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Physician-assisted death (PAD) has long been a strongly debated moral and public policy issue in the United States, and an increasing number of jurisdictions have legalized this practice under certain circumstances. In light of changing terminology, laws, public and professional attitudes, and the availability of published data about the practice, we review key concepts and terms in the ongoing PAD debate, moral arguments for and against PAD, the current legal status of PAD in the United States and in other nations, and data on the reported experience with PAD in those U.S. jurisdictions where it is a legal practice. We then identify situations in which emergency physicians (EPs) may encounter patients who request PAD or have attempted to end their lives with physician assistance and consider EP responses in those situations. Based on our analysis, we offer recommendations for emergency medical practice and professional association policy.

This work describes a way to study uniform circular motion (UCM) using a LEGO® MINDSTORMS® Robotics Invention System (RIS) stepper motor with a steel ball attached to a string. The equipment is inexpensive and the resulting motion takes place on a human scale. Times and lengths can be measured with a stopwatch and a meterstick, respectively. In addition, students get a brief introduction to robotics.

66 Background: SBRT is a safe and effective treatment option for patients with low to intermediate risk prostate cancer (PCa). SBRT delivers high biologically effective doses resulting in very low PSA nadirs. Strategies to diagnose and confirm salvageable isolated local failures (ILF) are needed. This study aims to examine the incidence and approach to management of ILF after SBRT in a large single institution cohort. Methods: All patients with low or intermediate risk PCa treated with SBRT at our institution were eligible for this study. Treatment was delivered using the robotic SBRT with doses of 35-36.25 Gy in five fractions. ILF were diagnosed using mpMRI and/or biopsy prompted by PSA rise after achieving long-term nadir. Choice of salvage therapy and post-salvage PSA were ascertained on follow up. Results: Between December, 2008 to August, 2018, 998 men with low to intermediate risk prostate cancer were eligible for analysis. Twenty patients (low risk, n = 4; intermediate risk, n = 16) were found to have ILF on either MRI (n = 15) and/or biopsy (n = 17). Three patients with MRI-identified ILF elected active surveillance in lieu of biopsy. Median pre-treatment PSA was 7.5 ng/ml. Median time to diagnosis of ILF was 72 months (37-96 months) with median PSA at the time of ILF of 2.3 ng/ml (1.1-10 ng/ml). Median PSA doubling time was 17 months (5-22 months). Thirteen patients with biopsy proven ILF proceeded with salvage therapy (cryotherapy n = 12, HIFU n = 1). Of 12 patients who underwent cryotherapy, 8 had a post-treatment PSA of < 0.1ng/ml, two patient’s results were unavailable, one patient had a PSA nadir of 0.7 ng/ml and one patient had yet to undergo post-salvage PSA test at the time of this report. Conclusions: The incidence of ILF is rare in our series. Diagnosis and management of ILF post-SBRT continues to evolve in the era of successful salvage therapy. Our report suggests an important role for early utilization of MRI and confirmatory biopsy at relatively low PSA levels and long PSA doubling time. Additionally, undetectable PSA post-salvage therapy supports early treatment after identifying ILF. Larger trials are needed for refinement of patient selection and most appropriate salvage modality.

