Showing papers in "Radiology in 1943"

Roentgenologic Manifestations and Clinical Symptoms of Rib Abnormalities

Abstract: During a period extending from January 1930 to June 1942, the Department of Radiology at the University of Colorado Medical School and Hospitals made 38,105 roentgenograms of those portions of the body which lend themselves specifically to a study of rib abnormalities. This includes all roentgenograms of the spine, chest, and abdomen. Among the number there were found 59 rib abnormalities (0.15 per cent of the total). For purposes of simplification, the anomalies have been grouped into seven classifications: (1) cervical ribs; (2) lumbar ribs; (3) bipartition, or “forking” of the anterior end of a rib; (4) synostosis, or bony union of adjoining ribs; (5) “tile-roof” ribs, or imbrication of ribs; (6) rudimentary ribs; (7) other deformities. Cervical Ribs Nineteen instances of cervical ribs, or 32 per cent of the 59 cases, were seen. Details as to their number, length, occurrence unilaterally or bilaterally, and whether they were jointed or non-jointed, are given in Table I. In every instance the cervical r...

Unusual Case of Carcinoma of Both Lungs Associated With Lipoid Pneumonia1

Abstract: A 52-year-old, single French-Canadian housemaid was admitted to the Presbyterian Hospital, New York (No. 640620) in April 1941. Her symptoms began ten months before admission with an acute upper respiratory infection which subsided in one week. Following this she had a lingering cough which persisted until admission. The cough was productive of only a small amount of whitish milky sputum at this time. Six months before admission the cough became productive of about two cupfuls daily of thin, watery, odorless sputum without blood. Three months before admission the patient began to experience dyspnea on exertion. Throughout the ten months of her present illness she lost 25 pounds and experienced several, irregularly spaced, short febrile attacks. Ten years before admission the patient had had sinusitis, which was later recurrent and chronic. At the time of her first episode of sinusitis she used four bottles of oily nose drops in one week. She continued to use this material intermittently but never again in...

Fluoride Osteosclerosis from Drinking Water1

Abstract: Although the medical and dental professions are well acquainted with the effects of fluoride-containing drinking water on the teeth, with resulting dental fluorosis (mottled enamel) (1), the condition of osteosclerosis in the bones of human beings who have incurred mottled enamel from this source is not well known. As a matter of fact, no case of this kind has been reported in this country. The condition may have potential public health importance. Such a case is the basis for this paper. Report of a Case M. W. D., white soldier, aged 22, entered William Beaumont General Hospital on June 18, 1942, because of a chalazion of the upper right eyelid. The lid infection promptly subsided under treatment but, because of a rather severe anemia noted on the routine examination, the patient was detained in the hospital for further study. On questioning, it was found that he tired easily but had no other complaints. His family history was negative for anemia. Two brothers, aged 28 and 30, were in the Army and in goo...

Roentgen Evidence Suggesting Enterocolitis Associated with Prolonged Cathartic Abuse

Abstract: The following case is reported because of the extensive changes in the lower part of the small bowel and throughout the large bowel observed in routine gastrointestinal studies. As far as can be determined, the etiological factor was the continued and abundant daily use of irritant cathartics for twenty years prior to the roentgenological examinations. A search of the literature has failed to reveal any other case presenting similar changes, although reference is made to catarrhal colitis resulting from overdosage or continued cathartic abuse from irritants (1, 2). Case Report The patient was a multiparous white female, thirty-six years of age, who for many years had complained of bloating and a feeling of general fullness in the abdomen. She believed that she could not be comfortable without complete evacuation every day. To insure this she had taken proprietary cathartic tablets, the active ingredients of which are phenolphthalein, aloin, and podophyllum, almost daily for the preceding twenty years, i.e...

