bluuebunny/crossref_metadata_2025_split huggingface dataset:
Heterotopic bone formation affecting the hip joint is preventable in high risk patients by post‐operative radiation
Authors: Spry NA , Dally MJ , Benjamin B , Chapman P , Morum P , Christie DRH 
Published: March 2008

SUMMARYBetween 1984 and 1993, 40 high risk patients (45 hips) received postoperative irradiation as prophylaxis against heterotopic ossification (HO). Radiotherapy was commenced within 5 days of the surgery in 43 of 45 hips. The development of HO was assessed by comparison of radiographic films prior to irradiation and at least 2 months after treatment (median interval 12 months). Progression of HO was observed in only two of 45 hips (4.3%) and of clinical significance in one (2.2%). Treatment was well tolerated with no acute complications or loosening of prosthetic components attributable to irradiation.During the study period, the treatment programme changed from 20 Gy in 10 fractions to 6–8 Gy in a single fraction, without loss of treatment efficacy. As well as improving resource utilization, single fraction techniques allow fewer patient transfers thereby reducing patient discomfort and risk of hip dislocation. This procedure is uncomplicated and should be considered more widely in the management of this disabling non‐malignant condition.
The estimation of lung dose from mid‐perineum ionization chamber measurements in total body irradiations: A quality control check on dose delivery
Authors: Cross Peter 
Published: March 2008

SUMMARYA series of patients (eleven males and eight females) receiving total body irradiation prior to bone marrow transplantation was monitored during treatment by recording the dose from an ionization chamber placed between the thighs in the mid‐perineal region. The treatment was delivered by opposed lateral 6MV photon beams. The patient was encompassed by the radiation field with the maximum collimator opening at a distance of 3.49 m from the X‐ray focus to the patient mid‐line.An analysis was made of the measured dose and the calculated percentage average lung dose for each patient in the series to seek a correlation between measured doses and patients' anatomical data so that estimates of delivered lung doses could be made.Whilst a global factor can be applied to measured dose to predict lung dose, it is concluded that perineal dose measurements distal to the region where dose is prescribed (mean lung dose) are sub‐optimal for checks on target dose delivery. Entrance and exit dose measurements at the level of dose prescription (in the thorax) are preferable for more accurate predictions and quality control checks.
Bizarre parosteal osteochondromatous proliferation of the hands and feet
Authors: Breidahl WH , Wylie EJ 
Published: March 2008

SUMMARYTwo adults with bizarre parosteal osteochondromatous proliferation of the hands and feet are presented. The pre‐operative diagnosis may be difficult to make and the correct diagnosis was not made in either case until pathological examination of recurrent tumour masses occurred.The radiological and pathological features of this lesion are discussed. The diagnostic features which differentiate this condition from other causes of new bone formation in the peripheries are described.
Metastatic carcinoma infiltrating lung mimicking BOOP
Authors: Nirenberg Alexander , Meikle Grant R , Goldstein David , Meikle Ronald G 
Published: March 2008

SUMMARYA 38 year old female with treated carcinoma of the breast presented with a clinical and radiological diagnosis of bronchiolitis obliterans organising pneumonia. Based on these findings a biopsy was not performed and she was treated with steroids. Following lack of response to steroid therapy a lung biopsy was performed showing peribronchiolar, lymphatic, venular and arteriolar metastatic carcinoma. Her symptoms responded to chemotherapy. Interstitial and intracellular spread of carcinoma should be considered in the differential diagnosis of the radiological appearance of BOOP, and therefore a histological diagnosis should be obtained to determine appropriate management.
Radiological imaging of a massive dermoid in the male pelvis
Authors: Van Gelderen WFC , Al‐Hindawi M , Archibald CG , Merrie AEH , Cheng KS 
Published: March 2008

SUMMARYA dermold cyst, arising from the posterior aspects of the prostate and seminal vesicles, and extending into the pelvis to masquerade as a full bladder, must be exceedingly rare. Ultrasound, computed tomography and especially magnetic resonance imaging (MRI) proved to be invaluable in making the diagnosis, and MRI in particular was very useful in providing an anatomical road map for surgery.
The ultrasonic diagnosis of urachal anomalies
Authors: Holten I , Lomas F , Mouratidis B , Malecky G , Simpson E 
Published: March 2008

