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Clinical study has been conducted to evaluate the efficacy of chemotherapy with docetaxel and cisplatin in six patients with advanced non-small cell lung cancer. Treatment schedule consisted of docetaxel 60 mg/m2 and cisplatin 80 mg/m2 on day 1 and repeated every 4 weeks. Eligible patients had histologically proven locally advanced or metastatic non-small cell lung cancer, PS < or = 2, age < or = 74, normal hematological, hepatic and renal functions and informed consent in writing. Six patients have been included; all were males, median age 64 (range 47-74), histology; adenocarcinoma 4, squamous cell carcinoma 2, stage III B 4, stage IV 2. Among these 6 patients, 3 PR (50%) were observed. Neutropenia was the most common adverse event (83%). The lowest granulocyte counts were most frequently seen on day 9.4 (range: 6-14). Non hematologic adverse events included alopecia (6 cases), general fatigue (5 cases), anorexia (5 cases) and emesis (3 cases). These events were recovered rapidly with no therapy. The results suggest that combination chemotherapy of docetaxel and cisplatin will be effective and safe under careful observation.

A questionnaire survey of blood donors at Santa Cruz General Hospital, Bolivia, showed that while there were no seropositive cases of syphilis, HBsAg, and HIV, the prevalence of Chagas' disease was very high (23%) among the 225 blood donors who responded to this questionnaire. Actual cases of Chagasic seropositive blood being used for blood transfusion were seen, including the urgent need for a program for Chagas' disease in Bolivia. From the results of this study, it is recommended that for blood donors from South American countries, the presence/absence of Chagas' disease should be confirmed.

We experienced three patients who have collagen diseases with respiratory failure accompanied by hyponatremia. They were one systemic lupus erythematosus patient with interstitial pneumonia, one rheumatoid arthritis patient with acute pneumonitis, and one dermatomyositis patient with pulmonary fibrosis and organizing pneumonia. In all 3 patients, hyponatremia appeared along with a decrease in arterial O2 partial pressure (PaO2) and the hyponatremia tended to improve when the PaO2 increased after inhalation of oxygen, even though their respiratory failure were not improved. In dermatomyositis patient, serum Na levels were over-corrected after increase in PaO2. The serum and urine osmolality, serum antidiuretic hormone (ADH) levels and clinical pictures demonstrated a presence of inappropriate secretion of ADH (SIADH) in all 3 cases when hyponatremia and hypoxia appeared. A close association between hyponatremia and hypoxia observed in 3 patients strongly suggested that their SIADH were associated with hypoxia since SIADH could be demonstrated by hypoxia. Therefore, it is important to realize that hypoxia-induced hyponatremia will be promptly corrected to hypernatremia by an oxygen inhalation, which could cause a lethal central pontine myelinolysis.

The following points on polyarteritis nodosa (PN) were presented: definition, difference between PN and vascular lesions in other collagen disease, diagnostic criteria, clinical symptoms and laboratory findings, clinical type, histologic stage, therapy and three case reports with two active vasculitis and one scarred vasculitis.

General review of the literature makes it apparent that there exist various combinations of associated movements between cranial nerves. Most of them involve four of nerves, the oculomotor, the abducens, the facial, and the motor potion of the trigeminal nerve. We report two patients in whom left upper eyelids produced peculior up and down movements in accompany with mastication. The one was a 9-year-old female who had shown left eye-lid retraction since 3 months; the other, a 4-year-old male, had produced the synkinesis one year since. Either children showed contraction of left palpebral levators associated with volitional mouth opening, deviation of the mandible toward the right, and sucking. Their pupils were normal and their upper eye-lids showed no ptosis on the affected side. The EEG showed high voltage rhythmic slow waves in parieto-occipital areas bilaterally. Head injuries or hereditary defects not being recorded in their histories, their synkinesis is assumed to be congenital in orgin. Abnormal neural connections have been presumed to be affected in the course of the development between the trigeminal and the oculomotor nuclei within the midbrain. In triggering the synkinesis, however, stretched muscle-spindles of the masseter muscle most play an important role. After all, synchronizing lid-jaw co-movements as observed in our two children represent an unusual pattern of the Marcus Gunn phenomenon.