64 Background: Prostate Cancer (PCa) related anxiety varies widely based on management option. SBRT offers a safe and effective treatment for localized PCa. However, there is a paucity of data regarding PCa specific anxiety following SBRT and its relationship with PSA kinetics. In this report we present the results of a mail-in survey conducted amongst the participants of our prospective institutional quality of life (QOL) trial and identify sociodemographic and disease specific predictors of anxiety. Methods: Patients with localized PCa treated with SBRT at a single institution from 2007-2018 were eligible for inclusion in this study. The Memorial Anxiety Scale for PCa (MAX-PC) survey, was mailed to 450 patients on July of 2018. Patient’s total MAX-PC score (scale 0-54) was recorded. A score of ≥ 27 was defined as significant anxiety. Disease specific as well as demographic features were analyzed for possible correlation with self-reported anxiety. Results: By August 31, 2018, 227 patients had responded to the survey . The median score at all time points was 5 (1-41). Stratified by risk grouping; Low, Intermediate, and High Risk patients’ median scores were 7, 4.5 and 6. Six patients had a MAX-PC score≥27. Patients who were at least 2 years out from SBRT treatment had lower mean MAX-PC scores than those who were still within 2 years (6.3 versus 8.1, p = 0.045). Stratified by age, patients > 80 years old had a median score of 2 versus those < 70 with a median score of 6. Caucasian patients had lower mean MAX-PC scores than non-Caucasian patients (6.6 versus 9.1, p = 0.021). Patients who had at least a 0.5 ng/mL increase in PSA in their last 3 measurements had higher mean MAX-PC scores than those who did not (13.0 versus 7.0, p = 0.040). Conclusions: Patients with clinically localized PCa treated with SBRT experience minimal PCa specific anxiety. Anxiety surrounding PCa decreases with time. Non-Caucasian patients tended to have more anxiety than Caucasian patients. Patients who had recent PSA bounces tend to have higher levels of anxiety about their disease. Further follow-up of these patients over time would aid in assessing the progression of PCa specific anxiety as their lives progress.

Gleason score from biopsy specimens is important for prostate cancer (PCa) risk stratification and influences treatment decisions. Gleason score upgrading (GSU) between biopsy and surgical pathology specimens has been reported as high as 50 % and presents a challenge in counseling low-risk patients. While recent studies have investigated predictors of GSU, populations in these studies have been largely Caucasian. We report our analysis of predictors of GSU in a large urban African-American population. A total of 959 patients with D’Amico low-risk prostate cancer underwent radical prostatectomy at Georgetown University or Washington Hospital Center between January 2005 and July 2012. Race, age, PSA, body mass index (BMI), cancer of the prostate risk assessment (CAPRA) score, and transrectal ultrasound (TRUS) biopsy characteristics (percent of biopsy cores showing adenocarcinoma, highest percent of biopsy core involved with cancer, and measured TRUS prostate volume) were analyzed with both univariate and multivariate analyses to identify significant predictors of GSU while controlling for clinical parameters. Of the 959 cases, 288 (30.0 %) were upgraded on final pathologic specimen with approximately 38 % (133/355) of African-American patients experiencing GSU. BMI (P = 0.02), percent positive biopsy cores (P

e18636Background: Geodemographic characteristics including median income, education, ethnicity, and rural residency mediate healthcare access and disparity. SBRT offers definitive treatment with ac...

91 Background: Patients with a history of procedures for BPH experience worse urinary toxicity following interstitial brachytherapy for localized prostate cancer. This retrospective study sought to evaluate the rates of urinary toxicity following SBRT in men with a history of procedures for BPH. Methods: Localized prostate cancer patients, treated with SBRT from August 2009 to February 2015 and a minimum follow up of 2 years, with a history of at least 1 procedure for BPH associated with a prostatic defect identified on the treatment planning MRI were evaluated. Radiotherapy was delivered in 5 fractions to a dose of 35 or 36.25 Gy using the CyberKnife system with fiducial tracking. Urinary QOL was assessed pre- and post-treatment using the International Prostate Symptom Score (IPSS) and the Expanded Prostate Cancer Index Composite (EPIC-26). Cystoscopy findings were retrospectively reviewed. Toxicities were scored using the CTCAE v4. Results: Thirty nine men with a median age of 72 years, 7 with a history of more than 1 procedure for BPH, were treated with a median follow up of 49 months. Grade 1, grade 2, and grade 3 urinary toxicity occurred in 11, 24, and 3 men, respectively; there were no grade 4 or 5 toxicities. Overall, 22 men experienced hematuria; the median time to the onset hematuria from the start of SBRT was 13 months (range 1-70). Cystoscopy was performed on 12 of these patients and bladder neck/prostatic urethra hyperemia were found in a majority of cases. Active bleeding from the bladder neck or prostatic urethra was found in 4 men. A mean baseline IPSS score of 9 did not significantly change at any point during follow up. A mean baseline EPIC-26 obstructive/irritative score of 84 significantly decreased to 76 at 1 month (p = 0.023). There was no significant change from the mean baseline EPIC-26 urinary incontinence score at any point during follow up. Conclusions: A history of procedures for BPH may lead to worse urinary quality of life and high rates of hematuria following SBRT for localized prostate cancer. Stricter urethra/bladder neck dose constraints or an alternative fractionation schedule may be required to decrease the risk of urinary toxicity.

