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ResultsThe clinical information was limited in many of these cases, but the great majority of conjunctival biopsies had been diagnosed either as pterygium or pinguecula (Fig. 1), though the criteria for this differentiation were not constant. There were also some patients with a clinically invasive carcinoma (Fig. 2) and a few with other lesions such as papilloma. HISTOPATHOLOGYThe main histological features and the diagnosis are shown in Tables 1 and 2; 167 lesions were reclassified as 'solar keratosis' with varying degrees of 102 on 11 May 2018 by guest. Protected by copyright.

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The histopathology of 176 cases of gynaecological schistosomiasis reported from Malawi during the period 1976-80 was reviewed. Schistosomal infection was found throughout the genital tract, with 60% of cases involving the cervix. The dominant tissue reactions to ova were categorized into five histopathological groups A-E and for each site the relationship between histopathological and clinical features was explored. No evidence was found linking schistosomiasis with cancer of the genital tract. Schistosomiasis was a significant cause of gynaecological morbidity, particularly when infection involved the lower genital tract; however in a proportion of cases ova were found coincidentally in other lesions or normal tissues, and were not apparently causally linked with symptoms. The findings are discussed in relation to previous studies of gynaecological schistosomiasis.

Aflatoxin levels were determined in 480 food samples stored for consumption between harvests and collected from different parts of Uganda, in 1966–1967. Among these samples, 29.6% contained detectable levels of aflatoxins and 3.7% contained more than 1 μg/kg. The frequency of aflatoxin contamination was particularly high in provinces with a high hepatoma incidence, or where cultural and economic factors favored the ingestion of moldy foods. This observation suggests that aflatoxin exposure may account for the high incidence of hepatoma in Uganda and perhaps elsewhere.

Fifty-six patients with tumoral calcinosis are presented. The lesions were located predominantly about the hip, elbows and scapula. The pathological features are described and the aetiology is discussed.Tumoral calcinosis is a distinct entity in which large deposits of calcified material arc found in the tissues adjacent to the large joints of the body. It is a rare condition in Europe and North America (Slavin et al., 1973) but is quite commonly seen in the populations of South, Central and East Africa and has also been reported from New Guinea (Berg, 1972)-This paper reports our experience with fifty-six cases from Malawi. MATERIALS AND METHODSSince 1968 St Thomas's Hospital Medical School has provided the histopathological service for Malawi. The slides and clinical information from all cases diagnosed as tumoral calcinosis in the decade 1970-1979 have been reviewed.Representative blocks from all pieces were decalcified, embedded in wax and 5-//m sections cut. These were stained with haematoxylin and eosin and also by the Von Kossa technique. RESULTS Clinical findingsThe series consisted of fifty-six patients (all coloured Africans), thirty-nine females and seventeen males. The age range was from 6 to 70 years (mean 30). Twenty-three patients (41 "n) were under 21 years and ten patients were aged 10 years or younger. The lesions were located about the hip (69".,), elbow (9'\,) and scapula (9'^,), sacrum (6'\,), ankle (3",,) and scalp (i"o).

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Summary and conclusions A prospective study of the prevalence of gall stones at necropsy in nine towns in England and Wales showed considerable geographical variations. The age-and sexstandardised prevalence ranged from 20.6% in Ipswich to 9.2% in Wakefield. The distribution of gall stones differed from that of all-cause mortality and was negatively correlated with that of mortality from ischaemic heart disease.Socioeconomic influences related to affluence do not appear to be major determinants of the distribution of gall stones.prospective study of the prevalence of gall stones at necropsy in nine county boroughs in England and Wales. We analysed variations in the prevalence of gall stones between the nine towns in relation to socioeconomic conditions and latitude. MethodsSelection of towns-We used a range of intercorrelated socioeconomic indices-for example, population density, income, and car ownership -to produce a single social-factor score for each of the 83 county boroughs in England and Wales.' On the basis of the score we divided the towns into three equal groups having better, intermediate, and worse social and economic conditions. Figure 1 shows the distribution Introduction Mortality is higher in the north and west of Great Britain than in the south and east. The variation is large-twofold among county boroughs, for example'-and the reasons for it unknown.