Application Of Radium Research Articles

Pyometra following application of radium for carcinoma of the cervix: With the late development of adenocarcinoma of the body of the uterus

Pyometra following application of radium for carcinoma of the cervix: With the late development of adenocarcinoma of the body of the uterus

The Problems of Protection and Their Solution in Short Wave Roentgen Therapy

THE International Recommendations for roentgen-ray and radium protection, which were elaborated at the Second Congress of Radiology, in Stockholm, in 1928, and revised at the Third Congress, in Paris, in 1931, are now observed by most roentgen-ray and radium workers throughout the world. These Recommendations are also steadily assuming increasing importance with various lay organizations, such as hospital boards, insurance companies, health agencies, etc., whenever the question of application of roentgen rays or radium is being considered. More recently, the health committee of the League of Nations, by collecting from the literature a bibliography of between five and six hundred articles and assembling all the protective measures adopted by the various countries, issued a most comprehensive pamphlet dealing with the subject. In America, an Advisory Committee on Roentgen-ray and Radium Protection was formed shortly after the International Congress, at Stockholm, in 1928. This Committee is composed of two ...

The Influence of the Antiquity of the Cell Upon Cell Resistance to Radium and X-Rays

THE object of this paper is to present certain evidence which indicates that those cells which have existed on the earth in an unchanged condition for a long period of time, have probably acquired a resistance to short wave radiation by reason of continued exposure to the radiation in the crust of the earth, and from cosmic rays, and that a careful consideration of this fact may be of value in advancing the efficiency of radiation therapy of malignancy. The resistance of both animal and plant cells to the rays of radium and x-rays has been of great interest to radiotherapists, as well as other scientists. Of the many biologic problems in radiation therapy, that of cell resistance is the most interesting and of greatest practical importance to the physician. The idea that cells may have developed a resistance to short wave radiation in Nature is not new, but the application of the idea as made in this paper is original. There is a vast amount of literature bearing upon the question of resistance of various organisms to radium and x-rays, the great part of which is of but little value because of lack of proper measuring and recording of dosage, and the fact that many of the early observers based their opinions on the immediate effect produced. Therefore, only a few of the more recent well-controlled experiments are referred to in this paper. Weare well acquainted with many factors, such as the type and age of the cell, rapidity of division, and chemical composition, which affect the resistance of cells to radiation, while for many years we have been interested in the question of whether or not a cell may develop a resistance to radiation as a result of the application of radiation. It seems that, since a plant or animal will become acclimated or accustomed to a change in physical surroundings, if the change be brought about gradually enough, a like tolerance may be produced by short wave radiation, provided the radiation be applied in proper quantity, and over a sufficient length of time. Radiologists frequently observe clinical evidence of the development of resistance to radiation during the application of radium and x-ray to malignant tumors; as when tumors at first show a marked reduction following a dose of radiation, and at a later date fail to reduce, or may even show a rapid growth, following the same or a larger dose. Of course, this is not positive evidence that direct stimulation of cell resistance occurs as a result of the direct action of radiation, but in the light of experimental evidence at hand, it is strongly suggestive that such resistance is developed. There is a vast amount of experimental evidence to show that cells develop a resistance to radium and x-rays. I was able to produce a resistance to x-rays in wheat plants by giving 3,000 roentgens to dry wheat seeds five days before planting. Plants from such seeds showed 30 per cent greater resistance to the same amounts of x-rays than controls.

