bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tunnelled central venous catheter insertion via the internal jugular vein using a dedicated portable ultrasound device
Authors: Downie A C , Reidy J F , Adam A N 
Published: July 2009

Abstract
We describe the use of a purpose-built portable ultrasound device to assist puncture of the internal jugular vein during percutaneous insertion of tunnelled central venous catheters such as Hickman lines. In many situations the internal jugular route is safer, faster and less costly in comparison with the subclavian approach. The use of ultrasound allows an accurate initial venous puncture with fewer complications, in the hands of both experienced operators and those less familiar with the internal jugular vein approach.
Radiological assessment of a new bone densitometer—the Lunar EXPERT
Authors: Njeh C F , Apple K , Temperton D H , Boivin C M 
Published: July 2009

Abstract
Dual energy X-ray absorptiometry (DXA) is one of the most widely used techniques in the management of osteoporosis and other skeletal diseases. Although patient doses from DXA are generally low, it is still necessary to measure them to assess the risk of radiation injury. We report on a study to estimate the effective dose (ED) to patients and staff from a new DXA scanner—the Lunar EXPERT, and make a comparison with a similar study carried out on a Lunar DPX-L. The entrance surface doses were measured to be 895 μGy and 10.25 μGy for the EXPERT and DPX-L, respectively. The EXPERT maximum EDs were calculated to be 74.7 μSv and 44.9 μSv for the anteropostenor (AP) lumbar spine and the proximal femur, respectively. More than 50% reduction in ED could be achieved by using a smaller scanning width. The maximum EDs for the DPX-L were calculated to be 0.21 μSv and 0.15 μSv for the AP lumbar spine and the proximal femur, respectively. The scattered dose rates (ambient dose equivalent) were measured to be less than 2 and less than 1 μSv h–1 at 50 cm and 100 cm, respectively, for the DPX-L, and the equivalent values for the EXPERT were 240 and 64 μSv h–1. Although both the patient dose and scattered dose rates are quite low relative to other radiological examinations, good practice aimed at dose reduction should still be implemented. Whilst protection for the operator is not needed for the DPX-L system, it may be (depending on the size of the room) for the EXPERT system.
Intracranial arterial calcification and ectasia in visual failure
Authors: Savy L E , Moseley I F 
Published: July 2009

Abstract
Calcification of the major intracranial arteries is frequently observed on computed tomography (CT), particularly in the carotid siphon, and has been implicated as a causative factor in low tension glaucoma. Ectasia of the carotid siphon has also been postulated as a possible cause of compressive optic neuropathy. 153 patients, in whom high resolution CT of the orbits and parasellar region had been performed for suspected anterior visual pathway pathology, were retrospectively reviewed The presence and severity of calcification and ectasia of the major intracranial arteries was recorded. There was a high occurence of carotid siphon calcification, increasing with age, and independent of sex or race. Calcification was very rare in anterior cerebral, middle cerebral and basilar arteries in all age groups The amount and degree of ectasia also increased with advancing age, and was more frequently observed in carotid and basilar than anterior and middle cerebral arteries. There was no correlation between the degree of calcification or ectasia and ophthalmological or neurological deficit.
Application of the principle of optical phase-contrast microscopy to velocity phase-encoded MRI of blood flow in the aorta
Authors: Dymond R C , Redpath T W , McKiddie F I 
Published: July 2009

AbstractA new method of presenting magnetic resonance phase information is described and an example of its application given in the context of velocity phase-encoded MRI of blood flow in the aorta. The method takes as its starting point Zernike's technique of phase contrast microscopy. It exploits the parallel between the transform plane in Fourier optics and k-space in MRI. In the example described two datasets are acquired, one with and the other without velocity encoding, as in conventional phase-encoded velocity imaging. A dataset is formed which is corrected for unwanted phase variations caused by static field inhomogeneity. The method then effectively combines phase and magnitude information into a single image. The technique is complementary to existing methods of displaying phase information.
Occupational dose to the radiographer in dual X-ray absorptiometry: a comparison of pencil-beam and fan-beam systems
Authors: Patel R , Blake G M , Batchelor S , Fogelman I 
Published: July 2009

