The data of an epidemiologic study of multiple primary malignant neoplasms in breast cancer patients in Israel are presented. During the 18‐year period of the study 12,302 cases of breast carcinoma were diagnosed, and, of these, 984 patients (8%) had multiple primary malignant tumors. Forty‐seven of these patients developed two multiple primary cancers. A significantly higher than expected incidence of second primary cancers occurred at the following five sites: the opposite breast, salivary glands, uterine corpus, ovary, and thyroid. Cancers of the stomach and gallbladder were fewer than expected. Treatment of the breast cancer by irradiation was associated with an increased risk of subsequent cancers of lung and hematopoietic system. The prognosis was mainly influenced by the site and malignancy of the second primary cancer. The incidence of multiple primary malignancies justifies a high level of alertness to this possibility in the follow‐up of breast cancer patients.

SUMMARYPrevious studies have shown that intravenous cardiac glycosides produce mesenteric vasoconstriction (MVC)

Symptoms equated with "threatened" or "near-miss" sudden infant death syndrome (SIDS) were noted during feedings in 4 infants. In each case, barium esophagrams revealed dysmotility. Acute "near-miss" symptoms required cardiopulmonary resuscitation during esophagography in 2 infants. The authors suggest that esophageal dysmotility is a cause of "near-miss" SIDS and most likely is responsible for more fatalities than commonly realized. The cause-and-effect relationship is explained by a vagovagal reaction. Etiologies of esophageal dysmotility and possible prophylactic measures are discussed.

Fetal Movement (FM) rate was evaluated in cases of symmetrical and asymmetrical intrauterine growth retardation (IUGR) and was compared to the FM rate in normal pregnancy. In the 25-36th week of gestation there was a significant decrease of FM rate in both groups of IUGR which was more pronounced in the symmetrical group. Also shown, was a gradual trend of increase of the FM rate with advancing gestational age in both groups of IUGR. Cases of asymmetrical IUGR were noted, who had markedly decreased FM until cessation. In this group of IUGR decreased FM demands prompt hospitalization and fetal heart rate monitoring so that possible respiratory failure and impending fetal death can be detected.

The authors review the relationship between esophageal dysfunction (dysmotility) and the unusual cardiopulmonary and neurological manifestations equated with the symptoms of the "near-miss" sudden infant death syndrome (SIDS). Six beagle puppies were studied to see whether esophageal irritation and dilatation could provoke any cardiac dysrhythmia. Some of the cardiographic irregularities observed in 10 of 11 trials occasionally precede fatal ventricular dysfunction. The authors conclude that esophageal irritation can be responsible for cardiac arrest and that one important cause of SIDS is esophageal dysmotility.