Performance of ultrasound as a second line test to serum CA125 in ovarian cancer screening.

Objective: To assess the performance of ultrasonography in a multimodal ovarian cancer screening strategy.

Design: Prospective ovarian cancer screening trial between December 1986 and June 1993.

Setting: General practice, occupational health departments and an ovarian cancer screening clinic at a London teaching hospital.

Treatment of external nasal valve (alar rim) collapse with an alar strut.

Alar (external valve) collapse may be iatrogenic or can occur as a consequence of ageing or trauma. We have utilized an autogenous cartilage graft inserted as an underlay graft to the alar rim to treat 17 patients who have presented with nasal obstruction due to alar collapse. We report the short- and medium-term functional results and the cosmetic sequelae of our approach and conclude that this procedure offers an improvement in nasal airway performance in patients with external valve collapse without producing serious adverse cosmetic sequelae.

Does intraductal breast cancer spread in a segmental distribution? An analysis of residual tumour burden following segmental mastectomy using tumour bed biopsies.

Introduction: Breast-conserving surgery for early breast cancer is now routinely used as an alternative to mastectomy. Despite post-operative radiotherapy, early local recurrence of tumour remains a concern. It has been reported that invasive and in-situ ductal carcinoma spread locally through the ductal tree in a segmental distribution, however, there is no consensus as to the best surgical method to maximize tumour clearance whilst leaving a good cosmetic result.

Surgical site infection surveillance.

Surgical site infection (SSI) is the third most commonly reported nosocomial infection and accounts for 14-16% of all nosocomial infections among hospital inpatients. A successful SSI surveillance programme includes standardized definitions of infection, effective surveillance methods and stratification of the SSI rates according to risk factors associated with the development of SSI. Surveillance with feedback of information to surgeons and other relevant staff has been shown to be an important element in the overall strategy to reduce the numbers of SSIs.

Interactive educational diabetes simulators: future possibilities.

In 1996 an interactive educational diabetes simulator called AIDA was released without charge on the Internet as a non-commercial contribution to continuing diabetes education. Over the past 3 years over 30,000 people have visited the AIDA Web site-- http://www.diabetic.

Does endoscopic laser ablation of the prostate stand the test of time? Five-year results from a multicentre randomized controlled trial of endoscopic laser ablation against transurethral resection of the prostate.

Objective: To determine the long-term objective and subjective outcome of patients with benign prostatic enlargement (BPE) treated by endoscopic laser ablation of the prostate (ELAP), as part of a multicentre randomized controlled trial of ELAP against TURP.

Patients And Methods: Initially, 151 patients with BPE were randomized to undergo either ELAP or TURP, starting in March 1992. ELAP was performed using the Urolasetrade mark fibre (Bard, Covington, GA, USA) in conjunction with a Nd:YAG laser source.

Performance of ultrasound as a second line test to serum CA125 in ovarian cancer screening.

Objective: To assess the performance of ultrasonography in a multimodal ovarian cancer screening strategy.

Design: Prospective ovarian cancer screening trial between December 1986 and June 1993.

Setting: General practice, occupational health departments and an ovarian cancer screening clinic at a London teaching hospital.

Correlation between ultrasound characteristics, mammographic findings and histological grade in patients with invasive ductal carcinoma of the breast.

Aim: To investigate the relationship between ultrasound characteristics, mammographic findings and histological grade in cases of invasive ductal carcinoma which produce a mass on ultrasound.

Material And Methods: A retrospective review was performed of the imaging findings in 120 patients diagnosed with invasive ductal carcinoma of the breast between January 1996 and December 1997. Imaging findings were correlated with the histological grade of tumour.

Autonomic dysfunction is related to impaired pancreatic beta cell function in patients with coronary artery disease.

Objective: To assess the role of beta cell failure in the development of autonomic dysfunction in patients with coronary artery disease.

Design: Autonomic function was measured by standard clinical methods and by heart rate variability in 24 type II diabetic and 24 non-diabetic subjects with coronary artery disease. Quantitative estimates of pancreatic beta cell function (%beta) and insulin resistance were made from basal plasma glucose and insulin concentrations using a computer solved model.

A study of the measurement errors associated with the analysis of velar movements assessed from lateral videofluoroscopic investigations.

Objective: The analysis of lateral videofluoroscopic images of velar movements during speech is a commonly used tool in the management of the cleft palate patient. This study tests the general hypothesis that measurements of velar movements taken from lateral videofluoroscopic images are accurate and reliable.

Method: A measurement system was used that allowed for the rapid assessment of velopharyngeal distance, soft palate velocity during the closure cycle, extension of the soft palate at maximum closure, and the angular lift of the soft palate above the plane of the hard palate.

A magnetic field control system for a variable field NMR spectrometer.

