The diagnosis of melanoma leads to increased sun-awareness and protection. While dermatologists should continue their efforts to promote and reinforce sun-awareness in patients with melanoma, additional emphasis on preventative targeting of high-risk individuals would be of marked benefit in decreasing the overall incidence of melanoma. Non-dermatologists, such as family physicians, can be key players in this preventative campaign, and can be educated to recognize and educate patients at risk, as well as direct them to be followed under dermatology care.

Performance characteristics of a positron emission mammographic (PEM) instrument were studied. This dedicated metabolic breast imaging system has spatial resolution of 2.8-mm full width at half maximum (FWHM), coincidence resolving time of 12-nsec FWHM, and absolute efficiency of 3%. Hot spots with diameter of 16 mm in a phantom with signal-to-background activity ratio of 6:1 were distinguishable with a scanning time of 5 minutes.

The diagnosis of melanoma leads to increased sun-awareness and protection. While dermatologists should continue their efforts to promote and reinforce sun-awareness in patients with melanoma, additional emphasis on preventative targeting of high-risk individuals would be of marked benefit in decreasing the overall incidence of melanoma. Non-dermatologists, such as family physicians, can be key players in this preventative campaign, and can be educated to recognize and educate patients at risk, as well as direct them to be followed under dermatology care.

A 6-month course for training general practitioners (GPs) in surgical emergencies was developed and piloted in Ethiopia. The course was designed after an assessment of the surgical manpower needs in Ethiopia. Seven GPs were selected by the Ministry of Health (MOH) from rural hospitals that had no surgical specialists but had operating facilities. The course consisted of 1 week of lectures followed by 11 weeks each in obstetrics/gynaecology and general surgery. The GPs trained in district hospitals under the supervision of surgical specialists. Emphasis was placed on practical experience in managing a limited number of previously identified surgical emergencies. Follow up 9 months after completion of the course showed that five of the seven GPs had completed significant numbers of life saving procedures. Complications occurred largely in advanced disease. Difficulties remain with the recognition of the GPs' training and their supervision. We conclude that GPs can be trained to provide life saving surgery in a short training programme at a modest cost, but mechanisms for ensuring ongoing support need to be established.

The authorship of the report "The Modulation of Fluorouracil With Leucovorin in Metastatic Colorectal Carcinoma: A Randomized Phase III Trial," published in the October 1989 issue (J Clin Oncol 7:1419–1426, 1989) should have read: "by the Gastrointestinal Tumor Study Group." The following appendix should also have appeared at the end of the report:

No abstract

We have previously demonstrated that our Positron Emission system can successfully detect small (e2 cni diameter) tumors. Images in the current system are judged qualitatively for the presence of focal uptake of 18F-FDG. We are presently taking steps toward quantibing the emission images. To this end, we have constructed a breast phantom and developed a novel technique for fabricating very small wall-less radioactive hot-spots. The hot-spots are made by adding 18F-FDG to a 25 mgkc solution of Agarose in water. The heated solution is poured into spherical molds which are separated upon congealing to yield robust wall-less radioactive hot-spots. The hot-spots were idjiorn to within I-5parts in 100. Less than 0.1% of the total hot-spot activity leaked into the background in 30 minutes. Contrast resolution experiments have been performed with 12 nzm and I6 nzm diameter hot-spots in the breast phantom containing water with various amounts of background activity. In both cases, the observed contrast values agree well with the ideal values. In the case of the 12 mm hotspot with a 350-650 ke Venergy window, image contrast diflered froin the ideal by an average of 11 96. . The i m g e contrast for12 mm hot-spot improved by 40% and the number of detected events decreased by 35 5% when the low energy threshold WQS increased from 300 keV to 450 keK

X-ray mammograms reveal abnormal tissue densities, while metabolic images identify regions of abnormal metabolism. Conventional nuclear medicine and radiologic breast images must be acquired at different times with different patient positions making coregistration difficult. Accurate coregistration of metabolic and x-ray images of the breast is likely to be important when acquiring information about the location and diagnosis of suspicious lesions or tumors. Our PEM-1 (positron emission mammography) system detects metabolic activity within the breast. The two planar detectors are integrated into a conventional x-ray mammography unit. This arrangement simplifies the image registration process by allowing a breast metabolic image to be acquired immediately after performing an x-ray mammogram. The patient is not moved between procedures. A coregistration tool has also been developed. A thin plastic sheet with a wire frame protrudes from the side of the upper PEM detector. With the tool positioned over the suspicious area of the breast, a magnified film density image is made using the available x-ray equipment. A radio-opaque rectangular outline of the wire frame is visible on the film image. During a positron emission metabolic scan, detectors acquire a 49 x 59 mm2 image of the same region. The PEM detectors can be positioned anywhere along the width of the breast. This provides an image of a particular region of interest. Several contiguous images may be combined to provide a complete scan.