Raymond R. Lanier

Fibrous stricture of the stomach due to iron (feosol) poisoning; report of a case and brief review of the literature.

Iron poisoning in children has been reported with increasing frequency in recent years. Most of the cases have resulted from accidental ingestion of ferrous sulfate tablets, many of which are of attractive color and taste, which appeal to children. The acute symptoms of iron poisoning are now well known. They may begin thirty to sixty minutes after ingestion; with less soluble products, damage may be delayed as long as twenty-four hours. The symptoms are vomiting, diarrhea, dehydration, shock, and coma. Severe acidosis has been reported in some cases. Dehydration, shock, and acidosis have resulted in death in about half of the reported cases. The usual treatment includes gastric lavage, cathartics, enemas, intravenous fluids, plasma, and blood. At autopsy the most striking lesions are seen in the gastrointestinal tract, consisting in mucosal necrosis, congestion, and focal hemorrhages. Hepatic and renal lesions are also noted. Davis and Gibbs recently reported a case in which a necrotic segment of gastroi...

Congenital absence of the hepatic portion of the inferior vena cava.

Abstract Complete absence of the hepatic portion of the inferior vena cava was fortuitously demonstrated by venous angiocardiography in an infant with severe cyanotic congenital heart disease. On subsequent post-mortem examination, it was possible to investigate thoroughly this unusual anomaly. The probable developmental basis for this condition has been discussed.

A Simplified Technic for Nephrotomoqraphy

THE TERM “nephrotomography” as first used by Evans et al. (1) refers to body-section roentgenography performed during the nephrographic stage of visualization of the renal parenchyma. This occurs approximately ten to twelve seconds after a two-second injection of 50 c.c. of 70 per cent Urokon through a large-caliber needle in an antecubital vein. By this method the arterial supply to the kidneys and, in fact, all of the major branches of the abdominal aorta can be visualized. A plain anteroposterior film of the abdomen is taken, after a predetermined circulation time, to visualize the renal arteries, followed immediately by another anteroposterior film to show the nephrogram. This, in turn, is promptly followed by a tomogram through the kidney at a depth determined by a preliminary film. The whole procedure, from the time of injection through the third exposure, takes approximately twenty-five seconds. The procedure of Evans et al. (1, 2) required a cut-down on an antecubital vein and the insertion of a R...

The clinical significance of SR (sensitization response to radiation) in normal vaginal mucosa.

It would be advantageous to know if certain patients with carcinoma of the cervix will fail to respond to radiation treatment, no matter how well it may be administered. That this may be so is attested by the fact that all of us have some failures even in the early stages of the disease. If these cases could be detected, surgery might be undertaken earlier, with greater chances for survival. This report is a commentary on an attempt to set these patients apart. Some women, while undergoing radiation therapy for carcinoma of the cervix, have certain distinctive changes in Papanicolaou smears of epithelium desquamated from an otherwise normal vagina. R. M. and J. B. Graham (1–4) have listed these changes—increase in cell size, nuclear degeneration, and vacuolization and abnormal staining reactions of cytoplasm—and have named the phenomenon “radiation response,” or “RR.” It is their belief that it is correlated with a patients chance for five-year survival, after treatment with x-rays and radium. This hypot...

Gonadal Exposure Dose from Diagnostic X-Ray Procedures

The study of gonadal exposure dose from diagnostic x-ray procedures to be reported here was undertaken (a) to provide the clinicians at the University of Colorado Medical Center with information about such exposures when a given examination is ordered, and (b) to add to the body of information on this subject. Until relatively recently, the question of radiation dose to the gonads has been neglected in favor of air dose at the skin or skin dose. Stanford and Vance (1), Ardran and Crooks (2), Billings, Norman, and Greenfield (3), and Webster and Merrill (4), among others, have recently published data on gonadal dose. Already a large range of variation in the doses obtained with different installations during the performance of the same x-ray examinations is apparent. For the present study three approaches were used: measurements in patients during actual examinations, measurements in phantoms, and measurements in cadavers. The technics of measurement and the difficulties involved will be discussed subseque...

A Simplified Technic for Nephrotomoqraphy1

THE TERM “nephrotomography” as first used by Evans et al. (1) refers to body-section roentgenography performed during the nephrographic stage of visualization of the renal parenchyma. This occurs approximately ten to twelve seconds after a two-second injection of 50 c.c. of 70 per cent Urokon through a large-caliber needle in an antecubital vein. By this method the arterial supply to the kidneys and, in fact, all of the major branches of the abdominal aorta can be visualized. A plain anteroposterior film of the abdomen is taken, after a predetermined circulation time, to visualize the renal arteries, followed immediately by another anteroposterior film to show the nephrogram. This, in turn, is promptly followed by a tomogram through the kidney at a depth determined by a preliminary film. The whole procedure, from the time of injection through the third exposure, takes approximately twenty-five seconds. The procedure of Evans et al. (1, 2) required a cut-down on an antecubital vein and the insertion of a R...

Hazards and Precautions for the Patient and the Doctor in Diagnostic Roentgenology

Sufficiently large amounts of ionizing radiation can cause death; possible non-lethal effects of large doses include cancer, atrophy of irradiated tissue, depression of immune reactions, and sterility. The authors claim that x-ray examination is justified only when diagnostic benefits outweigh the hazards. Results of a study to determine the amount of gonadal and bodily exposure during common x-ray examinations at a typical hospital are presented along with measures to be taken to reduce the gonadal dose.

Roentgen Aspects of Isolated Valvular Pulmonic Stenosis

Isolated valvular pulmonic stenosis is a congenital cardiac anomaly in which the sole abnormality consists of fusion of the leaflets of the pulmonic valve producing a stenotic orifice (Fig. 1). The ventricular septum is intact; the atrial septum may also be intact or there may be a patency of the foramen ovale. Isolated valvular pulmonic stenosis has been considered of rare occurrence (Taussig, 1; Green, 2). Recent studies (3–13), however, indicate that it must be considered one of the more common congenital anomalies. According to the majority of investigators complex diagnostic studies are necessary for the establishment of a definite diagnosis. In the past two years 30 patients with this anomaly have been studied at the University of Colorado Medical Center. This number represents approximately 12 per cent of the total patients with congenital heart disease observed during that period. The experience gained by the study of these cases has made it evident that the diagnosis can be established on the bas...

The combined effect of radiogold and nitrogen mustard and radiogold and certain other compounds on the ehrlich ascites carcinoma

Nitrogen mustard and radiogold in combination markedly inhibit growth of the intraperitoneal ascitic form of the Ehrlich ascites carcinoma in mice. The best inhibiting dose of radiogold, 15 mc/kg, was the most toxic one; 7.5 mc/kg was found to be the most effective dose with the least toxicity. The results of similar experiments using several other drugs, without significant success, are briefly presented. Advantages in the use of an ascitic tumor in research of this nature are discussed.