The magnetic field specifications necessary for use as part of a variable field NMR spectrometer are outlined. Although the widely used commercial magnet systems provide a high degree of temporal field stability and accuracy, they are relatively costly. This publication describes a novel and inexpensive magnet power supply, with field control provided by a Hall effect device.

Use of molecular assays in diagnosis and monitoring of cytomegalovirus disease following renal transplantation.

We compared two commercial molecular assays (the Murex Hybrid Capture CMV DNA assay [HCA], version 2, and the Roche Amplicor plasma PCR assay) with a standard shell vial assay in detecting and predicting cytomegalovirus (CMV) disease in a group of renal transplant patients and assessed the role of viral load measurements (using the HCA) in their management. The sensitivity of the HCA and Amplicor assay in terms of disease detection was 100%, compared to 71% for the shell vial assay. Both the HCA and the PCR assay detected all cases of disease, at medians of 11 and 12.

Arch width and form: a review.

A study of the literature reveals a variety of opinions on the potential for change in arch dimensions. The variations in sample sizes, treatment mechanics, and retention regimens may obscure relevant findings. These articles confirm some common findings, and a number of clinical cases are presented to illustrate these trends.

Potential of limited day 21 post-chemotherapy CT scan in predicting need for post-chemotherapy surgery in nonseminomatous testicular germ cell cancer.

Unlabelled: Nonseminomatous germ cell cancers (NSGCC) have a varied response to chemotherapy, some melting away with resultant cure, some have tumour stem cell necrosis and residual benign disease whilst others are resistant to treatment. The latter two require surgical excision in order to identify those needing high intensity chemotherapy.

Objective: The aim of this study was to investigate whether it was possible to give an earlier prediction of need for surgery after chemotherapy on the basis of a limited CT scan performed after the first course.

Effect of smoking on ovarian reserve and ovarian stimulation in in-vitro fertilization and embryo transfer.

The effect of cigarette smoking on ovarian reserve as measured by basal serum follicle stimulating hormone (FSH) concentrations, and by the response to a standard ovarian stimulation protocol, was examined retrospectively in 173 consecutive women (108 non-smokers and 65 smokers) undergoing in-vitro fertilization (IVF) and embryo transfer treatment. Women who smoked had a higher mean basal serum FSH concentration (P < or = 0.0001), in particular younger (<36 years) women, and required a statistically significantly higher mean dosage of gonadotrophins for ovarian stimulation than the non-smokers (48.

Ovarian cancer screening.

Despite advances in molecular biology, surgical oncology, and chemotherapy, the prognosis for ovarian cancer remains poor. The excellent survival rates for stage I disease provide the rationale for efforts to screen for early-stage ovarian cancer. However, there are doubts about the feasibility of screening related to the natural history of the disease, the performance of the available tests, and health economic considerations.

Non-separation assay for glycohemoglobin.

The determination of glycohemoglobin [HbA1c, HbA1, or total glycohemoglobin (GHb)] has become an established procedure in the management of diabetes mellitus. Here, we describe the development of a simple, fluorescence, non-separation assay for the percentage of GHb (%GHb). The fluorescence of an eosin-boronic acid derivative when it was mixed with hemolysates of unwashed erythrocytes was quenched in proportion to the percentage of glycohemoglobin.

Attitudes towards routine human immunodeficiency virus (HIV) screening and fertility treatment in HIV positive patients--a UK survey.

Of 70 fertility units licensed by the Human Fertilisation and Embryology Authority in the UK, 58 responded to a questionnaire regarding attitudes towards human immunodeficiency virus (HIV) screening and fertility treatment in HIV positive patients in November 1995. Of these 58 centres, 23 only performed routine screening for HIV for both partners, 24 for hepatitis B and eight for hepatitis C. In the event of a positive result in the male, fertility treatment would be offered in the form of donor insemination (n = 21), intrauterine insemination (IUI) after sperm washing (n = 21), and in-vitro fertilization (IVF) (n = 1).

Home relines and residual ridge resorption.

Two cases of patients who have relined their complete dentures with home-applied materials in an attempt to improve the denture stability are discussed. The resultant damage to the residual tissues is described. A review of the literature on the effects of home relines leads to suggestions for the regular review of patients who wear complete dentures.

99mTc-labelled SM3 in the preoperative evaluation of axillary lymph nodes and primary breast cancer with change detection statistical processing as an aid to tumour detection.

The extent of primary surgery for breast cancer could be tailored to the patient if previous information on the presence or absence of lymph node involvement could be reliably determined. Prospective radioimmunoscintigraphy in 29 patients with primary breast cancer that was found on screening has been undertaken with 555 MBq (15 mCi) 99mTc SM3, an Imperial Cancer Research Fund (ICRF) murine monoclonal antibody, 0.5 mg with images at 10 min and 22 h, and analysis using a change detection algorithm.