[Congenital duodenal obstruction in combination with heterotopic gastric mucosa in the gallbladder. Case report and etiology]. / Congenitale Duodenalobstruktion in Kombination mit heterotoper Magenschleimhaut in der Gallenblase. Fallbeschreibung und Atiologie.

A hitherto unique case of ectopic gastric mucosa of the gallbladder in combination with a congenital duodenal stenosis in an young male adult is presented and the etiology of both anomalies is elucidated. While the intestinal obstruction was confirmed prior to the operation, the diagnosis of the gastric heterotopia in the gallbladder has been established, as usually, first by histopathologic examination. Both anomalies required surgical treatment. The long-standing indistinct abdominal complaints of the patient vanished after cholecystectomy and duodenojejunostomy.

The relationship between Ki-67 labeling and mitotic index in gliomas and meningiomas: demonstration of the variability of the intermitotic cycle time.

The monoclonal antibody (mAb) Ki-67 is a marker for the growth fraction (GF) of tumor cells. The exact relationship between the Ki-67 labeling index (LI) and the conventional diagnostic criterion of the proliferative activity of brain tumors, the mitotic index (MI), is unknown except for some general references. On serial frozen sections Ki-67 LI and MI were determined in nearly identical areas of 32 glioblastomas, 20 grade III astrocytomas, 21 grade II astrocytomas and 20 selected cases of meningioma. The data not only clearly showed different median values of LI and MI for the various malignancy grades, but also similar regression coefficients for each glioma type. A non-linear relationship between the two indices was found for all glioma cases with high significance and high correlation coefficient; (LI) = 5.6 (MI)0.59. This results from differing intermitotic cycle times, the variability of which can be estimated from the data given.

[Occlusion of an implanted peridural catheter by a plug of epidermis]. / Okklusion implantierter Periduralkatheter durch Epidermisstanzen.

A patient suffering from intensive perianal pain due to recurrent rectal cancer, not controllable by systemic analgesics, was treated by continuous epidural morphine for a period of 8 months. Satisfactory pain relief was achieved although sometimes problems arose with the permeability of the epidural catheter. As a reason for increased resistance, the literature mentions nonspecific foreign-body reactions next to the catheter. In our patient, tumour infiltration into both the lumbosacral plexus and the epidural space leading to compression of the catheter could not positively be excluded. At autopsy an unexpected obstruction of the catheter by epidermis was observed. It could be demonstrated that pieces of epidermis may enter the catheter, bypassing the bacterial filter of the port, and can then clog the tip of the catheter.