Polyostotic Fibrous Dysplasia: Review of the Literature with Two Additional Cases1

Abstract: History Ever since the publication of von Recklinghausen's (91) monograph in 1882, the literature on fibrocystic disease of bone has become increasingly abundant and confusing. In retrospect, it is obvious that von Recklinghausen described not one disease but a number of heterogeneous, unrelated pathologic conditions which had, as a common denominator, the production of fibrocystic-like bone changes. For many years, his name has been associated with hyperparathyroidism and neurofibromatosis. As a matter of fact, it is not unlikely that some of his original cases may have been examples of polyostotic fibrous dysplasia. The latter disease entity was first popularized in this country by Albright and his co-workers in 1937 (3) and by Lichtenstein in 1938 (50). It had been known on the continent for some time prior to its recognition here. In 1922, Wieland (98) in Germany wrote an article entitled Osteitis Fibrosa Cystica Congenita, which may well have been a discussion of polyostotic fibrous dysplasia. The sa...

Physical Examination at Induction

Abstract: This paper is concerned with that section of the Army standards of physical examination having to do with diseases of the chest, particularly tuberculosis, and their application, as shown by a review of 53,400 chest x-ray films of inducted men. The standards for chest disease were prepared by the War Department with the advice and assistance of a subcommittee of the Division of Medical Sciences of the National Research Council, in conformity with a general practice of the War Department in the formulation of physical standards. Since the August 1940 edition of Mobilization Regulations, several modifications have been adopted as the need for certain changes has become evident. Inasmuch as definite standards in regard to acceptable and non-acceptable tuberculous lesions inevitably invite criticism, it might be well to examine the steps through which the present standards were evolved. Originally, in 1940, the primary concern of the committee was that x-ray examination of the chest be made an integral part o...

Basilar Impression: The Position of the Normal Odontoid1

Abstract: In 1939 W. E. Chamberlain (1) called attention to the syndrome of basilar impression, which had been described in the European literature (2–4) years before. The syndrome includes symptoms mimicking syringomyelia, progressive spastic paralysis, or multiple sclerosis in the region of the upper cervical cord and medulla, and a shortening of the neck. The roentgenogram shows deformities of the foramen magnum and anomalies of the base of the skull, the atlas, and axis, sometimes including fusion of the bodies of some of the upper cervical vertebrae, and often fusion of the anterior arch of the atlas to the occipital bone. Since 1939 enough additional cases have been reported to indicate that the condition is not excessively rare. The symptoms can often be relieved by surgery. It becomes a matter of some importance, therefore, to set up proper diagnostic criteria. Chamberlain points out that the final diagnosis must usually be made by the radiologist on the basis of changes in the relations at the base of the ...

Experimental Depth Dose for 5, 10, 15 and 20-Million-Volt X-Rays

Abstract: With the 20-million-volt electron beam of good intensity now produced in the University of Illinois betatron, questions about the practical use of high-energy radiations can be examined. The most promising way to use the betatron in therapy would be to send the original electrons accelerated in the vacuum tube directly into the patient. At 20 million volts these electrons will penetrate as far as 10 cm. and no farther. Thus no damage is done to the back of the patient. Furthermore, the ionization should reach a maximum 7 or 8 cm. beyond the entrance surface for the electrons, and the damage could be well localized within the body. About a 25- or 30-million-volt betatron would be ideal for this work, since it has the right energy and a reasonable size. Although a sufficiently intense beam of electrons now comes out of the betatron, it is not yet in a good enough state of collimation or control for practical use. The x-rays produced by this electron stream when it strikes a target cause an ionization intens...

