---------------------------------------------------------------------------- ---------------------------------------------------------------------------- INDEX and GLOSSARY Preventing Breast Cancer ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- NOTES: o - As a convenience to readers, both in the USA and abroad, we have tried to define all abbreviations and many terms. We do it either here in the Index-Glossary, or right in the text --- and sometimes in both places. o - An "e" before a page number (e41, for example) means an explanation is on that page. o - Many quotations in the book contain medical terms. When the weight of the passage can be felt without defining every term, we made choices. o - Readers may want to look for Index entries with indented sub-entries. For recurrent topics or key concepts, we try to provide specific reminders, instead of long lists of page numbers. There are a few exceptions. o - Within this Index, we sometimes abbreviate: BC = breast cancer (br.canc.) ca = cancer irradn = irradiation J = Journal radn = radiation w = with ^ means "raised to the power of", 130 o - We have tried to use an alphabetical order which "credits" only LETTERS (not spaces, etc.). A few numerical entries come first: 1 % estimate vs. 75 % est., 312, 314-316, 373 20/20 hindsight, 31 20/20 Television (Britain), 306, 307, 329, 330, 343 22 % of all deaths (USA, today) from cancer, 10 1960-1995 irradiation. See "Post-1960 irradiation" ---------------------------------------------------------------------------- o ================================================= A Abelson (Philip H.) 1994, on "safe" doses, 327 A-bomb radiation vs medical radiation, e11, 13, 83-84, 278 A-Bomb Study Average dose: less than 25 medical rads, 84 SEE also "Medical rad" in index Breast-cancer, 4, 18 Most easily induced of all, 279 Constant cohorts (need for), 276, 287, 334 DS86 dosimetry: proper use of, 276, 334 Early-onset breast-cancer, 12-14, 16 Enduring chromosome lesions, 293 Excess relative risk, children vs adults, 289 Individual differences in latency, 7 Prenatal exposure, 87 Still incomplete for youngest, 8, 282, 289 T65D dosimetry, 276, 277, 334 Unique value of A-Bomb Study, 8, 273, 287 A-bomb testing & fallout, 35, 161-162 Abscesses, treated with radiation, 96 Accidents: And childhood x-ray exams, 18 A stimulus to repeated x-ray exams, 259, 360 ACS = American Cancer Society, 175 ACS 1982: on lowest possible x-ray dosage, 375 ACS 1992: on avoiding fluoroscopy, 257 ACS 1994: on various cancer-rates, 281, 301 On Medicare & mammography, 355 SEE also "American Cancer Society" Actinomycosis = a fungal skin disease, 228 Action: breast-cancer prevention, 1, 18, 30, 31, 264, 291-300, 354, 361, 374-375 A certainty to rely upon, 1, 291, 300, 354, 361 Debate over exactitude: not productive, 264, 291 Effect of latency-period on seeing results, 300 Good news, 1, 291, 344, 351, 354, 375 Honest evaluation of past mistakes, 226, 311 Mammography does not PREVENT breast-cancer, 172-173, 296 Use the list of certainties, 296 Who cares enough to prevent breast-cancer? 226, 299, 314, 369, 374 SEE "Overdosing in current medical x-ray usage" SEE "Reduction of unnecessary doses" SEE "Vigilance required" Acute dose-rate = very fast rate, all at once, 336 Acute mastitis = mammary-gland inflammation, e34 Chap 13, + 342, 353 Adaptive cellular responses to radiation, 326 Adenoids = excessive amounts of normal adenoid tissue in the nasopharynx of children Removal and thymus irradiation, 32, 45, 77-80 Adenoma = a type of tumor, usually benign, e225 Radiation response, 225 Toxic adenoma (thyroid), 125 Adrenals, irradiated for thyroid disorders, 126 Affection = an ailment, disease, e220 Age 65 and older: not in Master Table, 30, 118, 264 Age: young are most vulnerable to radiation, 3, 18, 33, 267, 289, 366 Age-year 0 means birth to first birthday, e14, e30 Age-year vs calendar-year, e30, e33 Aggregate impact of small radiation-doses, 138, 175-177, 297-298, 299-300, 317-318, 343, 361, 368, 369, 371, 374 UNSCEAR 1993 statement: 317, 368 Airline travel: extra radiation, 12, 296-297 Allen (A. Lanham) 1951, on Hashimoto's Struma, 251 Alopecia = loss of hair, baldness, e227 Alpha particles: ionizing radiation, 2 "Amateurs" in x-ray use, 206. See "Unqualified users" American Cancer Society (ACS): 22 invitations to peer-review this book, 301-302 Advice in 1992 about fluoroscopy, 257 Advocate of mammography, 173-177, 312 Dodd (Gerald D.), peer preview, 306 Heath (Clark W.) review of this book, 312-316, 339 Policy against radiation overdosage, 375 Source for cancer-rates, 3, 278, 280, 281, 377 Sponsor BCDDP mammography, 173-177, 312 American Chiropractic Association, 139 American College of Radiology, 36, 139, 299 American J of Roentgenology: excellent journal, 31 Named in text, 53, 54, 106, 108, 110, 117, 132, 144, 201, 206, 210, 212, 242, 253 "American Martyrs to Science through the Roentgen Rays," book, 202 American Medical Assn., 302. See "Journal of AMA" American Roentgen Ray Society, 65, 105, 163, 203, 207, 218, 242 American Society of Radiologic Technologists, 299 American Standards Society, 167 Ames (Bruce) 1989 on DNA damage-rate, 327 Andrews (George) 1922, with MacKee, 110, 219 Anesthesia: unhappy outcomes and enlarged thymus, (40 Lange), (45 Kerley), (48 Jackson), (50 Carr), (65 O'Brien), (66 Mosher), (67+ Gwathmey) and status lymphaticus, 45, 48, 67, 68, 69 characteristics of risky patients, 68 chloroform and sudden death, 68, 75 sudden death, 44, 48, 66, 68, Ch10 from unskillful anesthesia, 69 Animal evidence (early) on radn carcinogenesis, 160 Ankylosing spondylitis, e8 pain relieved by radiation, 8, 247-248 Annual average breast-dose, e30, e31, e63-64 Anthrax: treated with radiation, 245 Antibiotic pharmaceuticals, 83, 91, 245 AP = anterior-posterior, front-to-back, e112 Appalling, if medicine opposes honest evaluation, 226 "Appendage" of small volume, 180 Area under a curve: meaning, 17, 287 "Armamentarium" in dermatology: MacKee, 110, 219, 220 Arthritis, gonococcal, treated with radiation, 245 Artificial pneumothorax therapy, e3, 4, 105-109 Asbestos (as carcinogen), 142, 284 "As low as ... practicable" (radn dosage), 330, 368 Associated Press, 172, 295 Asthma: Association with thymus syndrome, 45 Differs from Status Thymico-Asthmaticus, 50 Treated with radiation, 32, 113-115 Ataxia Telangiectasia and radiation risk, 181, 371 AT gene = gene for Ataxia Telangiectasia, 181, 371 Atomic-bomb: see "A-Bomb" Auscultation = listening with stethoscope, e208 Average annual breast-dose, explained, e30, e31 Average annual breast-dose: key to the analysis, 31 Average doses & risks: individuals above, below, 181 Axillae = armpits. ===================================================== o -- "Discovery consists of seeing what everybody has seen, and thinking what nobody has thought." -- Albert Szent-Gyorgyi, Nobel Laureate in Physiology, 1937. ===================================================== B Background rates of cancer, 10, 280 Bacteria: not stopped by radiation therapy, 92, 93, 104, 117, 244 Bailar (John C.III) 1976, on mammographic dose, 173 Potential peer-review of this book, 303 "Ballpark" estimate = an estimate having a large, acknowledged band of uncertainty. 169, 173, 180-81 Basedow's Disease, 125, 126 Baverstock (Keith) 1981, 1983, 1987 radium study, 321 1991 on threshold issue, 293 Bayley (John F. Jr.) 1968, rate of tonsillectomy, 78 BBE = Breast Biophysical Exam (non-xray), 356 BCDDP = Breast-Ca Detection & Demonstration Project 1970s screening of 280,000+ women, 173-177 2 rads per mammographic exam, 173, 175 Becquerel (Antoine Henri), 1852-1908, discoverer of radioactivity, 260 BEIR Committee = Biological Effects of Ionizing Radn BEIR 1972, p.11 BEIR 1990, p.11, 337, 342, 343 Belarus, (364), 371 Bellamy (Julian) of 20/20 Britain, 329, 330, 343 Benefits of radn in medicine, repeatedly affirmed in this book: examples at 18, 39, 40, 42, 47, 51, 53, 54, 69, 86, 93, 96, 99, 104, 105, 106, 113, 117, 121, 163, 183, 187, 190 207-209, 213, 219, 220, 222, 225, 226, 228, 229, 230, 231, 236, 244-245, 246, 247, 248, 249, 250, 251, 252, 253 311, 332, 375 Benson (Allen B.), author Radioactive Fallout, 303 Berenson (Bernard), quoted about consistency, 192 Berman (Robert) 1957, fetal irradiation, 89, 90 Berra (Yogi), quoted, 216 and within Index "Best doctors have no idea...," 2 Beta particles: ionizing radiation, 2, 13 "Better roentgenology, not less," 311 Bhatnagar (Jadish) 1981, on Full-Spine Exam, 139 Bias, 301, 309, 310, 334, 344 "Big Story," TV investigative series, 329, 331 Billen (Daniel) 1990, 1991 on trivial dosage, 327 Biopsies (breast), 355, 356 Birth defects: A stimulus to childhood x-rays, 18, 183, 257 Radn-induced in next generation by gonadal or whole-body dosage, 196, 201, 238, 345 Bishop (L.F.) 1922, advocate of fluoroscopy, 207-210 Diagnosis of heart problems, 208 "Every physician" will use the fluoroscope, 208 Finding of hidden chest/abdominal problems, 209 Blatz (Hanson) 1970, on well-baby fluoroscopy, 116, 145, 194, 205, 213, 261 "Blue ribbon commission," 30, 295 Boice (John D. Jr.), National Cancer Institute: 1977 on pneumothorax & radiation, 107 1992 on ca-risk for AT heterozygotes, 181 Bond (Victor P.) 1978, x-ray/gamma comparison, 337 Boyd (Edith) 1932, size of thymus, 44, 49, 84 Brachman (D.S.) 1933, tuberculosis case-finding, 108 Bradley (David), author No Place to Hide, 303 Braestrup (Carl), NYC Dept. of Hospitals, 199 1942: on fluoroscopy, 165, 187, 199 Some machines could be classified as a "lethal diagnostic weapon," 165, 199, 204 1942: on scattered radiation to staff, 200 1969: on past over-exposures, 143, 144, 193, 213 100 R limit / fluoroscopy exam, 144, 193, 204, 262 125 R output / minute, fluoroscopy, 11, 143 Skin as "personal monitor" of dose, 143, 144 Breast biophysical exam (BBE), being tested, 356 Breast-cancer causes: Non-radiation: 6, 280, 281, 282, 286, 287, 288 313, 333, 349-351, 353, 354, 370, 373 Radiation (ionizing), proven cause and not speculative, 2-4, 30, 261, 289, 295, 300, 320-321, 333, 346, 349-351 Evans' 1-percent estimate, 312, 314-316 Most easily induced, 279, 290 No.American vs. Japanese data, 313 Radiation is the MAJOR cause, 1, 6, 264, 285 Supra-linear dose-response, 313 Breast-Cancer Detection & Demo Project: see "BCDDP" Breast-cancer incidence, Table 1, for USA, 377 "1 in 9" women in their lifetime, 31, 198 Prevention. See "Action" Breast-cancer mortality rates per 100,000 women: Age-adjusted versus raw number, 377 By age, 347-348 Discussion in HEIR-3 Report, 349 Breast-cancer and radiation therapy, 371 "Breast-cancer years," or ages, e347-348 Breast-dose of radiation: 19 times higher from AP beam than PA, 112 Box with adjustments downward, 58 Breast tissue "radio-sensitive," 185, 278-279 Doubling-dose for breast-cancer, e13 1970 estimate: mixed ages: 20-50 rads, 175 1972 estimate: mixed ages: 28-120 rads, 175 1993 data for early-onset: ~4 rads, 13 SEE also next set of entries Breast-doses, actual individual doses: 0.074 rads / photofluorogram (TB screening), 112 0.465 rads per Full-Spine Exam, 139 0.6 rad or less, from modern mammogram exam, 172 1.5 rads / fluoroscopy, tuberculosis cases, 107 Full treatment sometimes meant 200+ exams, 4 1.6 rads from treatment for ringworm of scalp, 228 2.0 rads from iodine-131 in thyroid, 131 2.1 rads & up prenatally from pelvimetry, 90 3.5 rads from iodine-131 in circulation, 129 7.4 rads: sum, two years of well-baby checks, 198 12.8 rads for scoliosis patients, 136 69 rads for enlarged thymus, 57 69.3 rads (AP beam) for whooping cough, 122 88.7 rads (AP beam) for asthma, 114 138.6 rads for pneumonia, 119 245 rads for acute mastitis, 95 260 rads for chronic mastitis, 102 1,400 Roentgens, maximum, for skin therapies, 222 1,500 Roentgens, maximum, for skin therapies, 230 Fluoroscopy. SEE "Fluoroscopy: output, dose-rates" SEE also "Mammography: per-exam breast-doses" SEE also "Roentgen-to-rad" conversions SEE also "Superficial x-ray therapy" "Brilliant results" (from thymus irradiation), 42 British Natl. Radiological Protection Bd. See "NRPB" Bromley (J.F.) 1955, on Hashimoto's Struma, 251-252 Bronchoscopy, 41, 48 Brown (Robert L.) 1938, on chronic mastitis, 99, 100 Bucky (Gustav) 1927: and "grenz" rays, 221 Buerger's disease: radiation response, 226 Bullets: removal with fluoroscopic guidance, 207 Bureau of Radiological Health (part of FDA, USA): 1977 survey of diagnostic x-ray doses, 291-292 1978 on unnecessary x-ray exams, 365 SEE also "FDA" "Buried" useful items of knowledge, 86 Burlington (D. Bruce) 1994, current fluoroscopy, 184 Burns: report of pain relief from radiation, 249 Bursitis, treated with radiation, 247, 248 Buschke (Franz) 1942, on well-baby fluoroscopy, 124, 145, 154, 194-198, 205, 261 "Unbelievers" resist, 196 Warnings against over-use, 187, 194-197 Women & families owe their gratitude, 198 Worried about gonadal dose (not breasts), 196-197 ===================================================== o -- "Do what you can. Start where you are." -- Carroll O'Connor, contemporary author and actor, on excuses for not helping to solve problems. ===================================================== C Caldwell (Eugene), 218, 242 Calendar-year vs age-year, explained, e30, e33 "Synthetic" calendar-year, 55, 63 California Br.Canc. Research Counc., 302, 305-6, 370 Camel's back (last straw), 9 Canadian Natl.Canc.Inst., Br.Canc. Initiative, 302 Cancer: Age at which it occurs, 10, 286, 287-288 "Breast-cancer years," 347-348 Co-action of causes, 6, 280, 281, 282, 284, 286, 313, 333, 349-351, 370, 373 Multiple cancers per person, 286 Multi-step genetic model of cancer development, e5, e6, 9, 324, 325, 370 Variation in rates between countries, 280-282 Carbuncle = inflammation of subcutaneous tissue, accompanied by marked constitutional symptoms Treatment with radiation, 32, 91, 96, 226, 243 Carcinogenic = cancer-causing, 5 Carcinogenic lesions, e5, 9, 10 Weak vs. strong, e5, 10 Cardiac exams. See "Heart studies," + "Fluoroscopy" Carpender (J.W.J.) 1956: ulcer treated by radn, 253 Carr (Jesse) 1945 on thymus disorders, 49-50, 80, 85 Case (James T.), professor of radiology, 88, 225 President of American College of Radiology, 36 1942, on pelvimetry, 88 1942, list, radn-therapy of benign disorders, 225 1955, tribute to Dr. Pfahler, 36 Catheterization (heart), 183, 184, 214, 357 Caufield (Catherine) 1989: On estimated 20% of x-rays unnecessary, 365 On overuse of fluoroscopy in China, 371 On improper reasons for x-rays, 365 On TB screening by x-ray exams, 111, 146 On x-ray "re-takes," 365 Causation: if case would not otherwise have occurred, 6 Cause of breast-cancer, USA: Radiation not "a cause," but THE major cause, 1, 264, 285 Appalling, if medicine opposes honest evaluation, 226, 311 Duty to be realistic about fluoroscopy, 194 "Losing" some part of causation by omissions from our Master Table, 261 "The thing speaks for itself," 193 Not necessary to account for 100% of causation before starting action, 264 Exact radn share never knowable, 264, 291 Radiation a proven (not speculative) cause, 2-4, 30, 261, 289, 333 "Smoking gun," 310 Center for Devices & Rad. Health, 184, 363 Centi-gray (cGy), equivalent to one rad, e11 Cervical = neck, e246. Cervical spine exam, 150, 153 Cesium-134, radiological half-life = 2.06 years Cesium-137, radiological half-life = 30.17 years cGy = centi-gray, e11 (equivalent to 1 rad) Chadwick (Henry) 1933, on tuberculosis, 106, 108, 109 Chapple (Charles L.) 1950, on scoliosis, 134 Chemicals as carcinogens, 5, 6, 284, 351, 353-354 Chest x-ray exams, 111, 112, 152, 153 Childhood cancers (special set), 10 Childhood irradiation, past: See most chapters. And: 1924: for gastro-intestinal troubles, 210 1925: for heart studies, 211-212 1925: for lung examination, 210 SEE also "Newborns" and "Well-baby check-ups" Childhood irradiation, today: After accidents, 259, 360 Frequency and dose-variation of exams, 364 SEE also "Neonatal intensive care units" China, overuse of fluoroscopy, 371 Chiropractic exams, 139-141, 259 After accidents and workplace injuries, 259, 264 Overdosing, 364, 368 Cholecystogram = gall-bladder x-ray exam, 144, 151, 153 Christopher's "Surgery" (text book), 88, 133, 225 Chromosomes = structures composed of DNA winding around proteins, e10 Radn-induced injury observed (not speculative), 292-293 Repair and failure of repair, 142, 292-293, 313, 318-322, 325, 327, 328, Chronic mastitis, e34, 97-103 Advocates for breast-conservation, 99 Mastectomy for every lumpy breast? 98 Churchill (Winston), on determination, 376 Ci = Curie Cinematography of heart, 212-213, 214 Circumcision & sudden death, 65, 69, 77 Clarke (T. Wood) 1924, childhood G.I. exams, 210 Cleveland Clinic, 1953 occupational doses, 155-159 Clinically detected breast-cancer, e19 Clinicians on defensive when success lacks explanation, 54, 96, 104 CME = Continuing Medical Education, 298 Co-action of cancer-causes, 6, 280, 281, 282, 284, 286, 313, 333, 349-351, 370, 373 Cobalt-60, estimated tracks per rad, 323-324 Cole (A.M.) 1911, on Lange's paper, 41 Collimate = to adjust the line of sight, 146 Commercial promotion of x-rays, 204, 206, 242 Commission to do more studies (no action), 30-31, 295 Committed cancer means produced cancer, 19 Committee on BEIR: see "BEIR" Comparing doses: pitfalls, 83-84 Computed tomography, 356, 363, 364, 366 Conference of Radn Control Program Directors, 363 Conflict of interest & peer-review, 226, 301, 310-311 Consecutive newborns, irradiated, 44, 46, 51-52, 60 Consensus of opinion can be wrong: Crile quotation 234, Orville Wright 301, Schopenhauer 352 Consensus challenged by MacKee, 232 Conservative estimate = moderate estimate. Constancy of both population & dose-level, 29, 259 Constant-cohort, dual-dosimetry, 276, 287, e334 Conti (Eugene) 1948 on thymus irradn, 44, 46, 47 (quote), 60, 61, 80 Continuing medical education, 298 Conversion-factors, e1, e33, e57, 273-283, e350, e373 Adjustments of dose for constant conversion- factor, 58 (box), 265, 278 Low-dose conversion-factors, 33, e278 "Not married" to the current estimate, 286 Will continue to improve with new evidence, 273 Co-operative nature of science, 9, 225, 308 (dwarf) Costal cartilage: belongs to the ribs, e249 Cost-benefit of dose-reduction, 374-375 County and City Data Book, 56, 107, 118, 137 Cover-ups about radiation: During "Cold War," 167 Government today on safe-dose fallacy, 295 Cowie (Dean) 1941, National Cancer Institute survey Occupational doses, 155, 156, 158, 237-241, 264 Worry over gonadal doses (not breast dose), 238 Credible lower limit of dose, 71, 73, 81, 101, 118, 119, 193, 264 Summary on the likely underestimates in the Master Table, 262-264 Crile (George, Jr.), a magic name in thyroid disease 1948, thyroiditis treated with radiation, 251 1950, thyroiditis treated with radiation, 251 Consensus can be wrong (quotation), 234 Criticisms of past: See "Not judging" and "Rush to judgment" Crowe (Joseph P.) 1995, on biopsies 355, on BBE 356 Crowing sound in breathing, 38, 39 CT scans, 356, 363, 364, 366 Cunningham (J.R.) 1983, with Johns, 293, 294 Cure for breast-cancer: problematical, 2 Curie of X is the amount of X required to produce 37 billion radioactive decays per second. The longer the half-life, the larger the amount required. Examples: 1 gram of pure radium-226 (half-life = 1,600 years) qualifies as 1 Curie. By contrast, only 0.0000004 gram of pure xenon-135 (half-life = 9.1 hours) qualifies as 1 Curie. Curie (Marie Sklodowska), 1867-1934, p.237 1898: Discovered radium, 1 Curie (Pierre): good & evil uses of discoveries, 260 Curry (Francis), 1950s' x-ray mis-use, 111, 112, 146, 193 Cutaneous = pertaining to the skin, 225 Cyanosis = blueness of the skin, e38 ===================================================== o -- "You can observe a lot by watching." -- Yogi Berra, famous American baseball player. ===================================================== D Danger (potential danger) of x-rays. Recognition: Advertising should not hide danger: 1943 West, 204 "Dangers are 100 times as great today": 1925 Pfahler, 206 "Disastrous results": 1922 Hazen, 163 "Exceedingly dangerous agent": 1938 MacKee, 224 "Hidden dangers of the agent" 1943 DeLorimier, 204 "Irreparable harm may be done": 1942 Buschke, 196 "Lethal diagnostic weapon": 1942 Braestrup, 165, 199, 204 "No such thing as `minor roentgenology'" 242 Not just "glorified photography": J.T. Case, 195 "Powerful drug," 1942 Buschke/Parker, 195, 196 "Profound ignorance of the dangers": 1925 Pfahler, 206 Worse now than "tragic days": 1937 Leddy, 201 SEE also "Benefits of radiation in medicine" Davis (Devra Lee), 303, 306 Dawood (Richard M.) 1988, 366 DeBuys (L.R.) 1925, normal heart of children, 211-212 Decline in future br.canc. cases, 256, 347-349, 373 Defensive medicine, 365 "Deja vu all over again" (Yogi Berra), 216 Delivery of cancer off the shelf, e19, 64 DeLorimier (Alfred) 1943, army field units, 203, 204 Delusion: see "Self-suggestion" Denial of overdosing, 366, 374 Dental x-rays and breast-cancer, 346 Dermatitis = skin inflammation, e3, e228 Dermatology and radiation therapies: 80+ disorders treated w radn, 110, 219, 227, 262 1922 Hazen: radn "most useful single agent," 163 1922 + 1938 MacKee: x-rays "the most valuable [agent] in armamentarium," 219, 220 1952 Sulzberger: "not merely safe...but among the best therapeutic measures," 222 Breast-dose may exceed everything in Master Table, 219, 223 Breast-irradn from specific treatments, 227-232 "Superficial" therapy does reach breasts, 223 Customary dose-regimes for skin therapies: 85 Roentgens maximum in one treatment, 222 1,400 Roentgens, maximum total per area, 222 "Grenz" rays & "superficial" differ, 219, 221-222 "Superficial" therapy was customary, 222 Unevaluated breast-doses might exceed everything in Master Table, 262 Desjardins (Arthur), excellent papers on radiation action and benefits, 31, 96, 104, 117 Excerpts from his 1931 paper, 96, 104 Inflammation responsive to radn, 96, 104, 117, 118 Mentions acute mastitis, 93 (cited by Harvey), 95 Mentions pneumonia, 96 Desquamation = shedding (of skin) in scales or sheets, 185, 186 "Destiny" lesions vs "predisposing" lesions, e5 Detroit's management of tuberculosis, 105-109, 111 Dewing (Stephen) 1965, Book: Radn of Benign Disease, 228, 243-254, 255; "Excellent" book, 244 100-300 Roentgens called "very low doses," 83 Asthma treated with radiation, 113 Contempt & hostility among physicians today, 243 Inflammation responsive to radiation, 117 Radiation tried on every disease there is, 243 Thyroid disease, radiation vs surgery, 129 Didacus Stella, dwarf on a giant's shoulder, 308 Diet and breast-cancer, 6, 288, 296, 351 Digital computed radiography, 362 Disability claims, 264, 295 "Disaster creep," e1 Discoveries: 1895: x-rays, 1, 29, 75 1898: radium, 1 1965: radiation-induced breast-cancer, 3-4 DNA (genetic molecule), e5 DNA duplex = the 2-strand helix, 326 DNA recombination, 327 See also "Repair & non-repair..." Dodd (Gerald D.) and peer preview, 302, 306 Donaldson (Sam W.) 1930, on enlarged thymus, 51 1930: rate of 40% in suspect infants, 61 1938, consecutive newborns, 44, 52 1938, 11% had "definite" enlargement, 60 1938, 18% received therapeutic irradn, 44, 51 Donegan (Wm. L.), author of br.canc. text, 302, 333 Dose = amount of radn, e3, e11, e259 (box) Annual average breast-dose, e30, e31, e63-64 Box of downward adjustments, 58 High doses: reason why none in Master Table, 59 Low-dose: Dewing's 1965 concept, 83 Lowest possible dose, e318, 321-322, e323, e326 Table of tracks per nucleus, 319 Pitfalls in making dose-comparisons, 83-84 Rate of dose-delivery, 12, 33, 318, 