Operative management of chronic coccidioidomycosis.

Nine of fourteen patients with chronic coccidioidomycosis were treated operatively for therapeutic and diagnostic indications. Complications were minimal and no reactivation or spread of the disease resulted. This series emphasizes the role of the surgeon in the diagnosis and management of chronic coccidioidomycosis and demonstrates the need for the surgeon to be familiar with its natural history and diverse presentations.

Recurrence patterns and survival after combined radical mastectomy and postoperative irradiation: a retrospective analysis.

Recurrence patterns were analyzed in 323 patients treated by radical mastectomy, 219 of whom received postoperative irradiation. Thirty-five patients with inner quadrant lesions and negative axillary nodes received postoperative regional node irradiation; 33 of these 35 patients are alive without recurrence from 2 to 22 years later. Six of 219 patients receiving postoperative regional lymph node irradiation developed recurrence in the treated area. In patients with positive axillary nodes, 27% of all recurrence developed initially in the chest wall region, and an additional 10% of patients developed distant metastases in addition to chest wall recurrence. The high incidence of chest wall recurrence in patients with four or more positive nodes, and in patients with two or three positive nodes and primary lesions over 3 cm in diameter who did not receive chest wall irradiation, suggests that the maximal benefit from postoperative irradiation would not be realized in prospective, randomized studies without the use of chest wall irradiation postoperatively in these categories of patients.

The effects of testosterone on plasma and platelet monoamine oxidase (MAO) an plasma dopamine-beta-hydroxylase (DBH) activities in the male rhesus monkey.

Dopamine-beta-hydroxylase (DBH) and monoamine oxidase (MAO) in plasma and platelets were studied in male rhesus monkeys to evaluate the effects of changes in endogenous testosterone on the activity of these enzymes. High plasma testosterone concentrations attained at the end of the mating season were associated with relatively low levels of platelet MAO activity. When testosterone levels fell, platelet MAO increased significantly. Mean differences in platelet MAO activity between a group of castrated and control males were in the direction expected, with the highest MAO activity in the castrated monkeys, but these differences did not attain statistical significance. No significant mating season or castration effects were seen in plasma DBH or MAO enzyme activities. These data support the hypothesis of a link between testosterone and some monoamine systems, and possibly the monoamine-related behaviors linked to testosterone in primates.