Pseudotumor of Bone in Hemophilia1

Abstract: Hemophilia is a constitutional disease characterized by a delayed clotting time of the blood and a lifelong history of repeated prolonged hemorrhages The disease is hereditary and its transmission depends upon a sex-linked recessive mendelian characteristic Since hemophilia is dominant in the male and recessive in the female, women never suffer from the disease but transmit it to some of their male offspring The existence of the disease in early times is intimated, according to Quick (1), by certain passages in the Talmud In Tractat Jebamoth is an account of four sisters who lived in Zipporah The first three lost their sons when they were circumcised Quick states that it is logical to assume that hemorrhage was responsible for death following this religious rite Albucasis (2) in 1519 reported a condition resembling hemophilia He stated that in a certain village there were men who, when wounded, suffered uncontrolled bleeding which resulted in death Otto (3) in 1803 was the first to establish the

Treatment of Radiation Sickness with Vitamin B6 (Pyridoxine Hydrochloride)

Abstract: The great variation in the reaction to radiation therapy has long been a source of interest. It is difficult to explain why one patient will become violently ill after radiation therapy while another will get little or no reaction from the identical type of treatment. We have not found it possible to determine accurately before treatment just which patient will respond with radiation sickness. We feel that the region of the body treated, the area of the treatment portals, and the dosage have a definite relationship to the production of this response. Its severity is apparently dependent on some inherent susceptibility in the patient. It appears justifiable to say that a patient suffering from malnutrition, debilitation, and avitaminosis will usually not tolerate radiation therapy as well as a patient in good nutritional balance. Since the maintenance of the physical condition and general well-being of the patient at the highest possible level is the aim of all physicians, it is well for us to treat the pa...

Calcified Concretions within a Meckel's Diverticulum

Abstract: Calcification in appendiceal concretions of sufficient density to produce a visible shadow on the roentgenogram has been described on several occasions. As early as 1908 Seelig (1) reported a case of appendicitis which resembled ureteral calculus because of the presence of a calcified appendiceal concretion in the course of the ureter. Since then Pfahler and Stamm (2), Douglas and LeWald (3), Shelley (4), and recently Jackman (5) have contributed further examples. In 1940 Grevillius (6) reported a case of intestinal calculus which had caused perforation of a Meckel's diverticulum. We have been unable, however, to find in current American literature any case in which the shadows visible on a roentgenogram were proved surgically to represent calcified concretions within a Meckel's diverticulum. Such a case is reported here. Case History On Nov. 18, 1942, a 34-year-old white male was admitted to the Mary Hitchcock Memorial Hospital complaining of nausea and vomiting associated with abdominal pain. The sympto...

Roentgen Features of Scleroderma and Acrosclerosis1

Abstract: Scleroderma is not a rare disease. A few cases are seen each year in any large clinic. Likewise, acrosclerosis (Reynaud's phenomenon with scleroderma of the acral parts, face, and neck) is occasionally observed. In 1895 Lewin and Heller (7) collected 507 cases of scleroderma from the literature. Acrosclerosis was first studied and named by Hutchinson (5) in 1893 and was reviewed in 1931 by Sellei (13). Both diseases usually have their onset in early adult life and affect females chiefly. The prognosis in acrosclerosis is said to be better than in scleroderma. It is the purpose of this communication to bring together the important roentgen features of scleroderma and acrosclerosis. Since scleroderma is a diffuse disease, involving most of the tissues and organs of the body, it is to be expected that the roentgen manifestations will also be diffuse. A considerable thickening and condensation of connective tissue occur. In acrosclerosis there is the added factor of angiospasm. Cases illustrating most of the ...

Roentgen Therapy of Orbital-Pituitary Portals for Progressive Exophthalmos Following Subtotal Thyroidectomy

Abstract: In 1929, Burch (2), discussing a case of progressive exophthalmos following thyroidectomy, mentioned the use of intensive irradiation of the orbits. No improvement was obtained, and the patient lost both eyes from corneal ulceration and destruction. Stewens (15) in 1931 reported the use of a small dose of roentgen rays, which relieved pain in the eye but did not correct the exophthalmos. Merrill and Oaks (8) and Naffziger (11), writing in 1933, mentioned failures of roentgen therapy. According to the latter, in severe cases irradiation has been ineffective or futile. Borak (1), in 1935, advocated irradiation of the pituitary for the cure of Graves' disease, including correction of the exophthalmos, in patients who were refractory to thyroid irradiation. Rudemann (12), in 1937, reported favorable results of irradiation in four cases, at the Cleveland Clinic. In 1936, Thomas and Woods (16) wrote: “In three patients the secondary exophthalmos was so intense that it was necessary to partially suture the exter...

