Carcinoma of the breast is second in rank among all caucasian women suffering from cancer (42). First in rank is carcinoma of the uterus. In some reports (59), carcinoma of the breast ranked first; such is the case in New York state. The five year survival rate in operable breast carcinoma, by radical mastectomy is around f.fty per cent. This 5 year survival rate improves to seventy-five per cent if there are no regional or distant metastases and falls to around thirty per cent if the axillary lymph nodes are involved by metastatic disease. This tact stresses the importance of early diagnosis and treatment in carcinoma of the breast. Every year 25,000 American women die of cancer of the breast. This is a crude mortality rate of 24.6 per 100,000 for the United States (42). We cannot seem to lower this figure with any known method of diagnosis or treatment.

Almost one hundred years ago Paul Langerhans (1) described the pancreatic islet cells. Another 50 years had passed before its physiological significance had become clear, following the studies of Laguesse (2). On the basis of histological observations, particularly referring to profuse vascularization of the islets, Laguesse suggested in 1893, that islet cell have an endocrine function. The classical experiments of Banting and Best (3) in 1922 lead to the identification of the hormone insulin and consequently to the treatment of diabetes. According to present knowledge, insulin is secreted by Beta cells. It has been shown that the insulin content of the splenic portion of the dog's pancreas is much higher than the duodenal portion.

Revascularization of the ischemic myocardium is one of the major concerns in the field of experimental surgery. The increasing disability and death from obliterative disease of the coronary arteries, which all too frequently attacks men in the prime of life whose other organs are still intact and healthy, has stimulated widespread interest in the field of medicine to produce some means of increasing the blood flow to the ischemic myocardium. The causative factors in the genesis of coronary occlusive disease is still far from clear.

Evidence from paleopathology indicates that cancer is a very ancient disease. Preserved relies of prehistoric times reveal wide geographic and zoologic distribution of malignancy. Dinosaurs of the Mesozoic period are said to have shown signs of cancer, and other evidence of its antiquity (Sambon cited by Haddow) (68) are to be found in the treasures of the pyramids, from the Etruscan tombs, from Peruvian mummies and from the cuneiform tablets of the library of Nineveh. The earliest medical record known to man (94) is the "Edwin Smith Surgical Papyrus". This anonymous relic of antiquity is generally regarded by historians as having been originally written in the Egyptian Pyramid Age in the Old Kingdom (3000- 2500 B.C .), although speculation by Breasted and Cooper (16) suggest that this document may form part of the teachings of the oldest known physician, Imhotep, the 'patriach and sage of primitive medicine' (94) who lived in the thirteenth century B.C.

In spite of the fact that pulmonary emphysema has been recognized for one hundred and fifty years or more, it has only been in the last fifteen years that extensive efforts have been made by anatomists, pathologists, physiologists, biochemists and clinicians to correlate its various aspects. Unfortunately these efforts have not been completely successful in clarifying the aetiology and pathogenesis of the disease and in fact until recently there was no universally accepted definition of emphysema. The definition that will be used in this study is the one proposed at the Ciba Guest Symposium (1959): “Emphysema is a condition of the lung characterized “by increase beyond the normal in the size of air spaces “distal to the terminal bronchiole either from dilatation or from destruction of their walls”.

Membrane sulfhydryl (SH) groups have been reported to be important for the maintenance of red cell integrity in vivo (Jacob and Jandl, 1962). A technique has been developed for the determination of reactive membrane sulfhydryl content in intact erythrocytes, utilizing subhemolytic concentrations of p-chloromercuribenzoate (PMB). The erythrocyte membrane of 52 healthy subjects contained 2.50 - 2.85 x 10^-16 moles of reactive SH groups (mean 2.50 +/- 0.20) per erythrocyte, when determined by this method. A 27-36% reduction of erythrocyte membrane SH content was observed in various conditions characterized by accelerated red cell destruction, including glucose- 6-phosphate dehydrogenase (G6PD) deficiency, drug-induced, autoimmune and other acquired hemolytic anemias and congenital spherocytosis. Normal membrane sulfhydryl content was found in iron deficiency anemia, pernicious anemia in relapse, and in other miscellaneous hematological conditions. Inhibition of membrane SH groups with PMB caused marked potassium leakage from the otherwise intact cells. The possible role of membrane sulfhydryl groups in the development of certain types of hemolytic anemias, and in the maintenance of active transmembrane cation transport in the erythrocyte is discussed.

While accurate measurement of the excretory aspect of renal function is clearly a vital part of the assessment and follow-up of many patients with renal or urological disease, this unfortunately is not always easy to obtain. Screening tests such as BUN, serum creatinine and I.V.P. may not become abnormal until 2/3 of renal function has been lost, so that more finite clinical tests are necessary. Those commonly used are the creatinine clearance and the P.S.P. test. It is our experience, considering the overall hospital population, that 1/4 to 1/3 of these tests give inaccurate results when the urine is collected without a catheter.

The present hospital mortality rate for myocardial infarction is reported as 47%, and when shock occurs it is said to be above 85% regardless of the type of therapy. Most of these patients die in left heart failure. It is obvious that present treatment of myocardial infarction is inadequate and a new approach is required. The answer appears to lie in some type of support to the heart which could adequately maintain systemic and coronary circulation, while the damaged myocardium recovers from its injury. With such assisted circulation surgical correction could be accomplished in isolated lesions and collateral circulation might develop in diffuse disease.

This thesis describes investigations of a purely experimental treatment for severe burns, and seeks to relate the benefits of such treatment to the accepted pathophysiological principles of burn sickness. In particular it dwells on the eftect of hypothermia on the scalded rat in terms of mortality, development of shock, and postburn toxicity. The work was stimulated by certain observations made by Dr. N. G. Foy, reported in his Master of Science thesis of 1963, at McGill University. [...]

Since Liljestrand's classic work on the O2 cost of ventilation (10) there has been ample confirmation of his finding that voluntary hyperventilation requires more oxygen per litre ventilated than if hyperventilation is CO2 driven at the same frequency and tidal volume (1,6,7,10,13,17,18). Figure 1 illustrates this point graphical1y and shows two families of curves. One (solid lines), representing the oxygen cost of carbon dioxide driven hyperventilation while the other (dotted lines) represents the considerably greater oxygen cost of voluntary hyperventilation at any chosen minute ventilation. Liljestrand's explanation that the greater O2 cost of voluntary hyperventilation was due to the less efficient use of the respiratory muscles during voluntary as compared with CO2 driven hyperventilation has been generally accepted by most investigators. [...]