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Malignant change to glioblastoma multiforme in a mature cystic teratoma (dermoid cyst) is exceptionally rare. Besides a report on such a case we give a brief review of the literature on this subject and a comment on treatment. The reported case is about a 41-year-old woman with a mature cystic teratoma of the ovary with transformation to glioblastoma multiform. The tumor was limited to the ovary and completely excised by salpingo-oophorectomy. Three and a half years after surgery the patient is alive without evidence of recurrent disease. For limited stage Ia tumors we found support in the literature for expectant management after surgery, without adjuvant chemotherapy.

We report two cases of primary heterologous malignant mixed Müllerian tumour of the Fallopian tube. One of these was bilateral, a finding which, as far as we know, has not been reported before.

The presence of Langerhans cells and T cells in human cholesteatoma is demonstrated by immunohistochemical and submicroscopic analyses. Various monoclonal antibodies directed against Langerhans cells and T lymphocytes reveal the presence of these cell populations in the cholesteatoma matrices but not in the normal tympanic membrane. Their quantitative and spatial distribution in and around the cholesteatoma matrix might be of importance in the pathophysiology of human cholesteatoma.

The purpose of this study was to compare the utility of the 35-cm versus the 60-cm flexible sigmoidoscope in screening asymptomatic patients for colorectal neoplasia. Two hundred fifty-eight patients 45 years of age or older were examined in a randomized fashion with both the 35-cm and 60-cm instruments. Fifteen percent (39/258) of patients had a total of 50 polypoid lesions 3 mm or greater in diameter (including one carcinoma). Of all polypoid lesions, 76% were detected with the 35-cm instrument compared to 98% with the 60-cm sigmoidoscope. Eighty-four percent of all polyps occurred within the distal 35 cm of colon. The mean time required to complete the examination was significantly less with the 35-cm sigmoidoscope than with the 60-cm sigmoidoscope (2.5 vs. 5.7 min). Moderate to severe discomfort was experienced by 69% of patients with the 60-cm instrument compared to only 29% with the 35-cm sigmoidoscope. Seventy-two percent of patients preferred examination with the shorter instrument compared with 7% for the longer sigmoidoscope, while 21% of patients expressed no preference. The 35-cm flexible sigmoidoscope fulfills many criteria of an effective screening test for colorectal neoplasia including rapidity of examination, safety, good sensitivity, and excellent patient acceptance.

In 16 patients with a renal allograft the activity concentrations of aspartate aminotransferase and alanine aminotransferase and the percentage stimulation of both enzymes were investigated. After the transplantation the patients received prednisone and cyclosporine A as immunosuppressive therapy, while exactly 3 months after the date of transplantation prednisone and azathioprine were given as immunosuppressives. In the first period, the percentage increase of the activity concentration of aspartate aminotransferase and alanine aminotransferase upon supplementation of pyridoxal-5'-phosphate in vitro were similar to that of healthy individuals. In the second period, however, the percentage increase of the activity concentration of alanine aminotransferase was much higher than that of aspartate aminotransferase. Cyclosporine A given during a period of about 400 days did not influence the percentage increase of both enzymes. It is concluded that the high stimulation of alanine aminotransferase in the second period depends on the presence of azathioprine or its metabolites in serum.

In 76 patients with a renal allograft the plasma concentration of pyridoxal-5'-phosphate, the activity concentrations of aspartate aminotransferase and alanine aminotransferase and the percentage stimulation of both enzymes have been investigated. Generally, the concentration of the coenzyme was decreased in the patient group compared to normal individuals. The percentage increase of aspartate aminotransferase is the same for the patients as for the normal group. However, the stimulation of alanine aminotransferase is greatly increased for the patient group except for those patients who received cyclosporine A instead of azathioprine. The highly significant inverse correlation between the plasma pyridoxal-5'-phosphate concentration and the percentage stimulation of the enzymatic activity of aspartate aminotransferase and alanine aminotransferase observed before for a normal group, is not present in our patient group. The percentage increase is independent on the activity concentration of the enzymes. It is concluded that the high stimulation of alanine aminotransferase depends on the administration of azathioprine.