Osteopathia Condensans Disseminata (Osteopoikilosis)1

Abstract: Osteopoikilosis, osteopathia condensans disseminata, osteopoecilia, osteosclerosis fragilis generalisata, or Albers-Schonberg disease, is a pathologic condition of the skeleton characterized by the presence of multiple, small, widely disseminated areas of compact bone. It is probably a congenital anomaly of hereditary background. Following the report of a lesion in the cranium by Erbsen, in 1934, involvement of almost every bone has been recorded, with the exception of the spinal column and ribs. The lesions have been observed, in order of frequency, in the pelvic bones, femoral heads, humeral heads, metacarpals, phalanges and carpals, metatarsals, phalanges and tarsals, femoral condyles, proximal radius and ulna, scapula, and patella. More rarely, they have occurred in the clavicle, mandible, and cranium. The disease is usually diagnosed during roentgenographic examination for some other condition, such as trauma. It occurs in both sexes, somewhat more frequently in males, and is without symptoms. Albers...

Primary Atypical Pneumonia of Unknown Etiology

Abstract: Since the opening of the hospital at which the writer is stationed there had been, to Nov 1, 1942, 590 admissions of patients affected with a respiratory disorder that has been classified as primary atypical pneumonia of unknown etiology These cases are apparently of similar nature and probably of the same origin, and we have come to look upon this condition as a disease entity This disease is an acute respiratory infection, probably transmissible by contact, occurring at all seasons of the year, characterized by chilliness, fever, cough, chest pain, and varying degrees of prostration The mortality of this disease has been extremely low In our large group of cases there has been but one fatality in which the findings at autopsy clearly substantiated the clinical diagnosis of primary atypical pneumonia as the primary cause of death In this particular case we have two chest films, one made on admission and one the next day The pathologist's description of sections through the areas of pneumonic densi

Giant Gastric Rugae with Diffuse Hypertrophic Gastritis: A Case Resembling A Neoplasm on the Lesser Curvature of the Stomach1

Abstract: Giant gastric mucosal folds demonstrable roentgenographically are the most characteristic sign of hypertrophic gastritis. Of rare occurrence and of unusual interest in this form of gastritis is a filling defect on the greater or lesser curvature which closely resembles the defect produced by a neoplasm. Ordinarily, when the normal stomach is completely filled with an opaque medium, the curvatures are sharply outlined. Occasionally the greater curvature will show a slight serration due to the prominence of the normal mucosal folds. The lesser curvature, however, is usually smooth in contour with no serrations. This absence of serrations is due to the structural formation of the mucosal folds, which on the lesser curvature side of the stomach are closely attached to the submucosa and underlying structures. The fact that the rugae run parallel with the long axis of the stomach also tends to prevent the appearance of serrations. The mucosa of the greater curvature, on the other hand, is loosely attached, the ...

The Radiographic Postero-Medial Border of the Lung, or the Linear Thoracic Paraspinal Shadow

Abstract: Under the title “The Linear Thoracic Paraspinal Shadow” an editorial appearing in the August 1942 issue of Radiology (page 229) draws attention to “a slender line of demarcation which is often seen in anteroposterior or sagittal roentgenograms of the bony thorax and upper abdomen. This line lies on the left side of the lower two-thirds of the thoracic spine and sometimes continues as far down as the plane of the first two lumbar segments. The shadow is frequently an enigma to radiologists and other clinicians viewing such roentgenograms. It is not visible on all films or projections of this portion of the body but is observed with such frequency that it must be the result of variation in the course and position of a normal structure situated therein.” Then follows a discussion in which it is stated that it is not bony, not due to unilateral spinal ligaments, descending aorta, or inferior vena cava, “but it might be an enlarged and elongated hemiazygos vein …. This editorial is written with the suggestion ...

