Toward universal cell embeddings: integrating single-cell RNA-seq datasets across species with SATURN

Analysis of single-cell datasets generated from diverse organisms offers unprecedented opportunities to unravel fundamental evolutionary processes of conservation and diversification of cell types. However, interspecies genomic differences limit the joint analysis of cross-species datasets to homologous genes. Here we present SATURN, a deep learning method for learning universal cell embeddings that encodes genes' biological properties using protein language models. By coupling protein embeddings from language models with RNA expression, SATURN integrates datasets profiled from different species regardless of their genomic similarity. SATURN can detect functionally related genes coexpressed across species, redefining differential expression for cross-species analysis. Applying SATURN to three species whole-organism atlases and frog and zebrafish embryogenesis datasets, we show that SATURN can effectively transfer annotations across species, even when they are evolutionarily remote. We also demonstrate that SATURN can be used to find potentially divergent gene functions between glaucoma-associated genes in humans and four other species.

Towards Universal Cell Embeddings: Integrating Single-cell RNA-seq Datasets across Species with SATURN

Analysis of single-cell datasets generated from diverse organisms offers unprecedented opportunities to unravel fundamental evolutionary processes of conservation and diversification of cell types. However, inter-species genomic differences limit the joint analysis of cross-species datasets to homologous genes. Here, we present SATURN, a deep learning method for learning universal cell embeddings that encodes genes' biological properties using protein language models. By coupling protein embeddings from language models with RNA expression, SATURN integrates datasets profiled from different species regardless of their genomic similarity. SATURN has a unique ability to detect functionally related genes co-expressed across species, redefining differential expression for cross-species analysis. We apply SATURN to three species whole-organism atlases and frog and zebrafish embryogenesis datasets. We show that cell embeddings learnt in SATURN can be effectively used to transfer annotations across species and identify both homologous and species-specific cell types, even across evolutionarily remote species. Finally, we use SATURN to reannotate the five species Cell Atlas of Human Trabecular Meshwork and Aqueous Outflow Structures and find evidence of potentially divergent functions between glaucoma associated genes in humans and other species.

Interactive, integrated analysis of single-cell transcriptomic and phylogenetic data with PhyloVision

Recent advances in CRISPR-Cas9 engineering and single-cell assays have enabled the simultaneous measurement of single-cell transcriptomic and phylogenetic profiles. However, there are few computational tools enabling users to integrate and derive insight from a joint analysis of these two modalities. Here, we describe "PhyloVision": an open-source software for interactively exploring data from both modalities and for identifying and interpreting heritable gene modules whose concerted expression are associated with phylogenetic relationships. PhyloVision provides a feature-rich, interactive, and shareable web-based report for investigating these modules while also supporting several other data and meta-data exploration capabilities. We demonstrate the utility of PhyloVision using a published dataset of metastatic lung adenocarcinoma cells, whose phylogeny was resolved using a CRISPR-Cas9-based lineage-tracing system. Together, we anticipate that PhyloVision and the methods it implements will be a useful resource for scalable and intuitive data exploration for any assay that simultaneously measures cell state and lineage.

Cumulus provides cloud-based data analysis for large-scale single-cell and single-nucleus RNA-seq

Massively parallel single-cell and single-nucleus RNA sequencing has opened the way to systematic tissue atlases in health and disease, but as the scale of data generation is growing, so is the need for computational pipelines for scaled analysis. Here we developed Cumulus-a cloud-based framework for analyzing large-scale single-cell and single-nucleus RNA sequencing datasets. Cumulus combines the power of cloud computing with improvements in algorithm and implementation to achieve high scalability, low cost, user-friendliness and integrated support for a comprehensive set of features. We benchmark Cumulus on the Human Cell Atlas Census of Immune Cells dataset of bone marrow cells and show that it substantially improves efficiency over conventional frameworks, while maintaining or improving the quality of results, enabling large-scale studies.

