The pathology and histology are reported of five Scots who died of severe pneumonic illnesses after holidays in Spain, three in 1973 and two in 1977. There is strong evidence in favour of all the deaths having been due to the newly discovered Legionnaires' disease (LD) agent. The agent (or its soluble antigen) has been visualised in sections of lung tissue by fluorescent-antibody tests in all cases, and the agent has been identified by the Dieterle silver staining method in small numbers in all cases. Serological testing was possible in three of the patients, and two had very high antibody titres against the LD agent. Apart from the extensive and severe nature of the pathological process there is no feature to distinguish pulmonary infection by this agent from that due to more commonly known bacteria capable of causing lobar pneumonia. The severity and extensive nature of the process is partly a reflection of neglect in seeking treatment until late in the infection, and partly a reflection, as revealed in retrospect, on the use of the wrong antibiotic combination during treatment. Erythromycin has been recommended by other workers as the drug of choice against the LD agent. Infection by this organism is not confined to the USA or to Spain and is indigenous also in the United Kingdom.

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SUMMARY A two-fold increase in the incidence of hepatocellular carcinoma in the west of Scotland is reported on the basis of a 25-year retrospective necropsy review (313 cases). This increase is not accompanied by a corresponding increase in the incidence of hepatic cirrhosis. The relationship between hepatocellular carcinoma and hepatic cirrhosis is discussed in the light of these findings.Primary hepatocellular carcinoma (PHC) is a very common tumour in some parts of the world, notably Africa and south-east Asia, but has hitherto been regarded as relatively uncommon in Europe and the Americas. However, recent reports from the west of Scotland have suggested that the incidence of this tumour is increasing (Manderson et al., 1968;MacSween, 1974) and this trend has also been reported in Europe and North America (MacDonald, 1957;Glenert, 1961;Patton and Horn, 1964;Ohlsson and Norden, 1965) as well as in other parts of the United Kingdom (Elkington et al., 1963;Stone et al., 1968).We have undertaken a retrospective review of the necropsy records of the five major Glasgow teaching general hospitals over the 25-year period 1950-74 and report a twofold increase in the incidence of hepatocellular carcinoma. In three of these hospitals we have compared the incidence of this tumour with the incidence of hepatic cirrhosis in the same adult necropsy population over the same 25-year period.Stobhill Hospital) over the 25-year period 1950-74 have included 313 cases of histologically proven hepatocellular carcinoma from a total of 58 074 adult necropsies (total necropsy incidence 0 54%). During this period the necropsy incidence of this tumour has risen steadily to twice its original level (1950-54 incidence 0 34 %; 1970-74 incidence 0 73 %) and this trend is similar in both sexes (male 0 27% and 0 56o%; female 007 % and 0 16%) (Fig.

SYNOPSIS Twenty-seven specimens of human tissue, obtained by operation, were tested to evaluate the theory that iron uptake by tissues from serum is greater when transferrin is nearly completely saturated than when the degree of saturation is normal.Samples of each tissue were incubated in autologous serum so prepared that in one instance the transferrin was 50 % saturated and in the second 90 % saturated with iron containing 59Fe.In all samples the uptake of iron was greater from the transferrin which was 90 % saturated. The uptake by tissues of epithelial origin was significantly greater than that by non-epithelial tissues. Considerable variation in uptake was noted between samples of the same tissue from different individuals. The role of iron stores in the tissue and folic acid deficiency are discussed.It is concluded that the degree of transferrin saturation is important in determining iron uptake by tissues, especially in those of epithelial origin, and that such uptake may be modified by tissue stores and folic acid deficiency.It is felt that these factors are probably responsible for the extrahepatic parenchymal deposits of iron sometimes found in Bantu subjects with siderosis.

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