Echinococcus Cyst of the Lung1

Abstract: Echinococcus disease is rare in North America and the pulmonary manifestations are not generally appreciated by roentgenologists. In the past decade the disease has been thoroughly studied, particularly in South America and French Africa, and certain valuable diagnostic and prognostic features in the roentgen examination have been established. They may be of interest to radiologists working abroad, where the disease is more often encountered. It is said to be most prevalent in Australia, Iceland, North Africa, and South America. The present case is reported as it illustrates a pathognomonic roentgen sign of a pulmonary hydatid cyst. R. DeL., an Italian boy, 12 years of age, was admitted to the Children's Hospital of Michigan on March 16, 1942, complaining of a pain in the left side of the chest and a non-productive cough of ten days' duration. He had lived in Italy for seven years. In addition to the pain and cough, there had been some loss in weight, weakness, and pallor for six months. He was thought to...

Excretory Urography as a Test of Urinary Tract Function1

Abstract: Mr. President and members of the Radiological Society of North America, I want to assure you that we at the University of Pennsylvania are deeply grateful for the honor to one of its clinics which is implied in the invitation to deliver the ninth Carman Lecture. The obligations which acceptance entails are heavy, particularly so in the present instance, inasmuch as the standard set by the previous lecturers has been exemplary. This lectureship (23) was inaugurated at the Twentieth Meeting of the Radiological Society in memory of Russell Daniel Carman, for his extraordinary ability, his great service to radiology, and his loyal devotion to this Society. It will be stimulating to review briefly Doctor Carman's fruitful career for the benefit of those who had not the privilege of knowing him. Russell Daniel Carman (21), master roentgenologist and one of the founders of this Society, was born at Iroquois, Ontario, March 18, 1876. His preliminary education was obtained at Minneapolis Academy, after which he sp...

The Postero-mesial Pleural Line

Abstract: Several months ago there appeared in Radiology an editorial (1) entitled “The Linear Thoracic Paraspinal Shadow.” This editorial dealt with the question of the correct interpretation of a slender marginal line of demarcation sometimes visible in sagittal roentgenograms of the lower posterior thorax, especially on the left side. It was suggested that the true nature of this line had not been clarified and that it might possibly be due to an anomalous vascular structure. Within a few weeks some 6 letters were received offering various alternative explanations for the line in question. These were kindly forwarded by the Editor to the persons who perpetrated the editorial in question! The first letter reads: “We dissected a cadaver twenty years ago, taking straight anteroposterior films with each stage of dissection, removing successively the sternum, heart, aorta, esophagus, veins, lymphatics, etc. The paravertebral line on the left in this case was due to the fascia in which the esophagus and posterior medi...

Polyostotic Fibrous Dysplasia

Abstract: In the course of our examination of candidates for induction into the United States Army an example of a rather rare clinical syndrome was encountered. While this disease has been described in the literature under a variety of names, the one suggested by Lichtenstein (1)—polyostotic fibrous dysplasia—appears satisfactory and has been adopted in describing the present case. McCune and Bruch (2) and Albright (3) and associates have reviewed the literature on this subject through 1937 summarizing some 21 cases. In 1942 Lichtenstein and Jaffe (4) added 15 new cases, which with 75 previously reported brought the total to that date to 90. The characteristic features of the syndrome are: (1) predominantly unilateral skeletal changes; (2) pigmented areas, in most cases roughly corresponding to the region of bony involvement; (3) sexual precocity in females. Moreover, the disease is more likely to occur in women than in men. Of unknown cause, the disease usually has its inception early in childhood, which suggests...

