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In order to determine the incidence of pre-operative and postoperative deep venous thrombosis (DVT) in patients not receiving prophylactic anticoagulant therapy, bilateral phlebography was performed in a prospective study pre-operatively and on the 9th postoperative day, in 51 consecutive patients submitted for major abdominal surgery. The presence of a DVT before surgery was demonstrated in 15.7 per cent of the patients. This high frequency confirms objectively the rationale of starting prophylactic anticoagulant therapy before the surgical procedure. Thrombi were demonstrated postoperatively by phlebography in 54.9 per cent of the patients. Thus the true incidence of DVT induced by surgery was 39.2 per cent taking into account the 15.7 per cent pre-operative DVT rate.

Escalating doses of DDMP (metoprine) (15-280 mg/m2) were administered as single oral doses 24 h before a fixed leucovorin (CF) rescue (15 mg IM every 6 h for 72 h). CNS toxicity was dose-limiting and cumulative when the drug was given more frequently than at 3-week intervals. DDMP has a very long half-life (150 h) and is extensively bound to serum proteins (88%). It diffuses into the CSF and concentrates in brain tumours and normal brain tissue (brainserum ratio 3.8-5.3). DDMP is a potentially useful drug against brain tumors. Tumor regressions were seen in two patients with epidermoid carcinomas.

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