Search

Ann C. Raldow, MD1,2, Carolyn J. Presley, MD1,3, James B. Yu, MD1,4, Richa Sharma, MPH1, Laura D. Cramer, PhD1, Pamela R. Soulos, MPH1,3, Jessica B. Long, MPH1,3, Danil V. Makarov, MD, MHS1,5, and Cary P. Gross, MD1,3 1Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale Comprehensive Cancer Center and Yale University School of Medicine 2Department of Medicine, Memorial Sloan Kettering Cancer Center 3Section of General Internal Medicine, Department of Internal Medicine, Yale University School of Medicine 4Department of Therapeutic Radiology, Yale University School of Medicine 5Department of Urology, New York University School of Medicine and United States, Department of Veterans Affairs

This is the firstgrand roundsin otorhinolaryngology from the Mayo Clinic for theArchives of Otolaryngology. Today'sgrand roundswill be devoted to various aspects of transseptal, transsphenoidal pituitary surgery. A clinical case of a patient who died during the immediate postoperative period will be presented. A number of colleagues from various departments of our institution will comment on this case specifically and discuss various surgical and related problems of the pituitary region. Raymond V. Randall, MD, Department of Endocrinology and Metabolism, will be the chairman of this conference. Among the other participants are the following: John D. Earle, MD, chairman of the Division of Therapeutic Radiology; Louis H. Weiland, MD, chairman of the Department of Surgical Pathology at St Mary's Hospital; O. Wayne Houser, MD, Department of Diagnostic Radiology; Brian R. Younge, MD, Department of Ophthalmology; Edward R. Laws, Jr, MD, Department of Neurosurgery; Thomas J. McDonald, MD

This book is a compilation of chapters by physicians expert in the pathology, diagnosis, and treatment of intracranial arteriovenous malformations (AVMs). The authors' expertise covers a wide range of fields, including neurosurgery, neurology, pathology, and diagnostic and therapeutic radiology. The natural history of AVMs is approached in the initial chapters of the book, the conclusion being reached that of the patients harboring AVMs, about 2% to 3% per year will suffer intracranial hemorrhage, with an unknown number being subject to small bleedings that are not clinically evident. The risk of recurrent hemorrhage is 6% in the first year after the initial hemorrhage and then approximately 2% per year. In addition to bleeding, patients with AVMs can present with headaches, seizures, or progressive neurologic deficit related to steal phenomenon from surrounding brain. A solid demonstration of some of the hemodynamic effects of AVMs that might result in focal cerebral ischemia is

The Graduate Medical Education National Advisory Committee (GMENAC) adjusted needs-based model for determining physician requirements was applied to the specialties of anesthesiology, neurology, nuclear medicine, pathology, physical medicine and rehabilitation, and radiology, which had not been completed at the time of the original GMENAC final report. Physical medicine and rehabilitation continues to be projected as a shortage specialty; anesthesiology is in near balance. Neurology and pathology are no longer projected to be specialties of oversupply, but rather to be in near balance. Diagnostic radiology continues to be projected as a specialty of oversupply; therapeutic radiology is projected to be in near balance, as is nuclear medicine. The GMENAC aggregate-requirements estimates are thus revised upward from 466,000 to 473,000 full-time equivalent physicians for 1990, reducing the projected surplus from 15.0% to 13.3%. ( JAMA 1983;250:2623-2627)

Beginning in 1959 and revised and updated about every five years thereafter, the text by Moss, with and without various coauthors, has been used by trainees and by physicians practicing therapeutic radiology from that day to this. Ten years have elapsed since the last edition, the fifth, was printed, and now we have a new one, largely rewritten. Professor Moss has been joined by Dr Cox as coeditor and has confined his own writing efforts to part or all of seven chapters. It should be pointed out immediately, however, that one of the great strengths of the previous editions was an introductory section in each chapter detailing the response of the specific organ in question to irradiation. These were usually four- or five-page, succinct, well-illustrated discussions of the pathophysiology of irradiation, and they were, to my knowledge, unique to this particular text and vital to the understanding and analysis of

