Isolated breast metastases from gastrointestinal carcinomas: report of two cases.

Two patients with metastatic gastrointestinal adenocarcinoma in the breast are reported. Metastases in the breast are usually painless upper outer quadrant masses. On mammography they are typically well-circumscribed lesions without microcalcifications.

The early diagnosis of impending premature labour.

Early diagnosis of impending premature labour offers the possibility of early and effective tocolysis. This paper reviews recent work which has suggested that excessive uterine contractility or early cervical dilatation during pregnancy would provide this early diagnosis. Since marked uterine contractility and cervical dilatation can occur in pregnancy which proceeds to term, however, these features may not be specific enough predictors of preterm labour for clinical use.

Prostaglandin E production by the fetal membranes in unexplained preterm labour and preterm labour associated with chorioamnionitis.

The production of prostaglandin E (PGE) by amnion, choriodecidua and placenta was measured in 45 women delivered after spontaneous preterm labour, in 10 women delivered electively preterm, in 30 women at elective caesarean section at term, and in 28 women after spontaneous labour at term. In the preterm labour group 24 women had normal placental histology, and gestational age was 34 (31-36) weeks (median and range); 18 women had evidence of chorioamnionitis and gestational age was significantly shorter, 30 (24-36) weeks; three other patients had placental abruption. In the absence of inflammatory infiltration of these tissues the highest PGE output (fmol/mg dry weight/2 h) was found after labour at term and the lowest after uncomplicated preterm labour: 2640 (360-15,580) (median and range) compared with 1414 (164-11,045) in amnion, 677 (100-3245) compared with 308 (39-1086) in choriodecidua, and 1200 (520-3022) compared with 578 (150-1859) in placenta, respectively.

Diagnosis of recurrent upper gastrointestinal cancer at the surgical anastomosis by endoscopic ultrasound.

Endoscopic ultrasonography (EUS) with a 7.5 MHz transducer was used to examine the upper gastrointestinal tract in 40 patients who had resection of esophageal or gastric cancer, and symptoms suggesting recurrence. There were 24 patients with recurrent cancer in the area of the surgical anastomosis (based on endoscopic biopsy in 16, repeat endoscopy in 2, and surgery after negative endoscopy in 6), and 16 patients without anastomotic recurrence.

Managing gynaecological emergencies with laparoscopy.

A consecutive series of 49 women (50 procedures), whose conditions were haemodynamically stable, presenting with acute lower abdominal pain, pelvic tenderness, and either a urine concentration of greater than 50 U/l beta human chorionic gonadotrophin or a pelvic mass shown by ultrasonography were treated with operative laparoscopy under video monitoring (videopelviscopy) as an alternative to laparotomy. Ectopic pregnancy, ovarian and non-ovarian cysts, pelvic adhesions, endometriosis, and fibroids were found, for which salpingotomy, salpingectomy and salpingo-oophorectomy, cystectomy, adhesiolysis, thermocoagulation, and myomectomy were carried out by laparoscopy. In one patient pelviscopy was repeated because of persistent tubal pregnancy after the fimbria was expressed.

Fetal heart rate accelerations in second-stage labour; two case reports.

Two cases of umbilical cord compression are reported in which variable decelerations in the fetal heart rate in the first stage of labour progressed to marked periodic accelerations in the second stage. A respiratory acidosis was present at birth in both cases.

Spontaneous gastroduodenal perforation in cancer patients receiving cytotoxic therapy.

Spontaneous gastroduodenal perforation (SGDP) occurs in cancer patients receiving cytotoxic drugs, corticosteroids, or radiation therapy as primary or adjuvant treatment for their tumors. A retrospective review identified 12 patients from 1974 to 1987 at the Memorial Sloan-Kettering Cancer Center who underwent surgery for SGDP while receiving anticancer therapy. There were five gastric and seven duodenal perforations.

The fate of femoral windows in revision joint arthroplasty.

We retrospectively reviewed the radiographs of twenty patients in whom a window in the femoral cortex had been created to facilitate revision of a failed total hip replacement with a non-cemented prosthesis, to determine if the window had healed and, if so, how long it had taken. All but three windows showed clear evidence of healing three months postoperatively. At six months, only two windows remained radiographically visible, and at eight months, all of the windows had healed.

Transcervical resection of endometrium in women with menorrhagia.

As an alternative to hysterectomy 16 women with menorrhagia were treated with hysteroscopic transcervical resection of the endometrium with an unmodified urological resectoscope. Twelve patients requested total resection of the endometrial lining with the intention of producing amenorrhoea, and four chose partial resection and hypomenorrhoea. Surgery was completed successfully in 15; the remaining woman, who had an acutely retroflexed uterus, sustained a uterine perforation during insertion of the rigid hysteroscope.

Are leukotrienes involved in human uterine contractility?

The effects of leukotrienes (LT) on the contractility of human and rat myometrial strips in vitro were compared with the effects of prostaglandins (PGs) and oxytocin. Preparations of human myometrial membranes were investigated for the presence and characteristics of LTC4 receptors. Neither the peptido-leukotrienes (LTC4, LTD4, LTE4) nor LTB4 had any consistent effect, stimulatory or inhibitory, on human pregnant or non-pregnant myometrium, at doses up to 1.

Results of surgery for obstructing carcinomatosis of gastrointestinal, pancreatic, or biliary origin.

Results of operation for obstructing carcinomatosis of gastrointestinal (GI), pancreatic, or biliary origin were reviewed to assess relief of symptoms, management of re-obstruction, and duration of hospitalization. A retrospective review (1977 to 1986) identified 89 patients, 59 (66%) of whom had tumors originating in the colon, and 19 (21%) in the stomach. Normal bowel function was restored for a median of 102 days in 66 patients (74%) and all but four (94%) were discharged.

The Journal of clinical Investigation, Volume 41, 1962: iron absorption. IV. The absorption of hemoglobin iron.

The absorption of radioiron in rabbit hemoglobin, hemin, and ferritin has been compared to that of ferrous salt in healthy volunteers and in subjects with iron-deficiency anemia. At a dosage level of 5 mg elemental iron, hemoglobin iron was as well or better absorbed than ferrous salts in the normal subject. Absorption of hemoglobin iron increased less, however, in the iron-depleted or iron-deficient subject.

Experimental pancreatic cancer in the Syrian hamster: effect of cholecystectomy.

Because cholecystectomy stimulates hypertrophy and hyperplasia in the hamster pancreas, its effect on experimental pancreatic carcinogenesis was studied in this animal model. Forty female Syrian hamsters underwent cholecystectomy, while 40 others underwent sham operations. Two weeks later, 30 hamsters undergoing cholecystectomy and 30 hamsters undergoing sham operations received 4 weekly subcutaneous injections of N-nitroso-bis (2-oxopropyl) amine (BOP) (10 mg/kg).