The increasing incidence of bladder carcinoma observed in the past three decades has stimulated research into the identification of possible aetiological agents. The possible role of viruses in this respect is still highly controversial. 1-4The significant association between human papillomavirus (HPV) infection and genital cancers in both sexes has prompted attempts to identify HPV in bladder cancers as well as in various benign lesions of the urinary tract.5 At present more than 90 distinct types of HPV have been recognised 6 7 and more than 35 of these have shown specific tropism for the male and female genitourinary tract, ensuring an easy mode of transmission between these natural reservoirs. 3 However, even in the most up to date reports there is no agreement about the occurrence of HPV in bladder carcinoma, the percentage of positive cases ranging between 0% 8-11 to 80%. 2The choice of material and the diVerent techniques performed seem to influence the number of false positive and false negative results-that is, the use of single or multiple tumour fragments, fresh or fixed and paraYn embedded material, the number of virus genotypes sought, contamination by plasmid DNA or polymerase chain reaction (PCR) products, and the use of high or low sensitivity techniques (Southern blot, PCR, or in situ hybridisation). It was against this background that we set out to determine whether the use of multiple biopsies and multiple probes in an in situ hybridisation system could increase the detection rate of HPV positive cases. At the same time, we wished to examine the possible relation between circulating anti-HPV antibody detected by an immunoenzymatic assay and the presence of HPV positive bladder cancer, identified by in situ hybridisation of HPV DNA in cancer tissues.Our final aim was to make a preliminary evaluation of the possible correlation between the presence of HPV DNA and clinicopathological indices such as grade, stage, and evolution of the neoplastic disease. MethodsBetween 1995 and 1997, we carried out enzyme linked immunosorbent assays (ELISA) for serum antibodies against human and bovine papillomaviruses in 43 patients with transitional cell papillary carcinoma of the urinary bladder at the time of diagnosis (38 males, five females, age range 36 to 85 years, mean (SD) age 66.3 (19.8) years). Twenty seven of these were serum antibody positive, 13 were serum negative, and three were classified as uncertain, with antibody titres that were barely above the cut oV point. The

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Background-Cryptosporidiosis has been shown to be a common cause of diarrhoea in both immunocompetent and immunosuppressed individuals. There are very few data on the distribution of Cryptosporidium parvum along the gastrointestinal tract. Aims-To evaluate the location of Cryptosporidium parasites in the digestive tract of patients with AIDS. Methods-Gastrointestinal localisation of C parvum was studied in 71 patients with AIDS who underwent upper and/or lower endoscopy with biopsy for chronic diarrhoeal illness and/or other gastrointestinal disorders of unexplained origin. Results-Twenty four individuals (33.8%) were positive for C parvum, of which 16 (88.9%) had parasites in the gastric epithelium. Most patients with gastric localisation of C parvum did not show specific symptoms indicating the presence of this parasite in the stomach. Conclusions-Gastric involvement in AIDS related cryptosporidiosis is more frequent than expected, but no clear correlation between gastric location and related clinical and pathological features was observed. (Gut 1998;43:476-477) Keywords: Cryptosporidium parvum; AIDS; gastric location Cryptosporidium parvum is a coccidian protozoon with a worldwide distribution. It causes watery diarrhoea, which is self limiting in immunocompetent people but which can be prolonged and life threatening in severely immunocompromised individuals.1 The parasite mainly develops in the enterocytes of the small intestine, causing villus atrophy and crypt hyperplasia in patients with high intensity infections.2 To date, the extent of gastric involvement has not been studied; in fact, only a few cases have been described. 3 Our recent experience suggests that gastric location may be more frequent than previously reported. MethodsWe enrolled in this study all patients with AIDS (as defined by the criteria of the US Centers for Disease Control and Prevention) who underwent gastrointestinal endoscopy with biopsy at the Infectious Disease Clinic of the University of Modena, in the period 1986-1996. The cause for referral was chronic diarrhoeal illness and/or other gastrointestinal disorders of unexplained origin (epigastric pain, abdominal pain, vomiting, etc.), or the follow up of other pathologies. Endoscopic procedures were performed either by a gastroscope for upper endoscopy or by a colonoscope for lower endoscopy. Multiple biopsy specimens were taken from the oesophagus, stomach, duodenum, jejunum-ileum, colon, and rectum. Formalin fixed biopsy specimens were routinely processed for histological examination. Faecal samples were examined by modified acid fast staining and by immunofluorescence for C parvum, after formalin-ether concentration. Results and discussionSeventy one patients with AIDS underwent gastrointestinal endoscopy with biopsy during the study period. Most individuals (n=63, 88.7%) were young men (mean age 37 years, range 27-69), with an average of 62 CD4+/ mm 3 (range 0-499). A total of 215 biopsy specimens were examined. Some individuals underwent complete oesophagogastrod...

Venous thromboembolism (VTE) is a multifactorial disease determined by a combination of inherited and acquired factors. Inherited factors include mutations in the genes coding for coagulation factors, some of which seem to exert a differential influence on the risk of developing deep vein thrombosis (DVT) and pulmonary embolism (PE). In post-mortem studies of subjects who have died from pulmonary embolism (PE), the analysis of the factors that may have augmented the VTE risk is often limited to acquired factors. This is due to the complexity-and sometimes the unfeasibility-of analyzing genetic factors and to insufficient knowledge of their individual roles in PE development. The present study used formalin-fixed paraffin-embedded (FFPE) tissue to investigate a panel of 12 polymorphisms-the largest ever studied-that affect the VTE risk. Tissue samples came from post-mortem examinations performed by the specialists of the Section of Legal Medicine of the Department of Pathology of Marche's Polytechnic University, and by the specialists of Health Care District Hospital of Imola, on 44 subjects who died from PE in the period 1997-2014. All individuals were found to have at least one mutation affecting the VTE risk. The present study demonstrates that genetic analysis can be performed post-mortem and the results are useful for forensic investigations, especially from MTHFR C677T and PAI-1 4G/5G polymorphisms. Broader studies using the techniques described herein are needed to determine the relative influence of the individual polymorphisms and their interaction in PE deaths.

These findings suggest that, in individuals with AIDS, cryptosporidiosis and severe immunodepression, upper endoscopy with random gastric biopsies should be performed, even in the absence of endoscopically appreciable lesions. The diagnosis of gastric cryptosporidiosis has to rely on histological findings, and pathologists must be aware of the fact that Cryptosporidium parasites are mainly found in areas showing reactive hyperplasia.