Therapeutic Radiology: New Directions in Therapy is an excellent volume that will be useful to all radiation oncologists. This 520-page book is well written, well indexed, and well documented with references current through 1980, providing a useful overview of current radiotherapeutic treatment. Its 15 chapters by 24 contributors include basic radiation biology and physics, treatment planning, and clinical radiation therapy. Etiology, pathology, staging, and treatment options are discussed extensively in each clinical chapter. A complete chapter is allotted to the radiation therapy treatment planning with comparisons between different techniques, and examples of three-dimensional treatment planning. International contributions by physicians well known for their work in radiation therapy further add to the quality of the book. C. C. Wang summarizes the management of head and neck neoplasms. F. Chu discusses the management of early, advanced, and recurrent breast cancer. M. Snelling and H. E. Lambert describe the current radiotherapeutic approach for

During 1980 cancer will afflict more than 700,000 Americans, and some 400,000 Americans will die of cancer. As a cause of death, cancer is second only to heart disease. Certainly from the standpoint of emotional impact of disease it is second to none. As such, cancer presents a major challenge to the practicing physician in every area of medicine from surgery, therapeutic radiology, and medical oncology to dermatology, psychiatry, and family practice. Although the pages of this and other medical journals, the programs of postgraduate courses, and the curricula of our medical schools often present measures for early diagnosis of cancer, as well as advances in treatment with surgery, radiation, and chemotherapy, it must regrettably be admitted that these measures will be successful in terms of cure for only 4096 of cancer patients. The majority of patients with malignant disease will suffer the effects of advanced cancer and will present

In September 1926, I registered for basic medical studies at the University of Havana (Cuba). In exchange for serving as a scribe in the admission office, I was given room and board in the interns' quarters of the 2000-bed university hospital. Within 3 weeks, a hurricane hit Havana dead center; thousands were killed and many more injured. The flow of casualties was overwhelming and all hands were needed. I learned to place tourniquets and to give ether anesthesia. Blood transfusions required the presence of a qualified donor and were done arm to arm with large syringes. In the aftermath of the hurricane, I was assigned as a male nurse's aide to apply dressings and give injections in the dermatology pavilion. Professor Pardo-Castello came early to do his rounds and, in the absence of his interns, I followed him with the order book. In the process, he taught me a lot.

To the Editor:— Perhaps some official of the American Board of Radiology will write you regarding your editorial on "Who Is a Specialist?" ( 207 :746, 1969). The subspecialty designations included parenthetically after radiology were apparently copied from a list of terms for which definitions are given in the Booklet of Information of the Board and has little to do with the specialties which it is empowered to certify, namely, radiology, diagnostic radiology, therapeutic radiology, and radiation physics. Subspecialties currently pressing hard for recognition are nuclear radiology, neuroradiology, and pediatric radiology. Further proliferation can be anticipated as follows: radiation biology and radiation chemistry, and diagnostic subspecialties in urologic, gastrointestinal, bone and joint, and cardiovascular radiology. My purpose is not to approve or disapprove but just to tell it as it is.

The discovery of the therapeutic properties of x-rays was the outcome of the observation of damage to tissues as the result of prolonged exposure. Any therapeutic agent that is dangerous to tissues or to life must be administered according to standardized dosage, which must be determined by experience and animal experimentation. Before the dangerous properties of x-rays were known, some of the early patients were the victims. Steps were then taken to attempt to prescribe a safe limit for irradiation, but several years elapsed before this could be accomplished in an entirely satisfactory manner. The operator of the equipment was exposed to the radiation to a less amount than the patient, but continually, and the early roentgenologists, technicians, and even manufacturers became the victims of damage to their skin which was later found to be irreparable. The chronic and irritated ulcerations became the seat of cancerous degenerations in many instances

This volume is the latest in a comprehensive series of German reference works on diagnostic and therapeutic radiology which have been published since 1963. The editors state that "in non-malignant diseases radiotherapy has fallen into neglect" and that this book "... should help to ensure the wider use of this form of treatment." The relatively impartial reader can glean reasons for the former statement from the text, but not for the latter. The 15 contributors present the subject matter without relation to its contemporary importance and only occasionally concede the obsoleteness of the information. The undoubtedly definitive presentation of the use of x-ray therapy for angina pectoris(!) occupies 26 pages. Various methods are recommended, from irradiation of the stellate ganglia to irradiation of what is hoped to be the adrenal medullas. One is more chagrined by the absence of controlled evaluations of therapy than enlightened by the impartially recorded disputes. One