bluuebunny/crossref_metadata_2025_split huggingface dataset:
Silent embolism in diagnostic cerebral angiography: Detection with diffusion‐weighted imaging
Authors: Chuah Kenneth C , Stuckey Stephen L , Berman Ivor G 
Published: July 2004

SummaryAngiography has known and documented risks of neurological events. We prospectively studied 20 patients who underwent diagnostic cerebral angiographic examinations and diffusion‐weighted MRI (DWI). Eighteen patients had DWI before and after their angiogram, whereas two patients had a DWI only after their angiogram (DWI was normal in both of these patients). No clinical neurological deficits were detected in any of our patients after angiography, but in three of 20 patients there was a new hyperintense signal abnormality found on DWI. Diffusion‐weighted MRI provides an objective means of detecting both clinical and subclinical neurological events. Diffusion‐weighted imaging might therefore provide an easier method of assessing complication rates in cerebral angiography by reducing the number of patients required for meaningful statistical analysis.
Intrapleural nasogastric tube insertion
Authors: O'Neil Ross , Krishnananthan Ruben 
Published: July 2004

SummaryA misplaced fine‐bore nasogastric tube (NGT) might enter the bronchial tree. Pleural puncture and intrapleural passage of the tube is very uncommon but the location can often be inferred from the frontal chest radiograph. Following recognition of a NGT within the pleural space, progress films should be carefully screened for complications, particularly pneumothorax. This is often not done by staff involved in the monitoring of such patients because the staff frequently do not recognize the signs of intrapleural NGT insertion.
Identification and staging of pancreatic tumours using computed tomography, endoscopic ultrasound and mangafodipir trisodium‐enhanced magnetic resonance imaging
Authors: Ramsay Duncan , Marshall Martin , Song Swithin , Zimmerman Mathew , Edmunds Simon , Yusoff Ian , Cullingford Graham , Fletcher David , Mendelson Richard 
Published: July 2004

SummaryPancreatic malignancy can be staged by a number of different investigations, either alone or in combination. The purpose of the present study was to compare the use of endoscopic ultrasound, CT and mangafodipir trisodium‐enhanced MRI for the staging of pancreatic malignancy, particularly with respect to determining resectability prior to surgery. Twenty‐seven patients referred for the investigation of a suspected pancreatic malignancy were entered into the trial. All patients had contrast‐enhanced CT, gadolinium and mangafodipir trisodium‐enhanced MRI, and endoscopic ultrasound (EUS). Images were assessed for nodal staging, tumour staging and resectability for each investigation, and the results compared with findings at surgery. The results for the accuracy of MRI, CT and EUS, in detecting T4 disease versus T3 or lower was 78, 79 and 68%, respectively; nodal involvement was 56, 63 and 69%, respectively; and overall resectability (including the T stage, presence of involved nodes and metastases) was 83, 76 and 63%, respectively. There was no significant difference demonstrated between the three tests. The present study suggests that for patients referred for investigation and staging of pancreatic malignancy, EUS and MRI scanning convey little advantage over contrast‐enhanced CT. Furthermore, although mangafodipir trisodium improved the conspicuity of pancreatic tumours, it has little influence on T staging.
Skull base chordoid meningioma: Imaging features and pathology
Authors: Soo Mark YS , Ng Thomas , Gomes Lavier , Da Cruz Melville , Dexter Mark 
Published: July 2004

SummaryThe clinical, imaging and pathological features of a skull base chordoid meningioma (CM) are described. The huge tumour resulted in obstructive hydrocephalus and partial erosion of the clivus such that a chordoma was suspected. The lesion's MRI findings were similar to those of a meningioma. Light microscopic, immunohistochemistry and ultrastructural features were diagnostic of CM. Chordoid meningioma is a rare subtype of meningioma and has a great tendency to recur should surgical resection be incomplete.
Calcified nodal metastasis from squamous cell carcinoma of the head and neck
Authors: Gormly Kirsten , Glastonbury Christine M 
Published: July 2004

