Bernard J. O'Loughlin

Analysis of Roentgen Signs in General Radiology

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Radiographic findings in renal vein thrombosis.

In our clinical experience we have encountered several instances of bizarre pyelographic patterns which have not been characteristic in their appearance and yet have the same pathologic etiology. When the various patterns were studied, it was determined that further investigation would be necessary to establish definitely the developmental processes involved. In all these cases occlusion of the renal vein was the common denominator. In a review of the literature it was discovered that the roentgen aspect of renal vein occlusion has had little evaluation. The clinical syndrome and experimental details have been worked out and many case reports have been presented. Chronic renal vein thrombosis produces a nephrotic syndrome, which is the chief clue to diagnosis. Since definite changes can take place in the kidney and disturb the gross anatomy, roentgen findings should also be significant. With this in mind, we undertook a series of experiments to establish a roentgen-pathologic correlation. The animal exper...

Pulmonary Hypertension Due to Pulmonary Arterial Coarctation

With improved diagnostic methods many diseases which were previously grouped together as idiopathic can now be separated into etiologic categories. Essential pulmonary hypertension may succumb to reclassification, since several types are now found to be distinguishable on the basis of definite radiological and pathological changes (1, 27, 54). It is not only our duty to refine these idiopathic categories, but it is our privilege as physiologically oriented radiologists to try and understand the basic changes which make this refinement possible (49). There have been many recent reports (2, 6, 11, 14, 20, 41, 45, 48, 51, 53, 55, 58, 60) on supravalvular or postvalvular constriction, coarctation, or stenosis of the pulmonary arteries. Four mention the association of pulmonary hypertension with this condition (2, 11, 14, 41). It is our observation that the two are always associated. Four reports have appeared in the radiologic literature. This is apropos, since coarctation of the pulmonary artery can be diagn...

Nonspecific Spondylitis of Infants and Children

It is our purpose to present 6 cases of self-limited spondylitis of infants and children. All were characterized by failure to identify a specific infectious agent, a mild clinical course, positive roentgen findings, and recovery without antibiotics. The radiographic findings were indistinguishable from those of pyogenic osteomyelitis of the spine. In 1950 Saenger reported 4 cases of spondylarthritis in children, with systemic signs of infection but negative diagnostic tests for a specific infective agent (16). The radiographic changes, consisting in narrowing of an intervertebral disk space and mild destructive lesions in the contiguous surfaces of the involved vertebral bodies, were progressive for one to two months and then regressed over another two to eight months, with only partial restoration of a normal picture. Saenger pointed out that Smith had reported a group of similar cases in 1933 in adults. Reference was also made to a paper by Ghormley et al. in 1940 (7), in which an analogous syndrome wa...

Collateral Vein Sign: Angiographic Demonstration of Renal Vein Invasion in Renal Carcinoma

Angiography currently assumes a major role in the diagnosis and staging of adenocarcinoma of the kidney. The diagnosis may be confirmed by angiography performed in place of biopsy in metastatic hypernephroma (5). The extent of the tumor and its blood supply can be mapped out preoperatively, facilitating the choice of surgical approach and permitting adequate control of bleeding during surgery. Spread of the tumor beyond the kidney may also be documented by angiography. The purpose of this report is to describe the angiographic appearance of collateral veins about the kidney involved with hypernephroma. These vessels indicate partial or complete obstruction of the renal vein and are almost always associated with renal vein invasion by tumor. The presence of these veins is referred to as the “Collateral Vein Sign.” Review of our cases of adenocarcinoma of the kidney with renal angiography disclosed 10 cases with renal vein invasion. In all of these cases, the collateral vein sign was present. These findings...

Significance of calcification of the wall of the left atrium. Report of two cases.

Calcification of the wall of the left atrium was first reported by Shanks, Kerley, and Twining in 1938 (6). Since that time, only 31 cases have been reported. Although intramural calcification of the left atrium is primarily a radiological diagnosis, this concept has not been presented to the readers of this journal. It is believed that this lesion is more common than has been manifested by the published reports. In adding 2 new cases to the 31 reported in the literature, the importance of recognizing calcifications of the left atrium will be stressed, particularly in those cases in which some surgical procedure upon the heart is contemplated. Calcification of the left atrium is found in patients who have suffered from extensive rheumatic carditis and long standing valvular disease. It is believed that the calcification of the wall of the left atrium represents the site of the carditis. Many of these patients suffer from both mitral stenosis and insufficiency and most of them have involvement of other val...

A study of 24,615 separation chest roentgenograms.

Discussion of chest x-ray and allied surveys of military personnel have stressed the importance of routine pre-induction and separation examinations to the taxpayer, the soldier, and the public health. These reports all look forward with interest to the next step—the post-war separation examinations. The results of such an examination are offered here. While previous surveys, by their nature, were only local in scope, the present study represents a greater geographic and economic cross-section, since the separatees are the entire output of an Air Force Auxiliary Separation Base. They are natives of every state in the nation, ranging in rank from colonel to private, representing virtually every nationality and race. The ages are from 18 to 44 years; those whose separation was deferred because of chest abnormalities are all in the 18 to 25-year group. No attempt is made to distinguish racial incidences—first, because of a technical difficulty; second, because the environment in the Army was the same for all...

The core of radiological learning.

One of the most pervasive concepts in undergraduate medical curricular reform at the present day is that of the core curriculum. The use of a core fulfills the necessity for an elemental skeletal structure for intellectual discipline and still provides sufficient opportunity for flexibility and adaptation to the special needs of individual persons and situations. Very few medical schools today intend to produce finished general physicians; nearly all expect professional development to be a function of lifes continuing education. Most of them have accepted the concept of a core curriculum. A similar situation exists in the radiology residency today. Our students, residents, practitioners, hospitals, and others want radiologists who are experts in radiological aspects of cardiology, neurology, pediatrics, pediatric cardiology, therapy, nuclear medicine, etc. Society also expects more expertise as well in related fundamental fields such as radiation physics and radiation biology. Despite the fact that stude...

A Coordinated Approach to Appointments of Residents and Graduate Students

Residents throughout the country are realizing the need for recruitment into their profession. Many well qualified residents are denied their place because of inequities imposed by residency selection. It is time to review our methods and to consider the lack of synchronization in appointments for Graduate and Resident students. The American Medical Association at its Clinical Meeting recommended that all residents be appointed no earlier than November 15 of each year in order to pave the way for a residency-matching program. The American College of Radiology at its recent meeting in Los Angeles took a long, favorable look at this matter, and only two members were not positively inclined toward the matching program. The National Psychiatric Residency Matching Program was recently formed by 81 of the foremost psychiatric training centers and has already begun a matching program. This is its first year of operation, and its executive secretary says that it is eminently successful. The Association of Medical...