Radiography in the United States Army during World War II: Part II.

This is the second of two articles highlighting Army radiography during World War II. Topics center around the certification of Army radiographers, rank structure, scope of service, adverse working conditions, improvisations, and contributions by Arthur W. Fuchs. The contributions of Army radiographers during World War II were significant in helping to meet the challenges of the military medical threat and assisted in saving thousands of lives around the world.

Radiography in the United States Army during World War II: Part I.

This is the first of two articles highlighting Army radiography through World War II. Topics concentrate on a few important military and civilian events between wars (1918-1941), such as the Army's contributions in (classifying) radiographic knowledge and escalating x-ray commercialization. Peacetime objectives, the mobilization effort, personnel and training, and how WACs and civilians contributed are discussed also.

Radiography in the United States Army during World War I.

This article highlights the Army's early involvement with radiography. The mobilization of the Office of the Surgeon General for World War I is depicted, including roentgenologic logistics, personnel, battle area roentgenology, and the development of the portable x-ray field unit. This early period of military medical history facilitated the establishment of radiography as a profession.

[Dissimilar course in the right and left ventricular function in a patient with dilated cardiomyopathy]. / Diskrepanter Verlauf der rechts- und linksventrikulären Funktion bei einem Patienten mit dilatativer Kardiomyopathie.

The case of a patient with severe dilative cardiomyopathy and cardiomegaly demonstrates that M-mode echocardiography and planar chest radiographs are not always sufficient to follow up the disease correctly. Using other non-invasive imaging modalities, in this case radionuclide ventriculography and NMR tomography, which provide more precise information with regard to morphology and function of both the right and the left heart, allows a more reliable follow-up of the disease.

Investigations for vesicoureteric reflux in children: ultrasound vs. radionuclide voiding cystography.

In this study, 53 children suffering from recurrent urinary tract infections were investigated both by ultrasound and direct radionuclide voiding cystography (RNVC). The findings were: Most high-grade vesicopelvic refluxes were detected by both methods consistently. Discrepant results of high-grade vesicopelvic refluxes were seen in 6 kidneys from 4 children. Main advantages of RNVC are the quick results and the ease of interpretation of these results. In RNVC the whole urinary tract can be observed during the filling phase as well as during the voiding and postvoiding phase. In sonography, the different parts of the urinary tract must be explored one after another during the filling, voiding, and postvoiding phase. The investigation by sonography is time consuming and a strongly investigator-dependent procedure.

[NMR tomography in cardiology. I. Anatomy of the healthy heart]. / NMR-Tomographie in der Kardiologie. I. Anatomie des gesunden Herzens.

The normal anatomy of the heart and the neighboring large vessels of a healthy volunteer is depicted in ECG-triggered NMR tomograms. The tomograms were recorded with a slice thickness of 10 mm without gap in transversal, sagittal and coronal orientation. They show a variety of anatomical and morphological details which cannot be obtained by means of other noninvasive imaging modalities.

[Age and sex dependence of tubular kidney clearance in childhood]. / Alters- und Geschlechtsabhängigkeit der tubulären Nierenclearance im Kindesalter.

Nuclear medicine methods have gained wide-spread use for quantitative determination of renal function, but normal values related to age and sex are often not available, especially in children. Since pediatric clearance studies in our clinic are carried out routinely by means of I-123-OIH (ortho-iodo-hippurate), OIH-clearance determinations were performed in 33 children considered to have normal renal function. Within the investigated age of 3,5-15 years no significant correlation of tubular renal clearance with age and no difference between both sexes was found, the mean value +/- SD being 577 +/- 88 ml/min/1,73 m2 surface area. Comparing all age related values known from literature, our values from children and adults fit in quite well.

[Radionuclide ventriculography in coronary heart disease]. / Radionuklid-Ventrikulographie bei koronarer Herzkrankheit.

Heart function can be investigated non-invasively and without risk for the patient by means of radionuclide ventriculography. Coronary artery disease can be diagnosed with high sensitivity and distinguished from other diseases of the heart with high specificity by typical alterations of heart function as seen in rest and/or exercise scans. The hemodynamic significance of invasively proven stenoses of coronary arteries can de demonstrated and the function and functional capacity of surviving vital myocardium after myocardial infarction can be quantified scintigraphically. The efficacy of medical and surgical therapy can be documented and the course of disease can be followed up.

[Value of skeletal scintigraphy in the follow-up of breast cancer]. / Die Bedeutung der Skelettszintigraphie in der Nachsorge des Mammakarzinoms.

