Mediastinoscopy in the surgical management of lung carcinoma

Up to December 1973, we had performed 100 mediastinoscopies for lung carcinoma. Fifty-two were positive and 48 negative. In 80 cases there was clinical or radiological suspicion of mediastinal invasion. With radiological evidence of mediastinal node involvement exploration was positive in 32 out of 35 cases, when chest radiography findings were equivocal in 19 out of 45, and when radiology of the mediastinum was normal in only one of 20 cases. Mediastinoscopy was more frequently positive when the carcinoma was oat-cell or anaplastic. Of 48 patients with negative biopsies, 41 were explored. In 26 the carcinoma extended beyond the lung. In 1973 we circularized 83 thoracic surgeons concerning (1) the use of mediastinoscopy for patients with lung carcinoma assessed for surgery, (2) the significance of mediastinal node involvement, (3) the results of radiotherapy alone in patients rejected for surgery, and (4) the survival rate in patients with positive mediastinal nodes treated with surgery alone or together with radiotherapy. The replies to the questionnaire are summarized. The authors emphasize the usefulness of mediastinoscopy but state that care must be taken when deciding to withhold operation for a possible cure.

Hernia of Morgagni

París, F., Tarazona, V., Casillas, M., Blasco, E., Cantó, A., Pastor, J., and Acosta, A. (1973).Thorax, 28, 631-636. Hernia of Morgagni. Nine patients with Margagni's hernia of the diaphragm are reported, seven of whom have been operated on. Four patients had gastrointestinal symptoms, two respiratory symptoms, and one retrosternal pain; the other two were asymptomatic. In the first case the diagnosis was made at the time of thoracotomy, in the other eight it was suggested by radiological studies. The standard midline epigastric incision was used for repair in four cases and thoracotomy in two; the last patient was operated on through a preperitoneal subxiphoid route. This route has the advantage of not requiring a wide incision of peritoneum.

New developments in interferometry

This article is based on a series of talks presented by personnel of The Perkin-Elmer Corporation at a symposium held in September 1967 and thereafter brought up to date for inclusion in the APPLIED OPTICS feature discussing Interferometry vs Spectroscopy.

Observations on 205 confirmed cases of acute pancreatitis, recurring pancreatitis, and chronic pancreatitis

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