A ccording to the American Cancer Society’s Survey, 28,900 new cases of oral cancer emerged in 2000. The death rate associated with oral cancer is particularly high because in more than half of the cases, the cancer is discovered late in its development. In these instances, radiography plays a key role in the diagnosis. Dentists trained in radiographic interpretation can determine the presence of tumors or growths, and can even distinguish malignant tumors from benign tumors based on their radiographic presentation. Interpretation of lesions in the jaws, therefore, is a vital professional skill for dental practitioners. Dentists’ encounters with non-routine radiographic pathology are limited because of the small size of patient pools and the relatively low occurrence rate of certain disease processes. However, meaningful oral and maxillofacial radiographic pathology, including oral cancer cases, do exist and have been diagnosed and treated each year. Furthermore, dentists are less confident about their ability to interpret radiographic images accurately. This lack of confidence could potentially lead to a failure to recognize or misdiagnosis significant pathology including cancer. Dental faculty is faced with the challenge of finding teaching cases from various sources because they often do not have their own. There is a real need to enhance radiographic interpretation and diagnosis skills for both dental students and current practitioners. Interpretation of radiographic dental images is a process of decision making, which requires a broad knowledge and in-depth familiarity with the underlying pathology and consequent radiographic manifestations. It is a significant part of the radiology curriculum taught in every dental school. There are meaningful teaching cases that are not used to full potential because these cases are not properly annotated, archived, and shared. In the case of rare oral disease processes, these cases may occur so infrequently that the student’s sole exposure is the depiction in a textbook. Currently, teaching cases for the training of dentists are developed on an as-needed basis and generally created and maintained locally. This process necessarily limits the exposure of teaching cases to the population served by that dental health center and often to students who work with a particular instructor. Some areas are not sufficiently demographically diverse to account for differences between ethnic groups, population ages or other factors. Most radiology interpretation courses at the pre-doctoral level are given in large lecture format.

Background In upper endoscopy, overtubes protect the hypopharynx and esophagus in patients requiring multiple esophageal intubations. Transesophageal echocardiography (TEE) is frequently used in general cardiology practice to provide high-resolution, real-time images of cardiac structures that are often not visualized by transthoracic imaging alone. Patients with a history of esophageal disorders or difficult esophageal intubations may have increased risk for complications from the echoprobe. An esophageal overtube may facilitate TEE in such patients. Objective We sought to evaluate the usefulness of upper endoscopy with placement of an esophageal overtube to facilitate TEE in patients with prior difficult esophageal intubations. Methods We performed upper endoscopy, followed by placement of an esophageal overtube, in 4 patients who had an unsuccessful intubation with the TEE probe. The endoscopic procedures were successfully completed, thus, allowing for uneventful subsequent TEE. Conclusions Upper endoscopy with placement of an esophageal overtube may allow for safe successful completion of TEE in patients with previously unsuccessful blind esophageal intubation.

