Rupture of the spleen in infectious mononucleosis.
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Biomedical subjects
Publications and source records attributed to E A Benson.
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In vitro binding of labeled insulin was measured in crude membrane fractions of tumor and fat obtained at the time of breast cancer surgery in 23 women. There was significant insulin binding in 22 of 23 tumor specimens and in all 23 fat samples. High-affinity binding sites were present in tumors [Ka = 1.38 +/- 0.88 (S.E.) x 10(9) M-1 and adjacent fat membranes (Ka = 1.12 +/- 0.15 x 10(9) M-1]. The level of insulin binding was not related to either estrogen receptor status or tumor histological grade. There was a significant negative correlation between insulin binding to fat membranes and fasting insulin levels. In contrast, there was no significant relationship between insulin binding to tumor tissue and serum insulin levels, suggesting the loss of the capacity to "down-regulate" insulin-binding sites by breast tumor cells. The absence of this ability to regulate insulin-binding capacity could result in an increased sensitivity of breast tumor cells to the stimulatory effects of insulin.
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A series of 215 patients with breast cysts have provided 348 specimens of cyst fluid for cytological diagnosis. Only one of these specimens was reported positive for malignant cells and this patient had a carcinoma. Nine specimens were reported as suspicious, but none of these patients had or subsequently developed carcinoma. In 338 specimens cytology was negative. A total of 178 patients (294 specimens) was available for follow-up. Of these 2 proved to have carcinomas on immediate follow-up, i.e. a lump presisted after aspiration, and a further 2 patients developed cancers in the same breast, one 4 and the other 7 years after aspiration. We therefore conclude that the routine submission of breast cyst fluid for cytology is wasteful of time and resources.
Two cases of granular cell myoblastoma of the breast are presented occurring in women aged 20 and 22 years. The clinical findings, mammographic and naked eye appearances suggested carcinoma. The difficulties of diagnosis and the pathogenesis of this rare tumour are discussed. A definitive histological diagnosis of an apparently malignant breast lump, particularly in a young woman, is mandatory before proceeding to major surgery.
A case is made for the more general adoption of the transabdominal approach to the adrenal glands as this has obvious advantages over bilateral loin incisions.
In a small series of 20 consecutive patients it proved impossible, using conventional radiography, to detect free intraperitoneal air following herniorrhaphy.
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While resection with grafting is now the operation of choice for the treatment of abdominal aortic aneurysms there is still a need for a less traumatic procedure suitable for the elderly, poor-risk patient. Such a technique is described, the aneurysm being mobilized and wrapped in a double sheet of Marlex mesh. Two illustrative cases are reported with survival for 3 years and 2 1/4 years respectively.