SUMMARY Serum concentrations of fucose, sialic acid, and eight acute phase proteins were measured in single specimens from patients with cancer in order to determine whether the raised concentrations of protein bound sugars commonly found in cancer correlate with increased concentrations of the acute phase proteins. Strong positive correlations were found only with a,-acid glycoprotein, ai-antitrypsin, and haptoglobins. Changes in protein bound sugars and acute phase proteins were also examined in relation to patients' disease states. Serum fucose was raised more often in patients with advanced disease than in those in whom the spread of the tumour was more restricted; increased sialic acid concentrations, however, were found with a similar frequency in both these groups. Combined use of fucose and sialic acid values gave a high degree of marker positivity which could be only slightly improved on . The latter were either in hospital or attending outpatient clinics. Some were already receiving treatment and others had yet to start. Serum was separated by centrifugation and stored at -20°C until required for assay.

Background The goal of this study was to evaluate the effect of regional anesthesia using paravertebral block (PVB) on postoperative pain after breast surgery. Methods Patients undergoing unilateral breast surgery without reconstruction were randomized to general anesthesia (GA) only or PVB with GA and pain scores assessed. Results Eighty patients were randomized (41 to GA and 39 to PVB with GA). Operative times were not significantly different between groups. Pain scores were lower after PVB compared to GA at 1 hour (1 versus 3, p=0.006) and 3 hours (0 versus 2, p=0.001), but not at later time points. The overall worst pain experienced was lower with PVB (3 versus 5, p=0.02). More patients were pain free in the PVB group at 1 hour (44% versus 17%, p=0.014) and 3 hours (54% versus 17%, p=0.005) postoperatively. Conclusions Paravertebral block significantly decreases postoperative pain up to 3 hours after breast cancer surgery. Summary This paper reports on the findings from a prospective randomized trial of paravertebral block (PVB) for breast surgery. Paravertebral block significantly decreased postoperative pain up to 3 hours after breast cancer surgery.

: The continuous infusion pump system appears to be a safe and effective method for postoperative donor-site pain management in TRAM flap breast reconstruction patients and should be considered for postoperative donor-site pain management. However, continuous infusion pump local anesthetic delivery to the muscle-sparing TRAM flap donor site did not eliminate narcotic use for pain control.

Therapeutic, II.