Experience using the new GORE Septal Occluder at the margins.

Complex atrial anatomy continues to challenge transcatheter device closure of septal defects. Devices and technology continue to evolve. We report three cases from our institution where the new Gore Septal Occluder was utilized for the closure of a lateral tunnel fenestration, a moderate-sized secundum atrial septal defect and a long tunnel patent foramen ovale. Each case highlights the successful use of this new generation device in challenging circumstances.

Primary lung cancer: characterization and survival of 1024 patients treated in a single institution.

This report describes the presenting features, smoking history, diagnostic techniques and their yields, histological typing and tumor-node-metastases (TNM) staging for a cohort of 1024 Australian patients with primary lung cancer. It also includes survival data for the group as a whole and for subgroups of patients based on clinical stage, histology, treatment modality and postsurgical stage. Ninety-six per cent of patients had smoked. A much higher proportion of patients with adenocarcinoma had smoked than has commonly been believed. In surgically treated patients, stage, but not histological type or age, was related to survival. Approximately one-third of all patients had such advanced disease that no treatment to the primary site was offered.

Initial chemotherapy followed by surgery in malignant thymoma.

Initial combination chemotherapy with cisplatinum, adriamycin and cyclophosphamide was given prior to surgery in a young woman with an unresectable malignant thymoma. Complete remission was achieved following three cycles of chemotherapy. Subsequent thymectomy revealed no evidence of residual malignancy. Prolonged remissions following cisplatin-based chemotherapy have recently been achieved in metastatic thymoma. Initial chemotherapy should now be considered prior to surgery or radiotherapy in those patients presenting with very bulky or unresectable disease.

Cisplatinum-based chemotherapy in malignant mediastinal teratoma.

Five patients with primary malignant mediastinal non-seminomatous germ cell tumours have been treated with a multimodality approach, including cisplatinum-containing chemotherapy, at this institution over the past 7 years. All patients had bulky disease (greater than 10 cm maximum diameter) at presentation and showed raised serum concentrations of human chorionic gonadotrophin or alpha-fetoprotein. Two patients are alive with no evidence of disease at 22 months and 6 years, respectively, from initial diagnosis; two patients have died from progressive disease and one from acute non-lymphocytic leukaemia without evidence of residual germ cell tumour. Long-term survival is achievable for these poor risk patients with a combined modality approach.

The iso-enzyme of alkaline phosphatase in neutrophils during pregnancy.

The alkaline phosphatase from neutrophils of pregnant women and normal males has been extracted, subjected to various inhibitory procedures and to electrophoresis. It is demonstrated that the iso-enzyme obtained from each group is indistinguishable from the skeletal iso-enzyme, in contrast to the serum iso-enzyme of pregnancy which is placental.