Does Hepatocyte Paraffin 1 expression stand a role in determining the site origin of an adenocarcinoma from unknown gastrointestinal primary.

Background: Hepatocyte Paraffin 1 (Hep Par 1) was being extensively used to recognize the hepatocellular carcinomas, until recognition of its expression in tumors without hepatocellular differentiation. Aims and Objectives: The aim of this study was to analyze if Hep Par 1 stain can serve as a specific marker of the small intestinal (SI) adenocarcinomas, versus other gastrointestinal tract (GIT) primary tumors. Materials and Methods: In this retrospective cross‑sectional study, normal GIT mucosa (n ‑ 60), corresponding adenocarcinomas (n ‑ 60) and nodal metastatic foci (n ‑ 60) from the same patients, including 10 cases each from the esophagus, stomach, SI periampullary region, colon, rectum, and gall bladder were included. H‑score was calculated by multiplying the stain distribution and intensity scores. The H‑scores were compared with other clinical and histological parameters. Results: While normal SI mucosa showed diffuse strong Hep Par 1 staining, normal esophageal and gastric epitheliums were negative and normal colon, rectal, and biliary epithelium showed weak focal positivity. Adenocarcinomas from all these sites, however, showed Hep Par 1 expression, irrespective of the tumor type, site or origin, and tumor stage. The corresponding metastatic sites also showed variable Hep Par 1 positivity, without any site specificity. Conclusion: Hep Par 1 stain cannot help to determine the exact site of origin of primary GIT tumors. Its expression in adenocarcinomas across the GIT and their metastatic foci proves that it cannot be regarded as a marker of SI differentiation, especially in malignancy.

Mortality among homeless women who remain unclaimed after death: An insight.

Background. Some homeless people remain unclaimed after death. Although women constitute a minor proportion among the homeless, they represent a more vulnerable section. We reviewed the major autopsy characteristics and causes of death among women whose bodies remained unclaimed after death. Methods. We analysed the autopsy records and inquest papers of unclaimed bodies of women for the period 2006– 12 at the Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, New Delhi. Results. Most women whose bodies were unclaimed were 21 to 60 years old with a mean age of 45 years. Natural events (53.5%), largely attributable to acute/chronic lung diseases, were identified as the most common cause of death. Accidental deaths were predominant among the unnatural causes. Most bodies of women were found on the footpath besides the road (56.1%). Conclusion. The problems of physical/sexual abuse, acute chest infections and road traffic accidents are all aggravated in the situation of homelessness. More affordable shelters are needed to preferentially accommodate women. Also, awareness about the existing medical facilities needs to be increased. Natl Med J India 2016;29:207–8