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Annals of Surgical Oncology seeks to cover the broad spectrum of multidisciplinary clinical cancer care and basic cancer research relevant to practicing surgeons. As the official journal of the Society of Surgical Oncology, this new journal publishes annual meeting papers and distributes news to its more than 1000 members. Rigorous competition for manuscript acceptance and peer review characterize the editorial process. The editors essentially comprise the "who's who" of surgical oncology in the United States. The editorial board consists of oncologists representing notable institutions. Quality contributions from the US community of surgical oncologists fill its pages.Surgical oncologists frequently coordinate all aspects of cancer care, which encompasses diagnosis, surgical or nonsurgical treatment, rehabilitation, and surveillance. Their educational, clinical, and research activities include a wide array of cancers spanning all organ systems and various anatomic sites. Although this journal has strong appeal and value for general surgical oncologists, other surgical specialists

Browsing the world's dermatological literature with the intention of selecting the most important, clinically relevant articles to review and then assimilating their conclusive concepts into practical working knowledge are still giant tasks. Practicing dermatologists, trainees, and academicians still have difficulty accomplishing these tasks, despite increased accessibility to computerized database services. Now there is help from a new, user-friendly review journal, Medical and Surgical Dermatology: A Critical Guide to the World Literature. This product selectively disseminates information in a familiar, portable, reasonably priced, and visually appealing format. This journal serves as a tool for both current awareness and long-term reference. It complements rather than substitutes for peer-reviewed publications. As a "journal hybrid" that reaches beyond basic indexing and abstracting to include original essays and pictorial selections, the journal exhibits a unique composition, which serves several needs at once. At each issue's core are some 100 to 150 highly structured abstracts, which

Voyager Infrared Interferometer Spectrometer (IRIS) observations of Jupiter in the far infrared (180-1200/cm) are sensitive to emission originating from pressures less than 2 bars, while the 5-micrometer (1800-2300/cm) observations are primarily sensitive to emission originating from pressures greater than 2 bars. We use these differences in the location of the peak emission level to constrain the properties of the upper tropospheric cloud structure from the far-infrared observations and then use the 5-micrometer observations, with the upper tropospheric cloud structure fixed, to constrain the deep cloud structure. The relationship between observed 45- and 5-micrometer brightness temperatures reveals three distinct regions between +/- 25 deg latitude: North Equatorial Belt hot spots, which are 'hot' at both 45 and 5 micrometers; Equatorial Zone spectra, which are 'warm' at 45 micrometers and 'cold' at 5 micrometers; and North Tropical Zone spectra, which are 'cold' at both 45 and 5 micrometers. We find that the hot extreme spectral ensemble is unique to belts, and the cold extreme spectral ensembles are unique to zones, but that all other intermediate spectral ensembles are common to both regions. Analyses of these spectra using an anisotropic multiple scattering radiative transfer model reveal that the primary difference between belts and zones is the increased opacity and vertical extent of clouds in zones relative to their belt counterparts. In addition, we find a shift in the location of the para hydrogen gradient toward lower pressures in zones, with an increase in the 'equilibrated' cloud-top para fraction. We suggest that all of the variations in gas abundance profiles, temperature, and cloud structure are consistent with the effects of a simple mean circulation and large-scale wave motions.

Now in its third year, Operative Techniques in Orthopaedics was established to keep the practicing orthopedic surgeon apprised of new and effective procedures in a constantly changing field. According to an editorial statement, the goal is to focus on both rapidly evolving and widely performed operative procedures in this increasingly technical area of surgery. Published quarterly, the journal is structured thematically, with each issue devoted to a specific topic or procedure and guest-edited by a member of the editorial board. Manuscripts are solicited and reviewed within the purview of the board's 11 surgeons, the majority of whom are based in the Philadelphia area. Issues average 12 articles that range from five to 15 pages. Forthcoming topics are conveniently announced on the contents page. The large, 12-in × 9-in "atlas-style" format displays numerous, high-quality illustrations that embellish the text. In a 1992 catalog, the publisher states that Operative Techniques in Orthopaedics

