Factors influencing a woman's choice to undergo breast-conserving surgery versus modified radical mastectomy.

Background: The use of breast-conserving surgery (BCS) rather than modified radical mastectomy (MRM) for the treatment of breast carcinoma is an option for the majority of women (75%) with early stage breast cancer, but only 20% to 50% choose to undergo this procedure nationwide. The objective of this study was to identify factors influencing a woman's choice between BCS and MRM, and specifically, the surgeon's influence on this choice.

Methods: A total of 134 women eligible for BCS were sent a survey.

Seroma formation after breast cancer surgery: incidence and predicting factors.

The pathophysiology of seroma formation has yet to be determined. Therefore, the present study was undertaken to calculate the incidence of postoperative seromas after definitive breast cancer operations utilizing electrocautery dissection. Additionally, we attempted to identify risk factors associated with seroma development and to examine seroma formation in relation to operative procedure.

Laparoscopic cholecystectomy in a freestanding outpatient surgery center.

Laparoscopic cholecystectomy in a freestanding outpatient surgery center was evaluated. Fifty-five patients undergoing laparoscopic cholecystectomy during a 10-month period from December 1992 to October 1993 were included in this study. There were 10 males and 45 females, with a mean age of 42 years.

Laparoscopic cholecystectomy in a private community setting.

In order to evaluate early results and safety of laparoscopic cholecystectomy in community hospitals, the charts of 380 consecutive patients, scheduled between February 8 and November 28, 1990, were reviewed. There were 294 women and 86 men, with a mean age of 48 years. Forty-one patients required conversion to open cholecystectomy, for reasons including adhesions in 18 patients, intraductal filling defects in 11, marked inflammation in 6, excessive bleeding in 3, poor visualization of the operative field in 2, and gangrenous gallbladder in 1.

New options for treating gallstone disease.

Gallstone disease is a major health problem in the United States and in most Western countries. During the past century, cholecystectomy has been the treatment of choice. Recently, new modalities of treatment have been developed, including oral dissolution therapy, extracorporeal shock-wave lithotripsy, percutaneous transhepatic cholecystolitholysis using methyl tert-butyl ether, and laparoscopic cholecystectomy.

Molecular orbital calculations of proton transfer energetics in model systems: the interaction of opiate agonists and antagonists with opiate receptors.

Semiempirical (CNDO) molecular orbital calculations, based on a previously investigated morphine-receptor clastic-binding system, were performed using a series of ethyl and propyl amines as models for the analgesic receptor. Trimethyl and dimethyl amines were chosen to represent the opiate and noropiate agonist molecules. The opiate antagonist molecules, levallorphan, naloxone, nalorphine, and pentazocine were represented by a series of allyl and dimethylallyl amines.

Molecular orbital calculations of proton transfer involving amines as models for the clastic binding of opiates with their receptor.

Semi-empirical (CNDO) molecular orbital calculations, based on a previously reported ammonia-amine model system, were performed on an extended series of methyl-, ethyl-, and propylamines as models for the analgesic receptor. Methyl-, dimethyl-, and trimethylamines were chosen to represent the opiate molecules. Interatomic distances were varied within normally expected biological values.

Incidence and associated mortality of retained common bile duct stones.

A hundred consecutive patients who underwent cholecystectomy and exploration of the common bile duct were studied. The traditional indications for exploration resulted in a yield of 55 percent positive explorations. There were nine patients with retained stones, three of whom died.

Synthesis and bioevaluation of a series of fatty acid esters of p-[N,N-bis(2-chloroethyl)amino]phenol.

A series of even numbered fatty acid esters (C2-C18) of p-[N,N-bis(2-chloroethyl)amino]phenol were synthesized and evaluated as to acute toxicity as well as effectiveness against L-1210 mouse leukemia. The acetate through the decanoate derivatives demonstrated toxicity between 2 and 3 times that of phenol mustard in HA/ICR mice. The less soluble laurate, myristate, palmitate, and stearate derivatives were less toxic.

Synthesis and bioevaluation of a series of alkyl ethers of p-N,N-bis(2-chloroethyl)aminophenol.

A series of even numbered normal alkyl ethers (C2-C14) of p-N,N-bis(2-chloroethyl)aminophenol were synthesized and evaluated as to acute toxicity in mice and effects on survival in L-1210 leukemic mice. All of the ether derivatives demonstrated significantly lower acute toxicity than the parent phenol mustard. Significant survival times (greater than or equal to 125%) were obtained with all compounds except the hexyl derivative.

Interaction of L- and D-3-amino-1-chloro-2-pentanone with gamma-glutamylcysteine synthetase.

The optical isomers of 3-amino-1-chloro-2-pentanone, which are the alpha-chloroketone analogs of L- and D-alpha-aminobutyrate, were synthesized and found to be highly potent irreversible inactivators of gamma-glutamylcysteine synthetase. These chloroketones are 20 to 30 times more active than L-2-amino-4-oxo-5-chlorpentanoate. L- and D-Glutamate, in the presence of Mg2+ or Mn2+, protect the enzyme against inactivation.