this procedure would increase the number of “takes,” simulating the effect of anesthesia and surgery on cancer patients. Under these conditions there was an average of 48.6 per cent “takes” in control animals versus 75. Spercent in those who underwent celiotomy. Following this experiment a number of drugs were tested for their ability to reduce the increased number of “takes” in rats undergoing celiotomy. Among these drugs were histamine, antihistamine compounds, dextran, and reserpine. With the exception of reserpine, all drugs tried following celiotomy produced an increase instead ofa decrease in the percentage of“takes” over those with celiotomy alone. In 57 animals subjected to celiotomy and reserpine, “takes” occurred in 34(59.6percent)comparedwith44(75.9percent)in58 animals having celiotomy alone. In their discussion, Buinauskas et al. ’ suggest that this may be explained by the fact that 5-hydroxytryptamine was shown to increase the number of “takes,” this substance rather than histamine being more important in the rat in this regard. The results with reserpine might be explained because reserpine is a known antagonist to 5-hydroxytryptamine. Of course, the usual caution is necessary in relating the results of animal experimentation to clinical cancer in man, but this work may be important in suggesting a possible mechanism for the effect ofreserpine in cancer patients. At the very least it suggests an alternative explanation to the findings of our study and provides us with a testable hypothesis. Recent evidence has appeared suggesting that use of reserpine for treating hypertension in women may lead to an increased risk of breast cancer developing. 3-5 It would be strange, indeed, if a substance which increases the risk of one cancer developing can be shown to lessen the severity of another. David P. Byar, M.D. National Cancer Institute Bethesda, Maryland

Veterans

Clyde E. Blackard, M.D. Administration Hospital Minneapolis, Minnesota

References 1. COLE, W. H.: The mechanisms of spread of cancer, Surg. Gynec. Obstet. 137: 853 (1973). 2. BUINAUSKAS,P., BROWN, E. R., and COLE,W. H.: Inhibitingandenhancingeffectofvariouschemicalagentson rats’ resistance to inoculated Walker 256 tumor cells, J. Surg. Reg. 5: 538 (1965). 3. Boston Collaborative Drug Surveillance Program: Resperpine and breast cancer, Lancet 2: 669 (1974). 4. ARMSTRONG,B., STEVENS, N., and DOLL, R.: Retrospective study of the association between use of rauwolfia derivatives and breast cancer in English women. ibid. 2: 672 (1974). 5. HEINONEN, 0. P., SHAPIRO, S., TUOMINEN, L., and

TURUNEN, M. I.: Reserpine use in relation to breast cancer, ibid. 2: 675 (1974).

UROLOGY

/ JANUARY 1975

/ VOLUME V. NUMBER1

IMMOBILIZATION IN OFFICE

OF

VAS

VASECTOMY

To the Editor: I read with interest the timely article “Immobilization of the Vas in Office Vasectomy,” by James A. Roberts, M.D., in the Surgeon’s Workshop section of UROLOGY (vol. 4, page 475). Rather than utilizing a modified towel clip for vas immobilization I have routinely employed a simple Allis clamp. After isolation of the vas by finger palpation, the classic linear incision is obtained under local anesthesia, and the vas is then easily grasped with the Allis clamp. Over 200 vasectomies have been accomplished during the past three years via this technique with good results. Ronald S, Rosenthal, ;M. 1). 1245 Highland Avenue Abington, Pennsylvania 19001

CRYOSURGERY CARCINOMA

FOR

PROSTATIC

To the Editor:We have read, quite obviously, with much interest the attempt by Dr. Jones’ in his review article, “Cryosurgery for Prostatic Carcinoma,” to present salient studies of the application of cryotherapy and its immunopotential as a therapeutic modality in the treatment of prostatic malignant disease. We believe in light of Dr. Jones’ kind but yet frankly distressful reference to some of our studies, apparently due to the quite reasonable difficulties encountered by all of us in attempting to bridge the gap between basic science and clinical investigation, that it is important and particularly relevant to the readers of UROLOGY to clarify a few points. I. Studies of serum proteins ofpatients with benign prostatic hypertrophy (BPH) and prostaticcancer were carried out on specimens obtained prior to2s3not following (cryo)surgery, as would appear to be indicated by Hoch-Ligeti et al. 4 in their study of serum protein patterns following surgery. In this regard, we are aware that alterations of serum proteins occur following surgery, whether they be due to anesthetic agents, stress, trauma, or the operative procedure per se. In fact, although not appropriate to go into specific detail here, we should mention that in contrast to the general alteration of serum proteins following surgical trauma characterized by a transient decrease of albumin and an increase of the alpha 1 and 2 globulin fractions, 4,5our postcryosurgical observations revealed a distinct decrease in the alpha 2 globulin fraction, which appeared to correlate with the clinical response of the patient. 6*7 Furthermore, while the frequency of an elevated level of alpha 2 globulin in patients with BPH and

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