Various histologic factors correlated to survival were studied in 124 patients radically operated on for rectal carcinoma in order to establish valid prognostic criteria. The total survival rate after five years was 63 percent, while in stage B1 it was 89 percent, in B2, 61 percent, and in C1, 47 percent (P less than 0.05). With regard to histotype, the survival was 83 percent in the papillary subtype of adenocarcinoma, while in the tubular subtype it was 62 percent, and 29 percent in the mucinous type (P = not significant). Vascular invasion negatively affected survival (41 percent); however, when there was no invasion, the prognosis was better (71 percent) (P less than 0.01). In evaluating histologic grading and lymphoglandular reactivity, the difference in survival rates was not statistically significant. The marked peri- and intratumoral lymphocytic infiltration gave a very good prognosis (92 percent) contrary to when reactivity was moderate (59 percent) or even absent (51 percent) (P less than 0.01). Finally, the expanding type tumor, with reference to Ming's classification of gastric carcinoma, had a much better prognosis (75 per cent) than the infiltrative type (40 percent) (P less than 0.01).

The papillotomy knife, introduced by an endoscope, was employed to treat stenosis following stapler anastomosis, and to cut the stenotic ring in three points along its circumference.

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A 25-year-old patient, with multiple pulmonary metastases from osteogenic sarcoma who two years ago developed respiratory failure with unilateral left lung involvement and was successfully treated with independent lung ventilation, was readmitted to an ICU with recurrent unilateral lung disease. Conventional therapy failed to reverse the respiratory failure; independent ventilation temporarily improved the patient's oxygenation. At autopsy, different involvement of the two lungs by the tumor was evident so that blood flow of the right lung and lymphatic flow of the left lung were impaired. When respiratory failure unresponsive to conventional therapy develops, anatomical abnormalities should be considered.

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