SummaryCalcification within cervical lymph nodes is relatively rare, and most commonly ascribed to benign inflammatory or infectious processes. We present a case of a calcified submandibular nodal metastasis from squamous cell carcinoma of the lip and review the current published literature on nodal calcifications in the neck. To the authors’ knowledge, calcification resulting from metastatic squamous cell carcinoma of the head and neck has been described only once previously.
Rupture of the renal pelvis of a ureteropelvic junction hydronephrosis after blunt abdominal trauma
Authors: Ashebu Samuel D , Dahniya Mohamed H , Aduh Prosper , Ramadan Salwa , Bopaiah Harini , Elshebiny Yahaya H 
Published: July 2004

SummaryIn the present case report, we present the unusual occurrence of traumatic rupture of a ureteropelvic junction hydronephrosis, and discuss the potential mechanisms producing such a rupture and the management options.
Complications of occipital bone pneumatization
Authors: Moss Mary , Biggs Michael , Fagan Paul , Forer Martin , Davis Martin , Roche Jim 
Published: July 2004

SummaryFour cases of occipital bone pneumatization and subsequent complications are described, which include a pathological fracture of C1 and the occipital bone, spontaneous subcutaneous emphysema and pneumatocele formation. Reviews of the published literature and possible aetiological factors have been discussed.
Benefits of sonographic‐guided hydrostatic reduction opposed to air reduction in a case of intussusception due to lymphoma
Authors: Grant Robyn L , Piotto Lino 
Published: July 2004

SummaryA case of intussusception due to a pathological lead point in a child is presented. Such cases are uncommon in the paediatric age‐group. The pathological lead point was missed at air enema reduction but it was clearly defined on sonographic‐guided hydrostatic reduction. The advantages and disadvantages of these reduction methods are discussed.
Are single fractions of radiotherapy suitable for plantar fasciitis?
Authors: Schwarz Fabian , Christie David RH , Irving Michael 
Published: July 2004

SummaryThe use of radiotherapy for plantar fasciitis has never been reported in Australasia and is scarcely found in the English language medical literature, but it is commonly used in Europe, especially in Germany. In Europe, treatment courses consisting ofmultiplesmall fractions have been associated with high levels of pain relief. In the present report, the use ofsinglefractions or radiotherapy was evaluated by reviewing seven consecutive patients referred for treatment and by applying objective and subjective criteria for pain relief. One patient died of unrelated causes soon after treatment and one declined to receive radiotherapy. Four patients each received asingledose of 8 Gy resulting in complete pain relief. One patient was treated with 8 Gy and 12 weeks later was retreated achieving partial pain relief. A follow‐up interview was conducted after a mean of 15.6 months, ranging from 1.5 to 30 months. No acute or late effects occurred; however, the possibility that delayed effects may yet occur, particularly carcinogenesis, cannot be excluded. Radiotherapy for this common condition should be investigated further as it might be safer and more effective than other methods currently in use.
‘Boomerang’ technique: An improved method for conformal treatment of locally advanced nasopharyngeal cancer
Authors: Corry June , Hornby Colin , Fisher Richard , D’Costa Ieta , Porceddu Sandro , Rischin Danny , Peters Lester J 
Published: July 2004

SummaryThe primary aim of the present study was to assess radiation dosimetry and subsequent clinical outcomes in patients with locally advanced nasopharyngeal cancer using a novel radiation technique termed the ‘Boomerang’. Dosimetric comparisons were made with both conventional and intensity modulated radiation therapy (IMRT) techniques. This is a study of 22 patients treated with this technique from June 1995 to October 1998. The technique used entailed delivery of 36 Gy in 18 fractions via parallel opposed fields, then 24 Gy in 12 fractions via asymmetric rotating arc fields for a total of 60 Gy in 30 fractions. Patients also received induction and concurrent chemotherapy. The radiation dosimetry was excellent. Dose−volume histograms showed that with the arc fields, 90% of the planning target volume received 94% of the prescribed dose. Relative to other conventional radiation therapy off‐cord techniques, the Boomerang technique results in a 27% greater proportion of the prescribed dose being received by 90% of the planning target volume. This translates into an overall 10% greater dose received for the same prescribed dose. At 3 years, the actuarial loco‐regional control rate, the failure‐free survival rate and the overall survival rate were 91, 75 and 91%, respectively. At 5 years, the actuarial loco‐regional control rate, the failure‐free survival rate and the overall survival rate were 74, 62 and 71%, respectively. The Boomerang technique provided excellent radiation dosimetry with correspondingly good loco‐regional control rates (in conjunction with chemotherapy) and very acceptable acute and late toxicity profiles. Because treatment can be delivered with conventional standard treatment planning and delivery systems, it is a validated treatment option for centres that do not have the capability or capacity for IMRT. A derivative of the Boomerang technique, excluding the parallel opposed component, is now our standard for patients with locally advanced nasopharyngeal cancer when IMRT is not available.
Iodine‐125 brachytherapy for prostate cancer: First published Australian experience
Authors: Joseph David J , CS Woo Tony , Haworth Annette 
Published: July 2004

