Problems associated with iridium-192 wire implants

Three incidents are reported, from different radiotherapy centres, in which an implanted iridium-192 wire remained in the tissues of a patient after withdrawal of the plastic tubing in which it was contained. In each case the instrument used to cut the wire had probably formed a hook on the end of the wire which caused it to catch in the tissues. Detailed recommendations are made for avoiding such incidents in the future, the most important of which is that the patient should be effectively monitored after the supposed removal of all radioactive sources.     

The double contrast barium meal in patients with acute upper gastrointestinal bleeding

One hundred and seven patients admitted to a small general hospital with acute upper gastrointestinal bleeding have been examined by the double contrast barium meal technique. The presumed bleeding site was identified in 75 cases (70%). Twenty-eight patients showed radiological evidence of recent or active bleeding. These were all examined within 24 h of the bleed and 18 (64%) continued to bleed or had a further bleed whereas of 79 patients who did not show radiological signs of recent or active bleeding only 10(13%) continued to bleed or had a further bleed. The radiological features of recent or active bleeding seen on the double contrast barium meal are: 1, Blood clot in an ulcer or adherent to a recently bleeding lesion. 2. An artery in the base of an ulcer. 3. Active bleeding during the course of the examination seen as a dynamic alteration or disturbance in the barium as it flows over the bleeding site.     

Radiology of needle biopsy of pulmonary lesions.

A technique for percutaneous aspiration needle biopsy is described and discussed. It is concluded that it forms a simple and easy way of obtaining histological material and it can be carried out in most radiological departments.     

Antenatal detection of recurrence of Majewski dwarf (short rib-polydactyly syndrome type II Majewski)

Two cases of Majewski dwarfism are reported. both were the product of the same non-consanguinous marriage and each exhibited the key features of this syndrome: polysyndactyly, short ribs, cleft lip, disproportionately short tibiae and a normal pelvis. The first infant, a baby boy, died shortly after birth, whilst the second was detected prenatally by ultrasound and had female characteristics. Several skeletal dysplasias have been demonstrated in utero by ultrasound, but we believe this to be the first reported case of a Majewski dwarf detected by this method. In view of the difficulty in diagnosis of this syndrome comparison is made with other short rib-polydactyly syndromes.     

CT scanning in middle fossa arachnoid malformations

The typical appearances of middle foss arachnoid malformations as seen by computed tomography, are presented in six cases out of 3700 unselected CT scans performed in the last two years. These lesions have well-defined borders, the anterior border often conforming to the configuration of the greater sphenoid wing, and the posterior border merging into the Sylvian fissure medially. They exhibit the same attenuation coefficients as cerebrospinal fluid (CSF), in the range of 0 to +8 EMI units. Their size is variable. They produce less mass effect than might be expected, even when their size is considerable. Their appearance does not change after infusion of contrast material. Although arachnoid malformations occur in many intracranial sites, the site of predilection appears to be the middle cranial fossa. The clinical presentation and subsequent management of the six cases is briefly described. The pathogenesis and common clincial presentation associated with these lesions is discussed.     

Vacuum contoured, liquid crystal, dynamic breast thermoangiography as an aid to mammography in the detection of breast cancer.

New thermographic equipment is introduced in the form of liquid crystals embedded in flexible, transparent, elastomeric sheaths which may be vacuum contoured to any breast. Dynamic thermoangiography, a new physiological method of performing thermography with these liquid crystal sheaths, is presented. Thermographic changes are recorded during active skin cooling and rewarming with liquid crystals in situ. The new system eliminates skin preparation previously required. Preliminary results appear to show good correlation with conventional telethermography. Vascular, as well as thermal pathology, is accentuated with rich, high contrast, thermographically calibrated colour patterns. The new system is relatively inexpensive, simple to operate, and may be suited to a programme for the detection of breast cancer.     

The radiological and urodynamic significance of large bladder diverticula

Large acquired bladder diverticula in adults may cause severe urodynamic disturbance and exacerbate difficulty in micturition. They may accommodate a large proportion of the contents of the bladder during attempted voiding, thus decreasing the effect of the detrusor muscle contraction. The post-micturition radiographs on intravenous urography, after the diverticula have emptied again, may only show a large intravesical post-micturition residue and give little information as to the size of the diverticula during the act of micturition.