Primary lung cancer in patients under 40 years of age

There seems to be a resistance of patients and physicians towards aggressive diagnostic evaluation of the symptoms of lung cancer in young people. We here review nine series of young patients with primary lung cancer. Patients below 40 years of age represent between 1.2 and 5% of the total lung cancer population. The distribution of sex and histopathologic findings is different, there being more women, fewer cases of squamous cell and more cases of small anaplastic and adenocarcinoma in the young group. Between 87 and 96% are smokers. There is a delay from the debut of symptoms to the first contact with a general physician of 2.4 to 10.8 months. There is a wide variation concerning tendency to operate with a frequency of curative resection of between 15 and 57%. Based on the survival of young patients who are treated by curative surgical resection, the outcome of surgical treatment for young patients does not differ from the general experience concerning resection in patients of all ages. Young patients who are found inoperable have worse survival than the older patients. Seventy to 90%, more than in the group of patients of all ages, have stadium II or III at the time of diagnosis. In conclusion, physicians should be aggressive with respect to the diagnostic evaluation even of young patients with symptoms suggestive of lung cancer.     

Difluorocarbene modification of polymer and fiber surfaces

Difluorocarbene (difluoromethylene, :CF₂) generated by the pyrolysis of sodium chlorodifluoroacetate has been shown to irreversibly modify the surfaces of polymers and fibers. The critical surface tension values of several polymers are shown to decrease with increasing exposure to difluorocarbene vapors and ultimately approach the critical surface tension values of partially fluorinated polyethylenes. The rate-controlling step appears to be the diffusion of difluorocarbene from the precursor to the polymer substrate. The nature of the interaction between difluorocarbene and the polymer surface is unknown; however, the absence of infrared bands due to C? F bonds in attenuated total reflection measurements tends to establish the mono-molecular-like character of the modified surface.     

Modification of polyethylene surfaces with carbethoxy substituted carbenes and nitrenes

Carbethoxycarbene, carbethoxynitrene, and nitrene generated respectively by the pyrolysis of ethyl diazoacetate, ethyl azidoformate, chloramine and sodium hydroxyl amine-o-sulfonate are shown to irreversibly modify the surface of polyethylene as shown by wettability measurements. The nature of the modification is not fully understood; however, insertion of the carbene or nitrene into a carbon-hydrogen bond appears likely. The modified surfaces thus formed are shown to undergo several classical organic reactions as again determined by wettability measurements.     

Geotrichum septicemia

Although disseminated geotrichosis is an unusual disease (to our knowledge, only six cases have been reported), Geotrichum candidum is not a very virulent fungus. In our case, there was neutrophillic phagocytosis of the arthrosphores of G candidum, with rapid clearance of the fungus from the plasma of a chronically ill patient whose immune defenses were still intact.     

An evaluation of procedures used in staging carcinoma of the cervix

A review of 227 cases of invasive carcinoma of the cervix was undertaken to determine the efficacy of procedures using in the staging of this disease. All patients had a pretreatment chest radiography and intravenous pyelogram. 96.5% had pretreatment cystoscopy, 98.6% had pretreatment proctoscopy, and 92% had a pretreatment barium enema. These patients were retrospectively staged on the findings of physical examination only. Each additional procedure was then evaluated by comparison with the initial staging. Cystoscopy and chest film findings each would have changed the clinical stage in fewer than 1% of cases, barium enema in 1.4%, and proctoscopy in 2.2%. No patient had a positive barium enema without a positive proctoscopy, while two patients had positive proctoscopies with negative barium enemas. The overall yield of positive findings by pretreatment intravenous pyelography was 7.3%. Lymphangiography, although inconsistently done, yielded positive findings in all stages. Chest radiographs, intravenous pyelography, proctoscopy, and lymphangiography are recommended as part of the pretreatment workup of patients with carcinoma of the cervix. Routine barium enema is no longer recommended, and cystoscopy is only recommended in patients with clinical stage IIB disease or greater.