Voyager IRIS observations reveal that the Jovian para-hydrogen fraction is not in thermodynamic equilibrium near the NH3 cloud top, implying that a vertical gradient exists between the high-temperature equilibrium value of 0.25 at depth and the cloud top values. The height-dependent para-hydrogen profile is obtained using an anisotropic multiple-scattering radiative transfer model. A vertical correlation is found to exist between the location of the para-hydrogen gradient and the NH3 cloud, strongly suggesting that paramagnetic conversion on NH3 cloud particle surfaces is the dominant equilibration mechanism. Below the NH3 cloud layer, the para fraction is constant with depth and equal to the high-temperature equilibrium value of 0.25. The degree of cloud-top equilibration appears to depend on the optical depth of the NH3 cloud layer. Belt-zone variations in the para-hydrogen profile seem to be due to differences in the strength of the vertical mixing.

Empirical formulas are fitted to existing theoretical absorption spectra of H2-H2 pairs in the far-infrared allowing the inclusion of dimer absorption, parameterized with the height dependence of the para-hydrogen profile, in the calculations. Comparison between synthetic and Voyager IRIS spectra shows that once the dimer absorption is included it is now possible to reproduce the hydrogen portion of the IRIS spectrum to within the precision of the measurements.

The Voyager IRIS spectra of the Jovian North Equatorial Belt (NEB) hot spots are reanalyzed using a radiative transfer model which includes the full effects of anisotropic multiple scattering by clouds. The atmospheric model includes the three thermochemically predicted cloud layers, NH3, NH4SH, and H2O. Spectrally dependent cloud extinction is modeled using Mie theory and the refractive indices of NH3 ice, NH4SH ice, water, and H2O ice. The upper tropospheric temperature profile, gas abundances, height-dependent parahydrogen profile, and vertical distribution of NH3 cloud opacity are retrieved from an analysis of the far-infrared (180-1200/cm) IRIS observations. With these properties constrained, the 5-micron (1800-2300/cm) observations are analyzed to determine the atmospheric and cloud structure of the deeper atmosphere (P of greater than 1.5 bars). The results show that the abundance of water is at least 1.5 times solar with 2 times solar (0.00276 mixing ratio relative to H2) providing the best-fit to the Voyager IRIS hot spot observations.

Bacteria can be cultured from approximately one third of chronic middle ear effusions, yet the contribution of these bacteria to the pathogenesis of chronic otitis media with effusion (OME) is not clear due to the absence of signs and symptoms of acute infection in most children with this disease. To explore the role of bacteria in chronic OME, lysozyme, lactoferrin, serum complement factors C3 and C5a, and polymorphonuclear leukocyte (PMNL) chemotaxin content was measured in 21 chronic middle ear effusion samples. Concentrations of lysozyme, lactoferrin, and chemotaxin were significantly higher in culture-positive than in sterile effusions. Lysozyme appeared to be contributed by both PMNL and non-PMNL sources in the middle ear space. These non-PMNL sources, presumably middle ear epithelial cells, accounted for 50% to 80% of the lysozyme variation in middle ear effusion. Although C3 and C5a were present in effusion, chemotaxin content correlated poorly with the C3 and C5a content, suggesting that chemotaxins were derived from bacterial peptides rather than from complement activation products. These results suggest that bacteria contribute to chronic middle ear inflammation with effusion. The eradication of bacteria from chronic middle ear effusion might disrupt the host responses which maintain chronic OME.

Comparable worth and realignment are two strategies proposed to reduce the gap in earnings between men and women.

Timely, comprehensive screening for breast cancer is a major, though often overlooked, component of primary health care for women. This article reviews the scientific rationale for screening and outlines the current recommendations of the American Cancer Society and the U.S. Preventive Services Task Force regarding the use of mammography, clinical breast examination (CBE), and breast self-examination (BSE). Nursing interventions to decrease barriers to effective screening are discussed, and an expanded role of nurses in breast cancer screening is proposed.