336, 337 SEE also "Breast-dose" & "Breast-doses" SEE also "Overdosing in medical x-ray usage" SEE also "Reduction of doses" Dose-response = regular change in response with change in dose, 32, 57, 142 Important in showing causation, 142, 321 Visible in enduring chromosome injury, 293 Doubling dose, explained, e13. For breast-cancer: 1970 estimate: mixed ages: 20-50 rads, 175 1972 estimate: mixed ages: 28-120 rads, 175 1993 data, early-onset: 4 rads before age-20, 13 Douglas (B.H.) 1933, on pulmonary tuberculosis, 109 DS86 dosimetry versus T65D dosimetry, e334 Dullness in chest, explained, e38 Duncan (Sara Jeannette), 1 Duplex (DNA) = the 2-strand helix, 326 Duration of radn's carcinogenic effect, 8, 30, 289 314, 347-348, 349 Dwarf standing on giant's shoulders, 308 Dyspnoea (dyspnea) = difficult breathing, 39 Fatal cases, 68, 75 o ================================================= E Early-onset breast cancer, e11, e12, 11-18, 289 Easton (D.F.) 1994, on AT heterozygotes, 181 Easy readers, 2, 11, 13, 19 Eczema, treated with radiation, 228-231 Edema = abnormal accumulation of fluid, 228 Effective dose equivalent, e358-359 Egan (Robert L.), mammography pioneer, 178, 179 1962, 1963 papers, 178, 180 1964 paper: calls 10+ rads/year safe, 179-180 Electro-magnetic fields & breast-cancer, 6 Eller (Joseph) 1927, on grenz super-soft x-rays, 221 EMFs = electro-magnetic fields, e6 Empirical method in clinical medicine, 54, 96, 196 Engelstad (Rolf) 1944, on chronic mastitis, 99 Engle (R.B.) 1950, with Levi, 250 Enlarged thymus, first mention, 32 Association with sudden death, 38, 40, 53, 65, 67, 69 Debate on normal size: see "Thymus-size" Debate over pressure: see "Pressure" Doubts about the prevailing wisdom, 44, 49, 66, 67 Enlargement with & without overt problems, 66 Relationship with status lymphaticus, 40, 41, 46, 64, 66, 78 Screening to identify, 43, 60, 61, 65, 67 "Silent" asymptomatic enlarged thymus, 53, 64, 67 Until "violent" reaction to illnesses, 74 Syndrome described 1911 by Lange, 38-41 Syndrome described 1924 by Pfahler, 42 Syndrome described 1925 by Fisher, 54 Syndrome described 1925 by Perkins, 45 Syndrome described 1929 by O'Brien, 66 Syndrome described 1945 by Carr, 50 Syndrome, but no x-ray confirmation, 42, 69 Thymus NOT to blame for syndrome, 44, 49, 51, 83, 84 See also "Thymus irradiation" Epidemiology, e6 Clinicians resist "fairy tales" (Buschke), 196 Limits on what studies are possible, 197 Matched study-groups, 6, 10, 88 (prenatal), 288 Pitfalls, 85, 287-288 Epididymitis (inflammation next to the testicles), treated with radiation, 96 Epilation = removal of hair, 227 Equilibrium: time to reach it (Law of Equality), 285 ERR = Excess Relative Risk, e14 Erythema = morbid reddening of the skin, e144, e164, e224 Erythema dose = 300+ Roentgens, e76, e143, e164, e224 At about 60 KeV, 227 Fractional dose, 252 Suberythema dose: less than 300 R, 225-226 Estrogens and cancer, 6, 351, 353 Etiology = origin Evans (H.J.) 1979, radiation-induced chromosome lesions, nuclear workers, 293 Evans (J.S.) 1986 paper, with faulty 1% estimate, 312, 314, 315, 316 Evans (Nancy), 303 Every disorder once treated by radn, 32, 224, 243 Ewing (James), great American pathologist, 97, 98 Excess relative risk, e14 (equivalent to K-value) 2.524 times higher, breast-ca vs all ca, 279, 290 Implication of Japan-USA transport, 280 Implication of Law of Equality, 287 Is higher for children than adults, 289 Exophthalmic hyper-thyroidism, e125, 125-127 ===================================================== o -- "Everybody is ignorant, only on different subjects." -- Will Rogers, 1879-1935, beloved American humorist. ===================================================== F Fallout from a-bomb testing, 35, 161-162, 299 "False negatives" in diagnosis, 178 FDA = Food and Drug Administration, U.S. Government. FDA 1994, on high fluoroscopy doses, 184-186, 295 Film-processing surveys, 367-368 National x-ray surveys, 363 Survey: overdosing of scoliosis patients, 366 Feig (Stephen A.), 306, 313, 317 Fellows (H.H.) 1928, on TB screening, 189 Fibroid tumors, treated with radiation, 225 Figures in this book: Three Curves with a Story, 15 Law of Equality (four figures), 21, 23, 25, 26 Supra-linear dose-response, A-Bomb Study, 277 Cancer-Rate: Generic Lead-Lag Curves, 288 Film badges, 155, 156, 159 Film-processing, role in overdosing, 294, 367-368 Film-screens: reduction in x-ray dose, 145, 366 Film-speed: slow means higher x-ray dose, 145 "First cut" at annual incidence-rate, 1960-2000, p.29 "First, do no harm," 298 Fisher (Mulford K.) 1925, on thymus irradiation, 54 On value of empiricism in clinical medicine, 54 Flanagin (Annette), a JAMA editor, 302, 309, 312 Fluoroscopy: beam stays "on," e3, e43 1922: spread of machines, 207-209 1923: machines less bulky, 207 1923: "Every physician" will use fluoroscopy, 208 1930s: Wappler fluoroscope, 143, 144, 193, 204 1930 & 1933: Physicians urged to use fluoroscopy to search for enlarged thymus, 43, 80 1937: routine part of a work-ups, 201, 204 1943: spread of machines, 203-204 1992: AmCancSoc urges avoidance if possible, 257 1993: UNSCEAR warnings, "pedal," also PTCA, 357 1993: Very high doses, some unqualified users, 216 1994: FDA warning on high-dose menace, 184, 360 1995: Author warns it is biggest hazard of radiology, 213, 216, 262, 360 Cheaper & quicker than films, 4, 190, 208, 371 Higher doses than radiography, 43, 112, 188, 360 Informed consent: 1994 FDA recommendation, 186 "Lethal diagnostic weapon," 165, 199, 204 Machines take little valuable office space, 207 Medical staff also exposed, 185, 199, 214 Mobile units the worst (1942 Braestrup), 199 Non-recorded doses, 145, 186-187, 188, 190, 199-200, 209, 210, 261-262 1994: FDA urges that doses be recorded, 186 1994: UNSCEAR admits doses unknown, 188, 360 Sum of non-recorded doses, 1920-1960, probably exceeds everything in Master Table, 204, 262 "The thing speaks for itself," 193 SEE also two more sets of entries, below Fluoroscopy: output, dose-rates, dose-levels. 1 - 50 rads per minute today, 185 12 Roentgens per minute (shoe-fitters), 165, 167 21 R total (heart cath with intensifier), 214 25 Roentgens per minute (well-baby), 195 30-232 R total (heart cath, no intensifier), 214 100 Roentgens per minute, 11 100 R limit per exam, New York City hospitals, 144, 153, 193, 262 125-150 R/min at Wappler panel, 143, 144, 193, 204 200 R/min (worst well-baby exam), 195 348 R/minute (worst shoe-fitters), 165, 167 1,000 R/min, worst 1942 surgery, 199 Comparison with natural background rate, 12 Doses & various degrees of skin injury, 185-186 Ways to reduce dose, 186, 214-216 SEE one more set of entries Fluoroscopy: types of uses (examples). Angioplasty, 357 Catheterization, 183, 184, 214, 357 Chest problems, all ("Pancoast imperative"), 43 Finding enlarged thymus, 43, 60, 61, 79, 80 Finding pulmonary tuberculosis, 111, 189-190, 203 Gastro-intestinal tract studies, 203, 360 Heart studies, 184, 207, 208, 210, 214, 357 Removing metallic items, 202, 204, 207 Setting fractured bones, 202, 204, 207 Shoe-fitter machines, shoe stores, 165-170 Surgery, 184 (list of samples), 199 Upper G.I. Exams, 144, 360, 363 Well-baby check-ups, 116, 124, 145, 194-198 Blatz, 116, 145, 194, 205, 213, 261 Monthly use: Buschke/Parker, 124, 145, 154, 194-197, 205, 261 Pifer, 60, 116, 145, 194, 205, 261 SEE also "Unqualified users" and "Cinematography." Flying: extra radiation exposure, 12, 296-297 Food and Drug Administration (FDA), USA. 1994: certification for mammography centers, 172 1994: warnings on fluoroscopic doses, 183-186 National x-ray surveys, 363, 366, 367 Fredrickson (Donald S.), 303, 310 Free radicals: injury to DNA, 292, 326 Freud (Sigmund), "From error to error..." 182 Friedlander (Alfred) 1907: 1st thymus irradn, 38, 75 Frye (Northrup), 28 Full-Spine Exam, e139 ===================================================== o -- "Don't be afraid to take a big step if one is indicated. You can't cross a chasm in two small jumps." -- David Lloyd George, 1863-1945, British statesman. ===================================================== G Gallini (R.) 1985, on dose-reduction, 372 Gamma rays: ionizing radiation, 2, e235 SEE also "Ionizing radn" + "Potency..." Gangrene (gas), radiation response, 226 Geist (Robert) 1953, on occupational dose, 155 Genetic diseases, e5, 196 Genetic lesions, e5, 6, 9, 10, 286 Genetic molecules = DNA & chromosomes, e5, e10 They "remember" non-recorded radn, 35, 165, 239 Repair & misrepair of radn injury, 142, 181, 292, 313, 318-322, 324, 325, 327, 328 "Genie leaks out of the bottle," 217 Gershon-Cohen (J.), pioneer in mammography 1938: on breast x-rays, 177 1961: on mammography screening project, 179 "No concern about excessive radn," 179 1964: on history of mammography, 177-178 G.I. = gastro-intestinal, 144 Giant, with dwarf on shoulder, 308 Gilman (E.) 1989, obstetric radiography, 360 Gittings (J.C.) 1926, on thymus irradiation, 64 "Glorified photography," 195 Gofman 1969, on threshold issue, 33 Gofman 1971, on threshold issue, 33, 318 Gofman 1981, book Radiation & Human Health, p.4 Age-distribution of USA female population, 56 Analysis of early papers on radn & breast-ca, 4, 97 (Baral) Prediction on breast-irradiation in infancy, 8 Rejection of UNSCEAR 1977 concept, 18 Relation of photon-energy & wavelength, 221 Warning about dosimetry errors, A-Bomb Study, 334 Whole-body dose from I-131 ingested, 129 Gofman 1985 (and O'Connor), 1985 book on x-ray exams: Breast-dose: 19-fold difference AP vs PA beam, 112 Adjustment for various HVLs, 140, e150, e223 Entrance doses, common exams, 149+ Field-size of beams, e147 Frequency of diagnostic exams, mid 1970s, 143 Roentgens-to-rads, breast, 112, 114, 118, 140 box The full set of factors, for breast, 149 Spine exams, 141 Ways to reduce diagnostic film doses, 293 Ways to reduce fluoroscopic doses, 214-216 Gofman 1986, track-analysis vs. threshold hypoth, 318 Gofman 1990 book: Analysis of early papers on radn & breast-ca, 4 Average ages of the A-Bomb Study groups, 276, 282 Cesium-137, time-distribution of dose, 162 Disproof of safe dose, 33, 142, 293, 314, Chap 45 Doses in A-Bomb Study, 83-84 Female A-bomb survivors below age 20, p.12 Latency period for radn-induced cancer, 7, 8 Percent increase per rad, below age 20, p.13, 14 Starting point for conversion-factors, 273, 276 Supra-linear dose-response, 33, 58, 277, 313 Gofman 1993, on lipoprotein work, 310 Gofman 1994, on I-131 mean residence time, 130 On radiation's role in inherited disorders, 345 Gofman 1995-b, response in JAMA to Skolnick, 313-314 Gofman 1995-c, comment in Lancet on Hulka 1995, 317 Gofman 1996, on biomedical "milestones" in FASEB, 310 Gofman (Helen) 1943, infant-holding for x-rays, 200 Goiter and thyroid disorders, 126, 127 Goldberg (Henry I.) 1996, radiology syllabus, 317 Gonadal irradiation: consequences, 196, 201, 238, 345 Good/evil results of science (Pfahler 1955), 260 Goodman (Miriam), critique of First Edition, 346 Good news of this book, 1, 291, 344, 351, 375 Gordon (Everett J.) 1973, on defensive medicine, 365 Gould (Jay), on nuclear pollution, 346 Gradual decline of incidence after radn stops, 22, 29 Graham (Kenneth), on human nature, 306 Graves (G.W.) 1924, textbook with Kerley, 45, 85 Graves' Disease, 125 Gray: equivalent to 100 rads, e11 Gray (Joel E.) of Mayo Clinic: 1983 on breast-dose, scoliosis patients, 135 1983 on no safe dose of ionizing radiation, 137 1984 on not telling the dose, 171, 291, 297 Green (Morris) 1968, on scoliosis, 134 Greenthal (Roy M.) 1922, on thymus irradn, 70, 74 Greer (Kathleen A.) 1993, fluoroscopic overdoses, 216 Grenz rays, defined, discussed, e221-222 Different from "superficial" x-rays, 219, 221-222 Grier (G.W.) 1924, on thymus irradiation, 42 1925, on thymus irradiation, 53, 236 Grover (Ralph W.) 1965, with Dewing, 244 Gruder (Charles L.), Calif.Br.Canc.Research, 305 Gwathmey (James T.) 1914, "Anesthesia," 67-69, 75, 77 ===================================================== o -- "Life is what happens to us while we are making other plans." -- Thomas la Mance. ===================================================== H Haenisch (George) 1931, unqualified users, 218, 242 Fee-splitting, 218 "Get-rich-quick" users, 218 "No such thing as `minor roentgenology'," 242 Sales pressure by manufacturers, 242 Hair, unwanted, removed by x-rays, 163, 164 Half-life (radiological) is the time required for half the atoms of a pure radionuclide to decay into a different nuclide (stable or unstable). Half-value layer (HVL), e149, e222 HVL describes avg energy of x-ray photons in a beam, by measuring how much of some absorbing material is required to cut the beam's intensity in half --- e.g., 2.3 mm Aluminum. Hammar (J.A.) 1921, safety of thymus irradn, 70, 84 Hammerstein (G.R.) 1979, dose in mammography, 372 Hammerstein (G.R.) 1979, dosimetry, 223, 372 Hancock (Malcolm): A fine cartoonist (signing "Mal") and fine commentator on the human condition. Mal died of cancer in 1993, much too soon (age 56). "Happy results" from thymus irradn (Perkins), 69 Harbor 1995, on scinti-mammography, 356 Harmless procedures. SEE "Safety assurances" Harvey (Elizabeth B.) 1985, prenatal irradiation, 321 Harvey (Roger) 1945, on acute mastitis, 91, 92, 93 Hashimoto's Struma: radiation therapy, 251-252 Hasley (C.K.) 1933, fluoroscopy to study thymus, 80 Hazen (Henry) on benefits and risks: 1922 on unqualified x-ray users (physicians), 163 1922 on usefulness of radn in skin disorders, 163 1930 on x-ray use in beauty-shops, 163 Heacock (C.H.) 1954, pancreatitis treated w radn, 250 Heart defects & childhood x-ray exams, 18 Heart studies with x-rays, 184, 207-212, 214, 295, 314, 357, 358 (nuclear med.) Heath (Clark W., Jr.), 312, 313, 314, 315, 316, 339 HEIR-3 Report, 349, 373-374 Hempelmann (Louis H.): 1949: recommendations on shoe-fitters, 166, 170 1957: with C.Lenore Simpson on thymus irradn, 160 1977: with Shore on acute mastitis, 93 Henderson (Yandell) 1911, poor anesthesia, 69, 75 Heritable radn-induced disorders, 196, 201, 238, 345 Hickey (Preston) 1923, on fluoroscopy, 207 High doses of radiation: Accumulated in serial low-doses, 320-321 Mistaken assertion about breast cancer, 317 Reason for no high doses in Master Table, 59 100-300 Roentgens considered very high today, 83 High-LET radiation (e.g. alpha particles). SEE "LET" Hildreth (Nancy) 1985, on thymus irradn, 55-62 Breast-dose est. by Rosenstein, 57, 72, 81, 128 Hildreth (Nancy) 1989, on thymus irradiation, 55 On radiation-induced breast-cancer, 8 Hilliard (Harvey) 1908, circumcision death, 68, 77 Hillman (Bruce J.) 1990, on x-ray machines, 295 Hiltz (J.E.) 1969 in Myrden + Hiltz, 4 Hindsight, 31, 91, 226 Disagreement w one's own earlier views, 225, 243 Discarding assumptions when evidence appears, 286 SEE also "Not judging" History of radiation in medicine (selections), 29 1895: Roentgen discovered x-rays, 1, 29, 75 1898: Curie discovered radium, 1 1913-1964: mammography development, 177-180 1920s: spread of fluoroscopy machines, 207 1925: some users without "mental equipment," 206 1931: some "unscrupulous" users, 218, 242 1937: fluoroscopy was routine part of exams, 201 1950: iodine-131 commercially available, 129 1960-1995: annual avg breast-dose, 29, 268, 285 1960s: hospital x-rays exams increasing, 256 1960s: nuclear medicine exams increasing, 256 1965: discovery of radn-induced breast-ca, 3, 4 1965: new applications continue to appear, 243 1970s: hospital x-rays exams increasing, 256 1970s: nuclear medicine exams increasing, 256 1972+: Breast-Ca Detection & Demo, 173, 175-177 1993, 1994: radn burns from fluoroscopy, 184, 216 Book: "American Martyrs..." 202 Every disorder once treated w radn, 32, 224, 243 Luck: "smile of providence" w shoe-fitters, 168 MacKee (1938) describes 3 periods, 224 Radn-induced cancer: not considered, 70, 134, 196 Tribute in 1955 to Dr. Pfahler, 36 Hoffman (Daniel A.) 1989, on scoliosis, 135, 136 Holding of patients during x-rays, 158, 200-201, 236 Hormesis (net health benefit to cells), 322 Hormone pills and breast-cancer, 6, 351, 353 Horse, runaway (Mosher's story), 65 Host of a cancer, 9, 14 How to est. personal risk from mammography, 180-181 Huda (W.) 1984, on dose-reduction, 372 Hulka (Barbara S.) 1995, on BC from high doses, 317 Hull (Jennifer Bingham) 1985, on overdosing, 366 Husik (David) 1926, on thymic deaths, 76, 81 Hyperplasia = abnormal number of normal cells, 74, 77, 80 Hyper-thyroidism, 125-132 Breast-irradn by x-rays & radium, 128 Breast-irradn by I-131 in circulation, 129 Breast-irradn by I-131 in thyroid, 130-131 Complexity of "hyper-thyroidism," 125-126 Exophthalmic (protruding eyeballs), e125 Irradn: pituitary, adrenals, thymus, thyroid, 126 "Massive doses" to thymus, 132 Hypertrichosis = excess unwanted hair, 163, 164 "Hypothetical" assertion about risk, 317, 323, 369 Hysterosalpingography = x-ray study of uterus and oviducts, 89 ===================================================== o -- "The foolish and the dead alone never change their opinions." -- James Russell Lowell, 1819-1891, American essayist, editor, diplomat. ===================================================== I I-131 = iodine 131, for thyroid disorders, 127 ICRP = Internatl. Commission on Radiological Pro- tection, 156, 304, 336, 337, 358 (Eff.Dose Equiv.) ICRU 1986, Internatl. Commission on Radn. Units, 337 Idealized conditions (for analysis), 20, 30 "Ideas have consequences," 86 Idiopathic = cause unknown, e133 "If breasts could talk," 2 "If-Then" calculations: Mammography at current doses, 174 Mammography at BCDDP mid-1970s doses, 176 Well-baby fluoroscopy, 197-198, 205 Ignorance (pre-1965) on radiation-induction of breast-cancer: 32, 70, 180, 197 But animal-evidence provided general warning, 160 SEE also "Technological imperative" Immune system (vs. cancers), 322, 326 Incidence rate = rate of clinical diagnosis. Incidence to mortality ratio, 279, 280, 377 "Incredible" claims, 315-316 Incubation times, explained, e7 Incubation times not appreciated, 32, 70, 314, 347 SEE also "Latency" "I never saw any harm in my practice," 198 Inflammatory disorders: treated w radn, 244-252 Also 91, 96, 98, 104, 115, 117, 118 Appreciable breast-doses not in Master Table, 262 Benefits discovered by accident, 96 Why the radn works (1931 Desjardins' idea), 104 Informed consent, to fluoroscopy, 186 Informed consent to research studies, 211 Ingleby (Helen) 1958, mammography pioneer, 178 Inherited afflictions: radn-induction, 196, 238, 345 Inherited radiation-sensitivity, 181, 328, 369, 371 Inherited risk of breast cancer, 5, 7, 9, 181, 286, 345, 351 Initial analysis (this is a "first-cut"), 30, 256, 257, 259, 261, 264, 268, 281, 283, 285, 286, 291 "Initiating" carcinogens, e324 Injury (non-cancer) of patients by radiation: 1925: from unqualified users, 206 1930: skin & gum injuries, beauty shops, 163 1931: during treatment of malignancies, 104 1931: from inexperienced users, 242 1938: "many...serious injuries" early years, 224 1938: nipple irradiation needs caution, 231 1942: potential birth defects in offspring, 196 1949: potentially malformed feet, 166, 170 1950s: clinical symptoms, TB screening, 111, 193 1969: skin injuries in early years, 143, 193 1993: skin burns from fluoroscopy, 216 1994: skin burns from fluoroscopy, 184 Injury (non-cancer) of physicians by radiation: 1925: Pfahler on self-injured physicians, 206 1936: Leddy on self-injured physicians, 201, 202 1937: Leddy editorial, 201-202 1938: MacKee on injured pioneers, 220, 224 1943: West on younger radiologists, 204 Insurance claims: stimulus to x-ray exams, 18, 259, 264, 295 Insurance payments & growth of x-ray usage, 361, 365 Intensive care units. SEE "Neonatal ..." Interaction of carcinogens. SEE "Co-action" Internatl Commission on Radiation Units. SEE "ICRU" Internatl Commission on Radiological Protection. SEE "ICRP" Intravenous pyelogram, x-ray exam, 152, 153 Interventional radiology, e357 Intuition (mother's), 41 In-utero = in the uterus, prenatal. In vitro = in glass (experiment done in lab), 293 In vivo = in living persons, 293 Iodine-131 in thyroid irradiation, 127, 129 I-131 rads: adjustment to medical rads, 129 I-131, gamma-dose at 1 cm, 130-131 I-131, gamma-dose at 20 cm, 131 Ionizing radiation, explained, e2, e235, e318, e323 Proven human carcinogen, 138, 323, 328, 333 Radn-induced chromosome lesions, 10, 292, 324, 325, 327, 328 Special agent, unlike chemicals, 292 Units of dose, e11 X-rays worse per rad than gammas, 278, 337-38, 339 SEE also "LET" (Linear Energy Transfer) Isherwood (I.) 1978, on dose-reduction, 372 Isotope: see "Radionuclides" Itching, relieved by x-rays, 163, 219, 222, 228, 229, 230 o ================================================= J Jackson (Chevalier) 1907, bronchoscopy, 41, 48, 84 Jankowski (J.) 1984, on dose-reduction, 372 Janower (M.L.) 1971, on thymus irradn, 65, 71, 73 Japanese vs. North American br.canc. data, 313 Johns (H.E.) 1983, "Physics of Radiology," 293, 294 Johnson (David W.) 1986, on dose-reduction, 372 Journal of the Amer. Med. Assn., 96, 104, Chap 44 And denial 1985 of overdosing, 366 And safe-dose fallacy, 317, 328 o ================================================= K Karchner (Rolla) 1922, fluoroscopy & the heart, 210 Keefer (Geo.) 1947, w Pfahler, 97, 98, 100, 101, 103 Kellerer (Albrecht) 1987, repair capacity, 320 Kelly (Kevin) 1975, on pelvimetry, 87, 89, 90 Kendall (G.M.) 1989, obstetric radiology, 360 Kerley (C.G.) 1924, text on Pediatrics, 45, 85 Kerr (George D.) 1988, potency x-rays vs. gamma, 337 KeV = kilo-electron volts. Khalkhali (Iraj) 1995, on biopsies, 355, On scinti-mammography, 355-356 Kidney, x-ray exams: Abdomen (KUB), 152, 153 Intravenous pyelogram, 152, 153 Kilo = one thousand. Kilovoltage of various radiations: SEE "X-rays." Klement (A.W.) 1972, number of medical workers, 158 Kv = kilo-volts; kVp = peak kilovolts, 144 K-value, explained: equivalent to ERR, e14 K-value is the same for incidence & mortality, 14 Knowing (or not) our own radn history, 18, 241, 349 SEE also "Non-recorded radiation doses" Kodama (Yoshiaki) 1993, radn-induced lesions, 293 KUB exam = kidney-ureter-bladder, 153 Kuhn (H.F.) 1985, on dose-reduction, 372 ===================================================== o -- "I'm in favor of leaving the status quo the way it is!" -- Yogi Berra, famous American baseball player. ===================================================== L Lancet (medical journal), 4, 12, 87, 99 And safe-dose fallacy, 317, 328 And self-delusion among physicians, 371 Land (Charles E.), NCI radiation epidemiology: 1993, early-onset breast cancer, 12, 13, 17 1994, with Tokunaga, 8 1995, co-action; percent BC from radn, 313, 314 Potential peer-review of this book, 304 Lange (Sidney) 1911: start of thymus irradiation, 38 Quoted, 38-41; Mentioned in text, 44, 46, 51, 75 Larynx = "the voice box" in the throat, 43 "Last straw" and early straws, 9 LAT = lateral x-ray view, e149 Latency period, e7, 9 It means that cancer-prevention TODAY cannot show results TOMORROW, 300 Long latency not appreciated, 32, 70, 314, 347 Maximum duration uncertain, 8, 22, 314 No minimum duration, 9, 22 Variation among individuals, 7, 9, 10, 20, 289 Variation depicted, 21, 23, 25, 26 Law of Equality, stated, e22 Constancy of population & dose-level, 29, 259 Implication: excess relative risk disappears, 287 Time to equilibrium, 285 Laws (Priscilla) 1977, on chiropractic exams, 139 On time-pressure on rad techs, 365 On defensive use of x-rays, 365 Laws (Priscilla) 1980, on dose-reduction, 372 Lawsuits: A possible stimulus to mastectomy, 99, 100, 101 A probable stimulus to irradiation, 18, 44, 51, (64 + 78, implied), 259, 295, 365 "Lead-Lag" Curves for