We report a 31-year-old female who had repeated thrombosis and was diagnosed as having congenital homozygous protein C deficiency based on decreased protein C antigen and activity, and the findings of family history. This patient had shown no symptom of thrombosis until the age of 27 years, when she had cerebral infarction as the first symptom. Low molecular weight heparin was useful for disseminated intravascular coagulation (DIC) that complicated protein C deficiency in this patient. (Internal Medicine 31: 922-925, 1992)

Octreotide acetate, a long-acting somatostatin analogue, is effective in controlling and markedly reducing the symptoms of carcinoid crisis. Wereport a patient with carcinoid syndrome with prolonged survival for 4.5 years with high dose octreotide therapy and survived for 7.5 years after the first flushing, in spite of episodes of severe carcinoid crisis. Dose escalation was required in order to control carcinoid symptoms, and the final dosage was 5,950 jug/day. Although administration of such a high dosage ofoctreotide has never been reported before, we found that octreotide could be used at this dosage safely without inducing serious side effects, and probably prolonged the patient' s survival. Our experience with this case indicates that octreotide acetate is an effective drug in controlling carcinoid crisis and prolonging survival without serious side effects. (Internal Medicine 33: 100-102, 1994)

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A case of carcinoid syndrome is presented. Pulmonaly adenosqamous carcinoma with hepatic metastasis was found in a 60-year-old Japanese male who was complaining of fever, cough and haemosputum. After the treatment with 5-fluorouracil (5-FU) over 2 years, he was diagnosed as carcinoid syndrome on the appearance of facial flushing, face edema and watery diarrhea accompanied by high levels of 5-hydroxyindole acetic acid (5-HIAA) in blood and urine. Prednisolone, which was initially effective, was replaced by SMS201-995due to the considerable dose increase of the former because its effect became insufficient during the course of the treatment. Clinical symptoms were improved by SMS201-995and blood 5-HIAA level decreased gradually but markedly. Thus better results were obtained by SMS201-995compared with prednisolone. These results imply that SMS201-995 is appreciated as an effective drug for treatment of carcinoid syndrome.