The introductory physics lab curriculum usually has one experiment on uniform circular motion (UCM). Physics departments typically have several variable-speed rotators in storage that, if they work, no longer work well. Replacing these rotators with new ones is costly, especially when they are only used once a year. This article describes how an inexpensive (≈$10) tethered aeroplane, powered by a small electric motor, can be used to study UCM. The aeroplane is easy to see and entertaining to watch. For a given string length and air speed, a tethered aeroplane quickly finds a stable, horizontal, circular orbit. Using a digital video (DV) camcorder, VideoPoint Capture, QuickTime player, metre sticks and a stopwatch, data on the aeroplane's motion were obtained. The length of the string was varied from 120 to 340 cm while the air speed ranged from 200 to 480 cm s−1. For each string length and air speed, the period of the orbit and the diameter of the path were carefully measured. Theoretical values of path radii were then calculated using Newton's second law. The agreement between experiment and theory was usually better than 2%.

Although 2-dimensional echocardiography with adjunct intravenous contrast media improves endocardial visualization and enhances quality of spectral Doppler signals, widespread use of contrast agents has not occurred for various reasons. Results from this study indicate that discretionary use of contrast media will enhance endocardial and Doppler signal visualization scores without an impact on total procedure duration, lending credence to an argument for a lower threshold for discretionary use of contrast media.

Incidence of breast cancer (BC) varies among ethnic groups, with higher rates in white than in African-American women. Until now, most epidemiological and genetic studies have been carried out in white women. To investigate whether interactions between genetic and reproductive risk factors may explain part of the ethnic disparity in BC incidence, a genetic epidemiology study was conducted, between 1989 and 1994, at the Howard University Cancer Center (Washington, DC), which led to the recruitment of 245 African-American families. Segregation analysis of BC was performed by use of the class D regressive logistic model that allows for censored data to account for a variable age of onset of disease, as implemented in the REGRESS program. Segregation analysis of BC was consistent with a putative dominant gene effect (P < 0.000001) and residual sister-dependence (P < 0.0001). This putative gene was found to interact significantly with age at menarche (P = 0.048), and an interaction with a history of spontaneous abortions was suggested (P = 0.08). A late age at menarche increased BC risk in gene carriers but had a protective effect in non-gene carriers. A history of spontaneous abortions had a protective effect in gene carriers and increased BC risk in non-gene carriers. Our findings agree partially with a similar analysis of French families showing a significant gene x parity interaction and a suggestive gene x age at menarche interaction. Investigating gene x risk factor interactions in different populations may have important implications for further biological investigations and for BC risk assessment.

In this work, an inexpensive 10‐gallon glass aquarium was used to study wave motion in water. The waves travel at speeds comparable to a person walking (∼1 m/s). The scale of the motion allows for distances to be measured with a meterstick and for times to be measured with a stopwatch. For a wide range of water depths, standing waves were excited by hand using strips of Styrofoam. Several resonant modes were studied starting with the fundamental. Experimental values of wave speed were obtained from measurements of wavelength and period of oscillation. Theoretical values of wave speed were calculated using the surface gravity wave dispersion relation. The agreement between experiment and theory was usually better than 0.5%. The aquarium was a winner in the Apparatus Competition (Low Cost Category) during the AAPT 2006 Summer Meeting at Syracuse University.

BACKGROUND Older women have high rates of breast carcinoma, and there are substantial variations in the patterns of care for this population group. METHODS The authors studied 718 breast carcinoma patients age 67 years and older who were diagnosed with localized disease between 1995 and 1997 from 29 hospitals in 5 regions. Data were collected from patients, charts, and surgeons. Logistic regression analysis was used to evaluate determinants of treatment. RESULTS Women who were concerned about body image were 1.8 times more likely (95% confidence interval [95% CI], 1.1–2.8) to receive breast conservation surgery and radiotherapy than women without this preference, controlling for other factors. In contrast, women who preferred receiving no therapy beyond surgery were 3.9 times more likely (95% CI, 2.9–6.1) to undergo mastectomy than other women, after considering other factors. Radiotherapy was omitted after breast conservation 3.4 times more often (95% CI, 2.0–5.6) among women age 80 years and older than among women ages 67–79 years, controlling for covariates. Black women tended to have radiotherapy omitted after breast conservation surgery 2.0 times more often (95% CI, 0.9–4.4) than white women (P = 0.09). Women age 80 years and older also were 70% less likely (odds ratio = 0.3; 95% CI, 0.1–0.8) to receive chemotherapy than women ages 67–79 years, controlling for health, functional status, and other covariates. CONCLUSIONS After considering other factors, patient preferences and age were found to be associated with breast carcinoma treatment patterns in older women. Further research and training are needed to provide care for the growing population of older women that is both clinically appropriate and consonant with a woman's preferences. Cancer 2000;89:561–73. © 2000 American Cancer Society.