SUMMARYSeven cases of urachal anomalies are presented. The spectrum of the disorder and the criteria for ultrasound diagnosis are described. Six of seven cases were correctly diagnosed pre‐operatively with diagnostic ultrasound, but one case with no cystic component was missed. The appearance of a fixed, midline, cystic, extraperitoneal swelling between the umbilicus and the bladder should suggest the diagnosis.
Radiation treatment of superior sulcus lung carcinoma
Authors: Millar Jeremy , Ball David , Worotniuk Valentina , Smith Jennifer , FRACR Elizabeth Crennan , Bishop Michelle 
Published: March 2008

SUMMARYThe survival of patients with superior sulcus lung carcinoma and the effects of treatment were reviewed. From a prospective database of 4123 consecutive new patients with lung carcinoma, 131 (3.2%) cases of superior sulcus lung carcinoma were identified. Seventy‐four patients were planned to receive radiation with palliative intent, 53 radical radiotherapy and one was observed only. The remaining three patients, with small‐cell carcinoma, were treated with chemotherapy with or without radiotherapy. Of the 53 radically treated patients, nine were treated with pre‐operative radiation prior to intended radical resection. Analysis was carried out on the effect on survival of performance status, nodal involvement, weight loss, vertebral body or rib involvement, treatment intent and radical combined modality treatment compared with radical radiation alone. The estimated median survival for the whole group was 7.6 months; for those treated radically it was 18.3 months, while for the palliatively treated patients it was 3.7 months. Radically treated patients with no initial nodal involvement had an estimated median survival of 22 months, while radically treated patients with nodal involvement had an estimated median survival of 8.4 months (P= 0.003). There were no statistically significant differences in survival between radically treated patients grouped according to initial weight loss, performance status, or vertebral body and rib involvement. Patients treated with pre‐operative radiation did not survive significantly longer than patients treated with radiation alone, although the numbers are small.
Abdominal wall haematoma in anti‐coagulated patients: The role of imaging in diagnosis
Authors: Davies RS , Goh GJM , Curtis JM , Meaney JFM , Lewis‐Jones HG 
Published: March 2008

SUMMARYAbdominal wall haematomas are uncommon, difficult to diagnose clinically and often associated with systemic anticoagulation. Seven cases together with the imaging results are presented and the characteristic features and potential pitfalls are discussed. Ultrasound is the first line investigation but the results can be misleading and computed tomography (CT) is often required to confirm the diagnosis.
Computed tomography in miliary tuberculosis: Comparison with plain films, bronchoalveolar lavage, pulmonary functions and gas exchange
Authors: Sharma SK , Mukhopadhyay S , Arora R , Varma K , Pande JN , Khilnani GC 
Published: March 2008

SUMMARYComputed tomography (CT) of the chest, pulmonary function tests, bronchoalveolar lavage (BAL) and arterial blood gas analysis were performed in 26 patients with non‐HIV miliary tuberculosis (MTB). CT was repeated after treatment in 11 patients. Nodular lesions were characteristically seen on CT. CT showed discrete and fine nodules in five patients in whom the lesions appeared to be larger than miliary on chest X‐rays. Coalescing nodular lesions were noted on chest X‐rays (n= 7) and CT (n= 18). Consolidation (n= 6), cavitation (n= 4), fibrosis (n= 9) and air trapping (n= 14) were detected on CT only. During follow up, air trapping increased h = 14) and in some patients it appeared for the first time (n= 2). Lymph node enlargement and calcification were seen on both chest X‐rays (n= 9 and (n= 3, respectively) and CT (n= 12 and n= 7, respectively). Pleural involvement was also seen in chest X‐rays (n= 4) and CT (n= 5). Total lung capacity was higher in patients with a chest X‐ray score > 10. Similarly a higher total cell count in BAL fluid was observed in patients with a CT score > 10. It is concluded from this study that CT is superior to chest X‐rays in detecting nodular lesions, lymphadenopathy and air trapping in patients with MTB.
Pre‐operative staging of gastro‐oesophageal junction carcinoma: Comparison of endoscopic ultrasound and computed tomography
Authors: Holden Andrew , Mendelson Richard , Edmunds Simon 
Published: March 2008

