The local recurrence rates achieved with APR were not significantly different from those achieved with restorative operations. Tumours at the ano-rectal junction should not be dissected off the pelvic floor, but radically excised en bloc with the surrounding levator ani, as a cylinder, as originally described by Miles.

Forty patients over 65 years of age with fractures of the proximal femur, whose operation was delayed more than 24 hours after admission for medical reasons, were studied. Length of post-operative stay on the orthopaedic wards, mobility after one month and need for continuing supervision by the geriatric services, after discharge from the orthopaedic wards, were compared with a matched group in whom there was no delay. There were no significant differences between the results of the two groups, suggesting that, if medical conditions are adequately treated before operative fixation of fractures of the proximal femur in elderly patients, the short-term outcome is not adversely affected.

We present the case of a 54-year-old man who had an unusual finding in contrast echocardiography with agitated saline. Partition of the right atrium in two compartments, an opacified and a non-opacified one, was noted. Further assessment with a transesophageal echocardiogram revealed the presence of a membrane in the right atrium, with the final diagnosis being cor triatriatum dexter.

Contrast echocardiography with agitated saline is used to assess mainly the existence of interatrial communication. We report a case of a 26-year-old woman, with a "port-a-cath" central venous line, who had an unusual finding in agitated saline contrast echocardiography. Multimodality imaging revealed occlusion of superior vena cava and a systemic-to-pulmonary venous shunt.