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A case of metastasizing suprasellar germinoma (ectopic pinealoma) in a prepubertal part-Polynesian female is presented, and the histological features of the tumour are described. Review of the literature had disclosed 11 previous reports of extraneurally metastasizing pineal germinoma. The present case appears to be the first recorded instance of extraneural metastases from an intracerebral germinoma where the primary tumour mass is situated outside the pineal gland.

A new experimental model for the assessment of urethral catheters is described. Fifty catheters, comprising brands of latex, silicone, teflon-coated latex and polyvinylchloride (PVC) were assessed. The silicone, teflon-coated latex and PVC catheters were shown to cause minimal inflammatory change of the urethral mucosa, whereas the latex catheters showed variable and more marked changes. The model was simple to establish, and gave reproducible results.

Levels of volatile N-nitrosamines were measured in 10 brands of latex and 2 brands of silicone catheters using high performance liquid chromatography. The cytotoxicity of catheters from identical batches was determined by measuring the inhibitory effect of catheter extracts on the uptake of 3H-labelled thymidine into L-929 fibroblasts in culture (IC50). The most frequently encountered nitrosamines were N-nitrosodi-n-butylamine and N-nitrosodiethylamine. Total N-nitrosamine levels in excess of 100 ng/g were found in 6 of the 16 catheters tested. When compared with the cytotoxicity of the catheters a significant correlation was found, with increasing nitrosamine content being associated with greater cytotoxicity. In view of the reported toxic and carcinogenic effects of these compounds it is suggested that the nitrosamine content of catheters be routinely monitored and safe regulatory limits be imposed.

Nucleolar organizing regions (NORs), as demonstrated by the silver-colloid staining technique, have been counted in 75 renal cell carcinomas (20 grade 1, 22 grade 2, 17 grade 3 and 16 sarcomatoid), eight renal oncocytomas and nine renal adenomas. Mean NOR counts were 3.27, 6.28, 9.24 and 8.12, respectively, for grades 1, 2, 3 and sarcomatoid tumours, 3.09 for renal oncocytomas and 2.63 for renal adenomas. Analysis of data using the unpaired Student's t-test showed significant difference between NOR counts of grade 1, 2 and 3/sarcomatoid renal cell carcinoma, and grades 2, 3 and sarcomatoid renal cell carcinomas when compared to renal oncocytomas and adenomas. The association between type and grade of tumour, NOR value and tumour proliferation is discussed.

A 14-year-old girl who had colonic bleeding caused by colonic varices is described. Upper gastrointestinal endoscopy, radiography of the small and large bowel, and vascular studies of the superior and inferior mesenteric arteries and the portal vein were all reported to be normal. Submucosal varices, however, were identified colonoscopically in relation to the hepatic flexure and the sigmoid colon. Dilatation of subserosal right colonic vascular channels was identified at operation. Right hemicolectomy was performed and there has been no further bleeding. No obvious mesenteric arteriovenous communications were identified histologically.

The clinical and pathological findings in a patient with 3 adenocarcinomas of the colon, 16 pure hyperplastic polyps, 1 hyperplastic polyp with adenomatous elements and 1 hyperplastic polyp with malignant transformation to adenocarcinoma within an area of adenomatous dysplasia are described. The possibility of neoplastic transformation of hyperplastic polyps is discussed.

Eight hundred and sixty patients were preassessed for elective varicose vein and inguinal hernia surgery at Wellington Hospital ion 1975 and 1976. Eight were refused operation on the grounds that they were unfit for general anaesthesia. Forty-nine went forward to operation with no investigations. The remaining 803 underwent a total of 1792 routine radiological and laboratory tests (chest x-ray, Coulter screen and ESR, plasma urea, creatinine and electrolytes). Abnormal test results were noted in 172 patients, 63 of these being unpredicted. Apart from one death (test results normal) there was no respiratory, renal or significant wound pathology. In no case did an unexpected abnormal result alter patient management. It is suggested that there is no justification for the routine preoperative laboratory investigation of asymptomatic and clinically normal patients who are undergoing elective minor surgery.

A cell culture technique for assessing the toxicity of urinary catheters is described. The inhibitory effect of catheter extracts on the uptake of 3H-labelled thymidine by L929 mouse fibroblasts and human prostate derived epithelial cells in culture was measured. The concentration of extract which depressed uptake to 50 per cent of control (IC50) was determined for catheters of different composition. When compared to the degree of inflammation caused by the same catheters in an animal model, a significant correlation was observed (rs = -0.87). As a result of this correlation, the cell culture technique has the potential to be used as a valid alternative to the animal model.

