Experiences of women in cardiothoracic surgery. A gender comparison

OBJECTIVE: To assess the career and practice experiences of cardiothoracic surgeons, with references to gender similarities and differences. DESIGN: Four-step mailed 115-question survey. SUBJECTS: All identified women, and a cohort of men, certified by the American Board of Thoracic Surgery. MAIN OUTCOME MEASURES: Academic rank, career background, salary, perceptions and experiences of harassment or discrimination, and personal life characteristics. RESULTS: No differences were found in training backgrounds. More men (64%) than women (52%) were in university practices. Comparable proportions of men and women were assistant professors (27%), but more men (27%) than women (13.6%) were full professors. Fifty-eight percent of women and 21% of men reported salaries of less than $250000; 62% of men and 32% of women had incomes over $350000. Career satisfaction was comparable between genders; however, women perceived the promotion process as unfair and unrelated to academic rank. Both genders encouraged men toward a surgical career; men were less likely than women to encourage women to pursue a surgical career (P < .01). Women, much more than men, believed that discrimination hindered their career development (P < .001). Characteristics of personal life were also considerably different between the genders. CONCLUSION: Although practice and training parameters for male and female cardiothoracic surgeons are comparable, work experiences, personal life, and career rewards such as salary and promotion, and perception of discrimination are different.     

Grain-boundary penetration of type 316 stainless steel exposed to cesium or cesium and tellurium

When 20 pct cold-worked Type 316 stainless steel is exposed to Cs at 700°C under controlled oxygen-chemical potential environment, Cs penetration into the stainless steel grain boundaries occurs at oxygen potentials ΔG_o2 ≥ -96 kcal per mole. At lower oxygen potentials (~ΔG_o2 ≤ —110 kcal per mole), no corrosion occurs. Under the same experimental conditions, when the stainless steel is exposed to Cs:Te (2:1, atomic), corrosion occurs and penetration morphology appears to depend strongly on the oxygen-potential environment. The stainless steel suffers intergranular corrosion by Te (in the presence of Cs-Te) under conditions where chromium oxidation is not expected to occur. The kinetics of grain-boundary penetration by Te have been studied at temperatures between 550 and 700°C. The depth of the penetrated zone varies as (time)^1/2, and the process has an activation energy of 34 kcal per mole. The results are discussed, and the effects of stainless steel microstructure and externally applied stress on corrosion reactions are also described.     

Grain-boundary penetration of type 316 stainless steel exposed to cesium or cesium and tellurium

When 20 pct cold-worked Type 316 stainless steel is exposed to Cs at 700°C under controlled oxygen-chemical potential environment, Cs penetration into the stainless steel grain boundaries occurs at oxygen potentials ΔG_o2 ≥ -96 kcal per mole. At lower oxygen potentials (~ΔG_o2 ≤ —110 kcal per mole), no corrosion occurs. Under the same experimental conditions, when the stainless steel is exposed to Cs:Te (2:1, atomic), corrosion occurs and penetration morphology appears to depend strongly on the oxygen-potential environment. The stainless steel suffers intergranular corrosion by Te (in the presence of Cs-Te) under conditions where chromium oxidation is not expected to occur. The kinetics of grain-boundary penetration by Te have been studied at temperatures between 550 and 700°C. The depth of the penetrated zone varies as (time)^1/2, and the process has an activation energy of 34 kcal per mole. The results are discussed, and the effects of stainless steel microstructure and externally applied stress on corrosion reactions are also described.     

Positive 131cesium scanning in parathyroid adenoma

In a case of primary hyperparathyroidism, a palpable nodule, at the base of the right lobe of the thyroid, proved 'cool' during 99mTc scanning, but 'hot' when scanned with radiocesium. The uptake of this tracer was higher than the uptake of 75Seselenomethionine after suppression with T3. The authors discuss the possibility of cases of 'false-positive' radiocesium uptake in extrathyroid nodules, and in particular, the use of this tracer for the detection of parathyroid adenoma by scanning.     

Modification of cesium toxicity by calcium in mammalian system

The interaction between cesium chloride CsCl and calcium chloride CaCl2 was observed in bone marrow chromosomes of mice. The two salts were administered orally to laboratory bred Swiss albino mice in vivo singly or one followed by the other, or both simultaneously. CsCl induced chromosomal aberrations in frequencies directly proportional to the dose administered. The frequency of aberrations was reduced significantly when the two chemicals were administered simultaneously or when CaCl2 was given 2 h before CsCl. Thus, CaCl2 is able to protect against the cytotoxicity of CsCl.     

High-dose brachytherapy in endobronchial neoplastic stenoses

Form March, 1991, to September, 1995, twenty-nine patients with endobronchial neoplastic stenosis were treated with high dose rate (HDR) brachytherapy at the Casa Sollievo della Sofferenza Hospital in San Giovanni Rotondo (Foggia, Italy). Fifteen patients had hemoptysis, 10 dyspnea, 6 constant cough and 6 lung atelectasis. The total dose, specified at 1 cm from the source, ranged 5 to 21 Gy and the fraction doses 5 to 15 Gy. Fourteen of 29 patients (48%) died. The mean survival is 7 months, with the follow-up ranging 1 to 22 months. Subjective responses were achieved in 78.4% of cases, with 67.6% complete and 10.8% partial remission rates. Complete remission of hemoptysis was observed in 100% of patients. Dyspnea improved in 70%, cough in 46.4% and atelectasis in 83.2%. Endoscopic findings, 1 month after the end of brachytherapy, showed a response in 79.4% of patients. The complication rate was 13.8% (1 tracheoesophageal fistula, 2 pulmonary hemorrhages and 1 cavitary necrosis). Even though the number of treated patients is small, our experience confirms the efficacy of HDR endobronchial brachytherapy in the palliation of lung cancer-related symptoms. Literature data show that brachytherapy improves the quality of life in the patients with poor prognosis who are otherwise untreatable. The HDR technique is more accurate than the LDR technique and therapy is better tolerated also because execution time is shorter. Prospective clinical trials are needed to investigate the most effective total doses and fractionations and to better define the role of brachytherapy in the curative treatment of lung cancer.