Showing papers in "American Journal of Roentgenology in 1971"
TL;DR: There was pathology in the acromioclavicular joint in 12.7 per cent of the patients, as compared with 20 per cent with shoulder joint disease, in all patients with positive roentgen findings.
Abstract: The incidence of pathology in the "forgotten" acromioclavicular joint in patients with shoulder pain is higher than generally realized.With a high index of suspicion for pathology in the acromioclavicular articulation, and adding acromioclavicular roentgenographic films to the usual shoulder joint roentgenograms, more pathology will be demonstrated.In this series of cases, there was pathology in the acromioclavicular joint in 12.7 per cent of the patients, as compared with 20 per cent with shoulder joint disease. In all patients with positive roentgen findings, tendinitis calcarea accounted for 46 per cent of the pathology and acromioclavicular arthritis accounted for 35.6 per cent of all of the pathology.
306 citations
TL;DR: The combination of irradiation of the brain and oralprednisone offers only slightly better results in terms of duration of remission and survival than oral prednisone alone in the management of metastatic cancer of the head and neck.
Abstract: 1. The combination of irradiation of the brain and oral prednisone offers only slightly better results in terms of duration of remission and survival than oral prednisone alone in the management of metastatic cancer of the brain.2. In patients treated with the combination who enter remission, there is probably no advantage to continuing prednisone prophylactically.3. On subsequent relapse, re-use of prednisone can sometimes be effective.
191 citations
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TL;DR: Aggressive primary therapy—surgery combined with irradiation—which is designed to treat the entire breast as well as both primary lymphatic depots of the breast has resulted in marked improvement in local control and over-all salvage as well.
Abstract: Aggressive primary therapy—surgery combined with irradiation—which is designed to treat the entire breast as well as both primary lymphatic depots of the breast has resulted in marked improvement in local control and has increased over-all salvage as well.Primary breast cancers which have already spread to the internal mammary lymph nodes can be salvaged long-term wise through aggressive surgery and radiation therapy.
132 citations
TL;DR: Those conditions which may result in ureteral notching on an arterial and venous basis are discussed and illustrated.
Abstract: Impressions upon the ureters accounted for by extrinsic pressure defects exerted by adjacent or crossing arteries and veins are frequently noted on urographic studies. The observation of these extrinsic pressure defects is usually made, but their significance is often overlooked. We have discussed and illustrated those conditions which may result in ureteral notching on an arterial and venous basis.The arterial causes of ureteral impressions include:1. impressions by accessory but normal renal arteries;2. compression by a normal iliac artery;3. renal artery stenosis;4. aortic and iliac artery occlusion;5. cirsoid aneurysm of the renal artery;6. impression by aortic and hypogastric artery aneurysm.The venous impressions on the ureters may be due to:1. normal gonadal vein crossing defect on right or on left;2. right ovarian vein syndrome;3. varicocele and varices of the broad ligament;4. occlusion of the inferior vena cava below the level of the renal veins by tumor, clot, retroperitoneal fibrosis, or follo...
104 citations
TL;DR: Histologically, enchondral ossification is strikingly disorganized and matrix is lacking between the resting cartilage cells, and the condition may be differentiated from thanatophoric dwarfism and the other short-limbed types of dwarfs.
Abstract: Achondrogenesis is a lethal skeletal dysplasia in which micromelia is severe and delay in ossification is extreme.The roentgenographic features are diagnostic and form a distinctive pattern. Almost total absence of ossification is noted in the vertebral bodies, sacrum, ischial and pubic bones, and calcaneus and talus. The shape of the ilia is distinctive. The condition may be differentiated from thanatophoric dwarfism and the other short-limbed types of dwarfs.Histologically, enchondral ossification is strikingly disorganized and matrix is lacking between the resting cartilage cells.Achondrogenesis is probably an autosomal recessive disease.
89 citations
TL;DR: Since most patients have multiple metastatic foci in brain, the authors continue to advocate total brain irradiation to a dose of 3,500 rads in 3 to 4 weeks.
Abstract: A new series of 560 patients with intracranial metastases, treated by irradiation, has been reviewed and the results are reported.In this series worthwhile palliation was obtained in 54 per cent of the total number of patients, and 80 per cent of the 376 patients who completed the planned course of irradiation, and were available for evaluation. The mean duration of remission was 5 months and the median duration 3 months.The use of supervoltage irradiation and adjuvant corticosteroids reduced radiation reactions and permitted easier administration of irradiation, but there was no influence on the over-all response rate or duration of response when compared to 250 kvp. irradiation without adjuvant corticosteroids. The results were comparable with those reported previously.Since most patients have multiple metastatic foci in brain, we continue to advocate total brain irradiation to a dose of 3,500 rads in 3 to 4 weeks.
