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.

The use of extracorporeal shock wave lithotripsy for medullary sponge kidneys.

A number of patients with medullary sponge kidney recurrently form and pass stones with the risk of developing an obstructive nephropathy. These patients may benefit from extracorporeal shock wave lithotripsy to the medullary collections, as this appears to reduce the frequency of symptomatic stone passage.

Comparison of duplex ultrasonography and venography in the diagnosis of deep venous thrombosis.

Sixty-five patients with suspected deep venous thrombosis (DVT) in 68 limbs were entered consecutively into a study to compare venography with duplex ultrasonography scanning. Both tests were performed on 64 limbs, venography being contraindicated in four. Overall, duplex scanning correctly identified 86 per cent of DVTs diagnosed on venography and correctly excluded 80 per cent with negative venograms.

Relationship of pain to the radiological anatomy of the hip joint in adults treated for congenital dislocation of the hip as infants: a long-term follow-up of patients treated by three methods.

Sixty female patients with congenital dislocation of the hip treated by three methods were followed up to a mean age of 27.3 years. Standard radiographic measurements of hip joint morphology, including stereoscopic measurements of acetabular and femoral neck anteversion, were made.

Tamm-Horsfall glycoprotein excretion and aggregation during intravenous urography. Relevance to acute renal failure.

The effect of intravenous urography (IVU) on the excretion rate and precipitation of Tamm-Horsfall glycoprotein (THG) has been evaluated in 19 patients. Urine samples were collected immediately before the administration of contrast medium (U1) and then during the period of the excretion urogram (U2). The urinary THG: creatinine clearance ratio decreased in 15 patients by a mean of 28.

The pre-operative assessment of advanced gastric cancer by computed tomography.

Forty-five patients with proven gastric adenocarcinoma underwent pre-operative abdominal computed tomography (CT). The radiological findings of tumour spread were prospectively compared with the surgical findings obtained at laparotomy. CT evidence of involvement of three organs, together with the presence of a large gastric tumour mass, correlated with the inability to resect the tumour in this series.