Author Correction: A single-cell and single-nucleus RNA-Seq toolbox for fresh and frozen human tumors

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

A single-cell and single-nucleus RNA-Seq toolbox for fresh and frozen human tumors

Single-cell genomics is essential to chart tumor ecosystems. Although single-cell RNA-Seq (scRNA-Seq) profiles RNA from cells dissociated from fresh tumors, single-nucleus RNA-Seq (snRNA-Seq) is needed to profile frozen or hard-to-dissociate tumors. Each requires customization to different tissue and tumor types, posing a barrier to adoption. Here, we have developed a systematic toolbox for profiling fresh and frozen clinical tumor samples using scRNA-Seq and snRNA-Seq, respectively. We analyzed 216,490 cells and nuclei from 40 samples across 23 specimens spanning eight tumor types of varying tissue and sample characteristics. We evaluated protocols by cell and nucleus quality, recovery rate and cellular composition. scRNA-Seq and snRNA-Seq from matched samples recovered the same cell types, but at different proportions. Our work provides guidance for studies in a broad range of tumors, including criteria for testing and selecting methods from the toolbox for other tumors, thus paving the way for charting tumor atlases.

MEMS and microfluidics for diagnostics devices

There are conditions in clinical medicine demanding critical therapeutic decisions. These conditions necessitate accuracy, rapidity, accessibility, cost-effectiveness and mobility. New technologies have been developed in order to address these challenges. Microfluidics and Micro Electro-Mechanical Systems are two of such technologies. Microfluidics, a discipline that involves processing fluids at the microscale in etched microchannels, is being used to build lab- on-a-chip systems to run chemical and biological assays. These systems are being transformed into handheld devices designed to be used at remote settings or at the bedside. MEMS are microscale electromechanical elements integrated in lab chip systems or used as individual components. MEMS based sensors represents a highly developed field with successful commercialized products currently being incorporated into vitro,ex vivo and in vivo devices. In the present paper several examples of microfluidic devices and MEMS sensors are introduced together with some current examples of commercialized products. Future challenges and trends will be discussed.

[Pulmonary adenocarcinoma in myasthenia gravis--autoimmunity and late development of malignancy]

We report a 75-year-old man with myasthenia gravis for many years, who was hospitalized because of cough, fever, and dyspnea. Chest x-ray revealed a bilateral pleural effusion. Adenocarcinomatous cells were found in the pleural fluid. Computerized tomography of the chest showed widespread pulmonary dissemination of the tumor. The relationship between myasthenia gravis, an autoimmune disease involving the motor end-plate, and malignancy (thymoma) has been widely recognized. Current literature documents few reports of lung malignancies with concurrent development of myasthenia gravis. A tentative explanation, based on current research, is provided for the possible role of myasthenia gravis and the late development of lung cancer. Moreover, a model for the autoimmune phenomenon and the development of late malignancies is provided with explicit explanations. It is important to search for occult, developing malignancies in newly diagnosed autoimmune diseases.

An acute ischaemic event associated with the use of venlafaxine: a case report and proposed pathophysiological mechanisms

Venlafaxine, a structurally novel antidepressant, belongs to a new generation of antidepressants--the serotonin/noradrenaline reuptake inhibitors. In clinical trials, venlafaxine was found safe and effective in most patients. However, significant changes in vital signs (hyper- and hypotension) and cardiac conduction abnormalities were observed in a few patients, notably in elderly patients. We present a case of an elderly woman with a pre-existing history of ischaemic heart disease, who was treated with venlafaxine, and developed acute myocardial ischaemia within the first week of treatment. This is the first report of a possible association between an acute cardiovascular event and venlafaxine. The association of venlafaxine treatment with ischaemic events could be explained by its unique pharmacological and haemodynamic properties.

Recurrent aphthous stomatitis in Behçet's disease: clinical features and correlation with systemic disease expression and severity

Behçet's disease (BD) is a multisystem disease, in which recurrent aphthous stomatitis (RAS) is a universal finding. We studied the expression of RAS in patients with BD, and the correlation between major or minor RAS and systemic expression and severity of the disease. Thirty-five patients with BD were studied, of whom 13 (37%) had major, 21 (60%) had minor and one (3%) had herpetiform RAS. The frequency of major RAS was significantly higher compared with a control group of patients with idiopathic RAS (37% vs 9%, P < 0.05). The BD patients with major RAS had significantly more relapses of oral ulceration in a year, higher numbers of oral ulcers per relapse, and longer duration of aphthous episodes, compared with patients with minor RAS. Oral ulcers also appeared at a significantly younger age in patients with major than with minor RAS. However, the systemic expression of the disease, as well as the disease severity score, were similar in patients with major and minor RAS. The results of this study indicate that major RAS is common in patients with BD, and is associated with a more severe, repeated and prolonged oral disease. Nevertheless, the presence of major RAS in BD does not predict a more severe systemic illness.