Ground-based observations of Jupiter show that the planet's stratospheric and tropospheric thermal emission are anticorrelated. The observations can possibly be explained by latitudinal variations in cloud altitude. These variations cause differential stratospheric heating by sunlight which is reflected off the clouds and then absorbed within the stratosphere by visible and near-infrared bands of methane.

The characteristic time constants for the atmospheres of the giant planets were compared for the purpose of finding analogs for clouds in the atmospheres of these planets among the several types of cloud systems found on earth. The NH3 clouds on Jupiter and Saturn were found to be weakly precipitating systems, similar to the thicker cirrus clouds on earth, while the H2O clouds were found to be much more massive than the water clouds on earth. The CH4 and H2O clouds on Uranus and Neptune are completely unlike any cloud on earth, being 10 to 100 times more massive than the densest water clouds on earth. It is concluded that, while the microphysical characteristics of the clouds on Jupiter and Saturn are comparable to those of terrestrial stratus and cumulus clouds, the massive clouds on Uranus and Neptune reach conditions unlike anything on earth.

In a randomized clinical trial a comparison was made of two BSE teaching interventions delivered by primary providers during office visits in a group nursing faculty practice. Patients who reported no regular BSE (n = 121) received either individualized teaching focused on reducing perceived barriers and reinforcing benefits of BSE, or routine teaching limited to usual instruction in BSE technique. Patients reporting frequent/monthly BSE during the past year were comparison subjects (n = 81). Self-reported data on BSE behavior were obtained in questionnaires administered before the interventions and via telephone interviews three months after the visit. Analysis using chi square showed that, contrary to expectation, individualized and routine teaching were equally effective: 61.4% of the individually taught and 63.5% of the routinely taught reported frequent or monthly practice at followup. Both groups were significantly more confident in technique and ability to detect change in the breast. The previously non-practicing women remained significantly less likely than comparison subjects to be performing BSE monthly at followup. The perceived benefit of BSE giving peace of mind predicted non-practicers most likely to change.

Gonorrhea is one of the most serious infectious diseases facing sexually active women in the U.S. today. Gonorrhea infection may threaten a woman's potential fertility, cause extreme discomfort and pain, and/or adversely affect a woman's unborn fetus. Many of the health risks associated with gonorrhea can be ameliorated, however, thru early diagnosis, prompt treatment, and sensitive comprehensive patient education. In this article the authors describe the epidemiology, clinical presentation, diagnosis, and treatment of gonorrhea. In addition, the complications of this disease are outlined along with a brief look at the most current anti‐microbial therapy available to practitioners. A comprehensive management plan for a patient with gonorrhea is briefly outlined.

Impaired virilization of genetic males with testes (male pseudohermaphroditism) can result either from deficiency in androgen production or defects in androgen action, the latter most commonly involving an abnormal androgen receptor. We report here two maternal cousins with male pseudohermaphroditism and clinical features characteristic of the Lubs phenotype, namely apparent females with sufficient fusion of the labioscrotal folds so that a single urogenital sinus orifice is present. Testosterone levels in these genetic males rose appropriately after administration of human chorionic gonadotropin. The amount (maximal binding capacity of 24 to 30 fmol/mg protein) and hormone binding affinity (half-maximal saturation of 0.2 nM) of the androgen receptor in cultured skin fibroblasts was normal, but the receptor was qualitatively abnormal as evidenced by instability on sucrose density gradient centrifugation. The pattern of inheritance in this family is compatible with X-linkage. These findings, together with previous studies, indicate that the spectrum of abnormalities that result from defects of the androgen receptor in genetic men can encompass the entire spectrum between male and female phenotypes.

Describes the experiences of the first clients to participate in Florida's Cash and Counseling Demonstration, the Consumer-Directed Care program. Notes that most clients are children (47 percent) and nonelderly adults (36 percent).