cancer-rates, 288 Leborgne (Raul) 1951, on mammography, 177 Lederman (Manuel) 1965, with Dewing, 244 Leddy (Eugene), of Mayo Clinic: 1934 on speed in fluoroscopy, 43 1936 on self-injured physicians, 201-203 1937 on "careless" fluoroscopy, 187, 201-203, 213 1949 asthma & radiotherapy, 113, 114, 115 1949 inflammatory & infectious lesions & radn, 115 Leibovic (S.J.) 1983, on dose-reduction, 372 Leonard (R.D.) 1929, on thymus, 67 Lesion = an injury or loss of function, e5 LET = Linear Energy Transfer, the amount of energy transferred from a high-speed particle to the surrounding tissue, per unit of distance traveled along its path. As the particle transfers its energy, bit by bit, it loses speed. When it is slower, the average distance decreases between consecutive energy transfers, and the amount of energy transferred per unit of distance BECOMES HIGHER, on the average. Relative to alpha particles, which are HIGH-LET particles ("densely ionizing," with very short tracks), the high-speed electrons from x-rays and gamma rays are LOW-LET particles. SEE also "Ionizing radiation" "Lethal diagnostic weapon," 165, 199, 204 Leukemia, before age 20, p.10 Leukocyte = a "white blood cell", but not specifying exact cell-type, 96 "Level One" Health-Care, e363 Levi (L.M.) 1950, pancreatitis treated w radn, 250 Levin (Erwin) 1957, ulcers treated with radn, 253 Lewis (George M.) 1938, with MacKee, 227, 228 Lewis (Mark), 20/20 producer, 329, 330, 343 License (proposed) to use x-rays, 206 Lichen planus (a skin disorder), 220, 232-233 "Lift-off" phenomenon, e15-17, 283, 287 Our "lift-off" adjustment in conversion-factors, 282-283, 289 Potential pitfall in various studies, 287-288 Lincoln (Edith M.) 1928, on childhood hearts, 212 Linear & non-linear dose-responses, e33, 336, 337 Linear dose-response, used in comparison, 14 Supra-linear dose-response, explained, 57-58, 336 SEE also "Dose-response" "Lipservice" to breast-cancer prevention, 138 List of certainties, 289-290 Livermore National Lab: chromosome work, 293 Mortimer Mendelsohn, 306 Liver: study of the normal, 211 LMDS = Local multiply damaged sites, e327 Local multiply damaged sites, and repair, 327 Loman + Comandon 1925: heart cinematography, 212-213 Longevity Magazine, 306 Love (Susan M.), surgeon, author, 304, 353 1993 commentary in JAMA, 353-354 1995 commentary on this book, 353 Lowest possible dose & dose-rate of radiation, e314, e318, 321-322, e323, e326 Table of ionization tracks per cell-nucleus, 319 Low-LET radiation (e.g., x-rays, gammas). SEE "LET" Lucas (Joseph N.) 1995, x-ray potency vs. gamma, 337 Luck and its role: In who develops radiation-induced cancer, 9 Reliance on luck, or authorities, or own watchdogs, 299-300 "Smile of providence" (shoe-fitters), 168 Lumbar spine = lower portion of spine, 151, 153 Lundberg (George D.), JAMA's chief editor, 302, 309 Lungs: study of the normal, 210, 211 Lymphadenitis, tuberculous: radiation therapy, 246 Lymphocyte = a variety of white blood corpuscle. The most radio-sensitive cells, 104 ===================================================== o -- "The rule on staying alive as a forecaster is to give `em a number or give `em a date, but never give `em both at once." -- Jane Bryant Quinn, contemporary financial analyst. ===================================================== M Mabuchi (Kiyohiko) 1994, on A-Bomb Study, 4 Breast-cancer mortality vs incidence, 279-280 MacKee (George), great figure in dermatology, 219, 220, 227 1922: Roentgen rays the best remedy, 110, 219 1938: Third edition of his book, 110, 220, 227 300 Roentgens are "safe," 227 Challenge to "consensus opinion," 232 Choice between radium and x-rays, 236 "Most important...agent in the armamentarium," 110, 220 "Radiomaniacs," 224 Self-deception about successful treatment, 220-221, 226, 232-233 "Unscrupulous...careless users," 225 MacKenzie (Ian) 1965, ground-breaking paper, 3-4, 180, 196, 238, 253 His paper available before BCDDP, 175 MacMahon (Brian) 1962, on prenatal x-rays, 88, 89, 90 And 1985, on pelvimetry, 360 "Mal." See "Hancock (Malcolm)" Malignancies: Cancer patients not in our study, 13, 32, 179 Malignancies treated with radiation, 104, 260, 371 Malpractice (medical). SEE "Lawsuits" Mammography, past and present, 171-181, 354-356 1913-1964 history, 177-180 1970s: Breast-Cancer Detection & Demonstration Project, 173, 175-177, 300 1994: FDA certification of centers, 172 Aggregate mammogram-induced breast-ca, 173-174 Alternatives (under development), 356 American Cancer Soc. 1982 dose-policy, 375 Author's position, 173, 347 Comments, risk from mammography, 306, 317, 346-347 False positive results, rate of, 355 How to estimate personal risk / mammogram, 180-181 Some reasons for variation, 181 Mammography does nothing to PREVENT, 172-173, 296 Medicare coverage, 355 Praise as model of dose-reduction, 293, 298, 311, 314, 347, 362; & good film-processing, 368 Rate of growth of such screening, 354-355 Wright (Charles J.) 1995, critic, Scinti-mammography under development, 355-356 SEE also next set of entries Mammography: per-exam breast-doses. Dose varies with breast thickness, 181 1961 Gershon-Cohen: 1.5 rads/exam, 179 1964 Egan: 3.3 rads/exam, 180 1972 UNSCEAR: 10-35 rads in earlier years, 172 1976 Bailar: average 2 rads/exam in BCDDP, 179 1984 Webster: 10-fold dose-variation, 171 1986 NCRP report: potential dose-reductions, 372 1994: maximum 0.6 rad/exam, certified center, 172 Often dose/exam is about 0.2 rad, 172 Marie-Strumpell Disease, 247 Mark left by radiation within breast-cells, 35, 165, 239 Martin (Charles) 1921, fluoroscopy & heart, 210 Martinez (Gonzalo) 1921, fluoroscopy & heart, 210 Mastectomy: 1947: Not for "every lumpy breast," 98 vs breast-irradn, chronic mastitis, 99, 100, 101 Women who were irradiated without their knowing it, 18, 241 Master Table, described, 33-35, 55, 63, 265-268 Is a reasonable approximation for 1960-1995 also, 29, 268, 285 Why it contains no high doses, 59, 265 SEE also "Breast-doses, actual individual" Origin of entries: Column A, pop'n by age-year, 56 Column B, natural background, 63 Column C, thymus age-zero, 62 Column D, thymus pre-surgical, 82 Column E, acute mastitis, 95 Column F, chronic mastitis, 103 Column G, tuberculosis, patient-monitoring, 108 Column H, scoliosis, 137 Column I, tuberculosis, mass screening, 112 Column J, bronchial asthma, 114 Column K, prenatal irradiation, 90 Column L, thyroid irradiation, 132 Column M, thymus misc, 73 Column N, pertussis (whooping cough), 123 Column "O", weapons-test fallout, 162 Column P, routine diagnostic, 154 Column Q, occupational, 159 Column R, chiropracty, 141 Column S, pneumonia, 119-120 Columns T, U, W, 269, 285 Column V, conversion-factors, 273-283 Mayo Clinic, Rochester, MN: special place, 114, 115 And x-ray dosage from CT scans, 356 And radn therapy of bronchial asthma, 113, 266 SEE also "Desjardins" + "Gray (Joel)" + "Leddy" McGinley (Laurie) 1994 WSJ, on pertussis, 122 Means (J.H.) 1948, on Hashimoto's Struma, 251 Mediastinum = chest-region where thymus lies, e39 Mediastinal shadow (shadow of enlarged thymus seen on x-ray or during fluoroscopy), 39, 40, 42, 43, 67, 70, 71, 76, 84, 209 Medical progress: pay attention to what works, even if there is no explanation yet, 54, 86, 104, 245 Medical education, deficiencies: 1942: denying reality of unseen harm, 196-197 1995: failure to teach fluoroscopy hazards, 187 1995: graduates spouting "safe-dose," "airplane," & "sunbath" fallacies, 293, 296-298, 317, 346, 369, 374 1995: non-emphasis on cancer-prevention, 187, 298 1995: non-recognition of ombudsperson duty, 295 Medical journals: role in overdosing, 374 Medical rad, e11 vs A-bomb or other gamma radiation, e11, 13, 83-4, e235, 278, 337-338 (references), 339, 341 Medical schools: role in cancer-prevention, 18, 297-298, 299 Medicare coverage of mammography, 355 Mega-Curie = one million Curies, 161 Mendelsohn (Mortimer), 303, 306 "Mental concrete," 349 Menville (Leon) 1932, radn for thyroid, 127, 128 Metropathic hemorrhage = excessive uterine bleeding, 225 Metropolitan Life Insurance, TB screen, 190-191, 261 Mettler (Fred A.): 1985, on increase of nuclear medicine exams, 256 1987, on Chinese over-use of fluoroscopy, 371 1987, on rate of diagnostic x-rays, 148 Meyer (Harriet S.), JAMA book editor, 302, 309 Micro = one-millionth or 0.000001 Miettenen (O.S.) 1971, with Janower, 65, 71, 73 Milli = one thousandth or 0.001 "Mitchell-Nelson" textbook of Pediatrics, 84, 134 Modan (Baruch) 1977, x-ray-induced thyroid canc., 321 1989, breast-dose from radiotherapy for ringworm of the scalp, 228 "Monday-morning quarterbacking," 31 Monitoring by Mail (TLD service), 369 Montanara (A.) 1986, on dose-reduction, 372 Moody (Robert O.) 1923, x-ray study of normal organs, in university students, 212 Morgan (Karl Z.), "father" of health physics, 145 On doses from chest x-rays, 111 Morgan (Richard) 1933, on tuberculosis therapy, 109 Morris (N.) 1984, on dose-reduction, 372 Morton (John J.) 1940, pancreatitis radn-treated, 250 Mosher (Harris) 1926, thymus & sudden death, 65-67, 75-78, 80 Quoted: 65, 75, 76, 77, 78 "One of the supreme tragedies," 65, 75, 77 Mothers afraid of x-rays, 41 Mothers embrace x-rays, 44, 60, 116, 145, 194 Muirhead (Colin) 1995, critique of this book, 331-344 Muller-Runkel (Renate) 1990, radn therapy for BC, 371 Multi-step genetic model of cancer development, e5, e6, 9, 324, 325, 370 UNSCEAR 1993 affirms, 324, 325 Mustafa (A.A.) 1985, on dose-reduction, 372 Myrden (J.A.) 1969: expansion of MacKenzie Study, 4 "Mystery" of breast-cancer, 1, 4 ===================================================== o -- "To believe with certainty, we must begin with doubting." - Stanislaus, King of Poland. ===================================================== N Nanometer (nm) = one billionth of one meter. Nash (C.L.) 1979, reducing breast-dose, 134, 135 Nasopharynx = portion of pharynx lying above level of soft palate. Nasty surprises: later consequences, 197, 225 National Action Plan on Breast Cancer, 303, 381 National Breast Cancer Coalition, 303, 381 National Cancer Institute (USA) = NCI, 173, 237, 303 1990 booklet (excerpts), 138, 142, 284 National Council on Radn Protection. SEE "NCRP" National Radiological Protection Board. SEE "NRPB" Natural background dose and dose-rate, e11, 12, 29 About 10 micro-Roentgens per hour, 168 Entry into Master Table, Col. B, 63 Never absent in any human study, 350 Role in inherited afflictions, 345 NCI = National Cancer Institute, USA. NCRP = National Council on Radiation Protection. NCRP 100 = NCRP 1989 report, 18, 139, 140, 141, 148, 149, 256, 257, 356, 361 NCRP 1986, on dose-reduction in mammography, 372 NCRP 1989. See NCRP 100, above. Neamiro (E.) 1983, on dose-reduction, 372 "Neanderthalia," 193 Necrosis = death. Dermal necrosis = areas of skin-death, 184 Nelson (Waldo) 1950, text on Pediatrics, 80, 84-85 Neonatal intensive care units: x-rays, 18, 257, 314, 357, 367 Neoplasm = a new and abnormal growth, e.g., a tumor. "Never saw a single case myself," 196, 198 Newborns (healthy) irradiated, 44, 46, 51-52, 53, 60 "At birth" before any lung-changes, 210 Heavy newborns & thymus irradn, 51, 60 "Nearly all infants are x-rayed promptly," 67 Studies of consecutive newborns, 44, 46, 51-52 "Within 24 hours" for heart study, 211 SEE also next entry Newborns (premature, underweight, or severely ill): Irradiated, 257-258, 367 Newlin (N.) 1978, on dose-reduction, 372 New York City's attempts to reduce x-ray over-dose: 1942: Carl Braestrup's efforts, 199-200 Limit of 100 R / fluoroscopy, 144, 193, 204 Shoe-fitters: 24 R to feet per year, 167 New York Yankees (baseball team), 216 NEXT = Nationwide Evaluation of Xray Trends, 292, 363 NIH = National Institutes of Health (USA govt), 138, 142, 284. NIH includes National Cancer Institute. No flags on radiation-induced cancers, 322, 