SUMMARYFifteen patients with carcinoma of the gastro‐oesophageal junction were pre‐operatively staged with endoscopic ultrasound (EUS) and computed tomography (CT). The accuracy of tumour and nodal staging using both modalities was compared to the final histological staging of the resected specimens. In staging depth of tumour growth, EUS was significantly more accurate (87% of lesions correctly staged) than CT (40% correctly staged). In staging nodal involvement, EUS was again significantly more accurate (73% correctly staged) than CT (33%). Two‐thirds of the lesions were traversable with the endoscopic probe, but most of the nontraversed lesions were correctly staged on EUS. In this study, CT has performed poorly as a staging modality for carcinoma at the gastro‐oesophageal junction. Other studies have shown CT to be less accurate at this location than at other oesophageal sites. The orientation of the gastro‐oesophageal junction, lack of surrounding fat planes, proximity of adjacent organs and patient motion contribute to the poor staging performance of CT at this location. In contrast, EUS has been an accurate staging modality at the gastro‐oesophageal junction in this study and compares well with other studies evaluating EUS in the more proximal oesophagus. Endoscopic ultrasound is therefore a necessary modality if accurate pre‐operative staging of gastro‐oesophageal junction carcinoma is to be achieved.
Abscess in the non‐lactating breast: Radiodiagnostic aspects
Authors: MD. Malai Muttarak 
Published: March 2008

SUMMARYThe value of mammography and ultrasound in evaluating abscesses in the non‐lactating breast was assessed in 20 patients. Inflammatory breast masses in the non‐lactating period are uncommon and the clinical diagnosis can be very difficult when signs of inflammation are absent. There were 20 patients ranging in age from 25 to 60 years in the present study; the mean age was 39.35 years. Patients presented with a lump and/or pain without other clinical signs of inflammation. Mammography was performed to exclude malignancy. Mammograms showed an ill‐defined mass in 11 patients and an area of focal increased density in seven patients. Ultrasonograms showed echoic masses with central echopenia in 17 cases and central septation in three cases. Half the lesions were subareolar and half were peripheral. Two of 20 patients were treated by excision, three by incision and drainage, eight by aspiration and seven by antibiotics. The combination of mammographic and sonographic features may enable the radiologist to recognize this entity, thus preventing unnecessary surgery.
Barium enema preparation: A study of low‐residue diet,‘Picolax'and ‘Kleen‐Prep'
Authors: Hawkins Stewart , Bezuidenhout Peter , FRCR Phillip Shorvon , Hine Andrew 
Published: March 2008

SUMMARYA prospective, randomized three‐arm trial is presented of 150 consecutive patients attending for double‐contrast barium enema (BE). This compares ‘Picolax’(a combined stimulant and osmotic agent),‘Picolaxfollowing ‘ a 3 day low‐residue diet and ‘Kleen‐Prep’(a polyethylene‐glycol osmotic agent). Faecal clearance, mucosal coating and colon fluid were scored in four colonic segments by two radiologists working independently and blinded to the preparation used. Analyses of an elderly subgroup and of side effects was performed. Low‐residue diet conferred no benefit to Picolax preparation, which was satisfactory (ability to exclude 5 mm polyps) in 80% of patients. Kleen‐Prep failed to achieve adequate preparation in 46%, due to excess fluid and poor mucosal coating. Kleen‐Prep caused more patient nausea, abdominal bloating and pain than Picolax. Patients 70 years and older had similar results. Low‐residue diet need not be used in addition to Picolax. Kleen‐Prep as a single agent is not recommended for BE preparation.
Transrectal ultrasound‐guided biopsy of the prostate: What you see is not what you get
Authors: Bruce Leibowitz C , Staub Peter G 
Published: March 2008

