Minimal deviation adenocarcinoma (adenoma malignum) of the endocervix: a histochemical and immunohistochemical study of two cases

The histopathological diagnosis of minimal deviation adenocarcinoma (adenoma malignum) of the endocervix may be difficult. Two cases of minimal deviation adenocarcinoma (MDA) were examined using mucin histochemistry and immunocytochemistry with antibodies to epithelial membrane antigens (HMFG1, Ep1), low-molecular-weight cytokeratins (CAM 5.2), carcinoembryonic antigen (CEA), and alpha-amylase. The results were compared with those for normal endocervical glands. Reactivity for CEA in MDA was focal and would be unreliable for biopsy diagnosis. Both cases of MDA contained abundant neutral mucins and sialomucins, whereas sulfomucins were rarely detected; this pattern contrasted with that of normal endocervix. Neoplastic glandular epithelial cells in MDA consistently showed both luminal and cytoplasmic reactivity with Ep1 and HMFG1, whereas normal cervix showed luminal labeling only. Thus, mucin histochemistry and immunohistochemical detection of epithelial membrane antigens may distinguish between extremely well differentiated neoplastic glands in MDA and normal endocervical glands, and hence may aid diagnosis in biopsy specimens.

Essential fatty acids in plasma phospholipids in schizophrenics

Blood samples were taken from schizophrenics and control patients in three different centers. The phospholipids were extracted from plasma and their fatty acid composition analyzed. Similar and consistent differences between schizophrenics and controls were observed at all three centers. The n-6 essential fatty acid levels were significantly reduced, whereas n-3 essential fatty acids were elevated.

Computer aided diagnosis of acute abdominal pain at Middlesbrough General Hospital

This presentation reports the experience of the surgical house staff and registrars at Middlesbrough General Hospital who used a desk-top computer system to support their clinical diagnosis of acute abdominal pain. The results cover a two year period and are compared with a baseline period of one year. Substantial benefits followed the introduction of the computer-aided diagnostic support system; increased diagnostic accuracy of the whole surgical team, reduction in negative laparotomy rates, earlier surgical intervention for acute appendicitis, reduction in the number of cases of perforated appendicitis and more efficient use of resources. The reasons for these improvements include more thorough collection of data, use of common terminology and an educational element provided by detailed feedback from the computer system.

Plasma essential fatty acids in pure and mixed race American Indians on and off a diet exceptionally rich in salmon

Eskimos on a traditional diet have unusually low prevalences of cardiovascular disease and cancer. One possible reason is the high intake of eicosapentaenoic acid (EPA) which is thought to account for the high EPA and low arachidonic acid (AA) levels in Eskimo plasma. People who also consume a traditional diet exceptionally rich in EPA are the Indians of the west coast of Vancouver Island. There are about 12,000 of these people and their traditional diet has been affected much less than that of the Eskimos. When on their traditional diet the Vancouver Island Indians, like the Eskimos, have high EPA and low AA levels in plasma. When eating European food, EPA levels are in the European range, but AA levels are still exceptionally low, a finding also reported from Eskimos living in Denmark. In a small mixed race group, AA levels were intermediate between those in pure Indians and in Europeans. The high EPA levels in Eskimos and West Coast Indians are related to diet. The low AA levels, in contrast, are probably genetically determined. Unusual disease patterns in these populations cannot be entirely attributed to diet.

Transient riboflavin depletion in preterm infants

Biochemical riboflavin status was measured in 68 preterm infants who were receiving either human milk or a preterm infant formula (containing riboflavin, 1.8 mg/l) during the first few weeks of life. The relation between riboflavin status, type of diet, and time of introduction of a multivitamin supplement containing riboflavin was analysed and the duration of phototherapy was recorded. Those who received the multivitamin supplement on or before day 7 of life seldom became deficient and no significant difference between diets was seen in this group. Of those who received the supplement after day 7, human milk fed infants commonly developed abnormal riboflavin status (18 out of 23 infants) compared with a small and significantly lower incidence in the formula fed group. Dietary effects on riboflavin status seemed to outweigh in importance those of phototherapy. It is concluded that the riboflavin content of human milk, which may be lowered by photodegradation, is not sufficient to ensure normal biochemical status in preterm infants. The larger amounts provided by a multivitamin supplement or by a preterm infant formula may, however, prevent biochemical deficiency. The desirability (and safety) of routine riboflavin supplementation of preterm infants is discussed.

The significance of intraduct appearances in breast cancer

Metastatic mammary carcinomas in axillary nodes have been found to show histological appearances indistinguishable from intraduct carcinoma in breast. Since invasive breast carcinoma may mimic intraductal growth, some cases of breast cancer diagnosed histologically as intraduct carcinoma may in reality be invasive.

Intramucosal carcinoma of the gastric antrum complicating Menetrier's disease

A 48-year-old man presented with haematemesis and was found to have Menetrier's disease. Three and a half years later early gastric cancer was detected at routine follow-up endoscopy. This is the first report of the development of early gastric cancer during follow-up in a case of Menetrier's disease. It is probable that patients with Menetrier's disease are at increased risk of gastric cancer, and should have regular endoscopic follow-up with gastric biopsy.