Abstracts/Lung Cancer 10 (1993) 266-286 277

protein synthesis (WBPS - WBPT) was not different from that of the controls, regardless of how data were expressed. These results reveal that protein kinetics in the lung cancer patients were not significantly different from those of the control group when normalized to active muscle OIPSS, sod suggest theI newly diagnosed ooncachectic advanced lung cancer patients do not exhibit a signiticanC increase in whole-body protan kinetic rates.

An ACTH-secreting bronchial carcinoid: Rgeneeofcorticotropin- releasing hormone, neumpeptide Y and endotbelin-1 in the tumor tissue Murakami 0, T&h&i K, Sane M, Totsune K, Ohneda M, Itol K et al. SecondDeportment Infernal Medicine, Tohoku University, School of Medicine, I-I Seiryo-rho, Aoba-ku, Se&d, Miyagi980. ActaEndocriml 1993;128:192-6.

The presence of three regulalory peptides, corticotropin-releasing hormone, neuropeptide Y and endothelin-I, was studied by radio- immunoassay in the tumor tissue of no ACTH-secreting bronchial carcinoid. A 36.yearilld female was admitted to hospital because of moon face, central obesity end hypertension. High levels of plasma ACTH and cortisol and urinary I7-OHCS and 17.KS were found. One rug dexamethasone did not suppress plasma ACTH and cortisol levels, but 8 mg did so slightly. Corticotroprin-releasing homrone (100 g, iv) strmulated plasma ACTH levels (0 mm: 34.8 pmolll; 30 min; 41.1 pmol/l). Thecomputerized tomography showed the preseoceofa tumor in the right lung. This lung tumor was removed surgically and has been shown by rmcroscopical examination to be a bronchial carcinoid with ACTh-positive cells. The tomor tissue concentrations of corticotropin- releasing homwne, neuropeptide Y and endothelin-1 were 3.34 pmol/ g wet waght, 8.07 pmollg wet weight end 0.92 pmol/g wet weight, respectively, although plasma concentrations of these three peptides werenotelevated. Reversephasehighperfonnanceliqurdchromatography showed that immunoreactive peptides in the tomor tissue were mainly eluted in the posltion of the standard peptides. These findings indicate that this case of ACTH-secreting bronchial carcinoid had high levels of cortlcotropin-releasing hormone, neuropeptide Y and endothehn-I in Its tumor tissue and suggested that these peptides may act locally, III a paracrine or aulocnne manner, in the tumor.

Pancoast syndrome: An unusual presentation of adenoid cystic earriooma J&ton MQF, Allen MB, Cooke NJ. Belvidere Hospiral, London Rd. Glasgow. Eur Respir J 1993;6:271-2.

We report on a patient with primary pulmonary adenoid cystic carcinoma presenting with Pancoast syndrome. Pancoast syndrome has not previously been described with this hunour. Other unusual features of this case include the peripheral origin end mediastinal involvement, with lack of proximal endobronchial spread.

Patient progress modclling for small cell lung cancer Pearce RM, Gallivao S. Jackson RRP. Clinical Operational Research Unit. Depuimenz of S?afistical Science. Universiry College. Cower Srreet,London WClE 6BT. EurJ CeruxPnri AGen. Top. 1993;29:734- 7

This paper describes the use of a mathematical technique called Patient Progress ModeRing to reassess the results of en MRC trial on small cell lung cancer. The trial eoncemed patients treated initially with chemotherapy and radiotherapy and achieving at Ieat e partial response. It cornpored the effects of giving maintenance chemotherapy with those of giving no maintenance therapy. ‘I& results of the MRC trial established that there was oo significant survival difference between the hvo groups overall. However, it was observed that amongst patients achievingammpleteresponse,thosereceiv~gmPin~cbemotherapy had P small survival time advantage. The analysis described here suggests the hypothesis tba1 this can be accour~ted for by differences in the pattern of deaths n&r relapse. There appeared to be little difference in Ihe disease-free period.

Spontaneous pneumothorax as initial symptom of bmncbial caminoma Pohl D. Herse B, Criee C-P. Dali&au H. Klinikf: i’horar-. Her? und,

G$&rtirurgie, Univ0sirarGorringen. W-34OOGntingen. Pneumologie 1993;41:69-72.