Methods of Roentgen Treatment in Carcinoma of the Breast

DUE to its rapid progress, roentgen therapy has heretofore failed to show that degree of standardization which is so much admired in surgery. It evidently has not yet left the stage of experimentation. Nevertheless, though we are not at present able to explain the most fundamental biological reactions, recent communications are indicating that we have reached a point where we can decide as to the best method of treatment available. This statement holds true in cancer of the cervix, and also, to a lesser degree, in cancer of the breast. A considerable amount of material concerning results has been obtained from all parts of the world, but these statistics vary so much in their basic principles that they cannot be compared to best advantage. Lynham has ably pointed out that, if a few surgeons and radiologists of each country would get together and gather their material with the same basic understanding as to registration of cases and different methods of treatment, it would be easy to obtain enough data within a few years, clearly to establish the value of each particular method of treatment. In Europe, the Steinthal registration has been adopted. Its Group I and Group II are identical with those of the American College of Surgeons; as Group III, Steinthal registers all inoperable cases, including those with supraclavicular glands, and inoperable recurrences, whereas Group III of the American classification comprises operable local recurrences, and Group IV, inoperable local recurrences. The statistics of the last ten years have clearly established the fact that roentgen therapy, following the operation for cancer of the breast, has raised the percentage of five-year cures considerably. In inoperable and recurrent cases, it is indispensable. As a pre-operative procedure, it appears to be gaining increasing favor. Recent reports seem to indicate that further improvement in results may be expected by combination with interstitial radium application, according to Keynes' method. Occasional good individual results have already been obtained, in the early stages, and with a primitive equipment. With growing experience and the advancement of x-ray science, the figures have become consistently better, especially within the last decade. In the course of this development, many methods of treatment have been presented and later abandoned. Every radiotherapist has done his share of pioneering, and has tried to improve upon the different methods. This may be the reason why the number of methods in use is considerable, especially in the treatment of cancer of the breast. A part of this diversity is due to the fact that comparatively few authors have described their method so that it can be followed according to their specifications. In this country, the lack of a text-book on the different methods, unifying technic, written by a competent author, is felt keenly.

Conservative Surgical Measures Facilitating Radium Implantation

Irradiation may fail to control epidermoid cancer of the head and neck because of the omission of certain aids, chief of which are the various conservative surgical procedures. Many tumors require both external and interstitial irradiation to produce cure. In such cases surgical measures are indicated for exposure, drainage, and dealing with complications in adjacent bony structures. Removal of the bulky, raised portion of a skin tumor, for example, may make possible more effective radiation of the active base, while exposure of deep-seated growths is an aid to accurate implantation of radon, as in early neoplasms of the nasal accessory sinuses. Similarly, a justifiable substitute for radical neck dissection in metastatic carcinoma of the neck consists in exposure and implantation of gold-filtered radon seeds. Reduction of inflammation in tumor areas may be accomplished by a group of conservative surgical procedures which facilitate drainage, as by enlarging the opening or by removing the greater part of the irradiated area. Resection of bone secondarily invaded by cancer is advised because of its radioresistant character. Carcinoma of the Skin: The majority of superficial growths may be advantageously treated by external irradiation providing the application can be made with physical exactness for a sufficient dosage. Certain squamous-cell and basal-cell growths, however, which tend to infiltrate deeply, as well as those involving bone or cartilage, may require supplementary interstitial radiation. Some skin epitheliomas are elevated and bulky. When these occur directly over cartilage or bone a minimal lethal dose cannot be delivered with regularity without the expectation of a degree of devitalization of the underlying structures. Accurate dosage for this group of bulky tumors is greatly facilitated by removal of the protruding portion. More direct radium application to the active base is then possible with a smaller and more effective total dosage than if the full thickness of the growth were penetrated with a correspondingly greater dosage.

