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Objective. Evaluation of the sensitivity and specificity of fine needle aspiration of retroperitoneal masses and lymph nodes in gynecologic oncology. Methods. Retrospective study of 101 punctures administered to 84 patients aged 23–86 years. The method's sensitivity and specificity were evaluated by clinical follow-up. Results. A satisfactory sampling was obtained in 89.1% of punctures, and a cytological diagnosis was made in 88.1%. The size of the lymph nodes punctured was less than 14 mm in 46.5%. This test has a sensitivity of 87.5%, specificity of 88.9%, positive predictive value of 98%, negative predictive value of 53.3%, and accuracy of 87.7%. Four patients presented complications: pain (2), hematoma (1), and right ureteral perforation (1). Conclusions. The fine needle aspiration technique has excellent positive predictive value and low morbidity. As a method of visualization, CT-scan, in combination with lymphography, allows the location of small lesions and the definition of their internal structures. The weak negative predictive value of fine needle aspiration might be correctible by laparoscopy-directed biopsy, and its potential is clearly ensured by the development of techniques for locating sentinel lymph nodes.

Contrary to the issues of perioperative morbidity and survival following surgery for lung cancer, little attention has been given to quality-of-life. To address this, quality-of-life was assessed preoperatively and 1, 3, 6 and 9 months postoperatively in a cohort of 117 consecutive subjects who underwent thoracotomy with a certain or presumptive diagnosis of lung cancer. Those with cancer (n = 91) confirmed at thoracotomy were contrasted to those without (n = 26). Moderate to severe dyspnea, reported in 14% preoperatively, increased to 34% at 1 and 3 months (p < 0.005) but returned to approximately 10% at 6 and 9 months. Similarly, activities of daily living were impaired in 11% preoperatively; this disability increased to 21% at 1 month (p < 0.005), and returned to baseline at 6 and 9 months. Those with cancer compared to those without a postoperative diagnosis of cancer had similar quality-of-life preoperatively but deteriorated more in the postoperative period. This study demonstrates that important deterioration in quality-of-life occurs during the first 3 months postoperatively in those with a final diagnosis of cancer but improvement back to baseline can be expected thereafter.

A new portable photoacoustic and fluorescence photometer has been built. The instrument is especially made for field measurements but can also be used indoors. This new instrument has many advantages. It can measure the photosynthetic O2 evolution and energy storage, and the vitality index in the same sample. The system is very compact, which makes it easy to transport. A small electrical generator satisfies the 110 V power requirement for field applications. All manipulations are computer controlled including the data acquisition and treatment. The photoacoustic signal‐to‐noise ratio for carbon black is the same under field conditions as in the laboratory (∼2×104) at 130 Hz. Results obtained on declining sugar maple trees in the field are presented. The combination of photoacoustic and fluorescence measurements in one instrument represents a very powerful tool in photosynthesis research.

Photoacoustic spectroscopy was used to monitor acid damage to photosynthesis by measuring photosynthetic O2 evolution in leaves from com and sugar maple plantlets. For 2 months the seedlings were treated with simulated acid rain either by spraying the leaves or by watering the soil at different pH levels. The results indicated a decline of photosynthetic oxygen evolution as the pH of the foliar application of simulated acid rain decreased. The reduced photosynthetic activity was sometimes followed by depigmentation (below pH 3.5). For plantlets treated by watering the soil with an acid mixture, the results showed an increase in the growth rate at higher acidity levels without effect on the photosynthetic activity. All corn seedlings from seeds that germinated in media of different pH levels showed the same photosynthetic activity regardless of the pH, as measured by photoacoustic spectroscopy, but the growth rate was higher at lower pH values than at higher pH values. These results clearly indicate the importance of acid damage to photosynthesis at the foliar level, and the ability of photoacoustic spectroscopy to assess forest decline in its early stages. Key words: photoacoustic spectroscopy, photosynthesis, corn, maple, acid rain, oxygen evolution.

Two patients are described who developed non-regional metastases of adenocarcinoma of the lung at 11, and 14 years following resection of the primary tumor. In each case a careful search failed to reveal a second primary lung tumor. The metastases were discovered in brain and a supraclavicular lymph node. Such distant metastases arising more than 10 years after primary surgery is a very rare event in adenocarcinoma of the lung. These patients were part of a small group who had received adjuvant immunochemotherapy following curative surgery. They developed moderate to very strong delayed hypersensitivity reactions to soluble tumor antigens that persisted from 10 to more than 14 years. The clinical course of these patients share many features with the conditions needed for the induction, maintenance and abrogation of tumor dormancy in animal models.