Spootaneous poeumothorax is cased by benign lung diseases in more than 95 percent. Mainly preeeoling in younger male patients between 20 and 40 years of age its prognosis is generally good. - On the otber~d,powmothonxasinitinlmPoifesrptionofbronchinlcnrcinoma is P rare complication with poor prognosis. We report such P case of a 70 year-old man, review the literature and describe charactenstical problems in diagnosis and therapy of very soul1 broocbogenic hunore. Estimating that only 2 percent of all spontaneous pneumothoraces are coexisted with melignenc long diseases - either primary or secondary - this tumor-complicatioo especially most be considered in older patients. Their prognosis may be improved entirely by rapid diagnosis and therapy.

Broncbogenic carcinoma in young patients at risk for acquired bnmunodefciency syndrome Chao TK, Amode CP, Rom WN. Department of Medicine. Bellewe Hospital, New York University Sch. of Medicine. New York, NY. Chest 1993;103:862-4.

Several case reports have suggested that broochogemc carcmoma occurs more frequently in youog patients who are human mrmunodeficiency virus (HIV) seropositive. We investigated the incidence of bronchogenic carcmoma and its clinical presentations in young patients aI risk for HIV infection. The tumor registry of Bellevue Hospital was reviewed, and 261 cases of bronchogenic carcinoma during the period from 1976 to 1979 @e-AIDS period) and 232 during the period from 1987 to 1990 (AIDS period) were identified. These cases were stratified into age groups: 45 or younger, 46 to 55,56 to 65, and 66 years or older. All patients aged 45 years or younger m the AIDS period were subdivided by HIV risk, and clinical characteristics were comparedamong thesubgroups. Results revealed no increased inadence of bronchogenic carcinoma from the pre-AIDS period compared with the AIDS period. These results suggest that HIV seroposltivlty 1s not a risk factor for bronchogenic carcinoma.

A random&d study comparing cyclophospbamide, doxoruhicin, vincristine (CAV) with cyclophospbamide, etoposide, vincristine, metbotrexate (CEVM) in patients with small cell lung cancer Erkasi M, Unsal M, Tunali C. Burgut R, Dorae F. Department of Oncology, University of Cukurova. Adana. J Chemother 1993;5:56-9.

This tnal was carried out to assess the response rate and survwal benefit a&lewd. If any. by substitution of etoposlde for doxorubicm and addition of metholrexale in combmation with cyclophosphamide and vincristine m the treatment of 113 patients wth small cell lung carcinoma (SCLC). Cyclophosphamide, etoposide, vincristine, methotrexate (CEV-M) ylelded a response rate of 75% m localwed dwase(LD) aod63W inextensivedwease(ED), versus61 96 in LDaod 52% in ED m the cyclophosphamide, doxorubicin. vmcristme (CAV) arm. There was also a slgniticanl survival bznetit for the responders m favor of CEV-M (21.7 * 3.8 months of median survival compared lo 13.6 k 2.8 months in CAV arm) in p&ems wth LD.

Surgery

Exercise testing, 6-min walk, and stair climb in the evaluation of patients at high risk for pulmonary resection Holden DA, Rice TW, Stelmach K. Meeker DP. Cleveland Clinic Foundarion, 9500 Euclid Avenue, Cleveland, OH 44915-5038. Chest 1992;102: 1774-9.

To evaluate thr= types of exercise testing in predlchon of death or prolonged mechanical ventilation afler lung resection in lugh-risk patients, 16 patients underwent evaluataon prior to resection. Eleven patients(group I)hadminorornocomplicatiotw(arrhythmia,atele&sis, pneumonu) sod five patients (group 2) died within 90 days of surgery. Exerase testing showed Ihat group 1 had a longer 6-min walk distance. and a higher stair climb than group 2. The maximum oxygen uptake on a cycle ergometer was not sigmficantly different between groups, althoughonly tenpatientscompleredthistest. Group I hadnslgnificaotly greater calculated oxygen uptake with stair climbing then group 2. A 6. mm walk distance of greater than I .OCO feet and a stair climb of greater