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Visceral candidiasis in 56 patients, 39 of whom were thought to be immune deficient, was investigated using three serological detection methods--whole cell agglutination, haemagglutination, and counterimmunoelectrophoresis for antibodies; two determinations of circulating antigens--haemagglutination inhibition and latex agglutination; and determination of the arabinitol:creatinine ratio. Of the 39 patients with suspected immune deficiency, 13 had confirmed invasive candidiasis and 26 were colonised; of those without signs of immune deficiency, 10 patients also had invasive candidiasis and seven were colonised. Twenty three patients with invasive candidiasis were analysed in total. For suspected immune deficient patients the best discrimination between visceral candidiasis and colonisation was obtained by combining the results of haemagglutination inhibition and arabinitol:creatinine ratio. For patients without signs of immune deficiency the best discrimination between invasive candidiasis and colonisation was achieved with counterimmunoelectrophoresis. The results of the serological tests confirmed the classification on clinical grounds of those with and without immune deficiency.

Treatment of hypernephroma presenting with atria-caval involvement without distant metastases is a surgical challenge. The procedures used in three different cases are described. In one case the caval thrombus extending into the atria-caval junction was delivered during clamping of the atrium without cardiovascular bypass. In another case the remaining atrial thrombus was removed in a second session with cardiovascular bypass. For the third case cardiac bypass was established immediately to permit safe and complete removal of the atria-caval thrombus. In order to plan the surgical procedure adequately, it appears essential to determine exactly the upper level of the thrombus. In cases with atrial involvement, cardiovascular bypass is advisable to perform radical surgery under the safest conditions.

On the basis of a false aneurysm of the radial artery caused by a synovial sarcoma, the behavior and histology of this fairly rare tumor are discussed. There are no reports in the literature which record such a rapidly developing synovial sarcoma as that observed in the patient described here.