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cinoma the frequency of the Hp 2-2 type was significantly (p < 0.05) lower com- pared to the controls, with a correspond- ing increase of the Hp i-i and Hp 2-1 types. This difference was more pronounced (p < 0.025) among females with pulmonary adenocarcinoma.

Therapy-Related Leukemia and Myelodysplasia in Small-Cell Lung Cancer. Report of a Case and Results of Morphologic, Cytogenetic, and Bone Marrow Culture Studies in Long-Term Survivors. Dang, S.P., Liberman, B.A., Shepherd, F.A. et al. Department of Medicine, Toronto General Hospital, Toronto, Ont., Canada. Arch. Intern. Med. 146: 1689- 1694, 1986.

The bone marrow of ii patients with small-cell lung cancer, who survived more' than two years following combined- modality therapy, was subjected to morphologic, cytogenetic, and bone marrow culture studies. One patient, after a prodrome of anemia and thrombocytopenia, developed acute leukemia 60 months after the start of chemotherapy. Four months before frank leukemia developed, bone marrow culture studies showed a marked inability to form colonies. Cytogenetic studies demonstrated an abnormal clone of cells that included the deletion of the long arm of chromosome 5. No morphologic abnormalities were noted in the bone mar- row of any other long-term survivor; however, the mean corpuscular volume of peripheral red blood cells was greater than normal in three of four patients who remain alive and disease free. In one of these patients marrow culture studies also failed to grow colonies. The other patients showed a decreased ability to form multilineage colonies and colonies of the granulocyte-macrophage lineage in vitro compared with a control population. All patients showed some degree of aneuploidy on cytogenetic analysis; in two cases approximately 50% of cells were aneuploid. However, no clonal abnormality was detected in any patient. Follow-up for the development of secondary acute leukemia and other long-term complica- tions continues in these patients.

Embolic Haematogenous Metastasising of a Bronchial Carcinoma into the Myocardium. Grbac, I., Knezevic, F., Omcikus-Pevalek, M., Grbac, V. Universitatsklinik 'Dr. M. Stojanovic' Institut fur Lungenerkrankun- gen und TBC, Zagreb, Yugoslavia. Prax. Klin. Pneumol. 40: 385-388, 1986.

The authors report on a 64-year old patient with planocellular anaplastic bronchial carcinoma and rare embolic haematogenous matastasising into the myocardium. The metastases were iden- tified via electroncardiography and two- dimensional echocardiography and were later confirmed by postmortem findings. Histology showed that the metastases in the myocardium and the thrombi in the

coronary arteries demonstrated the same histological pattern as the bronchial tumour. This confirm definitely the embolic-haematogenous metastasising of a bronchial carcinoma into the myocardium.

Anorexia, Serum Zinc, and Immunologic Response in Small Cell Lung Cancer Patients Receiving Chemotherapy and Prophylactic Cranial Radiotherapy. Lindsey, A.M., Piper, B.F. Department of Physiological Nursing, University of California, San Francisco, CA 94143, U.S.A. Nutr. Cancer 8: 231-238, 1986.

Anorexia is a major clinical problem for patients with certain types of cancer. The specific mechanisms that result in this spontaneous decline in food intake remain unknown. In noncancer populations, zinc has been shown to play a role in maintaining normal appetite, taste acuity, amd immunocompetence. One purpose of this prospective, longitudinal study of cachexia in ten males with small cell lung carcinoma was to determine if anorexia (caloric intake), perceived taste changes, zinc intake, and impaired cellular immunity were associated with serum zinc concentrations. The average daily caloric intake declined 490 kcal from time of diagnosis to seven months after diagnosis (mean caloric intake = 72% of RDA). Daily zinc intake ranged from 6.5 to 25.4 mg over the seven months. During this period, the mean serum zinc concentrations, although low (71 mug/dl), remained within the normal range. The average weight declined from 81.7 to 74.1 kg. There was no identifi- able pattern of perceived taste changes; most of the perceived changes were re- corded during the period coinciding with prophylactic cranial radiation. At the initial testing, four of nine subjects were anergic to a battery of skin test antigens (mumps, candida, tuberculin purified protein derivative). The only subject who remained responsive to two antigens throughout the study remained alive at 12 months. Caloric intake was inadequate to maintain weight. While zinc intake was low, low normal serum zinc concentrations were maintained; thus in this sample, serum zinc does not appear to be the anorexigenic factor.

Significance of Neuron-Specific Enolase in Diagnosis of Bronchial Carcinoma and Neuroendocrine Tumors. Fishbach, W., Jany, B., Nelkenstock, R. Medizinische Universitats-Poliklinik, 8700 Wurzburg, Germany. Dtsch. Med. Wochenschr. iii: 1721-1725, 1986.

The diagnostic significance of neuron-specific enolase in serum was ex- amined in 54 patients with bronchial car- cinoma and in 28 with neuroendocrine tumors. Control groups were 42 patients with epithelial and 39 with nonepithelial malignant neoplasms as well as 40 patients with benign pulmonary diseases.