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In an autopsy material consisting of 35 alcoholics and 13 non-alcoholic traffic casualties the heart was made the object of a thorough prospective study. The investigation of the histological sections was performed blindly. In two-thirds of the alcoholic hearts changes were found which could not be explained by mechanisms other than chronic ethanol intoxication. The coronary arteries showed the same degree of atherosclerosis in both groups. Three alcoholics died suddenly without any alcohol in blood or urine probably from acute alcoholic cardiomyopathy. It is stressed that the combination of heart hypertrophy, subendocardial, interstitial, and perivascular fibrosis, and the presence of chronic inflammatory cells is highly indicative of alcoholic heart disease. The entity is probably more common than generally accepted.

Serum carcinoembryonic antigen (CEA) levels in relation to survival, flow cytometric DNA ploidy pattern, Dukes stage, and recurrent disease was prospectively evaluated in 406 patients with colorectal carcinoma. In 246 patients (61%) the carcinomas were DNA aneuploid. Increased preoperative CEA levels (> 5 micrograms/l) were found in 151 of 363 evaluable patients (42%). Dukes stage-B patients with preoperative CEA elevation showed significantly poorer prognosis than those with normal CEA values (p = 0.001). A weak but significant correlation was found between preoperative CEA level and Dukes stage (Kendall's tau = 0.25, p < 0.01). Of 50 evaluable patients with clinical recurrence and postoperative normal or normalized CEA levels, 28 (56%) had a rise in CEA before or at the time of clinical recurrence. The sensitivity of the CEA test for primary and for recurrent disease was not significantly different in the DNA aneuploid and the DNA near-diploid groups.

Fresh tissue specimens from 406 colorectal carcinomas were analyzed by DNA flow cytometric study, and the DNA ploidy pattern was compared with Dukes' stage, histologic grade, and degree of cellular atypia. Sixty-one percent of the carcinomas had a distinct aneuploid DNA pattern. The proportion of aneuploid carcinomas was significantly higher in the advanced Dukes' stages than in the localized ones. A highly significant association was found between DNA ploidy pattern and degree of cellular atypia, whereas no association was demonstrated between DNA ploidy pattern and histologic grade. This finding might indicate that cellular atypia has a stronger prognostic impact than the growth pattern of the tumor. The authors suggest that flow cytometric DNA quantification may replace assessment of cellular atypia in the histologic evaluation. Furthermore, together with earlier findings by others, these results indicate that the degree of cellular atypia may be conserved during the development from adenomas to carcinomas.

Six patients with spontaneous colonic perforation after cadaveric kidney transplantation are described. Five perforations occurred in a diverticulum of the sigmoid colon, while one was at the suture line after a colotomy performed 5 months previously. Four patients died. Clinical diagnosis was difficult, but on x-ray examination free air in the abdominal cavity was found in 3 patients. Explorative laparotomy should be performed promptly when the diagnosis is suspected. All patients above the age of 4o should be screened with a barium enema prior to transplantation.

Summary A clase of primary pulmonary hypertension in a 5-week-old child is described. The mother had used amitriptyline in the gestational period, and the possible induction Of pulmonary hypertension by this drug is discussed.