Selective distribution of calretinin in adenocarcinomas of the human colon and adjacent tissues.

The expression of calretinin, a calcium-binding protein, has been studied in a series of 82 human colorectal adenocarcinomas. In 22.5% of the cases, part of the tumor cells were calretinin-positive, whereas the cells of the normal and paratumoral mucosa were always negative. Two types of cells from the tumoral mass reacted positively and selectively with calretinin-antisera: the tumor cells and giant fibroblasts. The neurons of enteric ganglia and reactive mesothelial cells also reacted positively to the same antibody. The results obtained by immunochemistry have been confirmed by Western blot analysis and in situ hybridization for calretinin mRNA. There is a correlation between the expression of calretinin and the degree of differentiation of the tumor. Well-differentiated tumors express calretinin in only 5% of the cases, whereas this percentage is 20% for moderately differentiated tumors and 66.6% for poorly differentiated or undifferentiated tumors. We conclude that calretinin is expressed by most undifferentiated colorectal adenocarcinomas, but only by a limited number of cells in well-differentiated tumors. The degree of its expression coincides also with additional signs of malignancy, such as an increase in the number of metastases in the regional lymph nodes and in other organs.

Scar sarcoidosis in a patient with Crohn's disease.

A patient with scar sarcoidosis and Crohn's disease is described. The possibility of patients with Crohn's disease being more prone to develop sarcoidosis is discussed.

[Amebic appendicitis with subsequent perforated pancolitis]. / Amöben-Appendicitis mit konsekutiver perforierter Pancolitis.

Amoebic appendicitis is very rare, occurring in about 0.5 to 1% of acute appendicitis in tropical countries. The most severe complication is transmural amoebic colitis with perforation, described in 1.6 to 3.2% of cases. The mortality of such cases can be very high (up to 80%). We present a Swiss patient with amoebic appendicitis followed by severe perforated colitis; a total colectomy was necessary and the patient survived. Because of the good results of amoebicidal therapy and because of the severity of the complication after colitis we suggest that patients with signs of acute appendicitis after travel in tropical areas should be screened.

Transient cholestatic hepatitis in a neonate associated with carbamazepine exposure during pregnancy and breast-feeding.

We report a 3-week-old boy with cholestatic hepatitis, most likely due to carbamazepine exposure during pregnancy and breastfeeding. Cholestasis resolved after cessation of nursing. Liver function test results and histological findings were compatible with a drug-induced hepatitis. Other causes were excluded. While carbamazepine-induced hepatitis is well known in children and adults, it has never been described in association with prenatal exposure and/or breast-feeding.

[Partial algodystrophy]. / Parzelläre Algodystrophie.

Two patients are described with parcellar algodystrophy, a special form of algodystrophy. Bone biopsy in one patient revealed increased bone resorption and irregular new bone formation. Parcellar algodystrophy is characterized by the very localized pathological changes in the region of a joint. Only a small area of demineralization may be visible on X-ray. Skeletal scintigraphy shows hyperfixation of technetium-99m already in an early stage. Although the inflammatory signs are clinically impressive, the ESR may be normal. History may reveal previous involved joints. Parcellar algodystrophy normally runs a benign course. The difficulty of correct diagnosis is discussed. The changes are compared to those of partial algodystrophy and algodystrophy with no radiological abnormality throughout the course of the disease.

[Carcinoma in mature cystic teratoma of the ovary: pathology, therapeutic and prognostic problems]. / Karzinome in reifen zystischen Teratomen des Ovars. Pathologie; therapeutische und prognostische Probleme.

Carcinoma develops in about 1-2% of ovarian mature cystic teratomas, usually in postmenopausal women, squamous cell carcinoma being the most common tumor type. This study is based on a review of 300 published and 5 new cases. The carcinomatous tissue tends to invade adjacent organs, whereas lymph node metastasis has rarely been diagnosed. A five-year survival rate of about 15% testifies to the poor prognosis. The treatment of tumors confined to the ovary (stage Ia, Ib; FIGO) usually consists of bilateral oophorectomy and total hysterectomy. Exceptionally, in young women of childbearing age, treatment may be limited to unilateral oophorectomy. A thorough surgical, cytologic and bioptic examination of the abdominal cavity should be done to confirm an early tumor stage. In more advanced stages (FIGO Ic to IV), complete eradication of the malignant tissue offers the only chance of cure. The efficacy of chemo- and radiotherapy has not been studied systematically. We suggest that carcinoma in mature cystic teratoma be staged and treated according to the guidelines established for common epithelial neoplasms of the ovary.

[Pulmonary embolism: epidemiology and pathology]. / Embolie pulmonaire: épidémiologie et pathologie.

The following facets of pulmonary embolism (PE) are reviewed: 1. Main pathological aspects. 2. When can death be attributed to PE? 3. PE and life expectancy. 4. Mortality trends from PE in Switzerland from 1920 to 1982. The incidence of PE, as assessed from published data on approximately 300 000 autopsies, is plotted versus time and compared with death certificate diagnoses from Switzerland and other countries. In spite of the discrepancies between death certificate and autoptic diagnosis of PE, the results are consistent with a marked increase in mortality from PE during recent decades, at least in some countries. However, the rate of increase has slowed since 1975.

[The mucous secretion anisotropy of the sublingual gland of the guinea-pig by means of topo-optical histochemical reaction (author's transl)]. / Anisotropie du mucus de la glande sous-linguale du cobaye étudiée au moyen des réactions histochimiques topo-optiques

The authors study the mucous secretion of sublingual gland of the guinea-pig by means of topo-optical histochemical reactions with polarized light. They show a "paracristalline" organization of glucidic and protidic portion of these macromolecules. The results are discussed and compared with those of the literature.