Whole Animal Exposures to Highly Filtered Gamma Rays

I. Introduction SINCE the development of high voltage x-ray tubes operating at voltages of the order of a million volts, the question of adequate protection for those engaged in this work against the very penetrating gamma-rays which are produced, an appreciable fraction of which passes through whatever shielding may be used, has become of considerable importance. More and more laboratories are expending efforts in this direction, a development which makes not only possible but practical the use of such tubes for medical applications. Roughly speaking, an x-ray tube operating at a million volts and 4 ma. gives off as much radiation as would be obtained from 1,000 grams of radium, and when 4 or 5 inches of lead is used to shield only 4 or 5 grams of radium the magnitude of the protection problem for those working with such tubes is readily seen. For this reason it seemed valuable to perform some experiments with highly filtered gamma-rays from radium in order to ascertain the dangers from exposure to such penetrating radiation. Estimates of the protective measures required and the dangers involved doubtless might be made from previous work, but for comparison it appeared desirable to have data on exposures to gamma-rays from radium from which all soft components were filtered out, thus approximating the quality of the radiation which passes through the protective screening of a very high voltage tube. It may be well to point out that in the usual clinical application of radium without heavy filtration a considerable part of the radiation has a wave length equivalent of from 300,000 to 600,000 volts. Filtering with 16 mm. of lead, as was done in these experiments, raises the average hardness of the radiation to a wave length equivalent of about 1,250,000 volts. Data for even the gross biologic effects of whole-body exposure to radiation of this hardness of voltage-equivalent do not appear to be available in the literature. It might also be remarked that an x-ray tube operated at, say, 1,500,000 volts will give out most of its radiation in the region below 1,000,000 volts, and, due to the lack of filters of higher atomic number than lead, even extremely great filtration will hardly raise the average hardness of the radiation to a wave length equivalent of 1,000,000 volts. The experiments here described may consequently be considered as a valid attempt to obtain primary data of interest in connection with the protection problem as indicated. II. Method of Exposure A total of 83 rats was used in these experiments. The stock originally came from the Wistar Institute but had been carried for twelve years by the School of Hygiene and Public Health of the Johns Hopkins University as a stock colony for the Department of Physiology. Of these rats, 38 averaged 111 days at date of irradiation, 28 averaged 64 days, and 17 were approximately 44 days old.

A Technic for Intensive Roentgen Irradiation of the Neck

The radiation treatment of intra-oral cancer involves technics combining intra-oral radium applications directly to the primary seat of the disease and external radiation to the glandular regions of the neck. The problem of the primary lesion has been successfully met by electrosurgical methods, radium seed implantations directly into and about the site of the disease, and by heavily filtered radium applicators immediately in contact with the diseased tissues (1). External radiation to the glandular region of the neck is generally considered essential even in the absence of palpable nodes. Heavily filtered radium packs applied over long periods of time—200 to 300 hours (1)—and short wavelength roentgen rays in massive and divided doses have been widely used with a moderate degree of success. Isolated nodes have been treated successfully with gold seed radon implantations and also with platinum needles (0.5 mm. wall thickness), using weak intensities (1 mgm. per 15 mm. length of needle) over continuous periods of six to seven days.

The value of the Aschheim-Zondek reaction in the diagnosis and prognosis of chorionepithelioma

CHORIONEPITHELIOMA is a relatively rare disease, usually presenting diagnostic difficulties until unmistakable symptoms of metastasis, either local or distant, appear. ·when the condition develops before the expulsion of the products of conception, as in the case reported by Schmitz wherein renal hematuria due to metastasis preceded termination of pregnancy by three months, a definite diagnosis is impossible without microscopic examination of the metastatic tissue. Even the usual case of chorionepithelioma, characterized in its early stage by abnormal uterine bleeding a month or two after the expulsion of the products of conception, is difficult to diagnose by microscopic examination of uterine scrapings, because the chorionic epithelium is normally a proliferative and invasive tissue showing a tendency to persist and penetrate to a considerable depth into the uterine musculature. '.i'his is especially marked when the syncytial covering proliferates for no accountable reason and forms polypoid processes which invade the surrounding tissue and lodge in the uterine and even in distant veins (SchmorP). The layer of Langhans is also prone to proliferate in the course of normal or mole pregnancy, break through the surrounding syncytial covering and invade the uterine musculature. The inadequacy of uterine curettage in the diagnosis of chorionepithelioma is clearly illustrated by the two case histories, herein recorded. Though the absence of fragments of chorionic villi and the presence of anaplasia in trophoblastic tissue recovered a month or two after termination of pregnancy are strongly suggestive of chorionepithelioma, a definite diagnosis cannot be made on the strength of these findings alone because they do not show the extent of invasion and necrosis of the myometrium. In reporting these two cases of chorionepithelioma, the authors hope to emphasize by contrast the value of the Aschheim-Zondek test in the early diagnosis and prognosis of chorionepithelioma and to stress the irreparable damage that may result from intrauterine application of radium in suspected cases through masking pelvic symptoms which

