Features of autoimmune-like bile duct disease were seen in almost half (15 of 32) of patients with benign hilar strictures resected for presumed hilar cholangiocarcinoma. Frank IgG(4)-related sclerosing disease was found in only two of the 15 patients with autoimmune-like bile duct disease.

This study suggests that lymph node metastasis risk for m3 and submucosal AEC may be lower than has been assumed on the basis of surgical series, and that current guidelines are valid regarding suitability of m3 AECs for endoscopic therapy. It may also suggest that selected patients with submucosal cancers are also eligible for endoscopic management. Confirmation of these results is needed in larger series with longer follow-up.

The HpSA test gave a high number of false- positive results in patients with PUB, probably because of blood constituents cross-reacting in the enzyme immunoassay. The HpSA test is not accurate for testing H. pylori infection in patients with PUB.

The reactions of seven contrast agents--pure barium sulphate, Micropaque, Gastrografin, Dionosil, Hytrast, Amipaque and Hexabrix--on the bronchi and lungs of rats were studied. This work was undertaken to find a safe gastrointestinal contrast agent for use in post-operative patients where aspiration may be an accompanying risk. Amipaque and Hexabrix produced no significant histological reaction in the lungs and would, therefore, appear to be suitable for use in such cases.

Background. The incidence of vulvar intraepithelial neoplasia Grade III (VIN III) is increasing and is diagnosed at a younger age than previously. VIN III is often multifocal and frequently coexists with multicentric dysplastic lesions in the cervix and vagina. Warty‐type VIN III more often has been found to contain human papillomavirus (HPV) DNA than basaloid‐type VIN III. The authors performed HPV DNA polymerase chain reaction (PCR) analysis in 48 VIN III biopsies and reverse transcriptase (RT)‐PCR in 8 HPV‐16 DNA‐positive multifocal VIN III biopsies to detect E6/E7 transcripts. Methods. Human papillomavirus DNA detection and histologic analysis were performed on alternating slides of paraffin embedded biopsies. Polymerase chain reaction was performed with consensus primers, and HPV typing was performed by direct sequencing. Total RNA was isolated from frozen biopsies by centrifuging a guanidinium thiocyanate (GTC) lysate through a cesium chloride (CsCl) cushion. The RT reaction was performed using a 3′ primer, located just downstream of the E7 stop codon, and the PCR reaction was performed using the same 3′ primer and a 5′ primer located just downstream of the E6 start codon. Results. The mean age of the 48 patients was 37.7 years. Eighty‐one percent had multifocal VIN III. Sixty‐six percent had multicentric neoplasia. Forty‐six percent of the biopsies were warty‐type, 17% basaloid‐type, 35% mixed‐type and 2% differentiated‐type. Ninety‐two percent were HPV‐positive and 83% contained HPV‐16 DNA. Human papillomavirus DNA was more often present in multifocal VIN III lesions than in unifocal VIN III lesions and also more often in VIN III lesions coexisting with other dysplastic multicentric lesions than in unicentric VIN III lesions. Warty‐type VIN III more often contained koilocytes than basaloid‐type VIN III. A correlation between different morphologic forms of VIN III and the presence of HPV DNA was not found. Both types of VIN III often coexist in one lesion. In all the RT‐PCRs, a 593‐base‐pair fragment was detected, corresponding to the expected length of the major E6‐E7 mRNA. Conclusions. The observed high prevalence of transcriptionally active HPV DNA associated with multifocal and multicentric dysplasia suggests a role of HPV in the pathogenesis of these lesions. A positive correlation between different morphologic forms of VIN III and the presence of HPV DNA was not found. Cancer 1995;75:2879–84.