84 citations
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81 citations
TL;DR: Forty-three cases of neonatal necrotizing enterocolitis are reviewed, showing a recent incidence of almost 4 per cent among premature infants at this medical center as mentioned in this paper.The onset is most frequent between days 2 and 5 following birth.
Abstract: Forty-three cases of neonatal necrotizing enterocolitis are reviewed, showing a recent incidence of almost 4 per cent among premature infants at this medical center.The onset is most frequent between days 2 and 5 following birth. The most common clinical manifestations are temperature instability, lethargy, gastric retention, abdominal distention, and guaiac positive stools.Pneumatosis intestinalis is the roentgenographic hallmark of NEC, being seen in 98 per cent of this series. Other important findings on routine abdominal roentgenography include rather nonspecific bowel distention, hepatic portal venous gas, and pneumoperitoneum. Barium enema examination is usually not necessary for diagnosis.Treatment consists of supportive measures, wide-spectrum antibiotics, and surgery (52 per cent of this series), with a combined mortality of 37 per cent. Long term sequelae are rare.The etiology is unknown. It is hypothesized that a primitive reflex redistribution of splanchnic blood flow, in response to significa...
TL;DR: There was a distinct relationship between a history of a recent nasopharyngeal infection, exanthema, high fever, or severe exertion and the development of a hemiplegia in the great majority of these children.
Abstract: Sixty-one of 176 children under the age of 14 years, who suffered an acute hemiplegia, underwent angiographic studies of the cranial vessels. This hemiplegia was not related to any intracranial mass lesion, infection, cardiac or hematologic abnormality. One or more lesions of the internal carotid artery and its branches or the vertebrobasilar system were demonstrated in 40 of these children.The sites of these lesions have been classified into 3 groups:Group I—Extracranial internal carotid or vertebral arterial diseaseGroup II—Unilateral intracranial arterial disease(a)Internal carotid artery (complete or incomplete)(b) Middle cerebral artery onlyGroup III—Bilateral intracranial arterial disease.There was a distinct relationship between a history of a recent nasopharyngeal infection, exanthema, high fever, or severe exertion and the development of a hemiplegia in the great majority of these children. An additional discrete stenosis of the cervical portion of the internal carotid artery with distal intracra...
TL;DR: The basic patterns of arterial supply to horseshoe kidneys are described as well as the experience with 14 cases, which shows the need to know the variations in vascular anatomy.
Abstract: The basic patterns of arterial supply to horseshoe kidneys are described as well as our experience with 14 cases.Knowledge of the variations in vascular anatomy is important to the radiologist, who has the responsibility of demonstrating all the vessels and to the surgeon who may have to operate for one or more of the frequent complications which occur in horseshoe kidneys.
TL;DR: A variety of carpal anomalies may occur in the congenital malformation syndromes, which include the presence of extra carpal, abnormal carpals, and abnormalities of the carpal angle.
Abstract: A variety of carpal anomalies may occur in the congenital malformation syndromes. These include the presence of extra carpals, abnormal carpals, and abnormalities of the carpal angle. Carpal fusion which affects carpals in different rows also has some significance, as do variations in maturational sequence. In some syndromes an increased incidence of anatomic variation may be found. The lack of good normal standards of carpal size and configuration and the lack of statistical data on the normal variability of these bones make evaluation subjective in most cases.Syndromes associated with carpal anomalies include arthrogryposis, diastrophic dwarfism, dyschondrosteosis, Ellis-Van Creveld syndrome, epiphyseal dysplasia, Fanconi’s anemia, Hand-Foot-Uterus syndrome, Holt-Oram syndrome, homocystinuria, OtoPalato-Digital syndrome, symphalangism, Trisomy 18, and Turner’s syndrome.
TL;DR: Measurement of the length of the opposite kidney before and after removal of a multicystic dysplastic kidney shows thatCompensatory renal hypertrophy does not develop in utero and probably develops whether or not the nonfunctioning kidney is removed.
Abstract: Measurement of the length of the opposite kidney before and after removal of a multicystic dysplastic kidney shows that:1. Compensatory renal hypertrophy does not develop in utero.2. Compensatory hypertrophy develops promptly after birth.3. Enlargement is sufficient to make total renal mass approximately normal by the age of 1½ years.4. Compensatory hypertrophy probably develops whether or not the nonfunctioning kidney is removed.
TL;DR: The vascular images were studied in 37 cases of primary liver cancer to assign a definite pattern, apart from the peculiarity of tumor vessels, relating to the histologic diagnosis of the tumor.