Campylobacter rectus,formerly known asWolinella recta,is an anaerobic Gram-negative bacillus, generally recognized as an agent responsible for severe periodontitis; only two cases of extra-oral infections have been reported. The first case of septicemia withC rectusandActinomyces odontolyticusis described in a 37-year-old farmer who suffered from severe sacroiliitis. Also presented are a review ofC rectusin human pathology, and a brief review of pyogenic sacroiliitis, a rather rare disease.

The problem of air pollution and forest decline has become one of the most controversial subjects today. This is mainly due not only to economical and political implications but also to conflicting results obtained by many research groups using different methods which are more or less sensitive and reliable [1,2]. It therefore appears that more sensitive techniques used under controlled experimental conditions are needed. We have utilized the photo-acoustic spectroscopy (PAS) to study the effects of O3, SO2 and simulated acid rains on the photosynthetic activity of corn and sugar maple leaves.

After surgical resection of their primary lung cancer, 33 patients were randomized into one of three groups. The first received high-dose methotrexate once per month with citrovorum rescue, for 3 months. The second group were immunized monthly with a homogenate of Freund's complete adjuvant and carefully characterized soluble antigen derived from allogeneic lung cancer cells of appropriate histology, for 3 months. The third group received a combination of methotrexate and immunization monthly, for 3 months. Each patient was monitored immunologically before, during, and after the treatment period, by use of delayed hypersensitivity reactions to recall and cancer antigens, in vitro lymphocyte response to mitogens, and mixed lymphocyte blocking factor activity. The group that received methotrexate showed little change in skin reactivity, a reduction of blocking factor activity, and significant rebound overshoot in in vitro lymphocyte performance. The immunized group showed a tendency to production of blocking factor activity, striking conversion and enhancement of skin reactivity, and little change in in vitro lymphocyte performance. The immunochemotherapy group showed dramatic increases in specific skin reactivity to cancer antigens, up to 2 years after treatment, in vitro lymphocyte rebound overshoot, and reduction of blocking factor activity production. Classic life table analysis of the probability of freedom from metastases in patients with stage-I cancer indicate that the disease-free interval in patients who received methotrexate is longer than in historic and concomitant controls but not as long as in those who received immunization. The best group appear to be those who received combination immunochemotherapy. We emphasize that the small numbers in this pilot study do not yet allow firm conclusions to be made.

A case of innumerable renal artery aneurysms of probable congenital origin is reported. No other lesion could be found in any other abdominal organ studied. We think it unique as no similar case could be found in the medical literature. Except for right flank malaise, the patient was otherwise asymptomatic. The radiologic diagnostic methods are discussed, stressing the differential diagnosis of calcifications in the area of the kidney. The management of renal aneurysms is discussed in regard to the nephrectomy.

A case is reported of a patient who developed a silent partial renal infarct with a perirenal hematoma.The angiographic studies and surgical findings are discussed.Greater awareness from a clinical and roentgenologic point of view seems warranted.The causes, diagnosis and differential diagnosis as well as the evolution of this lesion are discussed.

Three patients with recurrent or metastatic malignant meningiomas were treated with IV Adriamycin. Two of the 3 responded. Further studies are warranted.

In many neoplasms, lymphography is a reliable method with which lymph node metastases are demonstrated, but its accuracy in Stage IB cancer of the uterine cervix remains to be more firmly established. One hundred patients with Stage IB cancer of the uterine cervix underwent lymphography before radical hysterectomy with pelvic lymphadenectomy was contemplated. All the lymphographic findings were reviewed without knowledge of the pathologic parameters of the patients and were classified as being either positive (five cases), suspicious (15 cases), or negative (80 cases). The pathologic studies revealed lymph node metastases in 18 patients—in five with positive lymphographic findings, in three with suspicious findings, and in 10 with negative ones. The five true positive cases were compared to the 13 false negative or suspicious lymphographic results. It appears that the former have a greater number of involved lymph nodes and a greater mean size of the metastases. Thus, in Stage IB cancer of the uterine cervix, lymphography demonstrates an excellent specificity (100%) but a low sensitivity (27.8%).

In this report we give the survival data on 52 patients with stage I cancer of the lung who have been treated in Ottawa. A year has passed since the last figures for survival were published [15, 16]. We also indicate survival data for the small numbers of patients who were included in this study and who had either stage II or stage III disease. The rationale and design of this study has been reported in detail [14] as has the preparation and characterization of antigens used for immunisation [6]. The usefulness of such antigens in monitoring patients progress following curative surgery has also been reported [16].

This is a report of a complex anomaly of the lymphatic system involving the mediastinum, pericardium, ribs and scapula, in a six year old boy. The anomaly manifested itself by chylopericardium and chylothorax. The chylothorax increased in magnitude over a five month period, despite conservative measures. Surgery was unsuccessful. Fifty percent glucose injected in the pleural cavity finally controlled the chyle loss.