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Between 2002 and 2005, we made 343 intraoperative frozen section diagnoses with a telepathology system, which connected a neurosurgical department to our department of pathology. An expert neuropathologist performed at least one brief gross examination, and this was followed by a smear preparation and a frozen section slide for each case. Frozen section diagnosis lasted on average 26.1 min, calculated from the beginning of gross examination until the surgeon was given the diagnosis. The majority of cases (283 or 83%) were diagnosed in 15-40 min. The mean time needed for macroscopic examination was 3.0 min, time for staining 4.2 min, smear diagnosis took 5.4 min and time for histological diagnosis 10.7 min. Telemicroscopy of a smear slide took 11 times longer compared with light microscopy, and telemicroscopy of a frozen section slide took 16 times longer than with light microscopy. In 6% of cases, the telepathology software posed technical problems, which delayed the time of diagnosis, but not by more than 4 min. We were able to render a diagnosis in all cases (system reliability 100%). After eliminating sampling errors (i.e. cases with no diagnostic material in the frozen section slides and/or in smear preparations), the diagnostic accuracy for telepathology was 97.9%.

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AIM: The assessment of the value of the antibody QBEND10, which is directed against the haemopoietic stem cell related antigen CD34, in the immunohistochemical diagnosis of myelodysplastic syndrome in routinely processed bone marrow biopsy specimens. METHODS: 581 formalin fixed, paraffin embedded trephine biopsy specimens of the iliac crest were immunostained with QBEND10 (avidin-biotin complex/ABC method). The number of CD34+ haemopoietic stem cells/blast cells (referred to hereafter as CD34+ cells) was determined in each case. The Wilcoxon test was used for statistical analysis. RESULTS: The following diagnostic categories were defined: (1) normal or reactive bone marrow (n = 356), (2) lymphoproliferative disorders, usually non-Hodgkin's lymphoma of low grade malignancy or multiple myeloma (n = 118), (3) myelodysplastic syndrome (n = 22), (4) acute leukaemia (n = 44), and (5) myeloproliferative diseases (n = 41). The average number of CD34+ cells was very low (0.2/HPF) in normal and reactive bone marrow, in lymphoproliferative disorders and in the myelodysplastic syndrome subtypes RA and RARS. Myeloproliferative diseases showed an average of three CD34+ cells/HPF. However, the average number of CD34+ cells was significantly higher (p < 0.05) in the myelodysplastic syndrome subtypes RAEB and RAEB-T (8.7/HPF) and in acute leukaemia (including both myeloid and lymphoblastic leukaemia; 111.7/HPF). CONCLUSIONS: QBEND10 is of value for the identification of RAEB and RAEB-T in routinely processed bone marrow biopsy specimens because it enables the detection of even small increases in the number of CD34+ cells.

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Human colon carcinomas were operatively resected and the tumour-bearing segments interposed into an oxygenised ex vivo perfusion system. Pressure, flow, temperature, pH and metabolic parameters were controlled. Over a period of 45 min the 131I-labelled monoclonal antibody AUA1 was administered and its distribution in the tumour tissue analysed scintigraphically. The accumulated activity was determined in different tissues. The results showed that the AUA1 uptake increased with the degree of histological tumour differentiation. The main tumour:non-tumour ratio reached 0.8 in poorly, 4.1 in moderately and 5.9 in highly differentiated adenocarcinomas. Introducing the oxygenised erythrocyte-enriched perfusion media significantly increased the viability of the colon tissue. The ex vivo perfusion system will help to analyse factors determining monoclonal antibody accumulation in human colon carcinomas.

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We describe a model for the evaluation of anti-tumour antibody specificity, using a human carcinoma-bearing colon segment. After resection of the human colon tumour, the supplying artery was cannulated and perfused with fresh frozen plasma and heparin. Continuous control of pressure, flow, temperature, pH and various metabolic parameters were performed after administration of 131I-labelled anti-CEA antibody. Highly differentiated adenocarcinomas of the colon showed a much higher antibody uptake than undifferentiated tumours. Between 3 and 7% of the injected antibody was found in the tumour tissue. Autoradiography showed non-homogeneous binding in the tumour tissue. The non-specific antibody perfusion showed no tumour binding. We conclude that the ex vivo perfusion of resected colon carcinomas can be used to measure the kinetics of binding and clearance of MAbs in tumour tissue by direct scintigraphy. The cellular biodistribution of the antibody can be documented by means of autoradiography.

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Since 1971 premature labor has been treated with Fenoterol and Verapamil in the Department of Obstetrics and Gynecology of the University in Mannheim. In animal experiments as well as in the isolated fetal cardiac muscle elective myocardial necroses were observed following stimulation with beta-sympathomimetics. These lesions are prevented by additional application of Ca++-antagonists. Fenoterol and Verapamil are capable of passing through the placenta. To evaluate the question whether a possible cardiac lesion of the infant is caused by tocolysis, 31 newborns of mothers after tocolysis were compared to a group of 19 infants without tocolysis. At the first day of life as well as at the age of 2 and 4 weeks ECG was registered, and the serum electrolytes K+, Ca++ and Mg++ were determined. At day 1 and day 4 as well as during the 2nd and 5th week CK and CK-MB were measured, and during the 2nd week the size of heart was registered. We were unable to demonstrate pathological cardiac findings in newborns following tocolysis which were related to the preceding medication.

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In a joint retrospective study by 17 radiotherapy clinics in German-speaking countries the results of treatment of bronchial carcinoma after radiotherapy were analysed in 7503 cases. The age peak was between the 60th and 70th year. Squamous-cell carcinoma was the most frequent histological type, followed by anaplastic carcinoma, with adenocarcinoma being rare. There was a high proportion of histologically not clearly identified cases (27% in central and 35% in peripheral carcinomas). Survival rate at one year was 31% for central (3662 patients) and peripheral (961 patients) tumours, but only 2% at five years. Prognostically there was no difference between histological types and kind of radiotherapy or technique, but total dose affected survival rate. At a total dose of less than 5000 rd the survival rate at five years was minimal. The prognosis of combined surgical and radiotherapeutic measures was slightly better than with a radiotherapy alone, but results were unpredictable for the individual case. It is concluded that radiotherapy aiming at cure should be used in imoperable bronchial carcinoma if the tumour state and general condition of the patient appear to make a cure possible. But if this is not the case, radiotherapy should be used only palliatively, i.e. only to ameliorate symptoms.

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