SummaryWith the emergence of new imaging and implant techniques, prostate brachytherapy has become increasingly popular over the last decade. Brachytherapy promises to deliver twice the biologically effective dose as conventional external beam treatments without increasing the dose to tissues surrounding the prostate. However, there are few or no published Australian series of its efficacy in the clinic. We present the experience of one of the first centres in Australia to offer this service to its patients: a series from Sir Charles Gairdner Hospital in Western Australia. We present data on the efficacy of brachytherapy in maintaining prostate specific antigen levels, as well as the rate of urinary, rectal and sexual complications. Our results compare favourably with other brachytherapy and external beam treatment series. We believe that with the increasing trend towards dose escalation and novel therapies, standardized measurements of success and failure need to be better defined, and that randomized trials comparing modalities are needed to improve the management of prostate cancer.
A modified technique for craniospinal irradiation in children designed to reduce acute and late radiation toxicity
Authors: Phillips Claire , Willis David , Cramb Jim , Chicas‐Angulo Franc , Sexton Maree 
Published: July 2004

SummaryCraniospinal irradiation is an important technique for the treatment of a number of paediatric malignancies. The conventional technique uses photons for all fields and does not exploit the benefits of CT and computer planning systems. The present paper describes a modification of the conventional technique in which both photons and electrons are used for the spinal field (mixed‐beam technique). Computed tomography images and a planning computer are used for the selection of field junctions, electron beam energy and dosimetry. The intention of the technique is to reduce radiotherapy toxicity. A discussion of the potential benefits is presented.
A comparison of RANZCR and Singapore‐designed radiation oncology practice audit instruments: How does reproducibility affect future approaches to revalidation?
Authors: Shakespeare Thomas P , Mukherjee Rahul K , Lu Jiade J , Wynne Christopher J , Kumar Mahesh B , Back Michael F 
Published: July 2004

SummaryPhysician competency assessment requires the use of validated methods and instruments. The Royal Australian and New Zealand College of Radiologists (RANZCR) developed a draft audit form to be evaluated as a competency assessment instrument for radiation oncologists (ROs) in Australasia. We evaluated the reliability of the RANZCR instrument as well as a separate The Cancer Institute (TCI) Singapore‐designed instrument by having two ROs perform an independent chart review of 80 randomly selected patients seen at The Cancer Institute (TCI), Singapore. Both RANZCR and TCI Singapore instruments were used to score each chart. Inter‐ and intra‐observer reliability for both audit instruments were compared using misclassification rates as the primary end‐point. Overall, for inter‐observer reproducibility, 2.3% of TCI Singapore items were misclassified compared to 22.3% of RANZCR items (P < 0.0001, 100.00% confidence that TCI instrument has less inter‐observer misclassification). For intra‐observer reproducibility, 2.4% of TCI Singapore items were misclassified compared to 13.6% of RANZCR items (P < 0.0001, 100.00% confidence that TCI instrument has less intra‐observer misclassification). The proposed RANZCR RO revalidation audit instrument requires further refinement to improve validity. Several items require modification or removal because of lack of reliability, whereas inclusion of other important and reproducible items can be incorporated as demonstrated by the TCI Singapore instrument. The TCI Singapore instrument also has the advantage of incorporating a simple scoring system and criticality index to allow discrimination between ROs and comparisons against future College standards.
Primitive neuroectodermal kidney tumour
Authors: Ng Alex WH , Lee Paul SF , Howard Robert G 
Published: July 2004