Abstract: The vascular images were studied in 37 cases of primary liver cancer.In well differentiated hepatoma, vascular proliferation, tumor stain and A-V shunt formation are regarded as specific features.In anaplastic hepatoma and cholangiocarcinoma, however, it is difficult to assign a definite pattern, apart from the peculiarity of tumor vessels, relating to the histologic diagnosis of the tumor.Formation of collateral circulation in cholangiocarcinoma is considered to be a relatively rare finding.
TL;DR: Fourteen young drug abusers with a necrotizing angiitis indistinguishable from periarteritis nodosa were studied, and methamphetamine appears to be a common injectable substance in these cases.
Abstract: Fourteen young drug abusers with a necrotizing angiitis indistinguishable from periarteritis nodosa were studied. The six women and eight men had used narcotics, stimulants, hallucinogens and depressants. Methamphetamine, alone or in combination with heroin or d-lysergic acid diethylamide, was used commonly. The clinical presentation varied from a complete lack of symptoms in five patients to pleomorphic systemic signs and symptoms with renal failure, hypertension, pulmonary edema and pancreatitis. The vascular changes of necrotizing angiitis, including arterial aneurysms and sacculations, were noted in the kidney, liver, pancreas and small bowel at selective angiography. Post-mortem findings in four patients revealed generalized vascular changes of differing age, including chronic and healed lesions. Because of the multiplicity of injected substances with the high probability of contamination the exact etiologic agent in these cases is not clear; however, methamphetamine appears to be a common d...
TL;DR: Patients with cavernous hemangiomas of the liver are reported with particular emphasis on the variable but characteristic angiographic appearances, which reflect the variation in size and number of the lesions, their benign nature and their tendency to central fibrosis.
Abstract: Twelve patients with cavernous hemangiomas of the liver are reported with particular emphasis on the variable but characteristic angiographic appearances.These appearances reflect the variation in size and number of the lesions, their benign nature and their tendency to central fibrosis.The radiologist must be familiar with these angiographic findings: (a) to distinguish cavernous hemangiomas from malignant liver lesions; (b) to advise against percutaneous biopsy; and (c) because large lesions may require surgical treatment or radiotherapy.
TL;DR: The normal anatomy of the adult symphysis pubis was studied and a classification of variations and abnormalities is presented which forms the bases of differential diagnosis.
Abstract: The normal anatomy of the adult symphysis pubis was studied and a classification of variations and abnormalities is presented which forms the bases of differential diagnosis.Illustrations of various types of abnormalities are shown.It is hoped that this review will result in greater attention to and appreciation of abnormalities of this area.
TL;DR: Whole neck irradiation is indicated for squamous cell carcinomas of the nasopharynx, tonsillar fossa, base of tongue, and N2 and N3 of the palatine arch.
Abstract: 1. Eight of 469 patients (1.7 per cent) developed new nodal disease in an electively irradiated area.2. Nineteen of 185 patients (10.2 per cent) with partial neck irradiation developed new nodal disease in a marginally irradiated or unirradiated area.3. A tissue dose of 4,500 to 5,000 rads tumor dose in 5 weeks is proposed for the irradiation of elective areas. This dose produces no complications or even minor sequelae.4. Whole neck irradiation is indicated for squamous cell carcinomas of the nasopharynx, tonsillar fossa, base of tongue, and N2 and N3 of the palatine arch.
TL;DR: The appearance of the thoracic duct was analyzed in 390 sequential lymphangiograms and the classic bulbous dilatation of the cisterna chyli was visualized in 53 per cent of cases.
Abstract: The appearance of the thoracic duct was analyzed in 390 sequential lymphangiograms.The classic bulbous dilatation of the cisterna chyli was visualized in 53 per cent of cases. It was located at the T-12 to L-2 levels and was usually less than 5 cm. in length.The thoracic duct varied in size from 1 to 7 mm. Valves were visible in 84 per cent of cases (usually in the upper third of the duct). Double thoracic ducts, bilateral superior mediastinal ducts, and multiple variations in the cervical segment of the duct were observed. Intercostal lymphatic vessels were occasionally filled in normal studies. In the presence of mediastinal masses, the distance between the lateral tracheal wall and the thoracic duct measured greater than the normal of 10 mm. Kinking, tortuosity, and displacement of the duct were also apparent.Thoracic duct obstruction may be diagnosed by a sharp cut-off in its course, dilatation, tortuosity, visualization of collateral channels, and delayed emptying. If the site of obstruction is not c...
