Biomedical subjects
Publications and source records attributed to G D Dodd.
Xeroradiography is an excellent technique in evaluating the fit of extremity prostheses. Because of its inherent characteristics, xeroradiography can clearly demonstrate the stump-socket relationship. Consequently, the degree of contact achieved and attendant pressure problems, if any, can be precisely determined.
Familial aggregations of tumors may occur in virtually all organ systems. The gastrointestinal tract is a frequent site for the development of cancers having an hereditary basis. Their recognition has important relevance to cancer control and prevention. In addition, detailed clinical and laboratory studies of inherited tumors may throw light upon the cause of the more common forms of gastrointestinal neoplasms. Radiologists must have a working knowledge of the genetic and diagnostic elements of each in order to fulfill their responsibilities to the patient, the patient's family and the referring physician.
Eight cases of esophageal lymphoma are presented. Contiguous involvement of the distal esophagus and stomach with narrowing and/or nodularity was the most common esophageal abnormality. Other appearances noted were an ulcerated mass, multiple submucosal nodules, and a pattern simulating varices. The spectrum of radiologic appearances with esophageal lymphoma is similar to lymphomatous involvement in the remainder of the gastroinestinal tract.
Clinical findings and barium studies were reviewed in 34 patients with upper gastrointestinal opportunistic infections, including two with gastric involvement. The spectrum of radiologic features is presented with particular attention to early subtle findings such as disturbance of esophageal motility and tiny marginal filling defects. While most cases are due to Candida albicans, other organisms may also invade the upper gastrointestinal tract in the debilitated host.
Radiologic experience in 67 patients with melanoma metastatic to all portions of the gastrointestinal tract is reviewed. Besides the well known "bull's-eye" lesion of the upper gastrointestinal tract, a large variety of radiologic presentations of melanoma metastases is discussed and illustrated. Because of extended survival due to improved chemotherapy and immunotherapy, the importance of careful radiologic examination of the melanoma patient is stressed.
A simple technique for double-contrast esophagography is described. The technique involves successive swallows of an excellent coating barium mixture and water to create the double contrast effect. Clinical and radiologic situations in which double contrast esophagography have proven helpful include: (a) the detection of small esophageal tumors; (b) delineation of the morphologic features of neoplastic and inflammatory disease; and (c) assessment of the total vertical extent of esophageal disease. Accurate and/or confident diagnosis is aided considerably with double-contrast esophagography.
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Radical mastectomy as originally conceived at the turn of the century consisted of complete removal of the breast tissue, the overlying skin, the pectoral muscles, the intervening lymphatics and the axillary lymph nodes. The aim was logical but initially the results were poor. Only 41% of the 76 patients in Halsted's original series were without disease at the end of 3 years. The principal reason for this was the advanced stage of disease in the patients selected for treatment. By contrast, Gilbertsen, using clinical examination alone, surveyed women 45 years of age or older and found that of 32 patients with breast cancers detected by the screening procedure, 24 had no axillary lymph node involvement. The absolute 5-year survival rate of this group was 96%, which approaches the anticipated survival of comparable women free of breast cancer. Those with positive lymph nodes had an absolute survival rate of 75% at 5 years. Further, of 13 patients observed for 10 years, the survival rate for those without node involvement was 90% and for patients with node involvement was 33%. Patients treated at the Barnes Hospital in St. Louis between 1912 and 1933 were contrasted with similarly treated patients at the Barnes Hospital and the Ellis Fischel Cancer Hospital from 1940 to 1955. A poorer survival rate in the earlier series was related primarily to the greater frequency of advanced and larger tumors. That a significant reduction in breast cancer mortality can be achieved is becoming increasingly apparent. Among survey-detected breast cancers in the study conducted by the Health Insurance Plan of Greater New York, the 6-year mortality was half of that of controls. This reduction is even more impressive when one considers that among these patients were many with full invasive, mass-forming carcinomas at the time of initial screening. A recent report by Wanebo, Huvos and Urban discusses the treatment of prognostically favorable forms of breast cancer by modified radical mastectomy. It is possible to select from among their patients those who fit the definition of minimal breast cancer. In this group the 5-year survival rate was 97% and the 10-year survival rate was 95%. Only 1 patient died of breast cancer in 10 years. In another reported group of 65 patients with intraductal carcinoma only, there were no deaths due to breast cancer in 10 years. Should the NCI-ACS demonstration projects show, as now seems probable, that community screening programs can be effective in early breast cnacer detection, it is to be anticipated that widespread public demand for screening facilities will follow. This may present insurmountable logistic and economic problems. The total number of radiologists in the United States is not sufficient to screen annually the total population of women over age 40, or even over age 50. There is great need for the development of criteria for the ready identification of that segment of the population in which most of the cancers would be found...
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Radiation-induced injury to the normal esophagus, stomach, and duodenum in patients with advanced cervical carcinoma who received high para-aortic lymph-node irradiation to an average tumor dose of 5,000 rads is discussed. Radiation esophagitis is usually the result of mediastinal irradiation for bronchogenic carcinoma. The most consistent radiological finding is abnormal motility, with esophageal stricture and/or ulceration occurrring less frequently. Radiation gastritis usually presents as pyloric ulceration or irregular contractions of the antrum, simulating gastric carcinoma. Postbulbar duodenal mucosal thickening, ulceration, and strictures may occur. Pertinent clinical features, pathogenesis, and pathological correlations are discussed.
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Ultrasonic scanning was used to assist in the diagnosis and management of ovarian tumors. Tumor response to therapy was evaluated with sequential ultrasound examinations in conjunction with clinical observations. Contact B-mode scanning and physical examination were complementary in demonstrating a change in tumor size, delineating small amounts of ascites, and identifying early omental implants. The information was used to guide the patient's management by chemotherapy.
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