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The feasibility of long-term epidural catheterization for control of chronic pain from sacral metastases has been demonstrated. Infection was not a problem and obstruction of the catheter did not occur. The short duration of action of currently available drugs was the major limitation of the technique. The technique described merits further investigation as an alternative to currently available methods.

Factor VIII procoagulant activity, antigen concentration and von Willebrand activity as ristocetin cofactor were determined several times in 10 patients with DIC. These is a significant negative correlation between the DIC-score and the VIII:C/von Willebrand activity ratio.

29 out of 34 consecutive patients of pediatric age, operated upon for posterior fossa medulloblastoma, were divided into 2 groups according to the chemotherapeutic treatment (intrathecal methotrexate or intravenous cyclophosphamide) received at random after surgery and radiation treatment. The modalities of irradiation and chemotherapy are described. 9 patients have not yet shown a local recurrence and are alive at varous intervals after surgery. Only 1 patient with local recurrence is still alive 31 months after the primary operation. The mean actuarial survival of the whole series of patients is about 38 months. Differences between the two groups, concerning either the survival rate till local recurrence, or the general and neurologic conditions of survival, are not statistically significant. Hematologic toxicity was more pronounced in the group treated with cyclophosphamide, whereas late neurologic sequelae were a more prominent feature of the intrathecal methotrexate trial.

Data from 133 patients with cancer and suspected compression of the spinal cord or cauda equina was reviewed. Although there were differences in presenting symptoms and signs between the group of 62 patients with compression and the 71 without, no single symptom or sign discriminated adequately between the two groups. Multiple logistic regression was used to try to develop an index of signs and symptoms which could identify those without compression, thereby sparing them a myelogram. Eight characteristics, in combination, proved most effective as an index, but they were not perfect predictors of patients with block. Final diagnoses in the group without compression were: vertebral metastases 35%, carcinomatous meningitis 24%, plexopathy and/or neuropathy 21%, other 30% (10% had two diagnoses). Sixty-six percent of those with compression and 50% of those without compression died within six months, although patients rarely survived for much longer.

A case of hip osteoarthritis is reported, in which histological investigation demonstrated the absence of tumoral involvement in femoral head in spite of nearby intraosseous carcinomatous metastasis. It comes in addition to a previously reported similar personal case. Further studies of surgical or post-mortem specimens are needed to indicate whether these observations were fortuitous or whether the two conditions might not even be mutually exclusive.

Pituitary ablation by the injection of alcohol through a transphenoidal needle has been practised for a number of years. In order to reduce the complications resulting from the spread of alcohol to neighbouring structures, a cryoprobe has been constructed which can be passed up through the needle into the gland and a series of localised lesions produced. The degree of pain relief is as good if not better than that obtained with alcohol. Only one instance of temporary blurring of vision resulted and hormonal disturbances were not seen. No difference was observed between the results obtained from the treatment of hormone-dependent and hormone-insensitive tumours. Pain caused in one patient by a benign tumour was unsuccessfully treated.

A rare case of recurrent cervical cancer presenting multiple metastases to the small intestine is reported. A 69-year-old Japanese woman with a past history of early-stage (Ia) cervical cancer 13 years previously suffered sudden onset of panperitonitis caused by perforation of the small intestine. In the perforated lesion, squamous cell carcinoma, which was histologically similar to that of the primary lesion, was observed, and was diagnosed as a late recurrence of the cervical cancer. Perforation of the small intestine caused by tumor metastasis, especially metastasis from cervical cancer, rerely occurs. Furthermore, recurrence of an early cervical cancer presenting 13 years after hysterectomy is extremely rare. The present case draws attention to the possibility of late recurrence of cervical cancer, even in cases treated at the early-stage.

Acute renal failure proved fatal in a patient with metastatic breast adenocarcinoma, complicated by the hemolytic-uremic syndrome. Low-grade hemolysis probably was ongoing prior to a third course of chemotherapy that included mitomycin. Terminal renal failure was caused by glomerular infarction and tubular necrosis. Schiztocytes in the blood smear and casts in the urine sediment may be relative contraindications to prolongation of tumor-lysis therapy. Recent advances in "rescue therapy" for hemolytic-uremic syndromes justify dialysis at least on a temporary basis.