Faculty Bibliography

Twelve recurrences after surgical treatment of 83 cystosarcoma phyllodes of the breast were reported. The histology of the initial tumor was benign (n = 73), borderline (n = 6), sarcoma (n greater than 4). Nine recurrences were observed at the initial site of the tumor (2 in another quadrant of the same breast and I in the contralateral breast). The cause of local recurrence is related to incomplete tumorectomy (n = I), pseudo-capsule infiltration (n = 3), micro-nodules satellites (n = 2). No etiology for recurrence was defined in 3 cases. The importance of a careful microscopic examination of the initial tumor is emphasized because the infiltration of the pseudo-capsule and the presence of micro-nodules satellites can only be recorded on correctly prepared slides

An airtight facemask/mouthpiece assembly has been devised to facilitate the performance of a wide range of pulmonary function tests during treadmill exercise in dogs. Using this appliance, data were obtained from 6 normal dogs and 3 of the same dogs after left lung autotransplantation. All measurements were made during awake, resting conditions and again after 5-7 minutes of moderate exercise. Resting values for pulmonary function tests, hemodynamic parameters, blood gases and pH from both pulmonary and systemic arterial blood samples did not differ significantly between normal dogs and those studied after left lung autotransplantation. During treadmill exercise, cardiac output doubled and pulmonary vascular resistance decreased comparably in both groups of dogs. Heart rates in both groups rose to approximately 22 b/min and blood gases and pH remained normal. These results indicate the facemask/mouthpiece assembly permits normal ventilation during treadmill exercise. In addition, these data support the view that pulmonary autotransplantation per se need not impose obligatory defects in ventilatory and hemodynamic function despite the increased demands of treadmill exercise

Previous reports have suggested that renal allograft recipients have an increased mortality rate when returned to hemodialysis. We studied the survival of patients returned to hemodialysis after losing a renal allograft and compared it with the survival of patients undergoing maintenance hemodialysis during the same period as reported by individual centers in the United States and by the European Dialysis and Transplant Association. Six-year actuarial survival of 83 patients after loss of a first transplant and of 37 patients after loss of two or more transplants compared favorably with data on survival of patients undergoing maintenance dialysis. We conclude that a transplant recipient is not at increased risk when returned to hemodialysis

The association of severe peripheral arteriosclerotic occlusive disease and cancer is unusual. Review of 14 patients with both conditions treated by arterial reconstruction demonstrated excellent limb salvage without prejudice of survival or patency. Accordingly, we believe that limb salvage operations should be considered in patients with limb-threatening peripheral vascular disease and an associated cancer