Smith, D.H., Lynch, J.J., 1994. Modeling of fluid phase equilibrium of multicomponent hydrocarbon mixtures in the critical region. Fluid Phase Equilibria, 98: 35-48. Fluid phase equilibrium algorithms have an important role in the modeling of processes throughout the chemical industry. Conventional methods based on cubic equations of state often fail to converge or are inaccurate in the critical region. A model based on two-scale factor universality that conforms to critical scaling laws using effective exponents has been generalized to mixtures with multiple components. The modified Leung-Griffiths theory is a non-cubic, corresponding states model that has produced excellent correlations of many sets of two-component mixture vapor-liquid equilibrium (VLE) data. It has also successfully predicted the fluid phase boundaries of a few ternary fluid mixtures from correlations of the three constituent binary mixtures. The model has recently been extended further to predict N-component VLE boundaries from previous data correlations of the N(N-1)/2 limiting binary fluid mixtures. Where data are unavailable the binary parameters are estimated with simple relations suggested by factor analysis. Predicted coexistence boundaries are compared with experimental VLE data for several multicomponent hydrocarbon systems.

Curbside ethics consultations occur when an ethics consultant provides guidance to a party who seeks assistance over ethical concerns in a case, without the consultant involving other stakeholders, conducting his or her own comprehensive review of the case, or writing a chart note. Some have argued that curbside consultation is problematic because the consultant, in focusing on a single narrative offered by the party seeking advice, necessarily fails to account for the full range of moral perspectives. Their concern is that any guidance offered by the ethics consultant will privilege and empower one party’s viewpoint over—and to the exclusion of—other stakeholders. This could lead to serious harms, such as the ethicist being reduced to a means to an end for a clinician seeking to achieve his or her own preferred outcome, the ethicist denying the broader array of stakeholders input in the process, or the ethicist providing wrongheaded or biased advice, posing dangers to the ethical quality of decision-making. Although these concerns are important and must be addressed, we suggest that they are manageable. This paper proposes using conflict coaching, a practice developed within the discipline of conflict management, to mitigate the risks posed by curbside consultation, and thereby create new “spaces” for moral discourse in the care of patients. Thinking of curbside consultations as an opportunity for “clinical ethics conflict coaching” can more fully integrate ethics committee members into the daily ethics of patient care and reduce the frequency of ethically harmful outcomes.

This paper presents the behavioral interview model that we developed to formalize our hiring practices when we, most recently, needed to hire a new clinical ethicist to join our staff at the Center for Ethics at Washington Hospital Center.

How can the suspicion of myocardial ischemia be confirmed without putting the patient through an invasive procedure? In patients who have had myocardial infarction, how can those at risk for pump failure and other complications and future cardiac events be identified? How are such complications detected? The answer to all these questions is echocardiography. The authors review how to use the technique and provide illustrative images.

Extended scaling or the Wegner correction has been added to a model of vapor-liquid equilibrium (VLE) designed for the extended critical region. The model, that of Leung and Griffiths as modified by Moldover, Rainwater and co-workers, has heretofore incorporated only simple scaling. The revised formalism has been applied to the abundant data on carbon dioxide + n-butane, where versions of the model with and without extended scaling have been optimized by the simplex method. With extended scaling, the average thermodynamic “distance” between a measured and calculated dew or bubble point decreases by approximately 30 percent.

