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threshold dose, laser irradiation has an inhibitory effect on tumour growth as opposed to its simple thermal effect. Our experience suggests, however, that this potential '.cure" cannot be achieved in clinical practice. Simple laser irradiation, as opposed to laser irradiation after previous photosensitisation of tumour tissue with haematoporphyrin dye,12 therefore holds little hope of cure except, perhaps, in rare instances of slowgrowing polypoid tumours within the bronchial lumen. Surgery, however, is the treatment of choice for such growths.

SUMMARY All gastrointestinal tract biopsy specimens from 190 patients positive for HIV-1 or with AIDS were reviewed to assess the prevalence of cytomegalovirus (CMV) infection, morphology of infected cells, and the associated histopathological features. Eighteen patients (10 (7 7%) of 129 HIV antibody positive and eight (13a1%) of 61 with AIDS) had CMV identified in 35 biopsy specimens from the following sites: oesophagus (n = 3); stomach (n = 6); small intestine (n = 4); colorectum (n = 18) and perianal area (n = 4). Eleven patients had CMV alone as the potential cause of symptoms and in seven there were coexistent pathogens or Kaposi's sarcoma. The appearance and type of infected cells at different sites was highly variable. Immunocytochemical techniques and electron microscopic examination were performed to confirm the presence of CMV antigen and CMV virus particles and to exclude the possibility of an adenovirus producing similar cytopathic changes.It is important to recognise the different morphological forms of infected cells, and the use of immunocytochemical techniques is recommended in patients at risk for CMV or in whom CMV infection is suspected.

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Lymphocytes obtained from two donors who were producing anti-D were transformed with Epstein-Barr virus and grown in tissue culture. The lymphoblasts from both donors produced anti-D antibody, which agglutinated Rh-positive cells in saline. Both antibodies belonged to the IgM class; the concentration of anti-D in the culture fluid from one of the donors was approximately 250--500 ng/ml and bound firmly to Rh-positive cells with a functional affinity constant of approximately 1 x 10(9) M-1.

A B S T R A C T We have assessed the effectiveness of transplanted histocompatible fibroblasts as a long-lived source of lysosomal enzymes for replacement therapy in three patients with Hunter's syndrome, over periods ranging from 2.5 to 3.75 yr. The level of Hunter corrective factor excreted by all three patients increased after transplantation, as did the activity of a-L-idurono-2-sulfate sulfatase in serum, when measured directly with a radioactive disulfated disaccharide substrate. Sulfatase activity was also raised in leukocyte homogenates from the two patients that we were able to assess. These increases in enzyme activity were accompanied by corresponding increases in catabolism of heparan and dermatan sulfates, as shown by (a) a decrease in sulfate:uronic ratios of urinary oligosaccharides, (b) an increase in iduronic acid monosaccharide, and (c) a normalization of Bio-Gel P-2 gel filtration profiles. Both the increase in enzyme activity and increased catabolism were maintained during the period of study and were not affected by either a gradual decrease or total withdrawal of immunosuppressive therapy.

Fifty one patients with human immunodeficiency virus (HIV-1) infection who had been consecutively endoscoped for upper gastrointestinal symptoms were biopsied (stomach or duodenum, or both) and compared with 59 age and sex matched controls for the presence of Campylobacter pylori. In 28 (47%) of the control group but in only seven (14%) of the HIV seropositive patients were C pylori seen on histological examination (p < 0 001, odds ratio 5 6, 95% confidence interval 2-2-14-5). Sixteen patients who were HIV antibody positive had other index diseases for the diagnosis of AIDS in the biopsy material and, when these were excluded, comparison with the control group still showed a significant difference; p < 0 01, odds ratio 3-6, 95%, confidence interval 1-49-6. In this series, therefore, C pylori were far less common in HIV antibody positive patients than in controls. Among the HIV positive patients, a higher proportion of C pylori negative cases had AIDS but this trend was not significant.