323 Non-protective assumptions, e335, 337, 338, 341-342 Non-recorded radiation doses, 261-262, 297. Examples: Adults holding infants during x-rays, 158, 200-201, 236 Beauty-shops, 164, 254 Fluoroscopy in routine work-ups, 201, 204 From a great variety of benign disorders, 254 General practitioners using x-rays, 201, 203, 242 Radium-handling in hospitals, 241 Screening for cardiac problems, 209, 210 Studies of 1920s of "the normal," 210-212 Surgical & other uses fluoroscopy, 186-187 Tuberculosis pre-job screening, 190, 261-262 UNSCEAR 1994: uncertainty about fluoroscopy, 188 Well-baby fluoroscopy, 145, 194-196, 205, 261 Non-paper record kept in genes & chromosomes, 35, 165, 239 North American data (BC & radn), 313, 336, 337, 342 No safe dose. SEE "Safe dose" "Not everyone" who gets irradiated gets cancer, 9 Mammography, personal risk from radn, 180-181 Pneumothorax-fluoroscopy experience, 105 Not judging past uses of radiation, 31, 85, 91, 96, 211, 245, 254 "Not mysterious," if we go back in time, 1 Nova Scotia studies (BC & radn), 3-4, 321, 342 Risk per rad 6-fold higher, 313, 337, 342 "Remember Nova Scotia" lesson, 342-343 Nowak (Rachel) 1995, inherited radn sensitivity, 371 NRPB = Natl Radiological Protection Board (Britain), e304-305, e317 Critique of this book, Chap 46; also 345 NRPB 1986 report, 364 NRPB 1990 report, 356, 366, 368 NRPB 1993 report, 337, 342 NRPB 1995 report, 317, 326-328 Nuclear medicine: uses radionuclides, not x-rays, 256 How nuclear med. differs from x-rays, 259, 357 Breast-doses need evaluation, 256, 291 Rate of exams 1972-1982 doubled, 256, 299, 358 Scinti-mammography, 355-356 Whole-body exposure, 356, 357-358 Nuclear pollution, 295, 346 o ================================================= O OBL-PA = oblique postero-anterior, e149 O'Brien (E.J.) 1933, on tuberculosis therapy , 109 O'Brien (Frederick) 1929, thymus & sudden death: Patients with and without symptoms, 65-67, 70-71 Pre-surgical thymus irradn "requisite," 70, 77 Safety assurances, 70 Occupational radiation doses: 1941, "arbitrary" guides set by committees, 238 Recommended limit 0.3 extra R/week, 156 Recommended limit 0.5 extra R/week, 168 Recommended limit 0.1 extra R/day, 238 Fluoroscopy: exposure of medical staff, 185, 200 From radium-handling, 237-241 Ombudsperson, 297, 298, 299 "Once upon a time": UNSCEAR on breast-irradn, 18 Orwellian science (retroactive changes), 334 Osmond (John D.) 1949, thyroiditis radiotherapy, 251 Osteomyelitis (acute): radiation therapy, 245 Other nations: lessons of the book, 30, 291, Chap 48 Otitis media, treated with radiation, 96 Outcry before 20/20 broadcast, 330, 331 Overdosing in current medical x-ray usage, 354-372 Defined, e362 Belarus & Russia, 371 Britain, 343, 364, 365, 366, 368 Canada, 214-216, 293-294, 364 European Community, 364 USA, 184-186, 216, 291, 292, 363, 366, 367-368 Patients get no warning, 297, 362, 369-370 Trust needs to be earned, 342-343, 366, 369, 374 SEE also "Reduction of dose" (3 sets of entries) ===================================================== o -- "Man's mind, stretched to a new idea, never goes back to its original dimensions." -- Oliver Wendell Holmes, 1841-1935, Supreme Court Justice, USA. ===================================================== P PA = posterior-anterior = from back-to-front, e112 Page numbers in First & Second Editions, 332, 345 Paget's Disease, 231 "Paid the price" for radn received decades ago, 7 Pain (relief from), 8, 96, 247-248 Paltauf & status lymphaticus, 38, 40, 68 Pancoast (Henry), a "dean" of radiology, 41, 43, 47 Dept of Roentgenology, Univ of Penna., 41, 47 1911 response to Lange paper, 41 1930 adequate x-ray exam of child's chest, 43 1930 differentiation of thoracic disorders, 69 1930 fluoroscopy "imperative," 43, 61, 75 1930 on pressure controversy, 47, 48, 49 1930 on sudden death, 47-48 1930 on thymus radn therapy in own practice, 49 Pancoast role cited 1950 by Nelson, 84 Pancreatitis, treated with radiation, 250 Parade magazine, 296 Parker (B.R.) 1989, on dose-reduction, 366 Parker (Herbert) 1942, with Buschke, 124, 145, 154, 187, 194-198, 205, 261 Pathognomonic = uniquely predictive, e177 Pediatric fluoroscopy. See p.43, also "Well-baby" Peer-review, defined, e301 Desired by author, 301, 310, 332 Double-standard on this issue, 304-305 JAMA's role on this book, 309-312, 315-316 NRPB's role on this book, 332-344 Peer review vs. peer preview, 305 Role of journal editors on overdosing, 374 Safe-dose fallacy gets past the peers, 317, 328 Self-suggestion gets past the peers, 233 Pelvimetry = x-ray to compare size of mother's pelvis with baby's head, 87-90, 360 Peptic ulcer = class including gastric and duodenal ulcers Treated with radiation, 250, 252-254 Percentage increase in spontaneous rate, e10, 16, 17, 32 Explanation for high value in young, 14-17 Implication of Japan-USA transport, 280-282 Relation with area under lifetime curve, 17 Same for incidence & mortality, 14 Percussion = thumping on chest, e208 Perkins (C.W.) 1925, pre-surgical thymus irradn, 45 1929 on pre-surgical thymus irradn, 46 "Permissible" dose. SEE "Occupational radn dose" Person-rads = (number of persons x dose in rads), e59 In this study, the dose is a breast-dose, 273 Annual average population-dose after 1960, in person-rads, 29, 268, 285, 354, 361 Pertussis = whooping cough, 32, 34, 121-123 Pesticides & br.cancer, 6, 296, 350, 351, 353, 354 Pfahler (George): "the dean" of roentgenology, 36, 42, 86, 100, 203 Tribute ("the dean") on 80th birthday, 36 1924, thymus irradn, "brilliant results," 42, 86 1925, editorial on dangers in roentgenology, 206 Allusion to it, 187 1926, study of normal liver-size (w radn), 211 1947, on chronic mastitis, 97, 98, 100, 101, 103 1955, net benefit of radioactivity & x-rays, 260 Story of surgeon & dentist who went hunting, 203 Phantom = a dummy for measuring radiation dose. Used by Rosenstein, 72, 81 Photofluorograms in TB screening, e111, e112, 193 Photon, defined, e221 Action in "ionizing" radiation, 235, 323 Gamma photons vs. photons of medical x-rays, 235 Iodine-131 as a source, 130 Radium/radon-daughters as photon-source, 235 Relation of photon energy with wavelength, 221-222 Physicists, importance in dose-reduction, 186, 216, 293-294 Pifer (James) 1963: On pediatric fluoroscopy, 60, 116, 145, 194, 205, 261 On thymus irradiation, 60, 116, 194 Pioneer periods of radiation in medicine: Radn tried on almost every disease, 32, 224, 243 Self-injury of physicians, 201-202, 206, 220, 224 Pitfalls: in comparing radiation doses, 83-84 Pitfalls: in epidemiologic research, 85, 287-288 Pituitary, irradiated for thyroid disorders, 126 Plane trip (extra radiation dose), 12, 296-297 Pneumonia treated with radiation, 32, 91, 96, 117-120 Pneumothorax therapy, e3, 4, 105, 311, 320, 326, 342 Dose per fluoroscopic exam, 107, 263, 320 List of studies, 320 "Remember Nova Scotia" lesson, 343-343 Population figures, Table 2, USA 1850-2000 est., 378 Females: 1920-1960 avg.= 69 million, 56, 107, 268 USA male + fems, 1940 = 131,670,000, p.79 USA male + fems, 1960 = 179,333,000, p.57 1960 Cook County IL p.128, Forsyth County NC p.118, Hennepin County MN p.137, Monroe County NY p.57, 94, Suffolk County MA p.72, 122 Poretti (G.) 1985, on dose-reduction, 372 Post-1960 irradiation: Lower dose, bigger population, 29, 268, 285 Population: annual breast-rads, 285 Probably fewer person-rads now, 354, 361 Postero-anterior beam (PA) = back-to-front, 111 Potency per rad, x-rays vs gamma, e11, 13, 83-4, e235, 278, 337-338 (references), 339, 341 Poulsen (B.F.) 1952, asthma & radn therapy, 113 Predisposition to cancer, 5, 181, 286, 345, 351, 371 Premature infants, irradiation of: Past: thymus irradiation, 42 Today, 18, 257, 314, 357, 367 Presidential Commission, 30, 295 Pressure exerted by enlarged thymus: controversy Claims: 40, 41, 42, 47-48, 49, 50 Doubters: 83 (Dewing), 84 (Nelson) Pre-surgical irradn of thymus, 32, 45, 46, 52, 64, 65, 66, 71, 74, 75-82 Rate: at least 50 per 1,000 cases, 46 Rate: 7.5 % positive, 76 Rate: 7% positive, 77 Pre-surgical irradn NOT indicated (Nelson), 84 Prevention of breast-cancer: See "Action" Promoting-agents of cancer-development, 6, 286, 351 Properzio (W.S.) 1985, on dose-reduction, 372 Prophylactic = preventive, e46 SEE "Thymus irradiation, prophylactic use" Providence smiled on people (shoe-fitters), 168 Prudence. SEE "Ignorance (pre-1965)" and SEE "Technological imperative" Pruritis = intense and unrelieved itching, e202, e219 Relief from x-ray therapy, 163, 219 Psoriasis, treated with radiation, 231-232 PTCA = percutaneous transluminal cardio-angiog, 357 Public education about radiation: 1994: FDA on reliable mammography, 172 1983: Science Digest, 171 Mid-1940s: signs near some shoe-fitters, 167, 170 Nuclear interests in federal government, 167 Pulmonary = related to lungs, e3. SEE "Tuberculosis" Pyogenic = producing pus (inflammation-product), 96 o ================================================= Q Quigley (D.T.) 1932, radn for thyroid patients, 126 o ================================================= R R or r = Roentgen, e11 Rad, defined, e11 (equivalent to a centi-gray or cGy) Radetsky (Peter), 306 Radford (Edward P.), 304, 307 Radiation committees (list), 304-305 Radiation (ionizing), e2, e235, e318, e323 Every disorder once treated by radn, 32, 224, 243 SEE also "History of radn in medicine" Radiation Effects Research Foundation (RERF), e8 Breast-cancer: see Tokunaga 1994. Cancer-incidence: see Thompson 1994. Cancer in exposed children: see Yoshimoto 1988. Potential peer-review of this book, 303, 306 Radiation-induction of cancer: All types, Chap 45, also p.374, 375 Animal tests provided strong, early warning, 160 Breast-cancer. SEE "Breast-cancer causes" Cases caused by radiation wear no flag, 322, 323 Co-action, radn w other factors, 6, 280, 281, 282 284, 286, 313, 333, 349-351, 370, 373 Earliest human evidence: tumors of skin, bone, 160 Finally considered in medicine: 1957: thyroid cancer from thymus irradn, 160 1965: thyroid-cancer & enlarged thymus, 83 1977: breast-cancer & mammography, 172 1979, 1983: breast-cancer & scoliosis , 135 1994: FDA on cancer, breast & other sites, 185 Not yet considered in medicine, 70, 134, 196 1922: fluoroscopy, 209 1929: thymus irradiation, 70 1941: occupational exposures, 238 1942: in well-baby fluoroscopy, 196 1970s: from low dose-levels, 134, 214 SEE also "Excess Relative Risk" & "Percentage increase" Radiation-induction of heritable disorders, 196, 201, 238, 345 Radiation sensitivity, inherited, 181, 328, 369, 371 Radiation therapy for breast cancer, 371 Radioactive patients, 259 (box) Radiological Society of North America, 299 "Radiomaniacs" (MacKee's term), 224 Radionuclides = radio-isotopes = an element's unstable forms which undergo radioactive decay. Example: iodine-131. The "131" is the sum of protons and neutrons in the atomic nucleus. Every nuclide of iodine, stable and unstable, has 53 protons (which make it iodine), but the number of neutrons varies and determines the nuclide. Radio-sensitive breast-tissue, 185, 278-279 Radio-sensitivity (inherited), 181, 328, 369, 371 Radiotherapy of breast cancer, 371 Radium: 1898 was year of discovery, 1 Radium-226, radiologic half-life = 1,600 yrs, 235 Daughter-products, 235 Radium introduced into medical practice, 29 As a source of powerful gamma rays, 2, e235 Handling practices in hospitals, 237-241 Radiumhemmet of Sweden, 98, 99 Used for irradiating thymus, 37, 42, 64, 236 Used for irradiating thyroid, 126 Used for treating skin disorders, 219, 236 Radon introduced into medical practice, 29 "Rad techs" (radiologic technologists), 365 Random fluctuations of small numbers, 87 Random infliction of unnecessary cancer, 369 Rate of dose-delivery: Slowest possible, e314, e318, e323, e326 Slow versus acute, 336 Ray ("the ray"), e41 Raynaud's