SummaryRenal primitive neuroectodermal tumour (PNET) is a rare malignant tumour of paediatric patients. We describe the important imaging findings, including the ultrasound, CT and MRI of a case of renal PNET in a teenager. To our knowledge, some findings have not been described previously. Some features that have been considered as characteristic are not present in our case, and it is, to our knowledge, the first documented case with such extensive tumour thrombus. We also demonstrate the importance of including PNET as a differential diagnosis because combined chemotherapy is thought to be the best first‐line treatment in most cases. Histological diagnosis can be determined by a minimally invasive procedure instead of laparotomy or open biopsy.
Detection of occult bone metastases of lung cancer with Fluorine‐18 fluorodeoxyglucose positron emission tomography
Authors: Foo Serene S , Ramdave Shankar , Berlangieri Salvatore U , Scott Andrew M 
Published: July 2004

SummaryAccurate staging of cancer has a critical role in optimal patient management. Fluorine‐18 fluorodeoxyglucose positron emission tomography (FDG PET) is superior to CT in the detection of local and distant metastases in patients with non‐small cell lung cancer. Although Tc‐99 m methylene diphosphonate (MDP) bone scanning is well established in the evaluation of bone metastases, there are conflicting reports on the use of FDG PET in the evaluation of skeletal metastases. We report on a patient with locally advanced lung carcinoma in whom FDG PET accurately identified previously unsuspected widespread asymptomatic bone metastases (bone scan and X‐rays negative, confirmed on MRI). Assessment of glucose metabolism with FDG PET might represent a more powerful tool to detect bone metastases in lung cancer compared with conventional bone scans.
Endovascular‐covered stent treatment of posttraumatic cervical carotid artery pseudoaneurysms
Authors: Haq Tanveer ul , Yaqoob Jamal , Munir Khalid , Usman Mohammad U 
Published: July 2004

SummaryPseudoaneurysm involving the cervical portion of the carotid artery can result from prior trauma or dissection. Two patients are reported with posttraumatic carotid artery pseudoaneurysms. In both cases, endovascular‐covered stents were placed across the diseased portion of the artery resulting in thrombosis of the aneurysm and preservation of the parent artery without any significant complication. It is therefore concluded that covered stent placement is an alternative approach in treating carotid artery pseudoaneurysms.
Low dose BCG as adjuvant therapy for superficial bladder cancer and literature review
Authors: Cheng C. W. , Ng M. T. , Chan S. Y. , Sun W. H. 
Published: July 2004

Background:  Bacillus Calmette−Guerin (BCG) at low doses has long been employed as prophylactic and therapeutic treatment for superficial cancer of the urinary bladder, aiming at reducing toxicity while maintaining efficacy. A retrospective review was reported, together with a review of the literature with respect to a low dose BCG regimen.Methods:  Forty‐five consecutive patients with superficial bladder cancer (Ta or T1) with one or more of the appropriate criteria (grade above 1, stage above a, size >1 cm, multiple or recurrent), after complete transurethral resection, received 27 mg Connaught strain BCG weekly for 6 weeks. There was no maintenance therapy. Patients were evaluated with urine cytology and cystoscopy. Recurrence, progression and death were analysed.Results:  With a median follow up of 14 (range 3−61) months, 24 (53%) of the 45 patients responded to one course of 6 weekly BCG without recurrence. A further group of 13 (29%) patients responded to a second course of BCG on recurrence. Disease progressed in one (2.2%) patient. Two (4.4%) patients died of an unrelated condition. There was no disease specific mortality. Side‐effects were common but well tolerated, with only two (4.4%) cases of treatment interruption.Conclusions:  Low dose BCG could be an alternative option of adjuvant therapy for superficial bladder cancer with acceptable toxicity and good compliance.
Graduated compression stockings (20−30 mmHG) do not compress leg veins in the standing position
Authors: Lord Reginald S. A. , Hamilton Debra 
Published: July 2004

