James T. Case

Chronic Obstruction of the Small Intestine1

THE literature is filled with accurate and, we may say, classical descriptions of the X-ray findings in duodenal ulcer and its differential diagnosis. Less accurate, and certainly less in agreement are the findings and their interpretation in conditions involving the second and third portions of the duodenum and the remainder of the small bowel. A great deal of controversy has arisen as to the conditions called chronic duodenal ileus and chronic ileal stasis—stagnation of opaque material in the duodenum and in the terminal portion of the ileum. There is such a large personal factor obviously present in the interpretations that one is almost bewildered by the divergent opinions voiced. There is a clear field of agreement and obvious sound sense in interpreting the findings of the opaque meal study in cases of congenital or neoplastic obstruction of the duodenum or remaining small bowel,—indeed, with any kind of obstruction where there is evident blocking of the lumen of the bowel, with accumulation of opaq...

Publicity Committee Report

September 30, 1933 Your Publicity Committee herewith begs to submit a brief report of its activities for the period preceding and during the Congress, closing to-day. While it is too early to tell the full results of our efforts, we felt that you would want to become familiar with the broad scope of what has been done. The press of both the Americas and the radio have been our chief means of communication with the lay public in publicizing the Congress. We have used the medical journals extensively to get our message to the physicians. We believe that the great amount of publicity obtained prior to the Congress certainly helped bring a number of members into the Congress. This was perhaps particularly true in South and in Central America and in Canada, whence we would have had a considerable number of delegates under more favorable economic conditions. Classified, we may report the following: Use of the daily press—by wire services (AP-UP-Universal-INS) and by personal contact and mail. The first stories ...

Some Pseudo-Vesicular Shadows and other Pitfalls in Gall-Bladder Roentgenology

IN the beginning of gall-bladder roentgenology, long before the introduction of the Graham test, it was not uncommon to observe in the films of the gall-bladder region an ovoid shadow corresponding rather closely in form and size to the gall bladder. It was natural to assume that this shadow was caused by the gall bladder, and numerous studies were made and papers written on the value of the gall-bladder shadow in the roentgenogram as a sign of gall-bladder disease. It was rather generally supposed that if the gall bladder cast a shadow upon the roentgen film, it was because the gall bladder was pathological; and it was presumed that the normal gall bladder would not cast such a shadow. Care was taken to make sure that one was not mistaking the shadow of the liver or the kidney for this supposed gall-bladder shadow. It was soon established as a primary requirement of a good gall-bladder region film that the outline of the kidney and the shadow of the lower border of the liver should both be distinctly rec...

Endocrine factors in hypertension; treatment by roentgen irradiation of the pituitary and adrenal regions.

In a paper published in 1933 it was pointed out by one of the present authors (1) that hypertension and diabetes are similar in so many respects as to suggest a least common denominator among their etiologic factors. Evidence available at that time pointing to endocrine participation in these conditions indicated (a) that the pituitary and adrenals are probably chiefly involved; (b) that an associated hypertension or diabetes, or both, has been found in every variety of hyperpituitarism —gigantism, acromegaly, and basophilism —while hypopituitarism is accompanied by lowered blood pressure and an increased tolerance for glucose; (c) that adrenal tumors are often accompanied by hypertension or diabetes, or both, while Addisons disease is characterized by hypotension and hypoglycemia. That hyperthyroidism may play a role in some cases of hypertension, which show improvement when the thyroid condition is corrected, has subsequently been suggested (2). Since 1933, additional evidence has accumulated tending t...

The Teaching of Radiology to Interns1

THE average physician cannot boast of great familiarity with the conduct or interpretation of roentgen examinations, or of adequate comprehension of the possibilities of diagnostic aid to be obtained from X-ray studies. His contact with X-ray problems consists in the main of emergency cases in which fractures or dislocations are suspected, and occasional reference of cases to X-ray laboratories for a “picture” of the lungs, stomach, or urinary tract. He has not appreciated that, in addition to skeletal diseases and injuries, roentgen studies may be applied with advantage to nearly all visceral disorders, including many diseases of the nervous system. He does not stop to realize that examination with the X-rays is much more complicated than the simple taking of a “picture”; that it is really no more a simple laboratory procedure than an ophthalmic examination or a urinary tract examination or a gynecologic study, and that a clinical knowledge of the conditions entering into his problems is a necessary part...