SUMMARYA prospective trial involving 282 patients, beginning in December 1993, was undertaken to assess the correlation between our sonographic impression of prostatic malignancy and the histological findings of a random six quadrant biopsy in addition to histology of any sonographically evident focal peripheral zone (PZ) abnormality. The sonographic criteria used to suggest malignancy were: (i) presence of hypo‐echoic PZ nodule; (ii) inhomogeneity of PZ; and (iii) loss of zonal architecture (ZA). The sonographic appearance was graded as either definitely benign, indeterminate, or definitely malignant. These impressions were then compared with the histology results. Eighty‐two patients had histologically proven malignancy. Ultrasound showed the correct extent and site of malignancy in 42 patients. A further 26 patients had the extent of their malignancy either over‐ or under‐estimated or had the malignancy placed in an incorrect site. Fourteen patients with histologically proven carcinoma had sonographically normal PZs. These findings highlight the shortcomings of ultrasound as a diagnostic tool in prostate cancer and show that six quadrant random biopsy of the prostate is far superior to unifocal biopsy of sonographically evident masses in the detection of prostate cancer.
Imaging of orbital floor fractures
Authors: Ng Perry , Chu Christopher , Young Noel , Soo Mark 
Published: March 2008

SUMMARYThe aim of this study was to compare the efficacy of plain films and computed tomography (CT) in defining inferior orbital fractures and any muscle involvement. Forty‐four patients with final diagnosis of orbital floor fractures in the period 1990–94 were retrospectively studied. Computed tomography was performed in 28 patients, 20 being direct coronal acquisitions and eight being fine axial acquisitions with coronal reconstructions. Water's view radiographs were performed in 34 patients. Fourteen fractures on plain films were associated with soft tissue opacities to suggest inferior rectus (IR) muscle involvement, but only two required surgical elevation of the orbital floor. The remaining patients were successfully treated conservatively. Three patients had IR entrapment on direct coronal CT, all requiring surgical elevation of the orbital floor. Seven patients had IR muscle displacement on direct coronal CT and all had conservative management. In four patients with axial acquisition and coronal reconstructions, the CT images were of inadequate quality to determine the presence or absence of a fracture. One patient who had no IR muscle involvement identified on reconstructed coronal CT required surgical elevation of the orbital floor on clinical grounds. We conclude that: (i) soft tissue opacities on plain films are not an accurate indicator of clinically significant IR involvement; (ii) axial CT is not efficacious in detection of fractures or IR involvement; and (iii) direct coronal CT is the most efficacious imaging modality.
Spontaneous intramural haematoma of the oesophagus: Radiologic recognition
Authors: DRACR; W Clark , Cook IJ 
Published: March 2008

SUMMARYSpontaneous intramural haematoma of the oesophagus (SIHO) is an uncommon disorder. It presents usually with acute chest pain followed by dysphagia. This condition may mimic spontaneous rupture of the oesophagus (Boerhaave Syndrome), dissection of the thoracic aorta or acute myocardial infarction. Hence early accurate confirmation of the diagnosis by radiology is vital for the appropriate acute management. The condition is frequently mistaken for acute myocardial infarction which may prompt inappropriate thrombolytic therapy. The appearances on contrast studies of oesophagus and on CT scanning are characteristic. Despite this, the diagnosis may easily be missed, if appropriate careful radiological technique is not used. This paper reports three consecutive cases of SIHO managed in one institution. These cases illustrate that early gastrografin contrast radiology followed by barium contrast radiology and if necessary by thoracic CT is diagnostic in all cases of this condition.
Ultrasound‐guided parathyroid aspiration to diagnose parathyroid adenomas
Authors: Campbell Joanne , Diamond Terrence , North Leslie 
Published: March 2008

SUMMARY Aim To ascertain the accuracy of ultrasound‐guided fine needle aspiration and parathyroid hormone assay in the identification of parathyroid adenomas. Design Case study. Setting Tertiary referral clinic. Patients 12 subjects, consisting of 10 female and two male patients, with documented primary hyperaparathyroidism. Intervention Ultrasonography of the parathyroid glands was performed using an Acuson XP 128 machine with a linear array 7.5 MHz multihertz probe. Following accurate localization of the parathyroid lesion, fine needle aspiration was performed using a 23 gauge needle, and parathyroid hormone assay was performed on the aspirate. Preoperative localization was compared with intra‐operative findings. Results Ultrasound examination detected 10 out of a possible 12 parathyroid adenomas (83% sensitivity), while ultrasound‐guided fine needle aspiration only confirmed nine out of the 12 adenomas (75% sensitivity). Conclusions While ultrasound‐guided fine needle aspiration may be simple and with minimal morbidity, it does not appear to provide any advantage over ultrasound examination alone for the localization of parathyroid adenomas. It has a potential role in defining the nature of ultrasonically localized nodules.
Results of definitive radiotherapy in T1 and T2 glottic carcinoma: Institute of Rotary Cancer Hospital experience
Authors: Mohanti BK , Tandon DA , Bahadur S , Rath GK , Tanwar RK , Lal P , Biswal BM 
Published: March 2008