TL;DR: The CNS-related complications of catheter vertebral angiography could not be correlated with the duration of the procedure, the total dose of contrast material, or the presence of hypertension; inverse correlation was apparent in respect to number of injections, the presenceof arteriosclerosis, and, perhaps, age.
Abstract: A series of 435 patients underwent 447 catheter cerebral angiographic procedures, 231 having vertebral artery catheterizations, and 216 having non-vertebral cerebral studies using the same technique. There was no significant difference in the over-all complication rates for the 2 groups (about 11 per cent), but vertebral artery studies were associated with a higher incidence of CNS-related complications (6.5 per cent compared with 4.2 per cent in nonvertebral studies). Only 1 permanent disabling complication of CNS-related type occurred, and there was no death.The CNS-related complications of catheter vertebral angiography could not be correlated with the duration of the procedure, the total dose of contrast material, or the presence of hypertension; inverse correlation was apparent in respect to number of injections, the presence of arteriosclerosis, and, perhaps, age.
TL;DR: The clinical, pathologic, and roentgenographic features of colon duplications are reviewed and an unusual case of an asymptomatic, double-barreled duplication is reported.
Abstract: The clinical, pathologic, and roentgenographic features of colon duplications are reviewed and an unusual case of an asymptomatic, double-barreled duplication is reported.
TL;DR: It is suggested that the patient with known primary malignant neoplasm, in whom symptoms of central or cerebellar dysfunction arise, be fully investigated for an operable lesion.
Abstract: In 51 patients, single metastatic brain lesions were excised. Only 10 (8 of these within the last 1½ years) received postoperative radiation therapy to the brain. More than half of the 51 patients had carcinoma of the lung, the primary neoplasm conceded by many observers to have the worst prognosis; yet 15 survived craniotomy longer than 1 year and 11 were alive at time of review. In addition, 12 other patients with histologically confirmed primary carcinoma, suspected of having intracranial metastatic disease, proved to have nonmetastatic lesions at the time of craniotomy, 9 of which were completely benign. There is thus substantial reason for considering the surgical removal of single metastatic brain tumors, or of lesions suspected to be in this category.It is suggested that the patient with known primary malignant neoplasm, in whom symptoms of central or cerebellar dysfunction arise, be fully investigated for an operable lesion. At least a tissue diagnosis should be made, and preferably surgical excis...
TL;DR: This investigation is concerned only with the effects of neutrons on skin and subcutaneous tissues and converted to equivalent megavoltage roentgen doses using data that relate the relative biological effectiveness (RBE) for neutrons to the size of the dose-fraction.
Abstract: The observations on patients treated with neutrons from the 60 inch Berkeley cyclotron between 1938 and 1943 are reviewed and reinterpreted. This investigation is concerned only with the effects of neutrons on skin and subcutaneous tissues.Utilizing data that relate the relative biological effectiveness (RBE) for neutrons to the size of the dose-fraction, the neutron doses were converted to equivalent megavoltage roentgen doses. When applicable, factors were introduced to account for the contribution from exit beams. The timedose-fractionation pattern varied from patient to patient and usually was inconsistent with schemes used in current radiation therapy. Therefore, the doses were calculated in terms of a nominal single dose (NSD) and a nominal 6 week dose (SWD). The NSD and SWD allow some comparison with conventional radiation therapy.Suitable for inclusion were 144 patients with 275 separate fields treated with the 60 inch cyclotron. Among this group were 25 survivors, with 51 treatment fields, who we...
TL;DR: In the experience postoperative radiotherapy did not improve the 5 year survival and even tumors of the lateral quadrants rarely metastasize to the internal mammary lymph nodes.
Abstract: It may be concluded from the whole case material that:1. About 22 per cent of the women with operable breast cancer had internal mammary metastases.2. Even tumors of the lateral quadrants rarely metastasize to the internal mammary lymph nodes.3. Survival among cases with internal mammary metastases only is very high (70-80 per cent at 5 years).4. In our experience postoperative radiotherapy did not improve the 5 year survival.
TL;DR: The roentgenographic features of various combinations of injuries are presented and the importance of their recognition and the appearance of these injuries on the anteroposterior roent genogram are stressed.
Abstract: Chance first described the transverse fracture of the spine in 1948. They were rarely encountered before the general use of the lap-type seat belt. The fracture is created by an acute flexion of the body over or against some object which serves as a fulcrum. This mechanism creates ruptures of the posterior ligaments, fractures of the posterior bony elements or some combination of both.The roentgenographic features of various combinations of injuries are presented. The importance of their recognition and the appearance of these injuries on the anteroposterior roentgenogram are stressed.The author’s experience with 6 fractures in 5 patients is reviewed.The "Seat Belt Syndrome" is discussed.