No abstract

Over a 10-year period, systematic bi-annual esophageal endoscopy uncovered metachronous esophageal tumors in 3.2% of 1560 patients originally treated for head and neck carcinoma, developing in a median time of 47 months. Patients with initial oropharyngeal tumors had a significantly higher risk of metachronous esophageal SCC, compared to the other tumor sites (P < 0.02 with Fisher exact test). Given the elevated death rate not related to the esophageal cancer and the median survival of 16 months, any potential benefit from this time-consuming procedure is debatable.

No abstract

The biliary excretion of cephalothin has been studied both by perfusion of isolated rabbit livers and during biliary drainage in the human. In the perfused rabbit liver, cephalothin added to the circulating blood is partly eliminated in the bile where the antibiotic activity is similar to that of the serum. Following a single injection of 1g to 10 cholecystectomized patients, the maximal concentration in the bile collected by external drainage reached after 1–3 h an average of 15.5μg/ml. Simultaneous determinations showed higher levels of cephalothin concentration in the gallbladder bile than in the common duct bile. In two patients with impaired renal function, cephalothin concentration in bile obtained by duodenal drainage was found to be more elevated than in five normal subjects. Biliary elimination of cephalothin appears to be sufficient to justify the use of this antibiotic in the treatment of biliary tract infections.

Rectal endoscopic lymphoscintigraphy was performed in 10 control subjects and in a series of 85 patients with adenocarcinoma of the rectum as a prospective study to evaluate lymphatic drainage of the rectum and lymphatic spread in rectal cancer. Complete cranial drainage was demonstrated in all control subjects, and internal iliac nodes were also visible in 50 percent of cases. Results were correlated with histologic node examination in all patients operated upon for rectal cancer. Rectal endoscopic lymphoscintigraphy was assessed for sensitivity (85 percent), specificity (68 percent), overall accuracy (76 percent), positive predictive value (71 percent), and negative predictive value (83 percent). False-negative and false-positive results are discussed. Rectal endoscopic lymphoscintigraphy represents the only method currently available for evaluation of lymphatic spread in rectal cancer.