SUMMARYEarly glottic carcinomas (T1 and T2) constitute only 2% of all laryngeal cancers in our data. Seventy patients were seen between 1985 and 1992. All patients were treated by cobalt‐60 small field radiotherapy using a beam directed shell. The total dose delivered was 60–65 Gy in 31 patients and 66–70 Gy in 39 patients. The follow‐up period ranged from 5 to 126 months, with a mean follow up of 37 months overall and 55 months in the surgical salvage group. Radiation therapy controlled disease in 71% (50 of 70) of patients overall; 75% with T1 and 67% with T2 lesions. Total laryngectomy as salvage surgery was performed in 70% (14 of 20) of patients whose disease recurred. Ultimate control including surgical salvage occurred in 64 (91%) of 70 patients in the present study. The actuarial 5 year survival was 83 and 80% in T1 and T2 tumours, respectively (statistically insignificant). This report supports the policy of definitive irradiation, reserving surgical salvage for radiation failures in early laryngeal cancers.
Initial qualitative evaluation of computed radiography in an intensive care unit
Authors: Hillis DJ , Crowe BL , McDonald IG , Kelly WJ , Truran RD , Hailey DM 
Published: March 2008

SUMMARYThe first computed radiography (CR) unit in Australia was installed at St Vincent's Hospital, Melbourne, in February 1994. An initial qualitative evaluation of the attitude of the intensive care unit (ICU) physicians to the CR unit was conducted in June 1994 by use of a survey. The results of the survey of ICU physicians indicated that images were available faster than under the previous system and that the use of the CR system was preferred to evaluate chest tubes and line placements.While it is recognized that a further detailed radiological evaluation of the CR system is required to establish the diagnostic performance of CR compared with conventional film, some comments on the implementation of the system and ICU physician attitudes to the CR system are put forward for consideration by other hospitals examining the possible use of CR systems.
Adjuvant VHF therapy in locally recurrent and primary unresectable rectal cancer
Authors: Trotter James M , Edis Anthony J , Blackwell John B , Lamb Margaret H , Bayliss Evan J , Shepherd John M , Cassidy Barry 
Published: March 2008

SUMMARYIn a prospective randomized study, 434 mHz microwave therapy combined with external beam radiotherapy (VHF+RT) was compared with standard external beam radiotherapy (RT) in controlling locally recurrent or unresectable primary adenocarcinoma of the rectum. Independent assessors documented quality of life scores, performance status, toxicities, local response to treatment, and systemic disease progression before treatment and after treatment and every 8 weeks thereafter. Of 75 patients randomized, 73 were eligible for inclusion in the study. Forty‐three of these patients had local pelvic tumour recurrence only and 21 also had distant metastases. In addition, nine patients had primary inoperable carcinomas, two of whom also had metastases. Thirty‐seven patients were randomized to RT and 36 to VHF+RT. The median dose of radiation in the VHF+RT arm was 4275 cGy with a median fraction size of 150 cGy and median duration of therapy of 48.5 days versus 4500 cGy in the RT‐only arm with a median fraction size of 180 cGy and median duration of therapy of 38 days. These doses are unlikely to be significantly different in biological effect. No significant difference between the two groups was observed in extent and duration of local control, measures of toxicity or quality of life scores. Additionally, survival and cumulative incidence of pelvic site of first progression did not differ significantly between the groups. We conclude that VHF microwave therapy in conjunction with radiotherapy produces no therapeutic advantage over conventional radiation therapy alone in the treatment of locally recurrent rectal carcinoma.