Colonic obstruction due to sigmoid muscular hyperplasia

We report a case of acute colonic obstruction initially presumed to be secondary to acute diverticulitis, necessitating emergent surgical intervention. Pathologic examination failed to reveal evidence of inflammation, fibrosis or neoplasia. Marked hypertrophy of the sigmoid circular muscle layer was documented and thought to be the etiology of the colonic obstruction.

Continuous avoidance measures with or without acaricide in dust mite-allergic asthmatic children

BACKGROUND

Improvement in the quality of life in the Western world and increased time spent indoors by children have enhanced the spread of house dust mites and increased the exposure time for sensitive children. Also, exposure to house dust mites in infancy and subsequent development of childhood asthma have been clinically linked. Recently, new acaricides have been developed.

OBJECTIVE

To test the efficacy of the new acaricide (esdepallethin and piperonyl butoxide--"Acardust") combined with environmental control compared with continuous house dust mite avoidance measures.

METHOD

Forty-six house dust mite-allergic, asthmatic children were evaluated for 6 months in a prospective, randomized, double-blind, and placebo-controlled study. Patients were randomly allocated to active and placebo acaricide treatment combined with avoidance measures, whereas only continuous avoidance measures were taken in the third group. Symptom score, medication usage, and peak flow measurements were recorded daily. The amount of house dust mite allergen in the dust vacuumed from the bedrooms was also measured.

RESULTS

Morning and evening peak expiratory flow rates and forced expiratory volume in one second remained unchanged throughout the study period. In all groups, the symptom scores improved significantly, whereas the amount of house dust mite allergen decreased significantly at the end of the trial.

CONCLUSIONS

Continuous house dust mite avoidance measures have a significant positive effect on the symptomology of children with mild or moderate asthma. "Acardust" combined with continuous house dust mite avoidance measures is not more effective than continuous house dust mite avoidance measures alone in the treatment of house dust mite-allergic, asthmatic children.

Neurotropic desmoplastic melanoma: a rare vulvar malignancy

Melanoma represents the second most frequent vulvar malignancy, and yet is still considered to be an uncommon neoplasm. Several varieties of melanoma exist. A patient who was diagnosed with a rare subtype of melanoma as a primary vulvar process is presented here. To date, there is only one other reported case of neurotropic desmoplastic melanoma as a primary vulvar lesion. Our management included wide local excision of the primary lesion with clinical follow-up. Microstaging of this lesion showed it to fall into the poor prognosis category as per Breslow's technique, with a thickness of 6.5 mm. Clinical follow-up has been greater than 30 months without evidence of recurrence.

The effect of intravesical instillations of thiotepa, mitomycin C, and adriamycin on normal urothelium: an experimental study in rats

The effects of intravesical instillations of thiotepa, mitomycin C and adriamycin on the normal urothelium were studied in rats. Changes in the bladder wall in the form of fibroblastic atypia and submucous fibrous plaques were significant in the mitomycin C treated group. In 46% of mitomycin C treated animals there was urothelial atypia and in one animal, the atypia was severe enough to resemble carcinoma in situ. None of the rats treated with thiotepa showed intramural fibrous plaques or fibroblastic atypia and only 8% showed urothelial atypia. In the group treated by adriamycin instillation, 17% showed intramural fibrous plaques, but none showed urothelial atypia or fibroblastic atypia. The fibroblastic atypia and submucosal fibrous plaques seen in the mitomycin treated group may explain the reduced bladder capacity seen in the clinical setting.

Intraoperative pathologic diagnosis of thyroid neoplasms. Report on experience with 504 specimens

Intraoperative pathologic examination with frozen section (FS) was performed on 504 specimens of thyroid tissue obtained from 457 patients over a period of 9 years. After examination of permanent sections (PS) a malignant neoplasm was diagnosed in 57 specimens (11.3%); 50 (87%) of these were primary thyroid carcinoma, four (8%) metastatic carcinoma, and three (5%) malignant lymphoma. The FS diagnosis was "benign" in 448 (88.9%), "malignant" in (30) 5.9%, and "deferred" in 26 (5.2%). The sensitivity of FS diagnosis of malignancy was 53% and the specificity and positive predictive value 100%. The negative predictive value was 97.8% and overall accuracy 97.9%. The PS disclosed a malignant neoplasm in 62% of specimens in which FS diagnosis was "deferred." Sixty-eight percent of papillary carcinomas, 87% of undifferentiated carcinomas, and a single case of medullary carcinoma were diagnosed with FS examination. A FS diagnosis of malignancy was not made in any of the ten specimens containing follicular carcinoma; in all ten the neoplasms were well-differentiated and eight were encapsulated and minimally invasive. The inability to diagnose follicular carcinoma intraoperatively with FS is the most significant factor accounting for the relatively low sensitivity of FS diagnosis of malignant thyroid neoplasms.