The modified Leung–Griffiths theory of vapor–liquid equilibrium (VLE) is generalized to the case of three components. The principle of ‘‘corresponding states’’ is reconsidered along with certain functions of ‘‘field variables’’ within the model. The mathematical form of the coexistence boundary in terms of the field variables remains practically unchanged and conforms to modern scaling theory. The new model essentially predicts ternary fluid mixture phase boundaries in the critical region from previous vapor–liquid equilibrium data correlations of the three binary fluid mixture limits. Predicted saturation isotherms of the ethane+n‐butane+n‐pentane and ethane+n‐butane+n‐heptane mixtures are compared with experimental ternary VLE data in the literature.

To examine the impact of mammography screening on treatment options received by a cohort of older breast cancer patients.We studied 718 newly diagnosed breast cancer patients, 67 years and over, diagnosed with TNM Stage I and II disease between 1995 and 1997 at 29 hospitals in five regions.Data were collected from patients, surgeons, and medical records. A breast cancer diagnosis was considered to have been by screening mammography if so reported by both patient and medical records. Bivariate and logistic regression were used to identify predictors of a women having her cancer detected by screening mammography and the relationships between mode of detection, stage of disease at diagnosis, and local treatment.Women with high school or greater education were 1.75 times (95%, CI 1.11-2.75) more likely to have their cancers diagnosed by screening mammography than women who had not completed high school, controlling for other factors. Screening found earlier stage disease: 96% of women with mammographically diagnosed cancer had T1 lesions, compared to 81% of women diagnosed by other means (p = 0.001). Women with mammography detected lesions were more likely to have ductal cancer, and to be referred to radiation oncologists more than women diagnosed by other means. Controlling for stage and histology, screening remained associated with a higher likelihood of receiving breast conserving surgery (BCS) with radiation (RT) (OR 1.56, 95%, CI 1.10-2.22) than other local therapies.Beyond the impact on stage, ductal cancers were more likely to be diagnosed by screening. Mammographically detected lesions were associated with referrals to radiation oncologists and higher rates of BCS and RT. Research is needed to explain the residual independent effects of mammography screening on breast cancer treatment.

The introductory physics lab curriculum usually has one experiment devoted to the study of the refraction of light. The most obvious way to study the refraction of light is to lay a transparent block down on the lab bench and aim a laser beam horizontally at the block so that it refracts twice—inward upon entering the block and outward upon exiting. The vendors that provide us with lab equipment (Sargent-Welch, PASCO, Fisher Scientific, and Frey Scientific to name a few) sell acrylic blocks for this very purpose, but these are either too small or they are too expensive. If students are going to measure angles of incidence and refraction, the blocks should be larger than the typical student protractor, which has a radius of 3 in (≈ 7½ cm). These blocks are just not large enough. They are generally not thick enough either so that the beam from a typical laser passes over them and not through them. The vendors mentioned above do sell blackboard optics kits that contain, among other parts, three blocks that are large enough—on the order of 10 to 20 cm. Unfortunately, these kits cost more than $1000.

L'A. se propose de degager ce que l'Eglise Ancienne (les conciles oecumeniques et les Peres) voulait dire quand elle affirmait un seul prosopon ou une seule hypostasis dans le Christ et trois prosopa ou hypostaseis en Dieu. Dans cette optique, il examine les usages varies de ces termes chez les Peres grecs, notamment ches Gregoire de Nysse. Il parvient a cette conclusion: prosopon doit etre entendu comme exprimant la personnalite, une existence individuelle concrete.