Bladder Reactions Following the Application of Radium to the Uterus

Bladder Reactions Following the Application of Radium to the Uterus

The Action of Radium on Blood Supply: The White Reaction

After a surface application of radium the skin sometimes show a white or pale area corresponding to the part radiated. This precedes the erythema and is usually accompanied by slight œdema. When the thin, transparent, featherless skin overlying the pectoral muscle in the chicken is radiated with β radiation, a white discoloration appears in the underlying muscle two or three days later, and may persist until it is concealed by the onset of erythema in the overlying skin. This white reaction also occurs in tumours when they are radiated, a previously described.1 If a mouse or a new-born rat be inoculated subcutaneously with a small piece of tumour, the subcutaneous growth which arises appears pink through the translucent skin. If this tumour be radiated with β or γ radiation it will turn purple in a few days and subsequently white and bloodless. If it has been given a dose of radiation sufficient to cause it to disappear, then it will remain white or yellowish. If however, a sub-lethal dose has been given, then its normal pink colour will return and it will continue to grow. In old rats it is not possible to see these vascular changes on account of the opacity of the skin. They can, however, be demonstrated by inoculating large quantities of Indian ink into the tail vein.

Application of Roentgen Radiation to the Barium-filled Stomach

THE most disappointing phase in the roentgen-ray treatment of malignant tumors has been the radiation results in inoperable gastric tumors. No matter what apparatus has been used and no matter what technic has been employed, the results, even in the most experienced hands, apparently have been not only uniformly negative, but in some instances the treatment has seemed to hasten the fatal course. In view of such results it is no wonder that at the present time the consensus of opinion of roentgen therapeutists of wide experience does not favor radiation in inoperable gastric carcinoma, Pfahler (1) says: In general, the intestine and the abdominal tissues will not stand the amount of irradiation necessary to destroy carcinoma of the stomach. We must obtain some addition to our present methods in order to accomplish such results. There is some hope in this direction. Levin (2) declares: In my experience, high voltage X-ray therapy in carcinoma of the stomach has its value only as a post-operative measure, i.e., after the main tumor mass is removed surgically or else destroyed to a large extent by intramural radium insertion. High voltage therapy, as well as surface or distance applications of radium in cases of advanced inoperable carcinoma of the stomach, has not given any satisfactory results as a general rule, though I did have a very limited number of cases in which there seems to have been a temporary improvement. It frequently happens in my experience that a high voltage course either creates a cachexia or enhances the previously existent cachexia. In view of all this I do not favor high voltage therapy as the only therapeutic measure in carcinoma of the stomach. Wood (3) is of the opinion that “carcinoma of the stomach cannot be favorably affected by treatment with either type of radiation.” And more recently (4) he states: I regret to say that I have never obtained results of any importance in irradiating carcinoma of the stomach. As a rule the patients are made more uncomfortable and I have abandoned treating such patients. Forssell (5) in a recent article reviewing the irradiation results obtained in the Radiumhemmet at Stockholm makes no specific mention of gastric carcinoma. In Table IX of his article he classifies gastric carcinoma among that group of lesions in which surgery is the only applicable method of treatment. My own experience in the treatment of gastric tumors dates back to the year 1915. From that time until the end of 1919 I treated with medium voltage rays, in the Lebanon Hospital and in private practice, altogether seven cases of inoperable gastric cancer without any appreciable results. Two of these patients, who were of advanced age and in whom gastro-enterostomy had been performed, died within 21 and 27 months, respectively, after the operation, while the remaining five younger patients, in whom only exploratory laparotomy had been done, succumbed within from two to nine months.

