The significance of new densities and microcalcification in the second round of breast screening.

Aim: To assess the nature of new densities and microcalcifications in the second round of breast screening.

Materials And Methods: A total of 34 634 women were screened at our unit in the second round of the United Kingdom National Health Service Breast Screening Programme. Of those attending for the second time, 302 were recalled for further work-up of 311 new lesions.

Retrograde embolization and causes of failure in the primary treatment of varicocele.

Objective: To assess retrograde embolization for the treatment of varicocele and to examine the causes of surgical and radiological treatment failure.

Patients And Methods: Of 154 patients with clinical varicocele associated with subfertility or symptoms who were treated, 100 underwent surgical high ligation, retrograde embolization under fluoroscopic control was attempted in 84 and 30 had both forms of treatment. Venographic findings were defined in those patients for whom embolization proved impossible and in those in whom prior high ligation had failed.

Use of image enhancement during lithotripsy.

Renal excursion during breathing is inevitable and is a cause of poor localization during extracorporeal shock-wave lithotripsy (SWL), which in theory might lead to poor treatment results. Eighty-one patients underwent lithotripsy treatment with and without the use of an image enhancement system designed for use with the Dornier MPL9000 lithotripter. This device contains a memory incorporated into a separate differential grayscale monitor, which allows the stone image to be stored.

Choosing the correct pain relief for extracorporeal lithotripsy.

Objectives: To determine the best choice of analgesic for patients undergoing lithotripsy, and to attempt to identify factors which might predict which patients are most likely to find the procedure painful.

Patients And Methods: Sixty patients with stones in the pelvicalyceal system of the kidney were randomized prospectively to undergo lithotripsy with the Dornier MPL9000 lithotripter (Dormier Medical Systems, Marietta, GA, USA) after receiving either diclofenac 100 mg per rectum (n = 30) or pethidine 50 mg intravenously (n = 30) for analgesia. The patients completed a detailed questionnaire prior to treatment, and the level of pain perceived during lithotripsy was monitored using visual analogue scales (VASs).

Does lithotripsy cause hearing loss?

Objective: To determine whether lithotripsy with the Dornier MPL9000 has any significant effect on the hearing of either patients or operators, as determined by pure tone audiometry.

Patients And Methods: Twenty patients had audiometry prior to a single exposure to lithotripsy and one hour after treatment. Staff were monitored on a 3 monthly basis.