Background:  Since graduated compression stockings (GCS) reduce the risk of deep venous thrombosis (DVT) in both hospital and ambulant patients, we checked the compressive efficiency of 20−30 mmHg GCS in the standing position.Methods:  In 30 volunteers (17 normal legs, 13 varicose legs), duplex ultrasound was used to measure the internal diameters of the long saphenous vein, posterior tibial veins, peroneal veins, and soleal veins in the lying and standing position and with and without 20−30 mmHg GCS.Results:   Graduated compression stockings effectively compressed both superficial and deep veins in supine individuals but not the superficial or the deep veins when standing. In the varicose leg, the stockings did not compress the long saphenous vein at the mid‐calf level even when supine. In the varicose leg the long saphenous vein was constricted at the upper band of the stocking, which might explain why superficial venous thrombosis is more common when compression stockings are worn.Conclusions:  In the standing position, GCS did not compress the deep or superficial veins of the calf.
Abdominoperineal resection or low Hartmann's procedure
Authors: Frye John N. R. , Carne Peter W. G. , Robertson Greg M. , Frizelle Frank A. 
Published: July 2004

Aim:  To compare patients having low Hartmann's resection (LHP) with abdominoperineal resection (APR) by investigating postoperative complications.Methods:  Retrospective comparative analysis of preoperative state and postoperative course for patients having surgery from 1 January 1997 to 1 July 2001, by the surgeons of the Colorectal Unit, Christchurch Hospital, Christchurch, New Zealand.Results:  Over a 54‐month period 65 patients underwent either LHP or APR (29 LHP, 36 APR). The median age/sex (male:female) of patients for LHP was 76 years (51−90 years) (14:15), for APR 72 years (31−93 years) (19:17). The indication for surgery was predominantly cancer (LHP 89.6%, APR 94.4%). There was a high rate of preoperative comorbidities: LHP 75.9% (cardiac 62.1%, pulmonary 17.2%), APR 75% (cardiac 50%, pulmonary 15.9%). Preoperative chemoradiation was used in 10.3% of patients having LHP and 30.6% with APR. There was no difference in postoperative non‐septic complications. There was a significant difference in the types of septic complications (P = 0.018), with a higher rate of pelvic abscesses after LHP (5). Perineal wound infection occurred in five patients having APR (14.3%). The median time to heal a perineal wound was 1 month (0.5−7 months). The median length of stay was 13 days for LHP (5−33 days) and 11 days for APR (6−19 days)(P = 0.0266).Conclusion:  This non‐randomized, retrospective, cohort study shows a surprisingly high rate of pelvic abscesses after LHP compared with APR. Perineal wound healing was a problem after APR, but less of a management problem than the septic complications after LHP. Both LHP and APR might be associated with significant morbidity. A high pelvic abscess rate following LHP is associated with a high likelihood of further surgical intervention and a prolonged length of stay.
Comparison of the effect of diclofenac with hyoscine‐N‐butylbromide in the symptomatic treatment of acute biliary colic
Authors: Kumar Anup , Deed Jagpreet S. , Bhasin Bharat , Kumar Ashok , Thomas Shaji 
Published: July 2004

Background:  Although non‐steroidal anti‐inflammatory drugs (NSAID) and spasmolytics have been used to relieve biliary colic, the role of these drugs in the natural history of biliary colic has not been clarified. The objective of the present study is to compare the efficacy of intramuscular diclofenac with intramuscular hyoscine in the treatment of pain of acute biliary colic, and to study their role in the natural history of biliary colic and in the prevention of cholelithiasis‐related complications.Methods:  Seventy‐two consecutive patients with biliary colic were enrolled in this prospective, randomized, double‐blind study. They received either a single 75 mg intramuscular dose of diclofenac (n = 36) or similarly administered 20 mg of hyoscine (n = 36). Pain severity was recorded on a visual analogue scale 30 min, 1 h, 2 h and 4 h after injection of the drug. Patients were then followed closely for the next 72 h for persistence or relapse of pain, or development of acute cholecystitis, or drug related complications.Results:  Diclofenac provided much more rapid relief of pain than hyoscine, as shown by significantly lesser pain scores after injection of the drug. 91.7% of patients on diclofenac were completely relieved of pain at 4 h as compared to 69.4% with hyoscine (P = 0.037). Progression to acute cholecystitis was seen in only 16.66% of patients on diclofenac as compared to 52.77% on hyoscine (P = 0.003).Conclusions:  In patients with biliary colic, diclofenac gives much faster and more effective pain relief in a significantly larger number of patients as compared with hyoscine. Most remarkably, diclofenac can prevent progression of biliary colic to acute cholecystitis in a significant number of patients.