Sherwood Moore

Body-section Radiography

Introduction FOR reasons which will be given later, I have chosen as a title for this communication the term, Body-section Radiography. The fundamental principle involved lies in the mathematical laws of light and optics. If an object is placed in the path or beam of visible light, a shadow is recorded. If the recording medium and the light are made to move synchronously in opposite directions about a fixed axis, the shadow of the object will remain constant in size and in relationship to the source of light. If another object is placed in the beam of light and out of the plane of rotation of the light and the recording medium, its shadow will be inconstant in size, definition, and relationship to the source of the light. The principle involved in visible light necessarily applies to invisible or x-light. It was obvious that sooner or later this principle would be applied to the use of x-rays. Bocage (1) is justly credited with designing a method of a co-ordinated movement of a source of x-ray energy and ...

GARGOYLISM (DYSOSTOSIS MULTIPLEX): TWO ADULT CASES WITH ONE AUTOPSY

Excerpt Gargoylism is a heritable and congenital condition, attributable at least in part to defects in cartilaginous development which lead to dwarfism and to numerous characteristic deformities o...

Roentgen Kymographic Studies of Cardiac Conditions1

ROENTGEN kymography is an objective and accurate method of recording the physiological movements of an organ or structure on a single x-ray film. The original idea was conceived by Bronislaw Sabat (1), in 1911, when he was a physiologist in Warsaw, Poland. The American pioneer in the development of this work was A. W. Crane (2), of Michigan, who, in 1915, presented his kymograph, elucidated the principles of kymography, and pointed out its application in the study of heart disease. In 1928, Pleikart Stumpf (3), of Munich (Fig. 1), made and later perfected a kymograph with multiple slits. By 1931 (4) he had developed the procedure so that it was practical and of clinical value. I. Seth Hirsch (5, 6) introduced multiple-slit kymography to this country in 1934, improved the technic, and made important clinical contributions. It was his work that stimulated our interest in kymography. The procedure is simple (Fig. 2). The essential part of the apparatus is a large lead sheet in which narrow, horizontal slits ...

Bagasse Disease of the Lungs.

Bagasse is the name given to sugar cane after it has been crushed and the juice has been extracted. The term was originally used in Provence, France, to refer to the refuse from the olive-oil mills. Bagasse disease of the lungs, or bagassosis, is a pulmonary disorder brought about by the inhalation of dried bagasse dust. It is a rare disease, with only some 30 to 40 cases reported in the medical literature, having been first described in 1941 by Jamison and Hopkins (8), of New Orleans. So far as is known today, the disease occurs only in people who have been exposed to the inhalation of dried bagasse dust. Industrial engineers have been aware that exposure to the dust was an industrial hazard, but very few physicians are cognizant of this fact. The fibers of bagasse are tough and possess insulating properties, which explains its use in the manufacture of acoustical and thermal insulating building boards and materials. More recently it has been used in the production of refractory brick. Two factors are la...

Rapid Automatic Serialization of X-Ray Exposures by the Rapidograph, Utilizing Roll Film Nine and One-Half Inches Wide

Prior to the introduction of cardiovascular angiography in 1938 by Robb and Steinberg (1), there was little need for radiographic technics permitting rapid serialization of the x-ray exposures. In the radiographic demonstration of the cardiovascular system, we are dealing with a new and fast moving medium, namely, the flowing blood within the arteries, veins, and chambers of the heart. In the larger vessels and in the heart chambers the speed of the movement of the blood is much greater than in other structures or tissues of the body demonstrable by diagnostic radiography. Consequently, the success of all cardiovascular technics is dependent upon two basic factors: first, the speedy injection of an opaque chemical in such quantities that, even on dilution by the blood, its opacity remains sufficient to provide adequate contrast with the surrounding tissues; second, making the x-ray exposure at the instant the column or “bolus” of opaque substance completely fills the vessels or chambers of the heart. The ...

ROENTGENKYMOGRAPHY: ITS CLINICAL AND PHYSIOLOGICAL VALUE IN THE STUDY OF HEART DISEASE

Excerpt Until recently the fluoroscope has been the only clinical means for routinely investigating the functional movements of an organ or structure. Frequently these movements are so small and qu...

The Construction of Roentgenkymographs and Kymoscopes

THE widespread interest in the roentgenkymograph, and the fact that the apparatus has only recently become commercially available, lead us to describe a kymograph devised for the Edward Mallinckrodt Institute of Radiology. The roentgenkymograph is an apparatus designed to record the functional movements of an organ or structure on a single x-ray film. The kymograph records simultaneously the movements of multiple small points on the border of the heart or any other structure radiographed. The points are usually spaced 12 mm. apart and correspond in area to the width of the slit in the grid, namely, 0.4 millimeter. The grid is a large sheet of lead, one-sixteenth of an inch thick, in which horizontal slits are cut (Fig. 1). In using the apparatus for cardiac kymography, the patients chest is placed in contact with the grid in the postero-anterior position (Fig. 2). The radiographic tube is behind the patient at a 70 cm. target-film distance and during a single continuous exposure of one and one-half secon...

Consideration of faint gall-bladder shadows in intravenous cholecystography

Abstract 1. 1. A survey was made of all patients receiving a radiologic diagnosis of “pathologic gall-bladder because of the faintness of the shadow” over a five-year period (January 1, 1933 to January 1, 1938). A total of 1,355 patients received intravenous cholecystography. The gallbladder was diagnosed as pathologic because of a “faint shadow” in 12.9 per cent of the patients (176), which constitutes the number used in this survey. 2. 2. Some 72.2 per cent of the total group were females; 93.7 per cent were white; and 51.2 per cent were between 40 and 60 years of age. 3. 3. The symptoms complained of by these patients were those accepted for the most part as characteristic of chronic cholecystitis: (right upper quadrant or epigastric pain (64.7 per cent); upper abdominal distress (77.2 per cent); coexisting jaundice (11.9 per cent). 4. 4. The radiologic diagnosis of pathologic gall-bladder based on the faintness of the shadow, when compared with the clinical diagnosis, showed an accuracy of 88.1 per cent in unselected cases, and 90.9 per cent in selected cases. A clinical diagnosis of chronic cholecystitis was present in 60.2 per cent; cholecystitis and cholelithiasis in 21 per cent; and acute cholecystitis in 4 per cent. A total of 34 per cent of these patients were submitted to surgery, and 24.4 per cent, or one in every four, had a cholecystectomy. An additional 13.6 per cent were advised to have surgery but either they refused, or the operation was contraindicated by the patients poor physical condition. 5. 5. The gall-bladders, when examined pathologically both grossly and microscopically, showed that 11.9 per cent had chronic cholecystitis; 15 per cent cholecystitis and cholelithiasis. A clinical diagnosis of cholelithiasis was made in 21 per cent, but in the radiologic diagnosis in only 6.2 per cent. A comparison of the operative findings and pathologic reports with the radiologic diagnosis of “pathologic gall-bladder because of faintness of the shadow” revealed an accuracy of 92.7 per cent.