Cash and Counseling had sizable effects on the proportion of people receiving paid care in Arkansas and New Jersey. It also had sizable effects among the nonelderly—but not the elderly—in Florida, where a higher percentage of enrollees were already receiving this type of care before enrollment.

This report estimates the effects of Cash and Counseling on caregivers who were providing the most unpaid assistance to adult beneficiaries at the time beneficiaries volunteered for the demonstration.

This paper presents an application of raking adjustment in the Fragile Families Survey (FFS).

To determine need to culture multiple anatomic sites of homosexual men, we examined 1803 cultures from 791 men who had positive cultures for Neisseria gonorrhoeae from one or more sites. The men were examined during fiscal year 1982 at a health center that serves the gay community. Not included are 184 patients who had positive cultures from the only site tested. Of the 607 patients cultured from two or more anatomic sites, 34 (5.6%) had cultures positive for N. gonorrhoeae from each site, and 492 (81.1%) had N. gonorrhoeae isolated from one site only. Of these 492 patients, 36 (7.3%) had positive cultures from the oropharynx only, 232 (47.2%) from the urethra only, and 224 (45.5%) from the anal canal only. Of 405 patients cultured from the urethra, anal canal, and oropharynx, 92 (22.7%) had N. gonorrhoeae at two or more sites; 313 (77.3%) had the organism at one site only. Of 84 patients cultured from the anal canal and oropharynx only, 11 (13.1%) had positive cultures from the oropharynx and negative cultures from the anal canal. Since it is highly improbable that the infected site will be selected if only one site is cultured, routine culturing of the urethra, anal canal, and oropharynx of homosexual men is necessary for accurate diagnosis.

Drift scans along the central meridian of Jupiter have been obtained at wavelengths of 7.9, 17.8, and 19.7 microns. These observations indicate a significant north-south temperature asymmetry within the Jovian stratosphere but not within its troposphere, results which agree with the recent Voyager 1 observations. Employing a time-dependent stratospheric model, it is found that the observed north-south asymmetry is consistent with seasonal stratospheric variability. In the model, the primary cause for this variability is the time-dependent absorption of sunlight by aerosols.

As nurses strive to control their professional destinies, they must function effectively with and as managers. This implies bridging the gap between the two cultures of professional and manager and understanding the two points of view. This article contrasts these two points of view in terms of sources of power, task orientation and professional socialization.

Chemical equilibrium models used currently to interpret observations of Jupiter are reexamined using new data defining thermal profiles, which are substantially different from those used in the previous models. A model is developed for the chemical reactions controlling the composition of the upper troposphere on Jupiter, specifically the cloud-forming region from 10 bar to 0.1 bar, which includes, for the first time, the effects of aqueous chemistry on the composition and the vertical distribution of many measurable species in the atmosphere, identifying the factors influencing their abundances above the H2O cloud. The thermodynamic data for potential condensates on Jupiter, i.e., NH3(s), NH4SH(s), (NH4)2S(s), and H2S(s), are reexamined, recognizing the lack of data on sulfides for the temperature range of interest on Jupiter. Vertical profiles of mixing ratios for CO2, H2S, NH3, and H2, obtained for several assumed bulk abundances with respect to solar, are presented.

Aqueous chemistry on Uranus affects the atmospheric abundances of NH3 and H2S below the methane cloud base. Here a complete thermochemical equilibrium model for the H2O-NH3-H2S system is presented. Inclusion of H2S increases the aqueous removal of NH3 to 20-30 percent, but aqueous chemistry alone cannot account for the depletion of NH3 in the 150-200-K region of the atmosphere required to fit microwave observations. Formation of NH4SH clouds can account for the observed depletion provided the H2S/NH3 ratio is enhanced by a factor of 4 relative to solar. Perturbations to the chemical balance between N and S, for example by the general circulation on Uranus, would then produce regions with either NH3 or H2S aloft.