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The volume of both ventricles was estimated in 25 hearts with chronic cor pulmonale. Also, the weight of the left ventricle, including the whole septum and the free part of the right ventricle, was determined to be 100 g. Distinct hypertrophy of the right ventricular part of the septum could be demonstrated in all cases. A weight increase of the left ventricle, including the whole septum, is frequently caused by the hypertrophic ventricular part of the septum. The relative weight of the right ventricular portion (calculated according to Müller's method) was subtracted from the weight of the left ventricle plus the whole septum. After this weight correction, a hypertrophy of the left ventricle could only be demonstrated in cases with hypertension or renal arterio- and arteriolosclerosis. In one case of left ventricular hypertrophy, hypertension could not be ruled out.

1.Two basic types of arterial vessels can be distinguished in the myocardium.a)Compacta or Ventricular Wall Type. Intramyocardial microarteries with ring musculature of the media.b)Papillary Muscle Type. Arteries with longitudinal musculature arranged as bundles in the broad media.2.The manifestation of intramyocardial microarteriopathy differs in these vessel types.PAS-positive and elastica-rich cushion-like thickening of the intima mainly occurs in the compacta type. Arterial vessels of the trabecular portion additionally show hyperelastosis of intima and media.The degenerative lesions of the papillary muscle type are characterized by early degeneration of the smooth muscle cells and hyperfibroelastosis of intima and media.3.Pathological vascular lesions in the compacta and papillary muscle type occur more frequently in the left ventricle, and increase with age.4.Slight and medium lesions are in the majority. Severe vascular changes are seen in the 7th to 9th decade in about 5–10% (compacta type) and in 30–35% (papillary muscle type) respectively.5.Hypertension seemed to raise the frequency of slight and medium lesions in the compacta type vessels. In the papillary muscle type the degenerative lesions frequently extend from the top to the bottom of the papillary muscles.6.No significant difference between frequency and severity of vascular lesions in diabetics and in the control group could be demonstrated.7.It appears that pathological vascular lesions occur less frequently in compacta type vessels in cases of high-grade stenosis due to extramural coronary artery sclerosis.8.Impairment of the quality of myocardial circulation is only encountered in the presence of severe pathological vascular lesions.

A 42-year-old woman had a 10-year history of external ophthalmoplegia, malabsorption resulting in chronic malnutrition, muscle atrophy and polyneuropathy. Computer tomography revealed hypodensity of her cerebral white matter. A metabolic disturbance consisted of lactic acidosis after moderate glucose loads with increased excretion of hydroxybutyric and fumaric acids. Post-mortem studies revealed gastrointestinal scleroderma as the morphological manifestation of her malabsorption syndrome, ocular and skeletal myopathy with ragged red fibers, peripheral neuropathy, vascular abnormalities of meningeal and peripheral nerve vessels. Biochemical examination of the liver and muscle tissues revealed a partial defect of cytochrome-c-oxidase (complex IV of the respiratory chain). This mitochondrial multisystem disorder may represent a separate entity to be classified between the spectrum of myoencephalopathies and oculo-gastrointestinal muscular dystrophy.

Morphological changes of the lung occur frequently in fatal acute hemorrhagic pancreatitis. The pulmonary alterations are independent of mechanical ventilation and therefore not due to iatrogenic damage caused by high inspired oxygen concentrations. The histological findings are similar to those seen in the so-called shock lung syndrome. The pulmonary lesion develops progressively and three stages can be separated: early, late, and final phase. The pulmonary complications in acute hemorrhagic pancreatitis may be explained by the release of mediators such as pancreatic enzymes or free fatty acids into the blood stream. In acute hemorrhagic pancreatitis a close monitoring for shock parameters is necessary. A fall in arterial Po2 is an early indication for mechanical ventilation, including positive end-expiratory pressure.

Summary The morphology and the risk of precancerous lesions (intraductal atypical epithelial proliferation, papillary proliferation, and carcinoma lobulare in situ) of mammary carcinoma are demonstrated and discuBed. According to the type of lesion, the surgery of choice based on short-term observation is subcutaneous mastectomy or simple mastectomy. Combined intraoperative histologic and cytologic staging, based on the investigation of the axillary lymph nodes has been developed. We prefer simple mastectomy for stage I and ablatio mammae (method of Rotter-Halsted) for stage II to extirpate as precisely as poBible the lymph nodes of the apex and the interpectoral nodes.

Summary Sodium taurocholate pancreatitis in the rat is a frequently used experimental model for evaluating therapeutical regimes in this disease. It is, however, uncertain when treatment should be started, as the early phase of this experimental model and thus the time when the pancreatitis really develops is unknown. Serum and pancreatic enzymes, as well as pancreatic morphology, were therefore studied 5, 30, and 60min after induction of sodium taurocholate pancreatitis. It was found that increase in serum enzymes and decrease in pancreatic enzymes and morphological changes characteristic for acute pancreatitis develop as early as 5 and 30 min after induction of pancreatitis. Thus, therapy in this model may be started shortly after induction of acute pancreatitis.

Two children are presented with Hodgkin's disease and a mediastinal mass which did not respond to polychemotherapy and radiation therapy and proved to be a benign thymic cyst. The coincidence of Hodgkin's disease with a benign thymic cyst has only been reported once before [11]. The diagnostic and therapeutic implications are discussed.