Coordinated prospective follow-up of Lynch syndrome is able to detect the majority of incident cancers.

Background: Lynch syndrome is one of the most common genetic predispositions to many cancers, most of which do not have a consensus recommendation for screening.

Aims: We studied in our region the value of a systematized and coordinated follow-up program for patients with Lynch syndrome on all organs at risk.

Methods: A multicenter prospective cohort evaluation was performed, from January 2016 to June 2021.

Pictorial review: Non-neoplastic soft-tissue masses.

As a tertiary centre for soft-tissue sarcomas, numerous non-neoplastic masses are referred to our institution. In many cases, review of the imaging allows a confident diagnosis to be made without the need for biopsy. Lesions include anomalous muscles and variants, muscle injury, haematoma, myositis ossificans, aneurysm, abscess, tumoral calcinosis, amyloidosis and elastofibroma.

Evidence for a human leucocyte antigen-DM-induced structural change in human leucocyte antigen-DObeta.

Human leucocyte antigen (HLA)-DO is a non-classical major histocompatibility complex class II molecule which modulates the function of HLA-DM and the loading of antigenic peptides on molecules such as HLA-DR. The bulk of HLA-DO associates with HLA-DM and this interaction is critical for HLA-DO egress from the endoplasmic reticulum. HLA-DM assists the early steps of HLA-DO maturation presumably through the stabilization of the interactions between the N-terminal regions of the alpha and beta chains.

Prospective, double blind, randomized, controlled trial of simvastatin in human fracture healing.

Although statins are widely prescribed as cholesterol-lowering drugs, a number of studies suggest that these compounds may have anabolic effects on bone. Our aim was to assess whether simvastatin affects the rate of fracture healing in humans. A prospective, double-blind, randomized controlled trial was performed.

A pictorial review of primary synovial osteochondromatosis.

Primary synovial osteochondromatosis has a variety of radiological appearances ranging from the pathognomonic plain film appearances to the more unusual non-mineralised extraarticular manifestation of the disease. The less common manifestations of the disease require multimodality imaging to make the diagnosis. CT and MRI are particularly useful in fully characterising primary synovial osteochondromatosis and to allow for appropriate surgical planning to minimise disease recurrence.

Can follow-up radiography for acute scaphoid fracture still be considered a valid investigation?

Aim: To determine whether follow-up radiography is a valid diagnostic investigation in patients with suspected acute scaphoid fractures and normal initial radiographs.

Materials And Methods: Fifty sets of radiographs (initial and follow-up) were independently assessed by four expert observers for the presence or absence of a scaphoid fracture. Magnetic resonance imaging (MRI), performed in all cases, was used as the gold standard to determine the sensitivity, specificity, positive and negative predictive values of the observers' assessment of the follow-up radiograph.

[About two cases of massive hypercholesterolemia].

Two patients presented massive hypercholesterolemia related to acquired disease, intrahepatic cholangitis with cholestasis in one and nephrotic syndrome in the second. Comparison of the lipoprotein patterns demonstrated distinctive pathophysiological processes different from those operating in primary causes of hypercholesterolemia.

Tumours and tumour-like lesions in the foot and ankle.

We present a spectrum of tumour and tumour-like lesions in the foot and ankle in which a specific diagnosis can be made or strongly suggested on the basis of location, imaging features and the relevant clinical findings. Characteristic imaging appearances are emphasized.

[Unexpected occurence of hemoglobin Athens-Georgia].

The following report concerned a 47 year old Caucasian diabetic patient. Routine HPLC of HbA1c (Variant II Biorad Laboratories - hemoglobin A1c program) resulted only in the evidence of HbF (1%) and increase in HbA1c (10%). Considering the presence of HbF a standard agarose gel electrophoresis of patient's hemoglobin was performed and revealed the presence of Hb Athens-Georgia.

Scaphoid and pronator fat stripes are unreliable soft tissue signs in the detection of radiographically occult fractures.

Aim: To determine the clinical value of scaphoid and pronator fat stripes in identifying occult underlying scaphoid and distal radius fractures, respectively.

Materials And Methods: In our department, all patients with clinically suspected scaphoid fractures and normal scaphoid series of radiographs undergo magnetic resonance imaging (MRI) of the wrist. We selected 50 cases with unequivocal MRI evidence of scaphoid fracture, 50 cases with distal radius fracture and 50 cases with no MRI evidence of bony injury.

Fibromyxoid areas and immature osteoid are associated with recurrence of primary aneurysmal bone cysts.

Aims: Primary aneurysmal bone cysts have a high recurrence rate following curettage. The aim of this study was to determine clinicopathological features associated with recurrence of aneurysmal bone cysts.

Methods And Results: The clinicopathological features of 86 patients (37 males, 49 females, age range 5-62 years) with aneurysmal bone cysts were reviewed.

Improved prognosis of patients with intermediate- and poor-risk nonseminomatous germ cell tumours by optimizing combined treatment.

