Earl R. Miller

An Infinite Number of Laminagrams from a Finite Number of Radiographs

Abstract The authors describe a technique that can produce an infinite number of laminagrams from a finite number of radiographs. The process involves taking a series of radiographs of an object from different angles, while the films bear a constant relation to the object. The resulting films are photographed on a composite photograph so that only one plane is in register. An infinite number of such planes can be chosen. The advantages and disadvantages of laminagraphy by the photographic process are discussed.

Vesicoureteral reflux. Role in pyelonephritis.

Abstract Vesicoureteral reflux is being demonstrated increasingly, not only in children who have intermittent bouts of acute pyelonephritis, but also in adults with chronic non-obstructive pyelonephritis. We present twenty-two of our own patients, all adults with recurring or chronic non-obstructive pyelonephritis, in each of whom reflux has been demonstrated. Reflux may be intermittent, hence, a negative cystogram does not rule it out. Normal intravenous pyelograms frequently are found in patients with ureteral reflux. Residual urine may represent return of refluxed urine to the bladder rather than vesical neck obstruction. Reflux may be the cause of atrophic pyelonephritis; it may be a factor in obstruction of the ureteropelvic junction and may explain abdominal pain after voiding. The ease with which reflux occurs in the human ureterovesical valve changes with the sex and age of the patient and closely parallels the natural history of pyelonephritis. Animal experiments demonstrate the valvular mechanisms involved in the prevention of reflux. Reflux perpetuates infection by overloading the intrinsic bladder defense mechanism immediately after evacuation of the bladder, by the return of the infected urine to the bladder. Surgical correction of reflux stops the clinical attacks of pyelonephritis and sterilizes the urine. Since asymptomatic infection of the bladder urine has been shown to be more common than previously believed, and since reflux is being demonstrated with increasing frequency, the detection and treatment of reflux may lead to a better understanding of the pathogenesis and treatment of chronic nonobstructive pyelonephritis.

Vesical physiology demonstrated by cineradiography and serial roentgenography; preliminary report.

On applying new technics to the study of an old problem, we have been forced to question some of the current concepts of the mechanism of urination, concepts which are based on cystometrographic studies (1–4) or on direct film or fluoroscopic observation (5–8). We were not able to convince ourselves that what seemed apparent on the fluoroscopic screen was not the result of our inability to separate rapid sequential movements, although these technics might profitably be explored by others. With suggestions from Dr. Howard L. Steinbach, we made use of cineradiography and serial roentgenography to produce sequences of cystograms during voiding. With the x-ray movies we were able to make exposures at the rate of 3.25 frames per second; with the Fairchild roll-film cassette, the time between films was 1.1 seconds. In this way we gained the dimension of motion without sacrificing the ability to study each film of the sequence individually and in relation to the rest of the exposures. In the preliminary study de...

Studies with radioiodine. III. Problem of dosage in the treatment of hyperthyroidism.

The aim of radioiodine therapy in hyperthyroidism is to produce remission of the disease by adequate irradiation of the abnormal thyroid. The dose delivered by an ionizing radiation to a tissue or ...

Studies with radioiodine. VI. Evaluation of radioiodine treatment of carcinoma of the thyroid based on the experience at the University of California from 1938 to 1954.

Between September 1945 and June 30, 1954, 124 Patients with histologically Proved primary carcinoma of the thyroid gland were studied. Only patients with residual inoperable neoplastic tissue were accepted for I/sup 131/ treatment, and, as a rule, they were treated only after the establishment of sorae degree of radioiodine uptake of the neoplastic tissue. In most cases the aim was to administer 100 millicuries of I/sup 131/ per month as long as evidence of tunnor avidity for I/sup 131/ could be shown. In these cases total doses of several hundred millicuries were given, distributed over several months. Results are summarized. Selected case histories are included. (C.H.)

Studies with Radioiodine

In a clinical radioiodine laboratory it is important frequently to determine the frontal area of a thyroid gland as a guide to its size, and to find out whether or not an area of the body or abnormal mass such as a metastatic thyroid tumor or a brain tumor contains I131 in excess of that in the surrounding tissue. If such a mass does exist, it is then important to record the fact of its existence and to establish its size, shape, position, and radioiodine content. Unshielded and partially shielded collimated Geiger and scintillation counters, either held by hand or by some kind of scanning rack, have been used for these purposes by most workers in the field of radioactivity. Uncollimated scintillation counters have a high sensitivity to gamma rays but have poor “localizing ability” at any appreciable distance. It is possible, by limiting the acceptance angle of the crystal for radiation through the use of a collimating cone, to gain a higher order of “localizing ability,” at the expense of sensitivity. Si...

A simplified procedure for viewing multiple films to create an infinite number of laminagrams.

The authors describe a method of obtaining an infinite number of laminagrams from 7 to 10 radiographs taken in equally-spaced linear intervals. After registration, they are viewed on a simple, inexpensive device which provides parallel, equally increasing increments of film movement.

Diagnostic Holography—A Feasibility Study

The possible application of ultrasonic holographic visualization techniques to medical diagnosis has recently been alluded to by several different authors. The practical realization of such techniques should allow soft-tissue visualization and differentiation to a degree not possible with existing acoustical and radiological technology. With this view in mind a preliminary feasibility study using biological material was undertaken. The objects were transilluminated by a continuous-wave 2-MHz sound source, with the transmitted acoustic field transduced and recorded optically using mechanical scanning and photographic transparencies. After appropriate scaling the hologram transparency was illuminated by a coherent light source and regeneration accomplished. The results obtained are presented, and existing technical and interpretative difficulties discussed, together with a survey of possible diagnostic uses in various fields of medicine.

Immediate Remote Access to Radiologists' Reports

IN LARGE hospitals with very busy departments of radi ology and especially in teaching hospitals, there is frequently a long delay between the radiologists dictation of hi s report and the referring ph ysicians receip t of it. This paper addresses itself to the problem of providing, on the ward or in the clinic from which the patient was referred, access t o the radiologists reports as soon as he dictates them. Briefly, we employ voice recorders in the x-ray department and in remote stations on wards and clinics. The appropriate remote stat ion receives the report at the same time the radiologist dictates it into his own dictating machine. The referring physicians listen to the reports on the remote stat ions at their convenience . Alternately, a clerk or the physician may transcribee it her the whole report or a summary of it for the chart . The final reports are transcribed from the radi ologists recorder and are delivered to the referring physician as the permanent record after they are typed. Seve...

A Device for Immobilizing Children During Radiographic Examinations

Children are usually held manually by parents or departmental personnel for roentgenographic studies. There has long been need for a device which would immobilize the child adequately, be safe, simple, and quick to use, permit radiography of various parts of the body in proper positions, and not interfere with the interpretation of the roentgenograms. Such a device would help to insure more adequate radiography of children and would obviate the exposure of personnel frequently entailed. Our experience with the device to be described here, an adaption of a circumcision board, has been surprisingly satisfactory. We have called it a “Brattbored.” The device consists of a series of plywood (3/8 inch, 3-ply) cutouts or “boards,” as shown in Figure 1, and a wooden “vise” for holding them. The various “boards” have “head,” “arm,” “body,” and “leg” parts. The “board” with the “arms” beside the “head” is used mainly for erect chest films. It has found use also in fluoroscopy and in pyelography and trunk exposures....