In a retrospective study of 728 patients with breast cancer up to 3 years after primary treatment skeletal scintigraphy yielded 15.8% (n = 115) bone metastases. By scintigraphic differentiation between a typical and an untypical pattern of bone metastasis a diagnostic accuracy of 99% was found. Depending on the local stage of tumor the rate of osseous metastases rises with increasing tumor size and with the extent of metastatic involvement of the lymph nodes. The frequency of bone metastasis proved to be also dependent on the histological type of tumor; it was highest in scirrhous carcinomas. By evaluating the scintigraphic behaviour of skeletal metastases under treatment in 122 patients we revealed an obvious decrease of metastatic deposits or complete normalization in 11.5% (n = 14), an unchanged finding in 32% (n = 39) and a progression of metastasis in 56.5% (n = 69). Therefore scintigraphic bone imaging in follow-up of breast cancer can be recommended for early detection of osseous metastases and for assessing the response of skeletal metastases to treatment.

[The use of split and regional renal clearance for indication for surgery in pediatric urology (author's transl)]. / Stellenwert der seitengetrennten und regionalen Nieren-clearance für die Operationsindikation in der Kinderurologie.

The differential and ipsilateral clearance of Hippuran allows for a quantitative assessment of the function of both kidneys, a single kidney and a part of one kidney. We have performed this investigation 179 times in 156 children in relation to dysplastic kidneys, obstructive lesions in the upper urinary tract, duplex kidneys and in follow-up situations. In many of these patients this investigation produced an indication for an organ-preserving operative procedure. The radiological findings are compared with the clinical picture.

Determination of total and individual kidney function in children by means of 123-I-hippuran whole body clearance and scintillation camera.

In 153 children suffering from various renal or urological disease a total of 179 individual and regional renal clearance studies were performed using 123-I-hippuran and a scintillation camera. The clinical diagnoses and questions before and the therapeutic consequences after clearance determinations are analyzed. The dynamic information fo sequential scintigraphy combined with renal clearance determination allow a quantitative estimation of the individual and regional kidney function. The method is considerably helpful in cases of unilateral small kidneys, obstructive uropathies, duplication of the urinary tract, and segmental renal disease.

[Lingual goiter with special regard to diagnosis and therapy]. / Zungengrund-Struma unter besonderer Berückeichtigung von Diagnostik und Therapie.

Starting with a case report, epidemiology, diagnosis, therapy and prognosis of lingual thyroid are discussed with special reference to the decisive value of scintigraphy. The usual 99mTc-scan often fails in detection of ectopic thyroid tissue because of tracer accumulation in salivary glands and its excretion into the oral cavity. Another disadvantage is the relatively high tissue absorption of 99mTc-photons. According to the low sensitivity and specificity of usual 99mTc-scintigraphy, all patients with suspected ectopic thyroid tissue and especially in case of suspected tumor in the retrolingual region should be examined by radio-iodine-imaging (123I, 123I). The decision between conservative and surgical therapy depends on subjective complaints, regional iodine uptake and growth behaviour of the lingual thyroid, and especially on cytological findings of fine needle biopsy, which is not dangerous in expert hands.

[Unilateral pulmonary artery aplasia with special reference to lung scintigraphy (author's transl)]. / Die einseitige Lungenarterienaplasie unter besonderer Berücksichtigung der nuklearmedizinischen Lungendiagnostik.

In a case of unilateral aplasia of one Arteria pulmonalis, i.e. proximal interruption, the diagnostic value of perfusion and ventilation scintigraphy is shown to be simple and non-invasive, exposing the patient to a lower radiation dose than other diagnostic screening methods. When an interruption of a main pulmonary artery is radiologically suspected the scintigraphic examination allows to distinguish between vascular and/or parenchymatous pulmonary diseases, thus clarifying the diagnosis of primary pulmonary malperfusion. The results of other examinations, the relevant literature, the pathogenesis and pathophysiology of unilateral pulmonary artery aplasia as well as therapeutical and prognostic aspects are reviewed.

[Chromosome investigations in subjects with occupational lead exposure (author's transl)]. / Chromosomenuntersuchungen bei Personen mit beruflicher Bleiexposition

The lead content in blood, the excretion of delta-aminolaevulinic acid (ALA) in urine, and the ratio of secondary chromosomal aberrations in lymphocyte cultures were investigated in 105 workers with varying degrees of lead exposure. While the mean lead content was slightly increased (377 plus or minue 207 mug/l) the mean ALA excretion was normal (3,8 plus or minus 4.7 mg/g creatine). Chromosome investigations showed a slightly increased rate of cells with structural abnormalities (14,1 plus or minus 7.0%). Statistical evaluation of these data showed no significant correlation between the lead content in blood, ALA excretion in urine, and cytogenetic findings. No other reason for the increased rate of chromosomal aberrations could be detected.