[Assisted mitral prosthesis].
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Biomedical subjects
Publications and source records attributed to J Colon.
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The effects of tamoxifen on cortisol binding globulin (CBG) and sex hormone binding globulin (SHBG) were studied in 25 women and one man with breast cancer. These patients were in various endocrine states according to age (15 post-menopausal women) or previous endocrine surgery (ovariectomy, two patients; ovariectomy plus adrenal surgery, five patients; hypophysectomy, three patients; ovariectomy plus hypophysectomy, two patients). The administration of tamoxifen (20-40 mg/day) resulted in increases in the level of CBG in all patients (mean rise in binding capacity 10.8 microgram cortisol/100 ml plasma) and in the level of SHBG in 21 patients (mean rise in binding capacity 0.79 microgram dihydrotestosterone/100 ml plasma for all patients). These increases were positively correlated. They were not associated with any alteration in the association constants of the steroid binding globulins. The effect of tamoxifen on CBG diminished with increasing age. The changes in the levels of CBG and SHBG were independent of the endocrinological state of the patient. It is inferred that tamoxifen has a direct oestrogen-like action on the liver which results in increased production of CBG and SHBG. Tamoxifen therapy for carcinoma of the breast appeared to be least effective in those patients in whom the drug caused the highest increase in the concentration of CBG.
In a series of 181 patients with breast cancer treated by mastectomy with axillary lymph node dissection, the authors developed and used an improved topographic technique, which they call the "Grid Method", which maps out the extent of a given cance of the breast. Three types of tumor spread are defined: Type 1, limited (L)(31%); Type 2, multifocal (M)(13.2%); and Type 3, extensive (E)(55.8%). This topographic information allows a more accurate assessment of prognosis when used in conjunction with the morphologic findings. Moreover, the topographic "Grid" study is simple to perform and easy to assess. Of prime importance is the relationship between the topographic and mammographic findings.
One hundred and twenty-eight patients with breast cancer who, on the basis of mammographic study, were treated by mastectomy were analyzed. The purpose of this endeavor was to correlate the roentgenologic features with the pathologic findings. The correlation between them was very good: the type of tumor opacity, the microcalcifications, and the various other radiologic patterns were compatible with both localized and extensive breast cancer. Mammography appears to be valuable in the selection of patients suitable for conservative treatment.
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