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To assess the feasibility of an exercise-diet intervention in sedentary, overweight breast cancer patients, we conducted a pilot 8-week intervention. Recruitment letters and interest surveys were sent to 99 stage 1 or 2 breast cancer patients, ages 25-75 years, who were identified through two Seattle breast surgery practices and the University of Washington Breast Clinic. Ten patients were eligible and interested and were enrolled in the intervention, which consisted of thrice-weekly monitored aerobic exercise sessions and a low-fat (20% of calories from fat) diet. Nine patients completed the program; all adhered well to the intervention and data collection protocol. The patients, ages 40-74 years, lost, on average, 2.6 pounds of body weight, 3.4 cm in waist circumference, 4.6 cm in hip circumference, 2.3% body fat, 3.3 systolic blood pressure points, 0.67 diastolic blood pressure points, and 4.0 pulse beats/min, and they gained an average of 2.3% lean mass. Slight, nonsignificant decreases were observed in serum concentration of total and free estradiol, estrone sulfate, total testosterone, androstenedione, and dehydroepiandrosterone. These pilot data indicate that breast cancer patients are highly motivated to join and adhere to an intense exercise-diet intervention and can experience significant measurable changes in anthropometric and fat mass measures.

Cholecystostomy retains a place in the general surgical armamentarium. In this series of 115 patients undergoing cholecystostomy between 1967 and 1977, 68 percent had acute cholecystitis, whereas in the remaining patients biliary drainage was undertaken as part of another procedure. The in-hospital mortality rate was 6 percent for the group with acute cholecystitis and 37 percent for the other patients. Forty-five patients subsequently had elective cholecystectomy, 29 of these for radiographically documented retained calculi. Thirty-four patients without retained calculi remained asymptomatic for more than 1 year. On the basis of this experience and the literature cited, we recommend that subsequent to cholecystostomy, cholecystectomy be performed if the patient is in good general health and has a long life expectancy. Conversely,in the aged, ill patient without evidence of retained stones, cholecystostomy may be a lifesaving and curative procedure and the only one needed.

The isolation of pancreatic islets from collagenase-digested Wistar rat pancreas was shown by the sedimentation method at a unit gravity using Percoll solution with a density of 1.041 g/ml. The density of digested exocrine tissues was in the range of 1.013-1.041 g/ml, while that of purely isolated islets was in the narrow range of 1.066-1.075 g/ml. More than a hundred islets were obtained freely from each rat pancreas without any gross contamination of digested exocrine tissues. A significant increase was observed in glucose-stimulated insulin release from islet isolated with Percoll in the same pattern as that without Percoll. In addition to the well preserved morphology and function of pancreatic islets isolated by Percoll, the simplicity of the technique strongly commends the usefullness of this method.