Abstract
The introduction of advanced dual X-ray absorptiometry (DXA) scanners with fan-beam geometry, improved image definition and faster scan times raises the question as to whether there is a significant radiation dose to the radiographer. We have measured the radiation dose to the operator from studies performed on four DXA systems; the Lunar DPX. Hologic QDR-1000, QDR-2000plus and QDR-4500. The results were compared with the radiographer dose from 99Tcm-MDP radionuclide bone scanning, where it is not usual to use a radiation barrier between the patient and the operator, and 18F-FDG positron emission tomography (PET) scanning where it is usual to protect staff. Ambient dose equivalent rate averaged over 1 h at 1 m from the patient with the DXA systems working at maximum patient throughput were 0.012, 0.12, 2.1 and 2.4 μSv h−1, respectively, for the DPX, QDR-1000, QDR-2000plus and QDR-4500. Annual operator dose for the DPX and QDR-1000 was well below the 1 mSv limit for members of the public recommended by the International Commission on Radiological Protection (ICRP) (1990). Results for the QDR-2000plus and QDR-4500 were similar to a radionuclide bone scan (2.2 μSv h−1), but smaller than for a PET scan (8.9 μSv h−1), and were close to the 5 mSv year−1 limit for a supervised area defined in the 1985 Ionising Radiation Regulations. Precautions to reduce radiographer dose with fan beam DXA include placing the operator at least 2 m from the patient, scanning the right hip instead of the left and using scan modes with short scanning times.
Incidence and possible aetiological factors in the development of pelvic insufficiency fractures following radical radiotherapy
Authors: Bliss P , Parsons C A , Blake P R 
Published: July 2009

Abstract
Five patients out of a total of 183 treated with radical radiotherapy for carcinoma of cervix at The Royal Marsden Hospital from 1991 to 1994 inclusive have developed severe pelvic fractures. Two patients had rheumatoid arthritis, one of whom died as a result of the radiation induced damage. This patient developed radiological evidence of radionecrosis within 1 month of completing radiotherapy. There are very few reports in the literature of such a rapid onset. We suggest that the presence of a connective tissue disorder in a patient with other risk factors such as steroid use, old age and osteopenia should alert the clinician to the risk of radionecrosis following radical irradiation.
Sonographic abnormalities of the thyroid gland following radiotherapy in survivors of childhood Hodgkin's disease
Authors: Healy J C , Shafford E A , Reznek R H , Webb J A W , Thomas J M , Bomanji J B , Kingston J E 
Published: July 2009

Abstract
The aims of this study were as follows. (1) To demonstrate the spectrum, frequency and changes on follow-up of sonographic abnormalities in the thyroid gland of survivors of Hodgkin's disease who had received radiotherapy to the neck in childhood. (2) To compare the sonographic findings with clinical examination and radionuclide imaging. (3) To investigate the association between the presence or absence of focal sonographic abnormalities with age at radiotherapy, the interval from radiotherapy, the presence of a raised thyroid stimulating hormone (TSH) and the length of time the TSH had been raised. 46 patients were scanned prospectively and rescanned at 6–18 months. The mean age at first sonography was 22.7 years, the median age at radiotherapy was 12.5 years, and the median interval post-radiation was 10.3 years. Sonographic abnormalities were seen in all 46 patients. 45 had diffuse atrophy and 30 had focal sonographic abnormalities. 18 patients developed new focal sonographic abnormalities on follow-up. Focal sonographic abnormalities were more commonly associated with longer duration of a raised TSH. Two patients had thyroid carcinoma. Sonographic abnormalities of the thyroid are common in patients following neck radiotherapy in childhood. Focal abnormalities are usually associated with a longer duration of raised TSH.
Bipedal lymphography in the management of carcinoma of the anal canal
Authors: Davey P , Saibil E A , Wong R 
Published: July 2009