The Leung—Griffiths model as modified by Moldover and Rainwater has proven successful for correlation of critical-region vapor-liquid equilibria (VLE) surfaces of many binary nonpolar fluid mixtures. In this work the model is applied to four binary mixtures of polar fluids: diethyl ether + n-butanol and methanol + n-butanol as measured by Kay and Donham and the refrigerant mixtures R13B1 + R114 and R22 + R114 as measured by Uematsu, Watanabe and co-workers. The model provides accurate correlations of the polar mixtures, although the number of required adjustable parameters is in some cases larger than that needed for a nonpolar mixture with an equivalent critical locus.

Recent JCAH survey results have reported serious deficiencies in quality assurance efforts of support departments, especially Rehabilitation Services. Because occupational therapy is grouped under Rehabilitation Services, occupational therapists should closely monitor quality assurance efforts. Quality assurance activity becomes somewhat more complex when dealing with psychiatric patients where treatment modalities lack unanimity. However, those quality assurance efforts can be more productive through better medical documentation. Medical documentation essentials are reviewed and described with an emphasis on problem oriented methods. It is proposed that adhering to these essentials will enhance professional performance as well as improve the outcome of quality assurance activities.

Guinea pigs which were injected with either whole bacilli or purified soluble glycerol teichoic acid (GTA) usually exhibited a rise in hemolysin titer to GTA-coated erythrocytes. The only exceptions were those animals having high baseline titers of natural anti-GTA antibodies. Rats yielded better responses than guinea pigs and produced significantly higher responses to the soluble antigen than to the cellular GTA. Rats reared on a GTA-free diet were predominantly free of natural antibodies to GTA and furnished a more clear-cut model for assaying immune responses. Using this model, it was shown that adsorption of GTA to homologous erythrocytes before injection resulted in poor responses, suggesting that such spontaneous adsorption does not account for the good responses to soluble antigen. In GTA-deprived rats, positive skin tests were induced only with bacilli, whereas migration inhibitory factor was induced with both bacilli and soluble antigen. Hemolytic plaques in immunized rats were increased over controls with both kinds of immunogen, but the GTA-deprived rats responded better than conventional ones, and hemolytic plaque responses to bacilli were better than those to soluble antigen. This reversal of the serum hemolysin results may be due to delayed suppression by soluble GTA or to antibody cycling. The guinea pig data, combined with results from GTA-deprived rats, suggest that high antibody levels resulted in depressed antibody synthesis, perhaps because antibody cycling was initiated. No evidence was found to explain the superior responses to soluble antigen, but it did not seem related to formation of immune complexes or adsorption to erythrocyte membranes.

The catalytic oxidation of carbon monoxide (CO) to carbon dioxide (CO2) in air by Hopcalite is the basis for a personal sampler for carbon monoxide. Four or eight hour integrated samples are obtained by drawing air at 0.5 liter per minute (lpm) through stripping beds of Ascarite and molecular sieve which remove water vapor and CO2 present in the ambient air. The air sample then passes to a preweighed glass U-tube which contains Hopcalite, Ascarite, and anhydrous magnesium perchlorate. After sampling, the U-tube is reweighed; the increase in weight is due to the trapped CO2 from the oxidized CO. At 0.5 lpm and 70°F, the 1.5 g of catalyst in the U-tube convert more than 90% of the CO to CO2. For a four-hour sample in the range of 20 to 100 parts per million (ppm) CO, the relative standard deviation of duplicate measurements is ±6%.

Actinomycin D and 5-fluorouracil, given with x-ray in a dosage regimen sufficient to produce definite but tolerable gastrointestinal and marrow toxicity, did not increase the percentage of patients with carcinoma of the lung showing shrinkage of lesions in the irradiated field. There was no evidence of a more rapid onset of shrinkage of the tumor or of an additive effect at subtotal doses of x-ray. Patient survival was not affected beneficially by the addition of the chemotherapeutic agents. Toxicity was not correlated with responses induced. Patients classified as responders to therapy lived longer than those classified as nonresponders.