Carcinoma of the Maxillary Antrum

IN the treatment of carcinoma of the antrum a clear conception of the disease and accuracy of detail are essential to care successfully for the many complications which may be encountered. It is the purpose of this discussion to present the technical procedures by irradiation and surgery. At Memorial Hospital, recent advances in the diagnosis and treatment of carcinoma in general have been furthered by the development of a method for measuring the minimum dose of radiation delivered to the lesion, and by a method of immediate histologic diagnosis. Their application to carcinoma of the antrum, with the principles of surgical exposure and drainage, promises better results in the future, not only with the operable, but particularly with the inoperable cases. A review of the literature reveals only a small percentage of patients well five years from the first appearance of the lesion, after any type of treatment. Until recently the principal treatment has been surgical excision of the tumor-bearing area. In regard to the resection of the superior maxilla for carcinoma, Scudder said that even the most painstaking surgery rarely succeeds, and that success by this means is the exception rather than the rule. The primary cause for surgical failure is the inability to resect widely enough. An important secondary cause is the high operative mortality, which has been reported by Schley (31) to be from 12 to 13 per cent in America, and even higher in Europe. New (26) reported the results of a carefully selected series of cases treated at the Mayo Clinic. He concluded that coagulation over a long period of time by cautery in the form of soldering irons, followed by radium treatment, eliminated to a considerable degree the operative mortality, and cured more patients than operative methods had previously done. Quick (27, 28) formulated the present principles and demonstrated the actual possibilities of irradiation in the treatment of carcinoma of the antrum. He stated that radium and X-rays may be depended upon to eradicate the tumor tissue if applied accurately and uniformly throughout the growth in sufficient dosage. He stated further that surgery must be employed to provide exposure and drainage for radium application. The technical procedures employed at Memorial Hospital are based on these principles, and are found to be highly efficient. Symptoms Carcinoma of the antrum may produce signs referable to the nose, orbit, or teeth, long before an associated neoplasm is suspected. Empyema of the antrum is frequently suspected and conservative drainage instituted. The primary symptom frequently furnishes valuable evidence in determining the origin of the growth. For instance, if the growth arises in the ethmoid area or involves the floor of the orbit, ocular derangements, with swelling of the lids, and conjunctivitis and lacrimation, are prominent clinical features.

Nodular Opacity of the Cornea: Report of case

The condition has been described under various names, with certain features in common to the various cases. In the case here reported the corneas were subjected to Wiener's wedge operation followed by radium applications, but without benefit. The excised specimen is described histologically. The characteristic lesions are in the superficial layers of the corneal stroma, and consist of nodules and interlacing lines; the nodules being probably hyalin. Read before the American Ophthalmological Society, June 4, 1930. The condition has been described under various names, with certain features in common to the various cases. In the case here reported the corneas were subjected to Wiener's wedge operation followed by radium applications, but without benefit. The excised specimen is described histologically. The characteristic lesions are in the superficial layers of the corneal stroma, and consist of nodules and interlacing lines; the nodules being probably hyalin. Read before the American Ophthalmological Society, June 4, 1930.

ORAL APPLIANCE FOR RADIUM TREATMENT

An implantation of radon seeds into the bony structures of the oral cavity is not always desirable. The limited amount of soft tissue in the alveolar ridge and the hard palate makes the interstitial use of radium very difficult and at times impossible. In these locations a surface application of radium is indicated. The great problem in oral applications is to get an applicator that will stay put. The movements of the tongue and muscles of deglutition will soon sweep ordinary applicators, such as forceps or pinch-cocks, from their anchorage. We experienced a great deal of difficulty in this regard until we commenced to use dental impressions made from a nonmetallic gum wax base. With them, we have been able to give treatments lasting over a period of hours without a great deal of discomfort to the patient. The accompanying illustrations will serve to explain our appliance.

