To learn about factors, that influence a physician's decision making, a mail survey was conducted asking physicians about their preferences for radical mastectomy vs. local excision plus irradiation, and for adjuvant chemotherapy vs. no adjuvant treatment for two hypothetical women with operable, clinical stage I breast cancer - one 35 years old and the other 60 years old. Two hundred and sixty-one physicians from varied specialties in Connecticut and Massachusetts returned the questionnaire. Approximately half of the respondents would accept either mastectomy or limited surgery plus radiation therapy for either patient. Adjuvant chemotherapy was recommended by 97% of respondents for the younger patient and by 66% for the older patient. Several factors appeared to be related to therapeutic preferences. An individual physician's attitude towards patient involvement in decision making was the most important predictor of surgical preference for both the patients, whereas the role of specialty (i.e., surgeons vs. other providers) was more important for the surgical management of the older patient. For the decision involving adjuvant chemotherapy, specialty, hospital size, and presence of radiotherapy equipment on site were important predictors. Factors other than survival (such as disease-free interval and cosmetic results) were viewed as important standards of effectiveness by some physicians.

The presence in human erythrocyte stroma of a chromogenic substance giving absorption spectra (direct Ehrlich and Bial reactions) identical with those of crystalline sialic acid has been confirmed. A potent water-soluble inhibitor of viral hemagglutination, containing 7-1 1% by weight of this chromogen, has been isolated by partition dialysis from concentrated human erythrocyte stroma. 30-40% of the chromogen in the crude stroma concentrate and up to 56% of that in the purified inhibitor was rendered dialyzable following treatment with concentrated infective influenza virus, which in most instances also destroyed receptors for indicator viruses.Limited chromatographic analysis indicated that the dialyzable chromogen is most probably sialic acid. These observations represent the first direct demonstration of split products resulting from enzymic action of influenza virus on human erythrocyte components. 1. 2. 525. 3.Sci., 4. 5.6.Previous studies by Lyman and Fawcett were induced to hibernate. The effect of the (1) have shown that the growth rate of low temperature of hibernation (5°C) on the homologous tumor transplants in the hamster tissue of an animal which does not hibernate cheek pouch was diminished when the animals has not been previously tested. Lyman and Fawcett suggested that such a tissue might be

This review discusses the contributions to chemotherapy which have been made by surgeons, beginning with the work on intraarterial infusion by Klopp in 1950. The technics of perfusion, infusion, adjuvant chemotherapy and wound washing are discussed. Suggestions are made for research in surgical applications of chemotherapy.

No abstract

No abstract