disease, radiation response, 226 Read (J. Marion) 1949, thyroid disorders, 126, 127 Recombination as DNA repair-method, 327 Reduction of doses to MINIMUM possible level: Author's view,187, 297-300, 311, 343, 369, 374-375 American Cancer Society's view, 375 Dawood's view, pediatric radiology, 366 UNSCEAR's view, 368-369, 375 Cost-benefit question, 374-375 Trust needs earning, 343, 366, 369, 374 SEE next set of entries Reduction of unnecessary doses, fine examples: 60-fold lower dose, scoliosis, 135, 293, 362 30-100-fold lower dose, mammography, 172, 293, 362 Achievements in Ontario, Canada, 293-294, 299 Carbon fibre tables, 366 Checking of fluoroscopy equipment, 214-216 CT scans, if correct detectors are used, 366 Digital radiography, 362 Film-processing, at USA mammography centers, 368 Neonatal exams, one hospital, 367 Rare earth screens, where used, 366 Table of potential reduction-factors, 372 SEE next set of entries Reduction of unnecessary doses, what needs doing: Easy 2- or 3-fold additional reduction in average radiography dose, 294, 298, 299, 368-369 Table of potential reduction-factors, 372 Modify medical education, 187, 297-298 Record all fluoroscopic doses, 186-187 Reduce unnecessarily high doses, fluoroscopy, 183, 187, 214-217 Especially in non-radiologic offices, 184, 216 Use advice of medical physicists, 186, 216 Use dose-reporting fluoroscopy equipment, 186 SEE also "Overdosing in medical x-ray usage" Reichel (W.S.) 1949, thyroid radiotherapy, 129 Reid (Ada Chree) 1929, on tuberculosis screening, 189 Relative risk (RR), explained, e16, 17 Explanation for early peak in young, 14-17 How to convert RR to percentage increase, 16 Rem, defined, e11 (equivalent to a centi-sievert) Remer (John) 1927, on thymus irradiation, 53 Repair & non-repair of radn-induced genetic lesions, 142, 181, 292, 293, 313, 318-322, 324-328 "Troublesome trio," 322; echoes 326, 327, 328 RERF = Radiation Effects Research Foundation (located in Hiroshima), e8, 12, 13, 14, 306, 332 Resistance to benign radn therapies, 96, 104, 243 Resolution of the 75% versus 1% views, 316, 331, 373 Retroactive shuffling of cases, 276, 334 Reynolds (Russell) 1932, chronic mastitis, 99 Ricketts (Wm. E.) 1951, ulcers treated w radn, 252 Right of individual to take risks, 167, 180 Rimkus (D.) 1984, on dose-reduction, 372 Ringworm of the scalp, 227 Risk for an individual is a RATE for a group (not a "maybe"), 8, 138, 289 Risky versus safe, 33 Robinson (A.) 1983, neonatal irradiation, 257-258 Roentgen, defined, e11 Roentgen-to-rad conversions for breast, e11, 102, 112, 114, 140, 198 Full set of conversion factors, breast, 149 "Soft" x-rays, 223 SEE also next entry Roentgen (Wilhelm Konrad), 1845-1923: 1895: discovered x-rays, 3, 29, 75, 86, 302 "New kind of ray," 260 (see Reference list) Second century with x-rays, 1995-2095, all the benefits with vastly less harm, 311 Roentgenography, defined, e3-4 Roentgenoscopy, defined, e3. SEE "Fluoroscopy" Rosenstein (Marvin) 1985, in Hildreth, 57, 59, 72, 81, 128 Rounding-off vs keeping extra digits, 268, 276, 285 Rousseau (J.P.) 1942, pneumonia & radn, 117-119 Rowley (K.) 1987, on dose-reduction, 372 Rules of research, 85 Runaway horse (Mosher story), 65 Rush (David), author Dead Reckoning, 304 Rush to judgment about past uses of radiation: About asthma radiation therapy, 115 About benign radiation therapy in general, 243 About thymus irradiation, 85 SEE also "Benefits of radn in medicine" Russia, high usage of x-rays, fluoroscopy, 364, 371 ===================================================== o -- "To avoid delay, please have all your symptoms ready." -- Sign in a physician's waiting room. ===================================================== S Safe dose, defined, e33, e325. For ionizing radn: Disproof of any safe (risk-free) dose, Chap 45 Fallacy of a safe dose, 291-293, 297, 313-314 Main cause of careless overdosing, 291, 295 Main disseminators are physicians, 369, 374 Main sponsors are segments of government, 295 and medical schools, 317 No dose is safe: Baverstock, 293 No dose is safe: Gofman, 142, 173, 290, 318-323 1990 Disproof of any safe dose, 33, 142, 293 No dose is safe: Gray, 137 No dose is safe: Natl Cancer Institute's view, 142 No dose is safe: NRPB Britain, 328 No dose is safe: UNSCEAR 1993, 325 No dose is safe: Ward, 293 Risk for an individual is RATE for a group, 8, 289 SEE also "Aggregate impact of small radn doses" Safety assurances about the patients, past & now, 293 "Absolutely no danger," 70 Advice from author to women, 197, 198 Airplane trips give extra radn too, 296-297 Animal evidence, as a warning, was ignored, 160 "Apparently harmless and perhaps beneficial," 44 "Harmless" (thymus irradiation), 64 "Harmlessness" of a few x-rays, 41 "I never saw any damage," 196, 197, 198 "Little evidence" of human carcinogenesis below 1,000 R," 160 "No concern about excessive radiation," 179 "No reports of harmful effects," 70 "Not merely safe..." 222 "Perfectly safe" (2,000 Roentgens), 252, 254 "Quite acceptable" (10+ breast-rads/year), 180 "Risks are negligible," 248 "Safe" (10+ breast-rads/year), 179 "Safe" (thymus irradiation), 53 "Safe" (1,650 Roentgens), 253 "Safe dose" (300 Roentgens), 227 "So far as we know harmless, both as to immediate and remote effects," 53 Sun-bath comparison, 296-297, 374 Tendency of technology "buffs" (enthusiasts), 171 What we fault about past assurances, 180 SEE also: "Radiation-induction of cancer" Salesmen of x-ray equipment, 206, 242 Sanatorium, sanitarium, 4 Sanford (K.K.) 1990, on radn-sensitivity, 371 Santayana (George), 1863-1952, "Those who...", 255 Savitsky (Kinneret) 1995, AT gene & radn, 371 Scatter of x-ray beams, e168, e185 To medical personnel, 183, 185, 200 From mobile hospital units, 204 From shoe-fitters, 168-170 Scheele 1941, with Cowie, 155, 156, 158, 237-241, 264 Schopenhauer (Arthur), 3 stages of truth, 352 Schwarz (G.) 1928, thyroid radiotherapy, 127 Scientific discovery: good/evil (Pfahler essay), 260 SEE also "Empirical method" Scinti-mammography, 355-356 Scoliosis = curvature of the spine, e34, e133 Chap 21; and reduction of dose, 134-135, 293, 366 Scott (David) 1994, radn sensitivity, 371 Segal (A.J.) 1982, on dose-reduction, 372 Seidman (Herbert) 1987, on BCDDP, 173 Self-published reports, 304-305 Self-suggestion among physicians? Asthma radiation therapy, 115 Comment (1993) by Lancet editors, 371 Dermatology, 220, 221, 232-233 "Strange to say...too optimistic," 232-233 "Unverified...marvelous results," 224 "Extraordinary capacity" for self-delusion, 371 Pharmacologic therapies, 233 Thymus enlargement, 49, 52, 85, 221 Shadow: mediastinal. SEE "Mediastinum" Shadow: thymic. SEE "Thymic shadow" Shapiro (Jacob) 1990 book: On dose-rate and flux, 130 Quoting Blatz 1970, well-baby fluoroscopy, 145 Quoting Braestrup 1969, on fluoroscopy, 143 Sharp (Chris), NRPB critique of this book, 330-344 Shelf: cancers put on shelf, for delivery later, e19 Relation with Master Table, e64 Reminders, 164, 175 Shielding body-parts from x-rays, 127, 138, 230, 346, 365, 366 Shleien (B.) 1977, rate of diagnostic x-rays, 143 Shoe-fitters (fluoroscopes), 165-170, 300 Doses to feet, 166; Doses to breasts, 169 Shope (Thomas B.) 1994, excellent work, 184 Shore (Roy E.) 1977, acute mastitis, 93 Shoulder, x-ray exam, 151, 153 Shoulder pain, treated by radn, 248, 254, 262 Shrivastava (P.N.) 1980, on dose-reduction, 372 Sievert: equivalent to 100 rems, e11 Significant figures vs extra digits retained, 276 Not "rounded-off," 268, 285 Simpson (C. Augustus) 1920, on thymus irradn, 132 Simpson (C. Lenore) 1957, maybe no 1000-R threshold for human carcinogenesis, 160 Sinclair (Warren) 1985, on x-ray/gamma potency, 337 Single-cell origin of cancer, 324, 325, 328 Single-track potency, 319, 324, 325, 326, 327 Sinusitis, treated with radiation, 96 Six-fold higher risk, Nova Scotia, 313, 337, 342 Skiagram = early term for x-ray picture, e39 Skin unit = dose of 300 R (erythema dose), 227 At about 60 KeV, 227 Dose-levels which injure skin, 185-186, 193 Skin as "personal monitor" of dose, 143, 144 SEE also "Dermatology" Skolnick (Andrew) 1995, 312, 315, 316, 317 Slesin (Louis) 1994: EMFs and breast-cancer, 6, 304 Slow dose-rates of radiation, 12, 33, 336, 337 Slowest possible rate, 318, 323, 326 Small numbers problem, e9; 87 Smith (Lawrence W.) 1925, on whooping cough, 121, 123 "Smoking gun," evidence on x-ray causation, 310 Specific = a remedy which is uniquely and consistently effective (example: insulin for diabetes mellitus), 42, 54 Speculation versus fact: Radn-induction of breast-cancer NOT speculative, 2-4, 30, 261, 289, 333 Radn-induction of genetic lesions NOT speculative, 10, 292, 324, 327-328 Spies (James B.) 1993, fluoroscopic over-dosing, 216 Spontaneous cancer rate (meaning), e10 Part of it is from radiation, 10, 282, 286-287 Variation between countries, 280-281 Spratt (John S.) 1995, 333 Stanton (R.) 1983, on dose-reduction, 372 Statistical Abstract of the USA, 139, 302 Statistical power, e12 Status lymphaticus (first mentioned 34 & 38): And Paltauf, 38, 40, 68 Association w sudden death, 65, 66, 68, 75 Described 1914 by Gwathmey, e67-68 Described 1924 by Kerley, e45 Relation to enlarged thymus, 40-1, 46, 64, 66, 78 Relation to sudden death, 47, 65, 66 Syndrome challenged, 50, 66 Steindler (Arthur) 1942, on scoliosis, 133-136 Sterility from radiation exposure, 224 Sternglass (Ernest) on nuclear pollution, 346 Stewart (Alice M.), 304 1956, 1958, 1970 papers on very low doses, 321 Stochastic health effects = effects whose probability (not degree of severity) is related to dose. Examples: Radn-induced cancer,inherited mutations. Stray radiation: Braestrup measurements, 200 Stridor = high-pitched respiratory sound, e38 Strontium-90: radiological half-life = 27.7 years Suberythema dose = dose below 300 Roentgens Sudden death in infancy & childhood: 44, 45, 65-71 Cases without anesthesia, 66, 68 Blamed on thymus, 40, 45, 46, 47, 48, 50, 65-71 Claim that thymus NOT to blame, 85 Sudden death (unexplained) among adults, 68 Suleiman (Orhan) 1992, on film-processing, 367, 368 Sulfonamide pharaceuticals, 91, 245 Failure in some pneumonia cases, 117 Sulzberger (Marion) 1952, safety claim, 222, 223 Sunbath (false comparison with x-rays), 296-297, 374 Sun (F.) 1985, paper in the Chinese language, 372 Superficial x-ray therapy, 219, e222-223 Dermatology: superficial x-rays "customary," 222 Energetic enough to reach breast-tissue, 223 SEE also next entry Super-soft x-rays = grenz rays, e221 Different from "superficial" x-ray therapy, 219 Suppuration = formation and discharge of pus, 96 Supra-linear dose-response, described, e33, e57, e336 Adjustment downward of doses, 58 (box, Col.C) Breast-cancer, 313, 336 Declining per-rad effect, 58 (box, Col.B) Discussion, 32, 57-58, 313, 336 Supra-linear curve depicted, 277 Surgery, catheterization & fluoroscopy, 183-187 SEE also "Pre-surgical irradiation" Swift (Michael) 1991, on ca-risk & one AT gene, 181 Syllabus for radiology students, 317 Synergy of carcinogens, e284, 313, e350, e351 SEE also "Co-action" "Synthetic" calendar-year, 55, 63 ===================================================== o -- "To people who don't know history, every idea seems new!" -- Dr. Thomas Sowell, contemporary economist and educator, Hoover Institute. ===================================================== T Table 1, located at page 377. Table 2 at 378. Taft (Robert) 1943, on unqualified use, 187, 203-204 Tamplin (Arthur R.) 1970, in the Lancet, 4, 175 Taylor (Howard) 1938, on chronic mastitis, 99, 100 Taylor (Kenneth) 1979 & 1983: How to reduce doses in roentgenography, 293-294, 299 How to reduce doses in fluoroscopy, 214-216 Taylor (Lauriston), improper usage of x-rays, 365 TB = tuberculosis "Technological imperative," 1, 165, 170 "Act now, think later," 172 Author is a technology enthusiast, 172 But urges SLOW introduction, if there is a biological impact, 32, 225 BCDDP mammography proposal, 175 "Expose now, regret later?" 