Two patients developed unusual causes of severe gastrointestinal hemorrhage associated with anticardiolipin antibodies. One patient bled from small bowel ischemia and mesenteric thrombosis. Another patient bled massively from an ulcer of the descending duodenum which was refractory to standard antiulcer therapy. Ischemia may have contributed to the atypical ulcer presentation in this second patient, which included atypical ulcer location, ulcer refractoriness to standard peptic ulcer therapy, and severe recurrent hemorrhage. In five previously reported cases intestinal infarction associated with anticardiolipin antibodies presented, as it usually presents in patients without anticardiolipin antibodies, as an acute abdomen without acute gastrointestinal bleeding. The current study demonstrates that intestinal ischemia due to thrombosis is in the differential diagnosis of gastrointestinal bleeding in the anticardiolipin antibody syndrome.

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(N.M., J.R., KR.), New Jersey DNA ploidy and S-phase fraction are considered to be prognostic variables in breast carcinoma. DNA content of 35 cases of breast carcinoma of varying histologic types and nuclear grades was analyzed by flow cytometry and image analysis in both fresh and formalin-fixed, paraffin-embedded tissue. Fresh cell and deparaffinized nuclear suspensions were used for flow cytometry. Fresh and deparaffinized tumor tissue samples were used for image analysis. The results of analysis for DNA ploidy, DNA index of DNA aneuploid GdG, peaks, and S-phase fraction were compared in different tissue preparations for both techniques. The two techniques produced comparable DNA ploidy results with both fresh and formalin-fixed, paraff in-embedded tissue. Sensitivity for detection of DNA aneuploidy was somewhat greater by image analysis, particularly in deparaff inized tissue. There was 89% agreement in detection of DNA aneuploidy by flow cytometry in fresh and paraffin-embedded, formalin-fixed tissue; the coefficients of variation of the DNA diploid Go/G1 peaks were much wider in the latter. In image analysis there was 91% agreement between fresh and fixed specimens. Agreement between the flow cytometry and image analysis in fresh specimens was 91%; in deparaffinized nuclear suspensions it was 94%. There is a high degree of correlation between the values of DNA index of DNA aneuploid Go/G1 peaks; the estimates of S-phase fraction are much more variable. Results also show a good correlation of the DNA ploidy with the nuclear grades. Results reconfirm that preferential loss of specific cell populations during processing together with sampling error and/or dilutional effect of normal cells present in cell suspensions should be considered in interpreting the results of flow cytometry and that sensitivity of image analysis for detection of near diploid DNA peaks is limited. We conclude that for detection of DNA aneuploid cell populations, a combination of both techniques is superior to either of them alone. o 1995 Wiley-Liss, Inc.Key terms: DNA ploidy, breast carcinoma, flow cytometry, image analysis, nuclear grades DNA ploidy and S-phase fraction (SPF) have been suggested as an independent prognostic variable in breast carcinoma (4,30,34). The most recent review of literature (22) has revealed that breast cancers with a DNA index of 1 .O ("diploid') have a favorable prognosis, but the magnitude of this advantage compared to tumors showing DNA aneuploidy is small. The literature also clearly supports an important association between high SPF and increased risk of recurrence and mortality for patients with both node-negative and node-positive invasive breast cancer. Histologic grading also provides prognostic information (1 7,27). Cellular DNA content in clinical specimens can be estimated by two techniques: flow cytometry (FC) and image analysis (IA). Each technique has distinct, specific advantages but also some limitations. Flow cytometry allows a rapid analysis of a large 0 1995 Wiley-Liss, Inc. number of...