Implications of extracapsular nodal metastases for treatment and prognosis of breast cancer.

Background: Extracapsular extension of nodal metastases from cancer of the breast is a frequent histologic finding, but its significance for prognosis and treatment is unclear.

Methods: One hundred forty-three patients with breast cancer who had metastases to axillary lymph nodes were identified and divided into two groups: those with entirely intracapsular metastases (ICM), and those with extracapsular metastases (ECM).

Results: ECM was found in 58.

Acetic acid visualization of the cervix to detect cervical dysplasia.

Objective: To determine whether acetic acid visualization of the cervix can identify cervical dysplasia and improve detection of lesions missed by Papanicolaou test screening.

Methods: During a 2-year period, patients attending family planning clinics for regular gynecologic examinations had acetic acid applied to the cervix, followed by gross visualization without magnification. Patients with suspicious acetowhite lesions and normal Papanicolaou tests were referred for colposcopic evaluation.

An investigation of colon cancer associated with urinary diversion.

The mechanism by which ureterocolic anastomoses promote cancer of the colon is uncertain. To investigate the role of anastomotic healing, rats were exposed to the colon carcinogen azoxymethane after which they had either 1) a sham operation, 2) colotomy with suture, or 3) colovesical anastomosis, performed randomly. The first two groups had an equally low frequency of colon cancers, whereas rats with colovesical fistulas had a significantly higher frequency, and cancers were concentrated at the anastomotic site.

Propionibacterium avidum as the etiologic agent of splenic abscess.

Propionibacterium avidum was isolated from an intrasplenic abscess in a patient recovering from coronary artery bypass surgery. This organism has not previously been reported as an etiologic agent of splenic abscess nor has splenic abscess been described as a complication of coronary bypass surgery. This report emphasizes the potential pathogenicity of normal microbial flora following surgical manipulation.

Manifestations of pseudoxanthoma elasticum during pregnancy: a case report and review of the literature.

A 30-year-old white woman with pseudoxanthoma elasticum (PXE) was followed throughout her pregnancy with several fetal ultrasonographic examinations and other diagnostic studies; these showed normal development up to the 26th wk and then a marked deceleration of fetal growth. The ultrasonographic appearance of the placenta was abnormal at all times probably related to the microscopic changes. The baby, born at 36 wk, showed severe intrauterine growth retardation as a probable consequence of the abnormal placenta detected by ultrasound and corroborated at birth.