Suicidal injuries caused by power tools have rarely been reported in the literature. The case of a 37-year-old white male schizophrenic patient who sustained a fatal self-inflicted neck injury from a band saw, while engaging in occupational therapy, is presented. Unusual features of this type of injury as noted at postmortem examination were the extent of the wound, the absence of hesitation injuries, and the presence of grease wipe, bone dust, and sawdust within the wound.

A detailed study of cerebral arterial forks by serial sectioning was made in a 33-year-old woman with typical Marfan's syndrome who died of septicemia following cardiac surgery. Two forks of the right middle cerebral artery exhibited the atrophic changes associated with early berry aneurysm formation indicating that the mode of development of these aneurysms is similar in both Marfan's syndrome and in non-Marfan subjects.

Tissue obtained from 102 renal tumours presenting over a 21-year period was reviewed in an attempt to identify histological features of prognostic importance. Statistical analysis showed the grade of nuclear pleomorphism to have a significant bearing on survival. Application of the proportional hazard model, and using the grade of nuclear pleomorphism as a baseline index, showed mitotic rate, pseudocapsule thickness and the presence of sarcomatoid tumour cells to have an independent association with survival. The presence of tumour cells with granular cytoplasm was correlated with outcome; however, this parameter was not independent of grade of nuclear pleomorphism. Tumour pattern, intensity of lymphocytic infiltrate, degree of fibrosis, necrosis and hemorrhage, and amount of haemosiderin and dystrophic calcification were found to have no association with survival.

A case of Takayasu's disease in a young Caucasian female is described. The major complications which developed over the ten year course of the disease include nephrotic syndrome, severe refractory hypertension, aortic valve regurgitation associated with aneurysmal dilatation of the ascending aorta, and recurrent congestive heart failure. Amyloid deposits have been demonstrated in the aorta, atrial appendage, aortic valve, and renal cortex. The association of amyloidosis and Takayasu's disease is discussed.

The pineal gland in the possum is represented by a thickening in the wall of the pineal recess. A superficial pineal body and a pineal stalk are characteristically lacking. The ependyma related to the gland is specialized but differs markedly from the lining in other circumventricular organs in form and in surface morphology. Two distinct topographic zones have been recognized. In the middle is a mass of cells which form a prominent knobby-surfaced central zone. These cells are characterized by the absence of cilia, the paucity of microvilli and blebs and the presence of processes which overlap adjacent cells. A surface pattern formed of cell outlines was lacking. it is suggested that the central zone is lined by pinealocytes, supporting cells and the processes of both cell types. Most of the central zone is surrounded by an intermediate zone of variable width. The latter region has been observed to possess a circumventricular organ-type surface morphology. It is sparsely ciliated, almost totally covered by a carpet of microvilli and it exhibits a variety of surface specializations. Supraependymal cells and various transitory supraependymal cell processes are also present. Outside the specialized ependyma is the peripheral zone which like the regular ventricular lining is densely ciliated. Supraependymal processes are found among the clusters of cilia, or rarely, on the surface of the ciliary bed. Season and sex related differences in surface ultrastructure were not observed.

A retrospective analysis was carried out on 162 patients presenting to Wellington Hospital with renal cell carcinoma between 1958 and 1978, to evaluate factors that may influence prognosis. Following radical nephrectomy the five year survival was 70% for stages 1 and 2, 53% for stage 3A and 13% for stages 3B and 3C. No patient with distant metastases survived this period. Those with renal vein or caval involvement had a significantly worse prognosis than those with stage 1 or 2 disease, and a significantly better survival than those with nodal spread. Once the tumour stage had been assigned as a baseline the influence of clinical, haematological and biochemical variables on the prognosis was analysed using a proportional hazard model. The only factor showing a significant independent association with survival was the presentation of the renal cancer as an incidental finding (p less than 0.01). The presence of anaemia or a low peripheral lymphocyte count may be independently associated with survival (p = 0.02, 0.08 respectively). Weight loss, symptoms length, the ESR, abnormality of liver function and tumour size, although associated when considered alone, do not have an independent association and therefore offer little added prognostic information. The age and sex of the patient were not related to survival.