Pathological Changes in So-Called Atypical Pneumonia1

Abstract: The lesion which forms the topic of this discussion has a most varied nomenclature. Such terms as pneumonitis, atypical pneumonia, atypical bronchopneumonia, bronchopneumonia of unknown etiology, acute interstitial pneumonia, and virus pneumonia with various modifying symbols, are used interchangeably. This pneumonia is in some respects quite different from bronchopneumonia and lobar pneumonia. The clinicians and roentgenologists were probably the first to direct attention to it. The former pointed out the relatively benign nature of the disease and the impossibility of obtaining any specific pneumococci, or a definite growth of streptococci or of other organisms, which could be considered to be the etiologic factor. The roentgenologists were impressed with the rapid appearance of lesions in various lung fields and their fast disappearance. They were the first to describe the interstitial features of the disease, and it was they who coined the term, “acute pneumonitis,” using the x-ray expression pneumoni...

Atypical Pneumonia of Probable Virus Origin1

Abstract: Evidence of infective non-bacterial primary bronchopneumonia in man has become sufficient to establish its recognition as a clinical entity. Many reports of this type of disease have appeared in the literature in the past seven years. Epidemics, both small and great, have been reported from several sections of this country, England, France, Spain, and Hawaii. Most of these have occurred in schools, among hospital personnel, or in military groups. An epidemic among the white troops stationed in Hawaii in 1933 was described as “acute influenza pneumonitis” by Major Albert Bowen, Medical Corps, U. S. Army, and reported in the American Journal of Roentgenology in August 1935 (3). Major Bowen pointed out that the condition occurred particularly during influenza epidemics and spoke of it as being more or less benign. He recognized it as a bronchopneumonia, but with certain features which characterized it as a distinct clinical entity. Most of the literature on the subject has appeared to carry this conception a...

Roentgen Therapy for Bronchiogenic Carcinoma1

Abstract: It has long been regarded as axiomatic that complete surgical extirpation of a malignant tumor offers the patient the best chance of obtaining a complete cure. After the pioneer work of Sauerbruch and of Lilienthal, who showed that, if a carcinoma of the lung can be removed, recovery occurs in a fair percentage of cases, there arose in all countries a school of daring expert surgeons who advocated pneumonectomy as the method of choice for early bronchiogenic carcinoma. The present status of the operative treatment of bronchiogenic carcinoma is beyond the scope of this presentation. The present surgical opinion is that pneumonectomy offers the best chance of permanent cure in cases in which radical operation can be performed, provided the patient survives the operation. Even though the indications for the radical operation are not always rigidly followed, pneumonectomy seems to be generally reserved for patients who have a relatively small localized tumor and who present no evidence of distant metastasis o...

The Roentgenologic Pattern of the Small Intestine in Infants and Children1

Abstract: In recent years there have been described variations in the roentgenologic pattern of the small intestine which have been considered to be characteristic of certain nutritional deficiency states. According to May and McCreary (1) “clumping” in roentgenograms of the small intestine of infants and children with the celiac syndrome was noted by Blackfan and Vogt as early as 1930. Apparently the first published report was that of Mackie (2), who in 1933 described certain functional changes in the roentgenologic pattern of the small intestine in a patient with non-tropical sprue. Subsequently, essentially similar observations have been made in such clinical conditions as steatorrhea in adults (3), infantile celiac syndrome (4), acholia (5), chronic ulcerative colitis (6), tropical sprue (7), hypocalcemia (8), nephrosis and diabetes insipidus (9). Such changes have also been noted in the roentgenograms of the intestines of dogs with hypoproteinemia produced by plasmapheresis (10). Golden (11) has pointed out th...

Factors Concerned in the Abnormal Distribution of Barium in the Small Bowel1

Abstract: The roentgen appearance of the small bowel in neoplastic disease and in certain types of inflammation ordinarily can be correlated adequately with the gross pathological appearance of the involved segments. The factors concerned in the production of certain abnormalities, however, which have been grouped together under the term “deficiency pattern” have been the subject of considerable speculation and investigation. In the present study the clinical data in a group of cases which revealed this pattern were reviewed and certain limited experiments were carried out. The group consisted chiefly of 6 cases of the acute phase of granulomatous jejuno-ileitis, 24 of sprue, 13 of celiac disease, and 9 of definite avitaminosis. The roentgen changes under discussion are: (1) variations in motility and tone, (2) dilatation of loops, (3) abnormal segmentation, (4) coarsening or obliteration of the mucosal folds, and (5) flocculation of the barium. The pattern is found in a variety of circumstances. It can be shown re...

