This is a case of a large lactating adenoma which developed in a 26 year old primagravida during the third trimester of her pregnancy. The presentation was that of a grossly enlarged and engorged breast with breast erythema, warmth and tenderness. Radiologic and pathologic examinations were difficult because of the lactational changes in the breast and areas of infarcted tissue within the large tumor. Skin biopsies and core biopsies of the mass were performed to exclude malignancy. Surgical resection of the mass was necessary for definitive diagnosis. The pathology proved to be a lactating adenoma, which is the most prevalent breast mass in young pregnant females. The large size of this tumor, and the presentation of breast erythema and edema raised the possibility of inflammatory breast cancer. Following surgical resection and definitive diagnosis of this tumor, the patient required plastic surgical reconstruction of the breast because of redundant breast tissue. Although most lactating adenomas spontaneously involute, the diagnosis is not always straight-forward and surgical resection may be required for definitive diagnosis and exclusion of other pathologic processes.
Endotracheal intubation in small laboratory animals is often necessary for survival experiments. Methods of airway control have included tracheostomy, blind intubation, and intubation under direct vision. Most of these methods are unsatisfactory and associated with high failure and complication rate. We developed an easy method of endotracheal intubation in the rat that requires simple material that is easily available to any research facility. The animals were anesthetized with pentobarbital sodium, the tongue was pulled out, and an otoscope was introduced into the oropharynx. By direct vision, a guide wire was inserted into the trachea and a 16-gauge intravenous catheter was glided over the wire. The first group of 70 rats underwent left thoracotomy with endotracheal intubation and mechanical ventilation at our laboratory as part of a study on isolated lung perfusion. The second group of five rats was anesthetized with pentobarbital, and a left carotid catheter and an endotracheal tube were inserted. Animals were ventilated with 100% O2. Arterial blood gases were sampled before intubation, 30 min after ventilation, and 60 min after extubation. In the first group, 94.3% (66 of 70) of the animals survived surgery and mortality was not directly related to the intubation and/or ventilation. All five animals of the second group survived the procedure to be extubated. Arterial PO2 before intubation, 30 min after intubation and ventilation, and 60 min after extubation was 77.1 +/- 8.5, 465.0 +/- 55.6, and 98.9 +/- 12.8 Torr, respectively. PCO2 at the same time points was 42.5 +/- 10.1, 35.1 +/- 6.3, and 32.7 +/- 6.5 Torr, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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