Walter C. Popp

Lymphoblastoma with Signs of Renal Involvement Improved By Roentgen Therapy: Report of Three Cases

THE three cases reported herein are presented because of the unusual complication in connection with lymphoblastoma. Each of the patients showed signs of definite renal insufficiency which decreased with roentgen therapy to the renal areas (Table I). The explanation for the striking improvement in the renal function of our three patients is not entirely clear. The symptoms and findings may have been obstructive phenomena and, therefore, spontaneous improvement followed shrinkage of the lymphoblastomatous tissue by radiation therapy with subsequent relief of obstruction. A second possibility is that the symptoms were caused by infiltration or direct extension of the disease into the kidneys and that they improved subsequent to irradiation over the kidneys themselves. A third possibility is that retrogression of the diffuse disease process by roentgen therapy may have brought about remission of a toxemia secondary to lymphoblastoma, with partial or complete restoration of normal renal function. Report of Ca...

Radiotherapy for Bone Tumors1

ALTHOUGH the classification of bone tumors is still difficult and unsatisfactory, a definite improvement in this respect has occurred during the past few years. Moreover, it is gratifying to know that radiology has played a valuable part in this improvement. The roentgenographic features of such abnormal growths are often distinctive, but sometimes they are not and an absolute diagnosis cannot be made. When tissue from such a tumor can be removed for microscopic examination, the growth can usually be identified. In certain cases, unfortunately, different pathologists cannot agree on the essential character of the tumor. As the experience of radiologists has increased, their attention has been attracted by the fact that certain tumors of bone are sensitive to radium or roentgen rays, while others are much less sensitive. By radiotherapeutic tests alone, or by correlating such tests with the pathologic data, it is now possible to distinguish certain tumors from others with which they had previously been con...

Roentgen Therapy for Psoriasis of the Nails and Psoriatic Arthritis

Psoriasis of the nails is usually charracterized by pitting, brownish discoloration of the nail bed, leukonychia, cracking of the free edges, and subungual hyperkeratosis. Among the remedies suggested for treatment of this lesion, the use of roentgen rays is one of the most prominent. Most writers suggest treating the nails after carefully protecting the nail base from the roentgen rays. Because of the fact that arthritis of the distal joints of the hands or feet (or both) occurs not infrequently in cases of psoriasis, we have tried, during the past five years, a different method of treatment with roentgen rays, applying them to the dorsum of the hands in a field extending from the nail tips to the wrists, and to the dorsum of the feet in a field from the tips of the nails to the ankles. We have used this method of treatment whether the individual patient did or did not have arthritis as a complication of his psoriasis. We have given treatment in 24 cases in which the diagnosis of psoriasis of the nails w...

The Hematologic Diagnosis and Roentgenologic Treatment of Myelogenous Leukemia1

THE importance of an accurate hematologic diagnosis in myelogenous leukemia, particularly in relationship to the phase of the leukemia, cannot be overemphasized. The relative activity of any variety of leukemia is and should be of vital concern to the roentgenologist. For that reason we thought it worth while to present this subject from the viewpoint of the hematologist as well as that of the roentgenologist. We will present the hematologic pictures of four different phases of myelogenous leukemia and make suggestions as to both roentgenologic treatment and a method of follow-up examination which we think permits better control of a patient who has leukemia than is offered by sporadic treatment. Myelogenous leukemia may be classified into four general types based on clinical and hemacytologic criteria. Diagnosis of acute leukemia may be made without difficulty. The disease usually has a rapid onset associated with fever, anemia, usually hemorrhage from the mucous membranes, petechiae and purpuric manifest...

Roentgen Treatment of Plantar Warts

THE gratifying results which follow the use of roentgen rays in the treatment of plantar warts have led to general acceptance of this procedure. In addition to the good results, the treatment is painless and, except for an occasional case in which tenderness may occur, incapacitation is not necessary. Andrews pointed to the older methods as unsatisfactory and showed that these lesions, often painful, may be cured easily with roentgen rays. MacKee, in his new work, supports this view and recommends roentgen treatment for the majority of cases. Although roentgen treatment in our hands has been curative in a large number of instances, there remains a group of cases in which the expected cure is not obtained. In 1933, Leddy and Johnson reported 76 cures in a series of 100 consecutive cases in which the end-results could be studied. Most of their patients were residents of Rochester, Minnesota, or the immediate vicinity, and had the benefit of frequent examinations to determine the progress of the lesion. Thus...

Roentgen Therapy for Chronic Macrolymphocytic and Mesolymphocytic Lymphatic Leukemia

Roentgen therapy long has been an established method of treatment for all types of chronic leukemia. We are all well aware of the necessity of some caution in treating leukemia, whether of the myelogenous or the lymphatic type. We are aware, also, of the pitfalls encountered in treating the relatively acute and subacute types of the disease. Every radiologist realizes that leukemia may follow an erratic course during roentgen treatment; occasionally, too, for no apparent reason a poor result will be manifested. Our experience has been like that of others and our object in this paper is to describe a phase of lymphatic leukemia which deserves special consideration. We do not suggest that this is a new type of lymphatic leukemia, but we think it is vitally important that the therapeutic radiologist be aware of the difficulties encountered in treating this phase of the disease. We propose the title, “;chronic macrolymphocytic and mesolyrnphocytic lymphatic leukemia,” to describe the characteristic type of ce...

The Use of Pentobarbital Sodium for Roentgen Nausea and Vomiting

NAUSEA and vomiting as a complication of roentgen therapy has been the concern of the radiologist since the advent of this mode of treatment. The causes of roentgen sickness are not definitely known; whether it is a toxic effect on the higher centers or a reflex action over the sympathetic or parasympathetic system has not been absolutely established. To overcome this complication many therapeutic agents have been tried but, because of their failure or their expense, they have fallen into disuse. As an empirical measure one of us (M. W. B.) prescribed a sedative to be taken at each session of treatment. As a result of this trial there was definite evidence of relief from the severe sickness which commonly attends roentgen therapy. Following this experience, many different sedatives were tried in the hope of finding one with a sedative action sufficiently rapid that the patient might be under fairly good sedation during the interval in which radiation sickness usually occurs. After the experimental use of ...