170 "First use, then learn," 199 Technology "buffs" often assume safety, 171 Or that benefits far exceed health-price, 300 Wisdom of Buschke + Parker, 197 SEE also "Ignorance (pre-1965)" Tendonitis, treated with radiation, 247, 248 Textbooks in medicine, influence of, 45 Thermo-Luminescent Dosimeters (TLDs), 298, 369, 370 "Thing speaks for itself," 193 Thompson (Desmond) 1994, A-Bomb Study, 4, 14, 277, 278-279, 290, 313, 334 Thoracic (thorax) = chest, 43, 69 Thoracic spine x-ray exam, 151, 153 Threshold dose. SEE many entries under "Safe dose" Thymic death, 40, 47, 66, 85 "One of the supreme tragedies of surgery," 1926 Mosher, 65, 75, 77 "A surgical tragedy," 1929 Perkins, 46 Thymic shadow = shadow cast by a large thymus on x-ray picture or screen, 42, 52, 64, 66, 70, 73 Thymus = a gland lying under breast plate, e32, e37 1929: "Popular subject for discussion," 67 1932: and "youthful appearance," 126 "Thymus conscious" public, 44 "Thymus phobia," 44 SEE additional entries below Thymus irradiation: six chapters (pp.37-86). Also used for thyroid cases (126, 127, 132 "massive doses") and sometimes psoriasis (232) Benefit to patients, (39-40 Lange), (42 Pfahler), (42, 53, 263 Grier), (47 Conti + Patton), (51 Donaldson), (53 Remer), (69 Perkins) "Brilliant results" (Pfahler) 42 Debate about pressure: See "Pressure" (earlier) Doubts and criticisms, 66, 83, 84-85 "Dramatic" relief (Fisher), 54 Entrance dose typically ~100-400 Roentgens, 51, 72, 76, 83 Comparison with Hiroshima-Nagasaki doses, 83 "Happy results" (Perkins), 69 Holding of babies during x-ray therapy, 236 "Miraculous" relief (Fisher), 54 "Nearly all infants are x-rayed promptly," 67 "Profound influence" (Lange), 40 Prophylactic pre-surgical use, 32, 45, 46, 52, 64, 65, 66, 71, 74, 75-82 Prophylactic use on children, 42, 53, 64, 65, 67 Prophylactic use on newborns, 44, 51, 53, 60, 67 "Rapid improvement...astonishing," 236 Rush to judgment about thymus irradn, 85 Stopped due to antibiotics, 84 Stopped due to radn-induced thyroid cancer, 84 Therapeutic trial: (obscure cases, 41 + 54), (worried parent, 44 + 60) What happened later? SEE References, "Hildreth" SEE also "Enlarged thymus" and "Thymus-size" Thymus-size: Normal size (controversy), 44, 47, 49, 84 Change in size observed after x-ray, 47, 52, 54, 70, 76, 77, 83, 84, 126 Criteria for "enlarged," 65, 76 Reasons for various sizes, 40, 44, 48, 49, 70, 84 Re-growth of gland after irradiation, 41, 70 SEE also "Enlarged thymus" Thyroid cancer, radiation-induced, 84 Thyroiditis, treated with radiation, 251-252 Tinea capitis = ringworm of the scalp, 227 TLD = Thermo-Luminescent Dosimeter, 298, 369, 370 Tokunaga (Masayoshi), analyst at RERF: 1993, paper with Land, 12, 13 1994, A-Bomb Study, 4, 8, 14, 16, 17, 18, 289, 334 "Tolerance dose." SEE "Occupational radn dose" Tonsillectomy & thymus irradiation: 77-79. Also: 32, 45 "Tonsil age-years," 76, 79 SEE also "Pre-surgical irradiation of thymus" Too young to remember, 7 Trachea = "windpipe" from larynx to bronchi, 43 Track (ionization), 314, e318, e323 Single-track potency, 319, 324, 325, 326, 327 Table relating tracks to rads, 319 Cobalt-60 estimate, 323-324 Trailing digits (unseen) make sums look "off," 150 Transport of risk-values from Japan to USA, 280-282, 313, 333, 335, 338-339, 342 "Troublesome trio" (repair of genetic molecules), 322 Affirmation of "troublesome trio," 326, 327, 328 Trust of patients needs earning, 313, 366, 369, 374 Truth, comment by Orville Wright, 301 Truth, stages of reception (Schopenhauer), 352 Tuberculosis (non-pulmonary), 163, 225 In lymph glands: treated w radn, 243, 246, 262 Neck, abdomen, joints: radn response, 225, 246 Tuberculosis (pulmonary): Detroit experience, 105-109 Pneumothorax therapy, 3, 105+, 311, 320-321 Nova Scotia, dose (263) and results (321) Nova Scotia shows high risk/rad, 313, 337, 342 Pre-employment screening, 189-190, 261-262 Radiation therapy ineffective, 224 Reminder: serious menace in the past, 189, 191 Could become serious again, 255 San Francisco mass screening, 111-112, 193 Tyndall (D.) 1987, on dose-reduction, 372 ===================================================== o -- "When you come to a fork in the road, take it." -- Yogi Berra, famous American baseball player. ===================================================== U UCSF 1995, on number of mammograms per year, 355 Ulcers, treated with radiation, 250-251, 252-254 Ultra-violet radiation, 297 "Unbelievers" in harm met by Buschke/Parker, 196-197 Unintended consequence: breast-ca, 31, 86, 225, 254 Need to allow for nasty surprises, 197 United Nations Scientific Com'tee. SEE "UNSCEAR" Unqualified users of x-ray equipment, described: 254 1922 Hazen: physicians rushing to buy x-ray, 163 1923 Hickey: internists can now afford small fluoroscopes, 207 1925 Pfahler: "untrained enthusiasts" lacking "mental equipment," 206 1930 Hazen: beauty-shop operators, 163-164 1931 Haenisch: "incompetent, dishonest" "inexperienced," 218, 242 1936 Leddy: "good strong dose" from the clerk, 202 1937 Leddy: more use by non-radiologists than by radiologists (p.201, 205), especially by surgeons & general practitioners, 201, 203 1937 Leddy: "indiscriminate, careless, indifferent, even ignorant use," 201-202 1938 MacKee: some young dermatologists, 220 1938 MacKee: "Radiomaniacs," 224 1938 MacKee: "Unscrupulous...careless," 225 1942 Buschke/Parker: some pediatricians, 195-196 1942 Buschke/Parker: some radiologists, 195 1942 Braestrup: some surgeons, 199 1943 Taft: physicians "fooling" with x-rays "without knowing what they are doing," 203 1943 West: "Increasing number... who do not appreciate the dangers," 204 1993 Greer: "Lack of training," 216 1994 FDA: fluoroscopes in non-expert hands, 184 1995: use continues in non-radiologic offices, 184, 216, 295, 299 Advertisement: nurse w toe on foot switch, 204 "Doing a little x-ray work," 201, 203 Pressure to sell x-ray equipment to all, 206, 242 Story of the surgeon & the dentist, 203 Unrecorded doses. SEE "Non-recorded radiation doses" UNSCEAR = United Nations Scientific Com'tee, e18, 171, e304-305, e317 Membership: from the radiation community, 171, 323 UNSCEAR 1977 report: On breast-irradiation while young, 18 On dose from heart/vessel exams, 214 On mammography, 171-172 On nuclear weapons fallout, 161, 162 On number of medical workers, 158, 159 UNSCEAR 1993 report: On safe-dose issue, 317, 323-326 On uncertain fluoroscopy doses, 360 On x-ray overdoses, Chap 48 (Part 3), + 371 Feasible to cut doses in half, 368, 371 On x-ray usage-rates, Chap 48 (Part 3) "Significant radiological impact," 317, 368 UNSCEAR 1994, uncertainty on fluoroscopy-doses, 188 1994-b, adaptive cellular responses to radn, 326 Unverified accounts of marvelous results (MacKee) Upper gastro-intestinal exam, 149, 153, 314, 360 Upper spine x-ray exam, 151, 314, 360 US Dept. of Health and Human Services, National Action Plan on Breast Cancer, 303, 381 USDHHS 1993, br.canc. mortality by age, 347-348 USSR, high usage of x-rays, fluoroscopy, 364, 371 o ================================================= V VanZwaluwenberg (J.G.) 1920, urges fluoroscopy, 210 Variation in dose for same x-ray exam, 291, 292, 343, 363, 364, 366 Vaughan (Henry) 1933, on tuberculosis, 108 "Verboten" subject (radn for chronic mastitis), 98 Vetter (R.J.) 1991, on dose from CT scans, 356 Vigilance required: "Deja vu all over again" (Yogi Berra), 216 Source of the most intense, enduring concern, 226 To control careless, over-enthused radn-users, 225 To keep a good radiologic office good, 298 To know when to say "no" to proposed use, 171 To prevent fluoroscopic overdosing, 187, 216-217 To prevent unnecessary occupational doses, 158 To prevent repetition of radiation over-use, 226, 255-259, 299 To "think first, expose later," 171 Who cares to prevent breast cancer? 226, 299, 314, 369, 374 Villains, none, 1 Viruses, as carcinogens, 5, 6 Vitro, Vivo: see In vitro and In vivo. VonBecterew's Disease, 247 vs = versus o ================================================= W Wagner (R.S.) 1976, on dose-reduction, 372 Wanebo (C.K.) 1968, radn-induced breast-ca, 4, 175 Wappler fluoroscope, 143, 144, 193, 204 Ward (John F.) 1991, case against threshold, 293 1991-a, on DNA damage and repair, 327 Warf (James C.), author All Things Nuclear, 304 "War on Cancer," 175 Wasson (W.W.) 1925, infant chest exams, 210-211 "Wasted radiation," e141, 146, 147, 254 "Watchdogging" x-ray frequency & doses, 171, 299-300 SEE also "Vigilance required" Wavelength: Relation with photon-energy, 221-222 Weapons-testing: fallout, 35, 161-162, 299 Webster (Edward) 1984, on mammographic doses, 171 Webster (J.H.D.) 1928, on chronic mastitis, 99 Well-baby check-ups with fluoroscopy, 116, 124, 194-198, 205, 261, 300, 315 Dose estimates, 145, 154 Non-recording of exposures, 145 Parents insist, 116, 145, 194, 205 West (Theodore) 1943, on unqualified users, 205-204 Weyde (Rolf) 1944, on chronic mastitis, 99 WHO = World Health Organization, United Nations, 281 Whole-body dose vs partial body, e12, e83-84, 356-7 Clinical symptoms at ~50 rads whole-body, 111 Whooping cough treated with radn, 32, 121-123 Wiatrowski (W.A.) 1983, on dose-reduction, 372 Williams (Alden H.) 1932, thyroid radiotherapy, 126 Williams (Charles R.) 1949, shoe-fitter, 165, 167-168 Williams (Francis H.) 1928, rate of tonsillectomy, 79 Wilson (T. Woodrow), and borrowing brains, 272 Wind in the Willows, comment by author, 382 Win-win advice from FDA, 184 Wise (Fred) 1938, with MacKee, 227, 231, 232 Wishful thinking, 165, 217, 233, 254, 293, 369 WIXMEASE = Women's Indep. X-Ray Measurement Svs, e369 Wochos (J.F.) 1977, diagnostic x-rays, 292 Women's Independent X-Ray Measurement Svs, 369-370 World Almanac 1991, edited by Mark S. Hoffman, 56 "Worst possible outcome" on this subject, 30 Wright (Charles J.) 1995, critic of mammography, 355 Wright (Orville), on reception of truth, 301 ===================================================== o -- "A hundred times every day I remind myself that my inner and outer life depend on the labours of other men, living and dead, and that I must exert myself in order to give, in the same measure as I have received." -- Albert Einstein, 1879-1955, Nobel Laureate in Physics, 1921. ===================================================== XYZ X-rays: ionizing radiation, e2, e235, e318, e323 1895 was year of discovery, 1, 29, 75 Use in medicine. SEE "X-rays: Medical" below Energy of medical x-rays vs A-bomb, 13, 84, 278 Energy of medical x-rays vs natural, 63 Energy of shoe-fitter machines (50 kv tube), 166 Energy of superficial x-rays, 60-100 kv, 222 Grenz rays (super-soft x-rays), e221 Average energy 6-10 KeV, 221 Harm per rad: x-rays vs gammas, e11, 13, 83-4, e235, 278, 337-338 (references), 339, 341 SEE also index-entry for "LET" X-rays: Medical Usage Advice of American Cancer Society, 257, 375 Advice of National Cancer Institute, 138 Advice of UNSCEAR 1993, 368-9, 375 How x-rays differ from nuclear medicine, 259 Manufacturers push x-ray machines, 206, 242 Patients and referring physicians don't know the doses, 171, 291, 297, 370. A solution, 369-370 Rate of diagnostic exams post-1964 rising, 256, 300, Chap 48 (Part 2) The X-Ray Effect (1995 TV program), 306, 307, 331 SEE also: "Aggregate impact" "Benefits of radn in medicine" "Danger (potential danger) of x-rays" "Fluoroscopy" (3 sets of entries) "Overdosing in current medical x-ray usage" "Reduction of doses" (3 sets of entries) "Unqualified users" Yoshimoto (Yasuhiko) 1988 + 1994, prenatal irradn, 87 Young: duration of radiation effect, 8, 30 Evidence not yet complete, 282, 289 Young: most sensitive to radn, 3, 18, 33, 267, 289 Zero (age-0) = birth to first birthday, 14, 30, 56 # # # # #