Abstract
The purpose of this study was to determine the extent of metastatic pelvic lymph nodes evident on bipedal lymphography in a group of patients under consideration for combined radiation therapy and chemotherapy as definitive treatment for carcinoma of the anal canal. Lymphography was attempted in 32 patients and successful bilateral cannulation and opacification of nodes was achieved in 28 (88%). Seven patients had lymphographic evidence of external iliac node metastases (25%). When patients were categorized according to the extent of clinically evident disease at presentation, 0/15 patients with T1/T2 tumours had positive lymphograms whereas 7/13 patients with T3/T4 tumours and/or positive inguinal or peri-rectal nodes had positive lymphograms (Fisher's exact test p = 0.0015). All patients with a positive lymphogram had undergone CT scanning of the pelvis and in only one patient was external iliac node involvement detected. In none of these patients was visceral or more extensive nodal metastases discovered. Subsequently, the external iliac nodes with radiological evidence of metastases on lymphography were included in the treatment volume taken to radical dosage. The projected cause specific actuarial 5 year survival for this cohort of patients is 86% (median follow-up 4 years). Since the prognosis for patients who relapse in pelvic nodes is poor, bipedal lymphography is advocated as a staging procedure in patients with advanced primary tumours and in all patients with clinically positive inguinal or peri-rectal lymph nodes who are being considered for curative therapy.
Patient doses in hysterosalpingography
Authors: Fernández J M , Vaño E , Guibelalde E 
Published: July 2009

Abstract
The results of a survey of doses imparted on 41 patients undergoing hysterosalpingography is presented. Dosimetric evaluations were carried out by measuring both the dose–area product using a transmission ionization type chamber, and the entrance surface dose using thermoluminiscent dosimeters. As a result, a local reference dose value was obtained for this examination. Correlations between the dose–area product and the entrance surface dose data were analysed and compared in order to find the most appropriate dosimetric procedure. The median dose–area product obtained was 713 cGy cm2 (range 247 cGy cm2–1623 cGy cm2). Ovarian doses were also calculated, and a median value of 4.6 mGy was obtained for the whole examination. Effective doses were estimated with a median value of 3.1 mSv, and a range of 1.0 mSv–8.1 mSv.
Localization of the prostatic apex for radiotherapy planning: a comparison of two techniques
Authors: Chen L M , Lubich L , Chiru P , Ignacio L , Sweeney P , Chen G T Y , Vijayakumar S 
Published: July 2009

Abstract
Autopsy and pathology studies have shown that the caudal portion of the prostate gland harbors tumour in 64–75% of specimens examined. Accurate localization of the prostatic apex may be important in improving local control with external beam radiation therapy. We compared the location of the apex obtained with CT based treatment planning versus localization using retrograde urethrography in 32 consecutive patients. The prostatic apex, localized by CT and retrograde urethrography, was compared relative to the ischial tuberosities and the symphysis pubis. Discordance between the location of the prostatic apex as defined on CT scan and retrograde urethrography was found in 50% of patients evaluated. There was 31% discordance between the location of the prostatic apex as defined on CT and retrograde urethrography when data were analysed with the location of the prostatic apex 1 cm above the narrowing on urethrography, a definition others have suggested. The urethrogram defined prostatic apex, as compared with the CT definition, necessitated the treatment of more of the surrounding normal tissues in 31% of our cases, with four-field techniques. Comparison of dose–volume histograms of the bladder, rectum and penis irradiated for target volumes defined by CT versus retrograde urethrography showed that more penis was irradiated in some patients with the urethrogram defined prostatic apex; irradiation of the base of the penis could be relatively avoided by using a six-field treatment plan instead of the standard four-field box. There is discordance between the CT and urethrogram defined prostatic apex. Dose-volume histogram information suggests that differences in apex localization can significantly affect doses to normal adjacent prostatic tissues. Combining CT localization with the urethrogram localization of the prostatic apex optimizes radiotherapy planning and dose delivery.
Long-term cardiac mortality after radiotherapy of breast cancer—application of the relative seriality model
Authors: Gagliardi G , Lax I , Ottolenghi A , Rutqvist L E 
Published: July 2009