Dosage Calculations for Various Combinations of Parametrial Needles and Intracervical Tandems

Abstract: Radium application by interstitial para-metrial needles in combination with intracervical tandems has been used and advocated in recent years by several authors (3, 4, 5). The published clinical results are quite promising and they seem justified on theoretical consideration of this method. There are many possible variations in the number, strength, and position of the needles and in the size and strength of the tandem. It is the purpose of this study to calculate the distribution of radiation in several such schemes of radium implantation and to compare the results with those published for other methods of treating cervix carcinoma. Theoretically this method is proposed to yield a wider distribution of radiation in the pelvis because of the introduction of the radium sources directly into the parametria. Furthermore, the use of many weak sources rather than a few strong ones will tend to produce a more uniform field of radiation and eliminate the danger of extensive necrosis around individual sources. Th...

Roentgen Examination of Pancreatic Tumors

Abstract: If we examine the textbooks dealing with diseases of the abdominal organs, we find that the chapters presenting the x-ray findings in pancreatic tumors are usually brief as compared with those concerning other abdominal viscera. In addition most of the opinions as to the value of roentgen examination in these tumors show a degree of skepticism which stands out in sharp contrast to the confidence expressed in x-ray studies of abdominal neoplasms of other origin. The explanation of this attitude is found in the fact that the pancreas, in contrast to other abdominal viscera, cannot be visualized directly with the aid of opaque media, whether administered perorally or parenterally. Thus the normal pancreas cannot be portrayed on the x-ray film. This failure of direct visualization, however, presents no handicap to diagnosis of certain tumors of other origin. Tumors arising from the hypophysis, for example, can be diagnosed roentgenologically despite the fact that the normal organ cannot be shown on the film. ...

Healing of Radiation Fractures of the Necks of the Femora, with a Report of a Case1

Abstract: Since 1927, when the work of Baensch (1) drew attention to post-irradiation fractures of the femoral necks, this subject has excited a good deal of interest. Particularly has this been so in the past six years. Dalby, Jacox, and Miller (2) helped to focus American attention on the problem with their detailed study published in 1936, and recently Slaughter (3) has summarized the literature and added cases of fractures of bones other than the femora. Much emphasis has been placed on the rarity of healing of these fractures, since the great majority of them fail to heal at all, or do so only by fibrous union. Ewing (4) analyzed the possible end-results of radiation osteitis and radiation fractures and stated that complete bony healing is rare. The causes of radiation fractures have been discussed by Slaughter (3) and by Ewing (4). These writers assert that the bony changes are directly proportional to the number of x-rays absorbed and that, while bone is relatively radio-resistant, its greater density increa...

Non-Organic Gastric Filling Defects Simulating Carcinoma

Abstract: The majority of benign and malignant gastric tumors are located in the pars pylorica of the stomach and reveal their presence roentgenologically as prepyloric deformities. Gastric spasm and extra-gastric lesions may produce such deformities. The differential diagnostic features of these defects have frequently been described. In a recent paper on gastric cancer, B. R. Kirklin (4) summarized the roentgenological findings usually considered as the pathognomonic syndrome of advanced mucoid carcinoma: a gross filling defect projecting from a wide base far into the gastric lumen; an irregular internal margin; sharp demarcation from the uninvolved portion; and, as a rule, little or no alteration in the size of the stomach. These features may be associated with physical signs and secondary manifestations, namely, a palpable mass; fixation of the stomach; destruction, effacement, or smoothing of the gastric rugae; absence of peristalsis from the affected portion, and rapid emptying time unless obstruction is pres...