Physical exercise conditioning in the absence of weight loss reduces fasting and postprandial triglyceride-rich lipoprotein levels

The effect of physical exercise conditioning on fasting and postprandial lipoprotein levels was studied in six normolipidemic subjects. The study consisted of two phases: a baseline stabilization phase in which subjects maintained their regular physical activity and an exercise conditioning phase in which subjects had 29 exercise sessions during a 7-week period. Each of these sessions consisted of jogging on a treadmill for 30 minutes. The subjects averaged 15.2 miles/wk. To control for possible confounding factors, such as changes in diet composition and weight loss, we placed the subjects on a metabolic diet and increased their daily caloric intake during the exercise phase. At the end of each phase of the study, a vitamin A-fat loading test was done to specifically label and follow postprandial lipoprotein levels, and a maximum oxygen consumption test was done to evaluate the subjects' physical fitness. The exercise conditioning phase significantly increased the subjects' aerobic capacity and postheparin lipoprotein lipase activity, and the phase decreased fasting triglyceride levels. Physical exercise also significantly decreased chylomicron (Sf greater than 1,000) levels by 37%. In summary, this study suggests that physical exercise conditioning reduces fasting and postprandial lipoprotein levels by increasing the catabolism of triglyceride-rich particles. Because these particles may have a role in atherogenesis, this could be a major mechanism by which exercise prevents coronary heart disease.

Fine-needle aspiration biopsy of the thyroid nodule. Results of a start-up project in a general teaching hospital setting

The results of the initial 102 fine-needle aspiration biopsies of the thyroid performed at a 795-bed general teaching hospital are reported. Eighty-four of the nodules (82%) were cytologically benign, 18 nodules (18%) were suspicious, and none of the nodules was diagnosed as malignant. Five nodules In the suspicious group (28%) were found to be malignant following microscopic examination of the surgical specimens. There was one false-negative result. Based on the data from 21 patients with both cytologic and histologic diagnoses, the positive predictive value of this procedure was 38% and the negative predictive value was 87% (sensitivity, 83%; specificity, 47%). Our results were comparable with those of major referral centers. Guidelines for establishing a fine-needle aspiration biopsy program at a general hospital are suggested.

Hyperglycemia associated with renal cell carcinoma

A case of renal cell carcinoma presenting with uncontrolled diabetes mellitus is reported. After a radical nephrectomy, the diabetic state completely resolved. Laboratory studies failed to reveal any endocrinopathy responsible for the diabetic state. Thus it appears that hyperglycemia and diabetes mellitus can now be included with the other paraneoplastic endocrinopathies associated with renal cell carcinoma.

Pulmonary tuberculosis and bronchocentric granulomatosis

Bronchocentric granulomatosis (BG) is an uncommon inflammatory lesion of unknown etiology defined on morphologic grounds by the presence of necrotizing granulomata centered on bronchi and bronchioles. We report the typical pathologic features of BG in a patient with tuberculosis. Mycobacterial and other types of infection should be excluded by appropriate stains and cultures in all patients with BG on lung biopsy, especially those who are nonasthmatic.

Inoperable gastric lymphosarcoma mistaken for carcinoma: response to radiation with twenty-year survival to date

With suitable treatment, the potential for long survival with gastric lymphoma is well-documented. However, since these tumors constitute only about 1-3% of gastric malignancies, they may occur only rarely in a particular radiologist's experience. The present report of a remarkable therapeutic response is a reminder that the possibility of lymphosarcoma should be included in the differential diagnosis of every gastric neoplasm.

Atypical leiomyoma of prostate

A prostatic leiomyoma with nuclear atypia, similar in appearance to atypia sometimes seen in uterine leiomyomas, was an incidental finding in a fifty-three-year-old man who underwent prostatectomy for hyperplasia. The smooth muscle nature of the lesion was confirmed by electron microscopic examination. This is the third lesion of this type to be reported.

