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Objective: To determine whether an investigation of microsatellite instability (MSI) in patients with colorectal carcinoma that have been selected by the pathologist could increase the number of detected families with hereditary non-polyposis colorectal carcinoma (HNPCC)., Design: Prospective inventory., Method: Pathologists selected patients with a newly diagnosed colorectal carcinoma for MSI analysis of their tumour tissue if they met one of the following four criteria: (a) colorectal carcinoma diagnosed below 50 years of age; (b) a second colorectal carcinoma; (c) a combination of colorectal carcinoma and another HNPCC-related cancer; (d) colorectal adenoma with high-grade dysplasia diagnosed below 40 years of age. Patients with a positive MSI-test were referred to a clinical geneticist. The new strategy was introduced and explored in 5 hospitals for a period of to months., Results: The new strategy was adopted and implemented successfully by pathologists and surgeons and accepted with satisfaction by the patients. Of the 55 patients included, 10 had a positive MSI-test. In 8/10 patients, DNA-mutation analysis was started by the clinical geneticist and 3 germline mutations in the MSH2-gene were detected. In 2 of 3 families with a pathogenic mutation, the family history alone did not fulfil the clinical criteria for HNPCC., Conclusion: Selection by the pathologist for MSI investigation was feasible in daily practice and identified more HNPCC patients than selection based on family history alone.

In 3 patients, 2 men aged 46 and 51 years and a woman aged 54 years, with colorectal cancer there was insufficient information on the basis of the family history to diagnose 'hereditary non-polyposis colorectal cancer' (HNPCC). Further investigation showed microsatellite instability in the tumour material, an indicator for a mutation in DNA-'mismatch repair' (MMR-) genes. Immunohistochemical study of lymphocytes showed an absence of the gene products MSH2 and MSH6. Study of the MMR genes revealed a pathogenic germ-line mutation in MSH2. All three patients were satisfied with genetic testing of the MMR-genes as this gave their children and their family members the opportunity to clarify genetic status. HNPCC is a clinical diagnosis, based on family history. As family history taking is often incomplete, the diagnosis is regularly not considered. The following individual criteria can help to recognize a patient at risk for HNPCC: (a) colorectal cancer diagnosed below 50 years of age, (b) second colorectal cancer, (c) a combination of colorectal and endometrial cancer.

Hereditary diffuse gastric cancer (HDGC) is a rare autosomal dominant syndrome associated with an early-onset, histologically diffuse, signet ring cell type gastric cancer and the occurrence of cancer at other anatomical sites, i.e. breast, colon, prostate and ovary. Inactivating germline mutations in the CDH1 gene, encoding the cell to cell adhesion protein E-cadherin, predispose to HDGC. About 30% of HDGC families have a proven pathogenic CDH1 mutation. Lifetime penetrance of HDGC is about 70%. In HDGC families the recommendation for prophylactic total gastrectomy is restricted to carriers of an inactivating CDH1 mutation.

All pigs passing along the slaughter-line in the slaughter-house of the Livestock and Meat Board of the Christian Farmers' Association of the Province of North Brabant are examined for the presence of lesions of the lung and liver. The proportions of animals without any severe lesions of the lungs and livers and the proportions of those with affected lungs, affected livers, condemned livers and pleurisy are reported every three months. Under the Animal Health Service of the Province of North Brabant, investigations were carried out on 251 farms with less than 10 per cent and 251 farm with more than 25 per cent of the animals with severe lesions of the lungs to study the effect of conditions of management on the incidence of diseases of the lung and liver. Among others, this produced the following results:--The average proportions of affected livers and those of the proportions of cases of pleurisy were higher, whereas the daily growth rate of each pig and the carcass quality were lower.--Slaughtered pigs with lesions of the lung and/or liver showed a significantly smaller daily growth rate during the fattening period. In pigs with pleurisy, retardation of growth was also observed on the breeding farm.--The proportion of affected lungs and livers is significantly affected by a number of factors on the farm. Among others, the following factors were found to be of importance: adopting the all in--all out system, removals, the origin of the piglets, the number of pigs in each compartment of the pig house and the construction of the piggery (width of pig house and slatted floor). Taking these factors into account, a "transverse housing system" is recommended.

The proportion of pigs which died during and shortly after transport was estimated in 1976, like it was in 1968 and 1972. The monthly inquiry included forty-four per cent (approximately 5.2 million animals) of the total number of pigs slaughtered in the Netherlands in 1976. Mortality during and after transport showed a decrease ever since 1968 and was reduced to 0.30 per cent by 1976. The main causes of losses during transport and methods suggested to reduce these losses to a further extent are briefly referred to. The findings will be discussed in greater detail in a following report.