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Seventeen patients with carcinoma confined to the pancreas and the peripancreatic area received preoperative radiation therapy in an attempt to increase the resectability rate and to reduce the incidence of recurrence. The tumors were considered either unresectable or of borderline resectability. The radiation dose ranged between 4000--5000 rads, the majority of patients (75%) receiving 4400--4600 rads in 4 1/2--5 weeks. After a period averaging six weeks the patients were reevaluated for surgery. Eleven patients were explored and six underwent radical resection. Two patients remained disease free after five years. Pancreatic resection is feasible following a course of preoperative radiotherapy to a moderately high dose. It is suggested that the response of the primary tumor to radiotherapy be used as a criterion for selecting patients for reexploration and resection.

To detect familial medullary thyroid carcinoma in a premetastatic stage, we administered tests provocative of calcitonin secretion (infusion of calcium or pentagastrin or both) each year for seven years to members of a pedigree now numbering 107. Since 1970, 21 patients converted from normal to abnormal secretory responses (two separate tests in which calcitonin levels exceeded 0.58 ng per milliliter). Twenty of 21 glands removed showed C-cell hyperplasia, and eight of the 20 also showed foci of carcinoma. As compared to the 12 patients with tumors detected during the first year of screening, all of whom had bilateral carcinoma (seven of 12 with local metastases), later carcinomas were smaller (mean diameter of 0.2 vs. 0.8 cm), were unilateral (in all but two cases) and occurred in younger patients (mean age of 14.9 vs. 36.4 years), and none had detectable metastases.

equalizing valve was opened, these fluctuations all but vanished; the remaining noise was attributed to the position indicator.The utility of the analyzer for continuous measurements over extended periods was impaired by the persistence of drift, which made it necessary to recenter the drop from time to time by momentarily opening the equalizing valve on the detector. The direction and magnitude of the observed drift were variable and may have been caused by slow changes in the source temperature, as compensation of the detector itself was apparently good. Drifts equivalent to 4 p.p.m. per minute were sometimes observed. Inasmuch as the analyzer was not compensated for fluctuations of the source, stabilization of the source deserved more attention than it received.Considering the simplicity of this analyzer, and its ability to detect changes of less than 3% of a 300 p.p.m. concentration of carbon dioxide, this analyzer was considered successful. However, improved performance might be expected from an analyzer with short dead cells at the ends of the sample cell for insulation purposes, high quality reflecting surfaces, and a more stable source, or perhaps reduction of source noise by an independent feedback circuit. ACKNOWLEDGMENTThe writers gratefully acknowledge indebtedness to Van Zandt Williams of the American Cyanamid Company for benefits derived from conversations which contributed materially to the progress of the work, and for checking the transmission of the mica used for windows.

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