Histologic material from 156 patients treated with surgery for cancer of the large bowel was studied with regard to tumor host interaction and with particular emphasis on the reactions of the regional lymph nodes. Prognostic evaluation of the tumor included the extent of the primary lesion according to Dukes' classification and the grade of differentiation of the carcinoma. Morphologic evidence of host resistance was judged by the presence and degree of lymphoplasmacytic infiltration of the tumor and the reactions of the regional lymph nodes, which were classified in four histologic patterns: lymphocyte predominance, germinal center predominance, lymphocyte depletion, and unstimulated. Of the factors evaluated, those that appeared to correlate best with five-year survival were the stage of the disease, the grade of differentiation of the carcinoma, the degree of lymphoplasmacytic infiltration of the tumor, the lymphocyte predominance pattern, and, to a lesser degree, the germinal center predominance pattern. None of the other morphologic features related to lymph nodes showed favorable prognostic significance. The relationship of morphology to host immune mechanisms is discussed.

A fatal case of the megacystis-microcolon syndrome in a newborn girl is presented and two previously unreported findings are discussed. The umbilical hernia is thought to represent a mechanically induced embryological defect, secondary to the expanding nonfunctional megacystis which appears to be the dominant component from an early stage. Hypertrophic changes of the large intestinal wall musculature, adjacent to dilated segments, may indicate an impaired propulsive activity in utero, as a result of defective neurotransmission. The latter is proposed as the common pathophysiological mechanism for both urinary and intestinal malfunction.

As an alternative to long-term ahinistration of oral cytotoxic agents, pulse intravenous nitrogen mustard (HN2) has been used in 5 patients with steroid-resistant INS (all had "early resistance") and one patient with steroid responsive INS. The dose of HN was 0.1 mg/kg/day x 4 days. All patients had minimal-lesion h?stology. The patient with steroid-responsive INS had a frequently relapsing course (4.8 relapses/year) despite treatment with cyclophosphamide (2 courses) and chlorambucil. Since HNZ, she has had no further relapses. The current status of 5 patients with steroid-resistant INS is: 3 have persistent mild proteinuria, normal excretory function and absence of overt nephrotic syndrome; 2 have persistent INS despite HN2 but subsequently remitted after cyclophosphamide and both have since had a steroid-responsive, relapsing course. No toxicity attributable to HN2 was noted. This preliminary experience suggests that HN2 may ameliorate INS in some patients with steroid-resistance. HN2 may also be a useful adjunct in the management of some patients with steroid-responsive, frequently-relapsing INS, in whom oral cytotoxic therapy may not be warranted. A controlled therapeutic trial to better assess the usefulness of HN2 is planned. (Kid Int 12:538, 1977; Ped Res 13:366, 1979). To determine whether enhancemcnt is primarily due to volume depletion, dogs were given im injections q8h for 10 days of the following: (F) alone 2 mg/kg, Grp 1; (NET) alone 15 mg/kg, Grp 2; (NET) 15 mg/kg + (F) 2 mg/kg, Grp 3. Group 4 rrccivc~l (NET) 1 5 mp/kp + (F) 2 m~/ k g + gnvngc (75 mEq NaC1+40 mEq KC1/1 in a daily volume equal to 5% of body weight). (VA) . A 184 P R E L~Y REPORT. Rizzoni G., ~w l a n u t M.

The urine of 104 patients with bladder cancer was examined by exfoliative cytology. Three staining methods (Giemsa, Papanicolaou and Oil Red O) were used and the results compared with the histological diagnosis. Giemsa was found to be superior to the other two methods but the highest sensitivity (which was statistically significant) was obtained by a combination of the three methods.