Pulmonary sarcoidosis: roentgenographic, functional, and pathologic correlations

Discrepancies were observed between functional (PFT), chest roentgenographic, and open lung biopsy findings (granulomata, interstitial pneumonitis, angiitis, and fibrosis) in 81 patients with clinical diagnosis of sarcoidosis. A combination of normal PFT and Type 1 roentgenographic findings (hilar lymphadenopathy) was associated with minimal lung lesions without fibrosis. Type 1 findings alone did not preclude extensive lesions or fibrosis. Advanced roentgenographic and PFT abnormalities correlated with the presence of extensive lung lesions. The pulmonary diffusing capacity correlated best with specific and overall lung pathology, and roentgenographic types. Only this test differentiated the extent of granulomata and the roentgenographic types. Moderate degrees of other pathologic changes were not distinguished by any other PFT. Degrees of overall lung pathology correlated with an individual PFT and most significantly with overall PFT (p less than 0.001). Serial studies of PFT are a practical and valuable means for assessment of the disease process in sarcoidosis.

Intraoral papillary squamous cell tumor of the soft palate with features of sialadenoma papilliferum-? malignant sialadenoma papilliferum

An unusual, recurring, squamous papillary tumor involving and possibly arising from minor salivary gland excretory ducts in the palate is presented. Similarity to sialadenoma papilliferum and upper respiratory tract papillomatosis is noted. A paraglandular cystic mass with some resemblance to the palatal lesion, and a solitary lymph node with papillary squamous epithelial deposits was found in a radical neck dissection. We suggest that the lymph node lesion represents a metastasis which may have arisen from the palatal lesion, and therefore propose the concept of a possible malignant analogue of sialadenoma papilliferum.

Nongranulomatous interstitial pneumonitis in sarcoidosis. Relationship to development of epithelioid granulomas

Nongranulomatous, nonspecific interstitial pneumonitis was a predominating or prominent histopathologic finding in 62 percent of 128 granuloma-containing specimens from open lung biopsies obtained from patients with sarcoidosis. Data from this study, combined with observations by others on the evolution of experimentally induced granulomas, indicate that interstitial pneumonitis represents a very early lesion, possibly the initial lesion, in pulmonary sarcoidosis. Because of the relatively large error of sampling inherent in the currently increasing practice of obtaining small specimens for lung biopsy via the flexible fiberoptic bronchoscope, we anticipate that interstitial pneumonitis will be seen as the only histopathologic finding in these specimens with increasing frequency. It is therefore important to recognize that interstitial pneumonitis is a characteristic, although nondiagnostic, morphologic feature of pulmonary sarcoidosis.

Fibromatosis of the breast

A case of fibromatosis of the breast occurring in a 37-year-old woman is described. Only 15 cases of this type have been previously reported. In 5 of these cases there was also involvement of the underlying pectoral muscles, raising the possibility that some of these may have been of pectoral musculoaponeurotic origin. Two of the previously reported cases occurred in patients with Gardner's syndrome and 1 in a patient with "familial muticentric fibromatosis." It is anticipated that fibromatosis of the breast will behave in a similar fashion to fibromatosis occurring in other sites; i.e., as a local aggressive lesion which exhibits a high incidence of local recurrence following incomplete excision.

Phlegmonous enterocolitis

Eight cases of phlegmonous enterocolitis which involved the small intestine exclusively in 5 patients, colon exclusively in 2, and both small intestine and colon in one are reported. Seven of the cases were studied at autopsy. The intestinal lesion was clearly the cause of death in 3 patients and was probably a secondary finding in 4 others. In one case, the cecum was involved and this segment was surgically resected. Five of the patients gave a history of alcoholism. The livers of the 7 patients studied at autopsy were all abnormal; cirrhosis was present in 4, severe fatty metamorphosis in 2, and moderate fatty metamorphosis in 1. The clinical, morphological, and bacteriological aspects of phlegmonous gastritis and phlegmonous enterocolitis are similar, and these two conditions are thought to represent the same infectious disease involving different levels of the gastrointestinal tract. In most patients the factor(s) predisposing to infection of the gastric and intestinal wall are unknown. In some patients mucosal injury of varied type and septicemia appear to have been the forerunners of the phlegmonous lesion. The possible relationships of ischemic bowel injury, alcoholism, and liver disease to phlegmonous inflammation of the gastrointestinal tract are discussed.

A homologous tandem translocation [45,XX,-13,-13,+t(13;13) (q12;q34)]

Chromosomal investigation of a young girl with mental and motor retardation and congenital anomalies revealed a translocation between both members of pair No. 13. Banding analysis showed that the translocation was "tandem," leading to monosomy for segments in both the long and short arms of No. 13.