RADIUM IN VERNAL CATARRH

Since 1917 my co-workers and I, at the request of several ophthalmologists, have treated with radium, a number of patients with vernal catarrh. This contact with a nonmalignant disease has come about because several years ago radium was reported to be of value in dealing with this condition and because our peculiar facilities made possible the preparation of various types of radium applicators in our laboratories. As favorable reports from radium treatment for vernal catarrh are constantly appearing in the ophthalmologic literature, it seems only proper that I should present our experiences to date. I offer this report at the present time particularly since I feel that certain hazards are attendant on this form of treatment, and that it should not be entered into without an unusual degree of caution. As for the immediate effects of treatment, it is my impression that the symptomatic improvement is much more marked when

ReviewsHandbuch der gesamten Strahlenheilkunde Biologie, Pathologie und Therapie. By LazarusPaulProfessor Dr. (J. F. Bergmann, Munich, 1927.) Vol. 1, Parts 1 and 2, 392 pp., 98 illustrations.

ReviewsPublished Online:29 May 2014https://doi.org/10.1259/0007-1285-3-31-331-bSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail AboutAbstractThis is yet another of the handbooks on radio therapy, of which a number have appeared in Germany. It is edited by Dr. Paul Lazarus, of Berlin, and deals with the therapeutic applications of radium, X rays, and ultra violet light. Previous article Next article FiguresReferencesRelatedDetails Volume 3, Issue 31July 1930Pages: 293-340 © The British Institute of Radiology History Published onlineMay 29,2014 Metrics Download PDF

An Improved Model of a Portable Electroscope for use in Hospitals

In spite of the careful watch over the stock of radium needles and applicators in most hospitals a tube or applicator will occasionally get lost. In view of the high monetary value attaching to the smallest of applicators it is highly desirable to have some means of tracking down the missing radium. On account of the small size of the radium applicators, it would be very difficult indeed to search for them by eye, especially in a large hospital where the radium has to be transferred over considerable distances for use in various cases; indeed one often discovers that the missing radium has found its way to the incinerators among the soiled dressings. One can imagine the difficulty of the task of searching the ashes of a furnace with the naked eye. It would be a task almost as impossible as that of looking for the proverbial needle in the haystack were it not for the very important property of all radio-active substances of emitting ionising radiations. The tell-tale β and γ rays from a radium tube afford ...

The Biological Action of Secondary Beta Radiation from Buried Needles or Tubes containing Radium

Secondary beta radiation is given off from a platinum tube or needle containing radium, even when the platinum is sufficiently thick to cut off all primary beta radiation. It has been suggested that this secondary beta radiation plays a not unimportant part in therapy when a platinum needle containing radium is placed in a tumour. The following experiments were carried out to see whether this secondary beta radiation could be detected biologically. Two radium applicators were used (a) containing 110·2 mgrs. of radium bromide and (b) 111·2 mgrs. The applicators were square and of 4 sq. cm. and the screen 0·12 mm. of silver. They were further screened with 3 mm. of lead covered with zinc oxide adhesive plaster on the outside. A series of exposures were first carried out to find the lethal dose for Jensen's rat sarcoma in vitro using applicator A. This was found to be in the neighbourhood of 200 minutes. The first experiment was made with an exposure of 109 minutes. The conditions are shown in Fig. 1. The pi...

Medizinische Praxis.

This booklet serves as a short, concise handbook of reference regarding the indications and usage of radium in medicine. A short résumé of the discovery of radium and of its physical and chemical properties is given. The decay of radium and its emanation is explained, and filtration principles with various types of radium applicators are illustrated and explained. The biologic response of skin, muscle, tendon, cartilage, bone, nerve tissue and the blood to the action of the rays from radium is reported. Indications and technic of treatment for gout, rheumatism, neuritis, dyscrasias of the blood and chronic suppuration by inhalations of emanation and by drinking and bathing in radio-active waters are given; a discussion of the radium content of the waters of various popular German watering places is also included. The types of lesions of the skin amenable to the action of radium are briefly discussed; for deeper tumors the

Epithelioma of the Vocal Cord (with Illustrations Showing the Condition of the Larynx during the Application of Radium)

Epithelioma of the Vocal Cord (with Illustrations Showing the Condition of the Larynx during the Application of Radium)