Paraffin sections of livers obtained at autopsy from 50 cases of hepatocellular carcinoma (HCC), 58 cases of cirrhosis and 54 cases of other miscellaneous liver disorders (controls) were stained for both surface (HBsAg) and core (HBcAg) components of hepatitis B virus (HBV) by immunoperoxidase and immunofluorescence techniques and rigidly controlled for antigen specificity, and in addition stained by orcein for HBsAg. The material was collected from different regions of India and adequate amounts of tissue were examined in most specimens t o overcome possible sampling error caused by random distributions of the antigens i n liver. HBsAg was detected i n 94% of HCC, 71% of cirrhosis and only 2% of control livers, while HBcAg was found i n 22%, 31% and none respectively. Antigen positivity seems t o be directly related t o the amount of tissue examined. Peroxidase staining detected smaller amounts of HBcAg than fluorescence and was also much more convenient for identifying the antigen. Both antigens were present i n 9 of 41 HCC cases, 12 of 39 cirrhosis and none of 25 controls. Most of these livers contained 1+ HBsAg and I+ t o 2+ HBcAg, an antigen expression pattern suggestive of a carrier state or, rarely, of mild chronic liver disease. Among all livers tested, HBsAg alone was present i n 48, both antigens were found in 21, and HBcAg alone i n none. HBsAg was seen inside tumour cells i n four cases, but no tumour showed HBcAg. Most HCC was associated with cirrhosis (92%) and antigen-positive cirrhosis had a higher chance of harbouring HCCthan antigennegative disease. HBsAg was detected in all four non-cirrhotic livers associated with HCC. while two of these also had HBcAg. Active cirrhosis was very frequently associated with HBsAg. These results and the overwhelming evidence of serological and epidemiological studies from various parts of the world suggest a strong association of the hepatitis B virus with HCC. The possible ways in which the two could be related are discussed.

This paper evaluates a simple tool, the icterometer, in assessing jaundice in the newborn. The instrument consists of a perspex scale with yellow stripes of increasing intensity, numbered 1-5, alternating with transparent areas through which the infant's blanched skin colour can be seen and compared with the coloured stripes. The scale was found to be useful for more objective screening of neonatal jaundice, particularly in decreasing the number of blood samples to be taken for serum bilirubin. The present study suggests that serum bilirubin estimation can be avoided when the icterometer readings on the face are 3 or less, unless there is a rapid rise in jaundice within 24-36 h. However, a reading on the sole of even 1 is significant and requires assessment by trained staff for blood sampling and/or phototherapy. The instrument may also be useful to peripheral staff in developing countries when deciding on referral to specialist centres and to staff in specialist centres for screening cases of neonatal jaundice and decreasing the number of blood samples.

Sixty-one children had a diagnosis of autistic disorder according to the DSM3-R criteria in a population based study of mentally retarded children between the ages of 5 and 19 years in the Aberdeen city area of Scotland. Obstetric case records were traced for 36 out of these 61 autistic children. The obstetric case records of siblings of 30 of these autistic children were also traced. Modified versions of Prechtl's obstetric optimality scale along with that of Parnas were used to score pre-, peri- and neonatal obstetric complications in the autistic group and their normal sibling controls. A Spearman's correlation coefficient test between the scores of the Childhood Autism Rating Scale (CARS) and the Obstetric and Neonatal Complication (ONC) scores of all autistic children did not reveal any significant correlation. However, among the 20 severe autistic children, Spearman's test showed significant correlation between the scores of CARS and some ONC scores. Overall, no statistically significant difference between the autistic children and their siblings in the scores of obstetric optimality was detected by using the Wilcoxon test.

A case of intramedullary neurilemmoma of the terminal phalanx of the right index finger is reported, and the cases previously reported are briefly reviewed.

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