Occurrence of lung granulomas in patients with stage I sarcoidosis

Granulomas were found in the lungs of 21 consecutive patients with stage I sarcoidosis who underwent open lung biopsy. The extent of granulomatous disease and fibrosis was significantly less (P less than .05) than seen in open lung biopsies from larger groups of patients with stage II and stage III sarcoidosis. The results of this study support what had previously been widely suspected: that is, if sufficient lung tissue is studied microscopically, granulomas will be found in the lungs of all patients having sarcoidosis with mediastinal lymphadenopathy but not radiographically demonstrable lung abnormalities.

Acute pulmonary complications in systemic lupus erythematosus. Immunofluorescence and light microscopic study

Lung tissue obtained from eight consecutive patients with systemic lupus erythematosus complicated by severe, acute pulmonary disease was studied by both light and immunofluorescence microscopy. Light microscopic examination disclosed interstitial pneumonia in four cases, cytomegalovirus pneumonitis in one case, bronchiolitis and peribronchiolitis in one case, pulmonary infarction in one case and focal atelectasis in the remaining case. Direct immunofluorescence examination revealed focally bound immunoglobulins or complement (C3) within pleural and/or pneumocyte nuclei in each specimen. Immunohistologic studies in these cases may thus suggest a diagnosis of systemic lupus erythematosus with acute pulmonary complications, despite the lack of specificity of the pathologic changes seen by light microscopy.

Endodermal sinus tumor of the mediastinum. Ultrastructural study

This is the eighth case report of an endodermal sinus tumor of the mediastinum (first case studied by electron microscopy). The ultrastructure of the tumor was found to mimic that of the normal yolk sac and was also similar to that of three previously reported cases of endodermal sinus tumor of the ovary, thus confirming the correctness of Teilum's original interpretation of the tumor as arising in germ cells and differentiating towards extraembryonic structures.

Ice crystal distortion of formalin-fixed tissues following freezing

The inability of slowly frozen formalin-fixed tissues to reimbibe water normally on thawing accounts for the persistence of extracellular ice crystal spaces in such tissues and renders them useless for diagnostic microscopic examination. This phenomenon may be encountered by the surgical pathologist when tissues obtained for diagnosis are placed in formalin for fixation and the inadvertently frozen. The same type of ice crystal distortion was produced when formalin-fixed tissues were slowly frozen under laboratory conditions. The freezing artifact was not produced when formalin-fixed tissues were frozen in non-formalin-containing aqueous media.

Granulomatous pulmonary angiitis in sarcoidosis

The occurrence and morphologic aspects of granulomatous pulmonary angiitis were evaluated in open lung biopsy specimens from 128 patients with sarcoidosis. All of the specimens showed parenchymal granulomas characteristic of sarcoidosis, and in 88(69%), granulomatous angiitis was seen. In the speclimens that exhibited granulomatous angiitis, venous involvement was mos common, seen in 92% of the cases. In 61% of these biopsy specimens, only venous involvement was seen; in 31%, both venous and arterial involvement was present. Only 8% of the positive specimens showed arterial lesions exclusively. The extent of angiitis was quantitated. Focal segmental elastic tissue destruction, partial or complete, was a common finding. No instances of aneurysm formation, endothelial erosion, or thrombosis were observed. Occlusive narrowing of small vessels was frequent. Bronchial blood vessels were not involved.

Infarction of the gallbladder: a complication of hypertension. Case report

A case of gallbladder infarction, occurring in a 34-year old man with severe hypertension is described, with uneventful recovery following cholecystectomy. In the absence of other obvious etiologic factors, the gallbladder infarction is presumed to be directly related to hypertensive vascular disease. Infarction of the gallbladder is rare; a few cases associated with hypertension have been previously reported. Other types of vascular disease including embolization, thrombosis complicating atherosclerosis and celiac angiography, polyarteritis nodosa, occlusion following torsion and cystic vein thrombosis have been reported to cause gallbladder infarction.

Submucosal mucous cysts at a colostomy site: relationship to colitis cystica profunda and report of a case

A unique case of submucosal mucus-containing cysts of the colon occurring at a colostomy site is described. The cysts appear to have been the result of surgery eight years previously, and were due to either implantation of colonic mucosa into the submucosa or entrapment of mucosa following healing of postsurgical ulceration. Because these cysts are identical to the lesions seen in colitis cystica profunda, this case provides additional support for the hypothesis that colitis cystica profunda is an acquired disease, and illustrates that it may occur as a rare complication of colonic surgery.