Abstract
Effects on the heart constitute a potentially significant and serious clinical problem in primary radiation therapy of early breast cancer. Increased cardiac mortality among irradiated patients may offset the potential benefit in terms of a reduced risk of recurrence or of death from breast cancer. Clinical data on long-term cardiac mortality among breast cancer patients included in two randomized trials (the Stockholm and Oslo studies) of radiation therapy as an adjunct to primary surgery were analysed using the relative seriality model of radiation response. Five different radiation therapy techniques were used in the trials. The original treatment plans were recalculated on a group of model patients using a three-dimensional treatment planning system. A mean dose–volume histogram (DVH) was calculated for each treatment technique. Both heart and myocardium, i.e. excluding circulating blood within the heart, were separately investigated as risk organs. Model parameters (D 50, i.e. the dose giving 50% complication probability, γ, i.e. the maximum relative slope of the dose–response curve; s, describing the organ relative seriality) were determined by a χ2 fitting of the calculated probability of excess cardiac mortality, based on the DVHs, to the incidence data. Computed complication probabilities for each treatment technique were modelled within the 95% confidence interval (CI) of the clinical incidence data. It was shown that the relative seriality model, assuming a homogeneous radiation sensitivity within the volume of the heart/myocardium can be used to describe the incidence data. A small dependence on the volume was found. The results do not, however, exclude the possibility that more sensitive structures within the myocardium are the main target for radiation.
MR imaging of juvenile papillomatosis of the breast
Authors: Mussurakis S , Carleton P J , Turnbull L W 
Published: July 2009

Abstract
Juvenile papillomatosis of the breast is a benign, localized proliferative condition encountered mainly in young women. We describe the contrast-enhanced MR imaging findings, including dynamic data, of a patient with histologically proven juvenile papillomatosis of the breast. The pre-contrast T 1 weighted sequence showed a hypointense lobulated mass which enhanced markedly in the post-contrast images. In the dynamic sequence the lesion showed a benign enhancement profile. The most specific feature was the presence of multiple small internal cysts, best shown on the T 2 weighted images. This constellation of findings should suggest juvenile papillomatosis.
Intravascular lipoma of the superior vena cava—CT and MRI appearances
Authors: Thorogood S V , Maskell G F 
Published: July 2009

Abstract
Intravascular lipomata are rare tumours occurring in the major central veins. We report a case in which an asymptomatic lipoma of the superior vena cava presented as mediastinal widening on a chest radiograph. The CT and MR features are presented.
MRI of the pharynx in young patients with sleep disordered breathing
Authors: Suto Y , Matsuda E , Inoue Y 
Published: July 2009

Abstract15 patients, aged 1–14 years, with sleep disordered breathing underwent turbo fast low angle shot MRI during drug-induced sleep. The site of obstruction within the pharynx was identified. Data from MRI were compared with fibroscopic findings. The degree of hypertrophy of the palatine tonsils as determined by MRI was also compared with that determined by visual inspection while awake. MRI was completed in all cases, whereas fibroscopy was completed in only six of the 10 cases examined. MRI findings agreed with those of fibroscopy in all the patients who underwent both investigations. On MRI, the pharynx was obstructed in 12 of the 15 cases examined (80%); the palatine tonsils were involved in all of these while both the palatine tonsils and nasopharynx were obstructed in three of the 12 cases. One of the 12 patients was graded as Grade I of Mackenzie's scale. One of the cases graded as Grade II showed no obstruction. In conclusion, fast MRI proved useful in identifying the site of pharyngeal obstruction in young patients with sleep disordered breathing.
Sludge in fetal gallbladder: natural history and neonatal outcome
Authors: Petrikovsky B , Klein V , Holsten N 
Published: July 2009

Abstract
Normal and pathological conditions of the fetal gallbladder have been a subject of recent investigation by ultrasonographers. Fetal gallstones are the most common abnormal finding and appear as echogenic foci within the gallbladder. We report a series of five fetuses in whom the gallbladders were filled with sludge which appeared as a pear shape echogenic structure. In the majority of cases, gallbladder sludge mimicked intrahepatic calcification or echogenic bowel. Serial ultrasound examinations of these fetuses revealed good interval growth. The gallbladders remained echogenic and were normal in size in three cases and were moderately enlarged in two. All neonates were born in normal condition with no identifiable malformations. Follow-up was obtained in four infants using abdominal ultrasound. A normal appearing sludge free gallbladder was seen in three neonates at 6 weeks of life and in four infants at 12 weeks. Accurate diagnosis of gallbladder sludge will spare the patient unnecessary work-up and anxiety. The natural history of gallbladder sludge in the fetus is benign in nature and is similar to that of fetal gallstones.
Mandibular bone mineral density as a predictor of skeletal osteoporosis
Authors: Horner K , Devlin H , Alsop C W , Hodgkinson I M , Adams J E 
Published: July 2009

