose, and the upper optimal dose might prove to be less than 80 Gy for the treatment of pulmonary hilar lesions.
Endoscopic ultrasound of the stomach
Authors: Nicholson D A , Shorvon P J 
Published: July 2009

Abstract
Endoscopic ultrasound (EUS) is the adopted term for the technique which enables endoluminal ultrasound to be performed using a specially designed endoscope with a fixed piezoelectric transducer. Since initial reports described the use of this technique in patients, its use in clinical practice in Europe, the Far East and the USA has been steadily increasing over the past few years. At present the technique is only practised in a very few centres in the UK but it is likely that this will increase in the future. This article describes the present day value of EUS in evaluating gastric pathology.
Further experience at the Bristol Centre, following the installation of a second MRI unit
Authors: Thomson J L G , Case A , Williams R 
Published: July 2009

Abstract
A second magnetic resonance imaging (MRI) machine has been installed at the Bristol Centre, which therefore now has two systems (both 0.5T), working alongside, one being 5 years older than the other. This has allowed a virtual doubling of patient throughput. The financial cost of adding the necessary building extension and the comparative capital costs of the two machines, together with the differences in the cryogen requirements are itemized; as are the extra number of staff engaged. It is estimated that the new machine cost approximately half that of the original, bought in 1987, after allowing for inflation; and that the revenue costs have increased by only 25% in the first year, with a likely increase of about 45% in year two. One result has been that in Bristol, where there are now three MRI machines, myelography and knee arthrography as diagnostic procedures have almost disappeared.
The right inferior lung margin: anatomy and clinical implication
Authors: Morrissey B M , Bisset R A L 
Published: July 2009

Abstract
Medical students and clinicians have, for generations, based their knowledge and application of anatomy on the study of cadavers which have been fixed in formalin. Assumptions are made that structures maintain the same relationship in the living as in the dead. Such a belief is untrue in respect of the inferior extent of the lung and pleura into the posterior diaphragmatic sulcus. This study of the plain abdominal radiographs of 100 adult patients demonstrates a clear difference between the classical anatomical teaching, which describes a potential space containing only pleura in the recess, and our finding that in the living patient lung extends deep into the sulcus. In 80% of patients, lung is seen to lie at or below the level of the 12th rib, while in 18% lung reaches the level of the body of LI. Medical students should be made aware of this and clinicians should approach the liver, adrenal gland and kidney posteriorly with caution in order to avoid traversing lung and pleura.