Objective: To assess whether the optimal use of combined treatment with chemotherapy and appropriately timed surgical intervention by a specialized team might improve the outcome for patients with poor- and intermediate-prognosis (International Germ Cell Consensus Classification, IGCCC) nonseminomatous germ cell tumours (NSGCTs).

Patients And Methods: Between 1984 and 1998, 47 patients with intermediate (16) and poor prognosis (31) NSGCT were treated; 43 had a testicular and four a retroperitoneal primary.

Results: Of the 47 patients only seven (15%) had a complete radiological response after primary chemotherapy; 36 (77%) required surgery after chemotherapy (29 para-aortic lymphadenectomy, 13 resection of pulmonary metastases, two each excision of supraclavicular and retrocrural lymph nodes and one resection of brain metastases; 13 required surgery at more than one site).

Early MRI in the management of clinical scaphoid fracture.

The incidence of MRI detected scaphoid and other wrist fractures was determined in a clinical setting in patients with suspicion of scaphoid injury and negative initial radiographs. The influence on subsequent patient management was examined. Patients attending Accident and Emergency over a 25 month period with suspected scaphoid fracture and normal scaphoid series plain films were referred for wrist MRI.

A phase I and pharmacokinetic study of capecitabine in combination with epirubicin and cisplatin in patients with inoperable oesophago-gastric adenocarcinoma.

Background: The purpose of this study was to evaluate the dose-limiting toxicity (DLT) and maximum tolerated dose of capecitabine when used in combination with epirubicin and cisplatin (ECC) in patients with oesophageal or gastric adenocarcinoma. Response rate, progression-free survival (PFS) and overall survival were also determined, and the effect of previous oesophago-gastric surgery or concurrent oesophago-gastric cancer on the absorption and metabolism of capecitabine was evaluated.

Patients And Methods: Patients with inoperable oesophago-gastric adenocarcinoma received up to six cycles of epirubicin (50 mg/m(2) i.

A phase II study of epirubicin, cisplatin and raltitrexed combination chemotherapy (ECT) in patients with advanced oesophageal and gastric adenocarcinoma.

Background: The aim of this study was to evaluate the efficacy of the combination of epirubicin, cisplatin and ralitrexed (Tomudex). ECT, in patients with advanced oesophageal or gastric adenocarcinoma. Efficacy was assessed primarily as response rate and secondarily in terms of toxicity, time to progression and survival.

Magnetic resonance imaging of suspected scaphoid fractures using a low field dedicated extremity MR system.

Aim: To determine whether magnetic resonance imaging (MRI) using a dedicated extremity system could be utilized for the routine assessment of patients with a clinically suspected scaphoid fracture, and to determine the most cost-effective timing of MRI for these patients.

Materials And Methods: MRI of the wrist using a 0.2T extremity MR system was performed in two groups of patients.

[Clinical value of urinary biochemical parameters].

Twelve of the urine parameters, namely sodium, potassium, chloride, urea, creatinine, uric acid, calcium, phosphate, protein, microalbumin, amylase and glucose, routinely measured in a biochemistry laboratory were chosen to revalue their interest in clinical practice. For each parameter, urinary collection method, physiologic review and specific indications were set out. The clinical interest of chloride, urea, phosphate or uric acid measurement seem limited to specific pathological conditions.

The value of the absent bow tie sign in MRI of bucket-handle tears.

Aim: To assess the accuracy of the absent bow tie sign in diagnosing bucket handle meniscal tears (BHT) of the knee menisci.

Materials And Methods: During a 3-year period, we correlated the MRI and arthroscopic findings and the presence of the various signs. One hundred and seven knees were reviewed: 74 where either MRI or arthroscopy had identified a BHT and 33 which were either normal (31), or a simple tear was identified (2).

Prospective survey to verify the Ottawa ankle rules.

Objective: To determine if the Ottawa ankle rules are valid in the setting of an urban teaching hospital in the UK.

Design: A prospective survey.

Setting: Accident and emergency department, Western Infirmary, Glasgow from 1 April 1995 to 31 August 1995.

Radiography of facial trauma, the lateral view is not required.

The value of the lateral radiograph in patients who have sustained facial trauma has been assessed. Three observers each assessed 200 sets of facial radiographs randomly containing either three- (occipito mental, occipito mental 30 and lateral) or two-film series (lateral excluded). No additional fractures were detected with three films.

A comparison of two or three radiographic views in the diagnosis of skull fractures.

The aim of the study is to determine whether a two rather than a three-view skull series is adequate for diagnosis of a skull fracture given a reliable history of the site of trauma. The radiographs of 50 patients who were diagnosed and managed as having sustained skull fractures were randomly mixed with 200 normal skull series and viewed independently by three observers. For all the film series viewed (a total of 1500 for the three observers), the diagnostic confidence level for two films was 94.