Analysis of survival following treatment of tumour-induced hypercalcaemia with intravenous pamidronate (APD)

The outcome of 114 patients with tumour-induced hypercalcaemia (TIH) treated between January 1992 and June 1993 with intravenous pamidronate (APD) was retrospectively analysed. The median overall survival was 55 days (range 3 days to > 21 months): 86 days if systemic anti-cancer therapy was available and only 35 days if not (P < 0.001). Survival was also significantly better for those who became normocalcaemic post APD (53 days vs 19 days, P < 0.001). There was no survival difference with respect to patient sex, age, tumour type, treatment of bone metastases with radiotherapy, initial calcium level, initial dose of APD or time from tumour diagnosis to first TIH. In those patients in whom systemic anti-cancer therapy is available, treatment with APD improves survival, but in all other patients the primary aim of treatment should be symptom control. This study confirms the dismal prognosis of TIH.

Imaged thoracic resection of a huge mediastinal tumor--role of extended incision and the use of conventional instruments

Intrathoracic lesions are usually removed through conventional thoracotomy. The long incision and the spreading of the rib usually results in much pain and interference of chest wall mechanics. Today, with the development of imaged thoracic surgery (combination of thoracoscope and video optics), major procedures can be performed through small incisions. However, indications are greatly limited due to lack of suitable instrumentation and restricted space of the trocar channel especially when a huge intrathoracic tumor is encountered. In this selected report, we demonstrate a successful procedure using extended incision and conventional instruments in imaged resection of a huge cystic intrathoracic tumor. The procedure offers the benefit of safe, easy and fast manipulation. The patient had an uneventful postoperative course and was discharged on the fourth postoperative day.

[Airway epithelium affects relaxing effect of verapamil]

The characteristic features of airway hyperreactivity disease are non-specific hyperresponsiveness, insensitive to spasmolysant and damage of epithelium. In our experiment, we measured the tension change of isolated trachea smooth muscle of guinea pig in reacting to acetylcholine and verapamil. It confirmed that (1) the removal of epithelium increases the reactivity of preparations to acetylcholine and reduces the effect of verapamil, (2) in above process the epithelium-derived relaxing factor (EpDRF) had participated in airway hyperreactivity and (3) EpDRF was not derived from metabolism of cyclooxygenase.