Abstract
A considerable amount of work has been performed on methods of detecting individuals with low bone mass at an early stage. Some researchers have considered if dental radiographs could have a role in the detection of individuals with osteoporosis. A basic requirement for this would be that bone mass in the jaw relates significantly to that of other skeletal sites in which osteoporosis is a significant problem. The first aim of this study was to investigate the relationship between mandibular bone mineral density (BMD) and that of other skeletal sites commonly used for bone densitometry in the detection of osteoporosis. The second aim was to assess the validity of mandibular BMD as a predictor of BMD in these other sites. 40 edentulous females underwent dual energy X-ray absorptiometry (DXA) of the lumbar spine (L2–L4), DXA of the right femoral neck, single photon absorptiometry (SPA) of the proximal and distal forearm and DXA of the mandible. Significant correlations were observed between BMD in the mandibular body, ramus and symphysis and all other skeletal sites (p&lt;0.02). Five patients (12.5%) had age matched Z-scores of −1.0 or lower in all three non-mandibular sites (lumbar spine, femoral neck and forearm). Using these patients as the proportion of the population with a positive finding of “low bone mass”, the sensitivity and specificity of mandibular BMD in predicting low bone mass for these patients was determined. Where a diagnostic threshold for low mandibular BMD was set at one standard deviation below the mean, the mandibular body BMD measurement gave high sensitivity (0.8) and specificity (0.97), the symphysis BMD low sensitivity (0.4) but a high specificity (0.77), while the ramus BMD had a moderate level of sensitivity (0.6) and high specificity (0.91). It is concluded that mandibular BMD assessed by DXA correlates significantly with BMD measurements of other important skeletal sites. The higher correlation coefficients and the greater sensitivity and specificity for the body of mandible suggest that this site should be used for any potential clinical application of dental radiographs in detection of osteoporosis.
Agenesis of the right lung diagnosed by three-dimensional reconstruction of helical chest CT
Authors: Wu C T , Chen M R , Shih S L , Huang F Y , Hou S H 
Published: July 2009

Abstract
Unilateral pulmonary agenesis is extremely rare and the diagnosis can be made by a number of conventional methods. We report two cases: a 16-day-old girl and a 14-year-old girl presenting with tachypnoea in whom three-dimensional reconstruction of helical chest computed tomography was used to demonstrate the complete absence of the carina, right main bronchus and right lung. To our knowledge, these are the first cases of right lung agenesis diagnosed by this method.
Severe fibrosis in a patient with scleroderma and previous radiotherapy—a case report and literature review
Authors: Aref I , Cross P , Nair B 
Published: July 2009

Abstract
Patients with scleroderma may develop marked local cutaneous fibrosis following radiation therapy. We describe one patient treated with wide local excision and radiation therapy, who subsequently developed scleroderma with severe fibrosis in the irradiated field.
Myelodysplastic/Myeloproliferative Neoplasms
Authors: Foucar Kathryn 
Published: July 2009

AbstractMyelodysplastic/myeloproliferative neoplasms (MDS/MPNs) are rare de novo myeloid neoplasms that exhibit hybrid dysplastic and proliferative features at presentation. This SHP/EAHP Workshop session was uniquely problematic owing to the overlap between MDS/MPNs and both chronic myeloproliferative neoplasms and myelodysplasia. The borderline between MDS/MPNs and overt acute myeloid leukemias was also an issue, mainly related to the accurate and consistent delineation of blast equivalents such as promonocytes. Aside from juvenile myelomonocytic leukemia, genetic features defining specific MDS/MPN subtypes have not been identified. Consequently, there is little change in the 2008 World Health Organization classification of MDS/MPNs compared with the 2001 version.