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Since the lesions of multiple myeloma are widespread, satisfactory control of the disease process would appear possible only with an effective systemic therapeutic agent. Unfortunately, the results of treatment by chemotherapeutic agents such as urethane, steroid hormones, and diamidines remain, by and large, unsatisfactory (1–4). External irradiation has been successful in relieving isolated painful areas, or lesions of unusual size or destructiveness. Radioactive isotopes given internally can irradiate all the lesions but are limited by the tolerable total-body dose. Radioactive phosphorus (P32) has received a trial (5–7) because, in general, leukemic and neoplastic tissues concentrate this isotope preferentially. Radiophosphorus collects preferentially also in the bone marrow, and the dose must be held below that which will produce a severe reduction in granulocytes, platelets, and red blood cells. It seemed logical to try radioactive iodine (I131), which would be evenly distributed in vascularized tis...

The clinical diagnosis of appendicitis is still a major medical problem, not only because of its frequency but because of the morbidity which is associated with the condition, not to mention a mortality of over 17,000 deaths per year in the United States. The literature has been saturated with data on the cause, diagnosis, and treatment of the disease; in 1931 McClure (1) reported that over 9,000 articles had been written on appendicitis, and to that number over 3,000 have since been added, making a total of 12,000 articles. Even though great strides have been made in the technic of appendectomy, and despite the use of the more recent antibiotics (sulfa drugs and penicillin), the morbidity is still considerable and complications remain a serious hazard. In one large clinic (2) the complication rate is unchanged over a period of 19 years. The common origin of the complications in some mechanical factor must therefore be considered. Roux (3) in 1913 was the first to write on the use of roentgen rays in the ...

How do you know where you're going if you don't know where you have been? A review of hepatolienography was presented before the Radiological Society of North America at its annual meeting in December 1950 and published in 1951 (24). This was an attempt to bring the literature on the subject into focus and to report our own investigations. The purpose of the present communication is to review the published (English) work done by others since our earlier paper and again to exhibit our own studies. Thorotrast Most of the literature concerning hepatolienography in the last decade has been concerned with Thorotrast and its effects. Fibrosis: Reports on the effects of extra vascular injection of Thorotrast with fibrosing sequelae have further emphasized our statement concerning “the serious problem in the late fibrosis and scar formation which may occur either in the liver or spleen or at sites of accidental extravascular injection” (24). A recent paper by Brady et al. (4) exemplifies these findings. This revi...

The Pharmacopeia of the United States (U.S.P.) has been published since 1820 and is the standard reference work for information on the purity and physical state of a pharmaceutical. It is kept up to date through periodic five-year revisions and supplements. The drugs and physical standards listed in it are selected by a panel of experts in the varied pharmacologic fields. The specialty of Radiology is represented by a radiologist heading an advisory panel of radiologists who consider the individual drugs used by the specialty. The two other standard pharmaceutical reference books are The National Formulary, published by the National Pharmaceutical Association since 1888, and New and Nonofficial Drugs, published by the Council on Drugs of the American Medical Association. The purposes of these publications differ in that The National Formulary lists all the modern drugs not found in the U.S.P., as well as many that are, and New and Nonofficial Drugs includes drugs whether new or old. (Some of the drugs hav...

Sporadic attempts to use radiation in conjunction with chemicals have been made (1, 5, 13), but it is difficult to assay either the clinical results or those obtained experimentally in lower forms of life, as for example Paramecium (6). Because of the poorly understood use of empiricism in treatment, it is necessary to dilate upon the empiric use of chemicals and radiation to insure a rational approach to the evaluation of combined chemotherapy. To understand this, one has only to review the difficulties which we, in our own specialty, have had in weighing the use of radiation, not only as to total dosage but also as to timing (fractionation) and assessment of the end-result. The empiric use of radiation in tumor therapy has been carried on for years, and to-day we have workable schemes of fractionation and a whole discipline by which we can produce results. The results, as time has passed, have improved only where the critical adjustment of dosage and dose rate has been carried out. What is to be expecte...

The liver and spleen are among the few structures in the body for which safe and reliable primary contrast roentgen diagnostic procedures have not been established. Hepatolienography with colloidal thorium dioxide2 has been widely performed for many years (65), but this material has fallen into disfavor with many workers, though not all, as a result of a number of cases in which injurious effects presumably related to its use have been reported. Since thorotrast has been in clinical use for over twenty years, there is available a rather large body of pathological and clinical material in which its long-term effects may be studied. It has seemed desirable to attempt an evaluation of these effects, to formulate criteria for an ideal medium for opacification of the liver and spleen, and to report preliminary studies with other media. I. Evaluation of the Effects of Thorotrast Thorotrast is a 25 per cent suspension of thorium dioxide (15 to 20 per cent by weight) with an average particle size of 3 to 10 milli...