Needle localization and biopsy in non-palpable lesions of the breast: an eight-year experience.
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Biopsy, Needle↗
Biomedical subjects
R E Rothenberg
Publications and source records attributed to R E Rothenberg.
Elective cholecystectomy and carcinoma of the gallbladder.
The incidence of carcinoma of the gallbladder has been reputed to be approximately 1.5 per cent among those who undergo surgery for chronic cholecystitis. The incidence at Cabrini Medical Center coincides rather well with that from other studies but has shown a marked decline, 21.5 per cent, within recent years. A report from the American Cancer Society projects an even greater decline to 0.65 per cent in the incidence of this almost incurable disease within the next 1-2 years. The decrease in the incidence of cancer of the gallbladder is attributed to the great increase in the performance of elective cholecystectomy for chronic cholecystitis among people 50 years of age or younger, before they have reached the age when carcinoma of the gallbladder is most prevalent. Early surgery is advocated not only as an effective and safe form of therapy but also as a valuable preventive measure.
Age Factors↗
Breast cancer and idiopathic galactorrhea.
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Breast Neoplasms↗
The incidence of intra-abdominal surgery in acquired immunodeficiency syndrome: a statistical review of 904 patients.
This communication concerns the incidence of intra-abdominal surgery in 904 patients with acquired immunodeficiency syndrome who were admitted to the Cabrini Medical Center during a 3-year period from January 1985 to January 1988. It was found that 36, or 4.2%, of the patients underwent surgery, including 12 cholecystectomies, 7 splenectomies, 7 appendectomies, 6 laparotomies, and 6 other operations for miscellaneous conditions. It was pointed out that the high incidence of inflammatory involvement of the gallbladder, appendix, and intestines in AIDS patients was in all probability due to the nature of the blood supply to these organs. All receive blood from terminal arteries or vessels with few anastomoses, and therefore when vasculitis ensues it is often followed by gangrene or ulceration of mucosal surfaces. Surgical intervention was deemed advantageous for those patients with splenomegaly and accompanying pancytopenia, acute appendicitis, and lesions of the gastrointestinal tract, but not for those with cholecystitis. The high postoperative mortality rate, 22.2%, was attributed primarily to the immunodeficient state of the patients rather than to complications of their surgery.
Abdomen↗
The surgical treatment of the Zollinger-Ellison syndrome: an update.
Forty-six professors of surgery in answers to a questionnaire reported that 143 patients with Zollinger-Ellison syndrome had been admitted to their hospitals within the last 2 years. The bed capacity of these hospitals totaled 27,019. In extrapolating these figures, it is seen that the capacity of the 46 institutions averaged 587 beds per hospital, and that an average 71.5 patients with Zollinger-Ellison syndrome were admitted each year. In other words, a hospital with 587 beds might expect 1.55 yearly admissions of patients suffering from this disease. Two surgical methods have emerged as today's main treatment choices for Zollinger-Ellison syndrome that is unaccompanied by isolated gastrinoma. These are 1) preoperatively administered H2 blockers followed by less-than-total gastrectomy, truncal vagotomy, and postoperative H2-blocker therapy; and 2) preoperatively administered H2 blockers followed by highly selective vagotomy plus postoperative H2-blocker therapy. Only seven of 46 respondents still maintain that total gastrectomy should be carried out to cure the disease. All respondents advocate excision of an isolated gastrinoma as the treatment of choice if one is found at surgery.
Bed Occupancy↗
Peritoneal lavage as an aid to diagnosis of peritonitis in debilitated and elderly patients.
Twenty-seven debilitated or obtunded patients were subjected to peritoneal lavage to determine the presence or absence of peritonitis. Fourteen lavages were found to be positive, revealing peritonitis in 12 patients. Two of the 14 patients refused surgery and subsequently died. Thirteen patients had negative lavages, none of whom subsequently developed any evidence of peritonitis or required surgical intervention. Peritoneal lavage is an extremely reliable procedure, both in establishing the diagnosis of peritonitis or in ruling out its presence in debilitated or obtunded, elderly patients. The procedure can be performed quickly, without prolonged preparation, and without fear of complications. In addition, there is little cost to the procedure, especially when compared to the cost of more sophisticated time-consuming tests such as x-ray studies, gallium or CT-scanning.
Acute Disease↗