Are cardiovascular reflexes more commonly impaired in patients with bronchial carcinoma?

44 group (n = 50). Forty per cent of the patients of group 1 had been referred on the basis of a coincidental radiograph (made in 18 patients as part of the screening), as against 14% in group 2. An operable tumour was found in 46% of group 1 and in 20% of group 2. The cumulative rate of survival after 15 months was 56% in group 1 and 36% in group 2. The one-year survival rate of patients referred on the basis of coincidental radiographs (out of the total group) amounted to 83%; it was 33% in the group who exhibited signs and symptoms at the time the diagnosis was made. Our findings are in agreement with recent publications on the effect of roentgen screening on the prognosis of bronchial carcinoma in the USA and constitute an argument in favour of organizing a similar study in the Netherlands. Lactic Acidosis and Small Cell Carcinoma of the Lung. Sheriff, D.S. The Salem Institute of Experimental Biology, Salem-636 O01.Tn, India. Postgrad. Med. J. 62: 297-298, 1986. Two patients with small cell carcinoma of the lung who presented with lactic acidosis are described. Hepatocel lular failure due to extensive metastases may be the cause of acute lactic acidosis. Long-term Survival in Bronchogenic Carcinoma with a Solitary Metastasis. Shachor, J., Luria, H., Cordova, M. et al. Chest Department and the Pathological Institute, Meir Hospital, Kfar Saba, Israel. Eur. J. Surg. Oncol. 12: 77-80, 1986. Partial resection of a huge anaplastic large cell carcinoma of the upper lobe of the right lung was performed in a 47-yearold patient in order to relieve symptoms of pulmonary hypertrophic osteoarthropathy. Several months later a solitary metastasis was noted in the muscles of the right forearm. The metastasis was resected and the forearm irradiated. The patient was further treated with injections of autologous tumour cell vaccine and BCG. Today, 7 years later, the patient is alive, without any signs of neoplastic disease. Are Cardiovascular Reflexes More C o m o n l y Impaired in Patients with Bronchial Carcinoma? Gould, G.A., Ashworth, M., Lewis, G.T.R. Department of Respiratory Medicine, Ham Green Hospital, Bristol, U.K. Thorax 41: 372-375, 1986.

Non-invasive tests of cardiovascular autonomic function were performed in 69 patients with histologically proved bronchial carcinoma and the results compared with those obtained in a group of age and sex matched controls. Only two patients were under 50 years of age, and with the exception of the heart rate response to deep breathing the tests performed have no accepted normal ranges in patients of this age. None of the patients had features of florid, disabling autonomic neuropathy. All the tests of autonomic function showed declining performance with age but in addition there were significant differences in the results when the two groups were compared. In the group with carcinoma the resting heart rate was higher (p < 0.05), the resting supine blood pressure lower (p < 0.01), and the postural fall in blood pressure greater (p < 0.01). Test results were not related to tumour histology, the presence of finger clubbing, drug history, or symptoms suggestive of autonomic dysfunction. Abnormal responses in tests of cardiovascular autonomic function are c o m o n l y found in elderly patients but bronchial carcinoma appears to have an additional effect. The precise mechanism of this effect remains a matter for speculation. Energy and Protein Intake of and Nutritional Status in Non-Surgically Treated Patients with Small Cell Anaplastic Carcinoma of the Lung. Enig, B., Winther, E., Hessow, I. Department of Oncology and Radiation Therapy, Aarhus Municipal Hospital, DK-8000 Aarhus, Denmark. Acta Radiol., Ser. Oncol. 25: 19.22, 1986. The spontaneous food intake and nutritional status was assessed in 23 patients with small cell anaplastic carcinoma of the lung before and two times during a treatment period of 6 weeks. Radiation therapy was given for 2 weeks followed by a course of chemotherapy and another 2 weeks of radiation therapy. The energy intake decreased during the treatment from 146 to 130 per cent of basal metabolic rate (p > 0.i0). The protein intake remained unchanged (mean 0.9 g/kg body weight). There were insignificant and small losses of weight, body fat, free body mass and arm muscle circumference, and no changes were seen in serum albumin and serum transferrin. However, 6 patients suffered a weight loss of 5 per cent or more. No correlation existed between the nutri-