Fifth Inter-American Congress of Radiology: Opening Address

Once again we are assembled to inaugurate an Inter-American Congress of Radiology, the Fifth. It was most fitting that the Capital of our country be chosen for the celebration of this Congress. In the name of all radiologists of the United States I have the honor to welcome you to this beautiful city, in the midst of the most revered monuments in the history of our Republic. The term “melting pot” has often been used to describe the character of our citizenry, which is composed of emigrants and descendants of emigrants from almost every country in the world. As a matter of fact, all of the New World republics have, in a lesser or greater degree, received immigration from the Old World and thus become “melting pots” or crucibles for the fusion of diverse nationalities. Actually, regardless of our birthplace or of the race of our ancestors, whether of the South or of the North, we are all Americans, citizens of this hemisphere and representatives of the strength of the New World. The rapid development of ra...

The Second Inter-American Congress of Radiology

At the combined meeting of the Radiological Society of North America and the American Roentgen Ray Society held in the fall of 1944, Dr. W. Edward Chamberlain, Dr. Pedro L. Farinas, and the writer were named as a committee to represent the Radiological Society of North America in cooperating with the Cuban Society of Radiology in arranging for the Second Inter-American Congress of Radiology. Committees were also named by the American Roentgen Ray Society and American College of Radiology. Because of the overlapping personnel of these committees, they were joined into one general committee for the United States, with the writer as Chairman and Mr. Mac F. Cahal as Secretary. The First Inter-American Congress of Radiology held in Buenos Aires in 1943, under the Presidency of Dr. Jose F. Merlo Gomez, had chosen Havana as the site of the Second Inter-American Congress of Radiology, and this automatically made the Cuban Society of Radiology the Committee of Arrangements. The Cuban society, under the Presidency ...

The Evolution of Radiology in Latin-America

A year or two ago, on the occasion of a dinner meeting in Chicago in honor of some visiting colleagues from Latin-America, your speaker was impelled to discuss extemporaneously some of the important contributions of Latin-America to the advancement of radiology. When I was informed of the honor bestowed upon me by our Program Committee, I decided to enlarge upon this discussion by attempting to narrate the evolution of radiology in some of the countries of Latin-America. My special interest in this subject has been stimulated by visits of numerous radiologists from Latin-America to my work in Battle Creek, Michigan, and in Chicago, and by my own visits to Cuba and to Mexico, as well as by two tours of the principal coastal national universities of South America. Further help has been afforded by correspondence and by a search of available literature. Argentina When Roentgens discovery was made known to the world, Dr. Jaime R. Costa, Professor of Medical Physics in the University of Buenos Aires, already ...

Roentgenologische Beobachtungen ueber die Bewegungen der Wirbelsaule

By Sigvald D. Bakke. From the Stadisches Krankenhaus “Haukeland,” Bergen. Supplementary Volume XIII, Acta Radiologica. Kungl. Boktryckeriet. Published by P. A. Norstedt & Soner, Stockholm, 1931. This little presentation of 75 pages of text and 24 excellent illustrations printed on fine paper sets forth the results of the authors roentgenologic observations on the movements of the spinal column. The results arrived at are somewhat different from those of other writers. For instance, the author finds that, contrary to the opinion of Professor Fr. Muller, the roentgenologic method holds good in examinations of the mechanism of flexion of the spinal column. The flexibility increases and decreases evenly from vertebra to vertebra along the whole of the spine. There are nowhere any inflexible parts interposed between the flexible parts. This is true of forward and backward bending as well as of lateral flexion.

A Minimum Standard for X-ray Service in a Hospital1

FIRST, I beg to call to your attention the fact that at this meeting last year I was privileged to address you on the “Fundamental Requirements of an Efficient X-ray Service in Hospitals.” At that time, feeling that we were discussing minimum requirements, I tried to put into as concrete form as possible a statement of the minimum equipment, space, organization, personnel, and recording service, together with a discussion on the interpretation of findings. It did not seem possible then, nor does it now, to attempt an ironclad itemizing of the various articles of equipment, for these will vary within certain limits according to the size of the hospital and the activity of the outpatient department. We have observed some very interesting conditions. For example, there are instances where a bequest has been given to a small hospital with the specification that it be expended on the X-ray department, with the result that the X-ray service possesses instruments altogether beyond the needs of the hospital or of...