Sialolithiasis: an unusually large submandibular salivary stone.

Salivary gland calculi account for the most common disease of the salivary glands. The majority of sialoliths occur in the submandibular gland or its duct and are a common cause of acute and chronic infections. This case report describes a patient presenting with an unusually large submandibular gland sialolith, the subsequent patient management, the aetiology, diagnosis and various treatment modalities available for management of salivary gland calculi depending on their site and size.

Attitudes to smoking on submarines: results of a questionnaire study.

An anonymous survey to assess the attitudes to smoking of men serving on two Trident Nuclear submarines was conducted by questionnaire. A total of 244 questionnaires were completed, representing 87% of the two crews. Thirty-two percent of respondents declared themselves to be smokers, 69% were nonsmokers, and of these, 31% were ex-smokers.

Tumour markers--magic or menace?

Breast cancer follow-up is aimed at the detection of metastatic disease at a stage when it can still be treated. Traditionally this has been done on a symptomatic basis confirmed by UICC criteria. By inference, tumour burden by this time is likely to be high, and therefore any therapy possibly less effective.

[111Indium-DTPA-D-phe] octreotide scintigraphy in the diagnostic assessment of palpable breast lumps.

It has been suggested that [111Indium-DTPA-D-Phe] octreotide scintigraphy may be useful in the staging of breast cancer. We evaluated its role in the diagnostic assessment of 40 female patients with palpable breast lumps. All were clinically assessed and imaged by ultrasound or mammography.

Sarcoidosis presenting as tattoo granuloma inadvertently treated with laser therapy.

A patient presenting with nodules in his tattoos was referred for laser treatment, following which there was a diagnosis of cutaneous and pulmonary sarcoidosis. Nodular change involving several different tattoo colours is characteristic of sarcoidosis.

National survey of imaging technologists in nuclear medicine 1998/99.

This survey investigated the nature of imaging staff and the distribution and structure of nuclear medicine departments in the UK. Total numbers of cameras and average per department were lower than in 1989/90 but higher than the 1992/93 survey. Total whole time equivalents, average per department and average per camera had increased.

The submarine service of the future?

Space missions, although now routine, are unique in terms of their environment and logistical requirements. The number of missions (man-hours) remains relatively small and planning still relies on comparisons with analogous missions, including submarine operations. Antarctic missions, which tend not to be classified, have provided more information about isolated communities because of the number of personnel per base.

Electrocardiographic changes following primary blast injury to the thorax.

Profound physiological changes occur following primary blast exposure but the contribution of cardiac arrhythmias is unknown. Thirteen rats, under intravenous anaesthesia, were exposed to a blast wave directed at the thorax (Group II); 10 other animals underwent abdominal blast (Group III) and nine animals acted as controls (Group I). Animals were monitored before, during and after blast exposure.

An evaluation of the first year's experience with a low-cost telemedicine link in Bangladesh.

In July 1999, the Swinfen Charitable Trust in the UK established a telemedicine link in Bangladesh, between the Centre for the Rehabilitation of the Paralysed (CRP) in Dhaka and medical consultants abroad. This low-cost telemedicine system used a digital camera to capture still images, which were then transmitted by email. During the first 12 months, 27 telemedicine referrals were made.

Combat casualties in the first decade of the 21st century--new and emerging weapon systems.

This paper reviews new and emerging weapons systems targeted directly or indirectly against personnel. It distinguishes emerging technologies that may form the basis of usable weapons in the next 10 years, from the speculations and aspirations of weapons designers, and identifies six groups of weapons systems which will present significant new or changing threats to UK forces. The article combines this information with knowledge of biophysical interactions and clinical effects, to identify possible consequences for the DMS in terms of types, patterns and numbers of casualties.

Penetrating wounds of the torso.

Penetrating trauma is on the increase as a result of interpersonal violence throughout the world. It is essential that military surgeons are familiar with such injuries and trained not only in the principles of their management, but also have first-hand operative experience before deployment in the field of conflict. More often than not, this experience is to be gained in the civilian urban setting in countries such as South Africa and the USA.

Pulmonary MALT lymphoma: imaging findings in 24 cases.

The aim of this study was to describe the imaging features of pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma. The chest radiographs (n = 18) and CT scans (n = 17) of 24 patients (18 men and 6 women) aged 27-78 years (mean = 56 years), with a known diagnosis of pulmonary MALT lymphoma, were retrospectively reviewed by two radiologists and the imaging findings are described. Six of the 24 patients had a history of an autoimmune disorder and 1 patient had acquired immune deficiency syndrome.

The management of cutaneous leishmaniasis from Belize.

We report 20 patients who contracted cutaneous leishmaniasis in Central and South America, 18 of them in Belize. The diagnosis was confirmed by the polymerase chain reaction (PCR) in 79% of those tested; the corresponding figure for histology was 62%, touch smear 46%, and culture 11%. Results of PCR can be falsely positive, so treatment should not be based on PCR alone.

Diagnostic applications of cystatin C.

Cysteine proteases are proteolytic enzymes involved in many pathological processes and found in the lysosomes of cells; examples include the cathepsins B, H and L. The role of cysteine proteases is crucial in normal cellular metabolism, being fundamental to intracellular protein turnover, degradation of collagen, and cleaving of precursor proteins. Cysteine protease inhibitors, of which the cystatin superfamily are one example, constitute the final regulatory step in the control of cysteine proteases.

Anterior tibiotalar impingement associated with chronic ankle instability.

The authors describe the surgical treatment of 13 cases of chronic ankle instability and concomitant anterior bony impingement of the ankle in professional and recreational athletes. All patients had symptoms and signs of lateral instability and a painful block to dorsiflexion. Two patients presented with recurrence of impingement after a previous debridement alone without an ankle stabilization.

Confidentiality within physiotherapy: perceptions and attitudes of clinical practitioners.

Objectives: This study examined the issue of confidentiality in relation to i) undergraduate curriculum content in physiotherapy, and ii) the awareness, experiences and attitudes of clinical physiotherapists.

Design: Postal survey of universities and focus group interviews with physiotherapists.

Setting: Twenty-five universities in the UK and Ireland and 44 therapists in five hospitals in southern England.

Successful defibrillation in profound hypothermia (core body temperature 25.6 degrees C).

We report a case of successful defibrillation in a severely hypothermic patient with a core body temperature of 25.6 degrees C as measured oesophageally. Ventricular fibrillation is a recognised life threatening arrhythmia in severely hypothermic patients.