A new method for the measurement of tibial torsion using computerised transverse tomography is presented. Its accuracy is equal to that of cadaveric skeletal measurement. This method may be used in patients with unilateral post-traumatic torsional deformities, especially when these are combined with genu varum or valgum. The study of torsional aberrations in connection with congenital abnormalities of the foot is of further interest.

A total of 11 cases of untreated carcinoma of the rectosigmoid colon and 56 cases of recurrent rectosigmoid carcinoma have been investigated by computed tomography. A tumor size of more than 2 cm in diameter is easily demonstrated within the rectosigmoid wall. Invasion of the pararectal fatty planes and the neighboring structures and organs is conclusively diagnosed when obliteration of the demarcating fat planes is demonstrated. Enlargement of the regional lymph nodes of more than 15 mm diameter indicates malignant metastatic spread. Local malignant recurrence following complete resection of the rectum is recognized when the tumor size has reached 2 cm or more. Fine-needle aspiration biopsy may be necessary to conclusively identify malignant tissue within the postoperative cavity.

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Seventy-seven patients with carcinoma of the urinary bladder were investigated by computed tomography (CT) and the results compared with those of pathological staging. The overall accuracy rate was 81% for the estimation of local tumour extension. Perivesical tumour extension was overestimated by CT owing to previous bladder surgery or radiotherapy in about half of the cases. Nevertheless, CT gives unrivalled diagnostic information in advanced tumour invasion. The diagnostic accuracy rate of CT in the detection of lymph node metastases was 89%, compared with 73% for lymphography.

SUMMARY Sixteen consecutive patients with renovascular hypertension were treated by transluminal dilatation and observed during 6-39 months (mean 21.8 months). Poststenotic renal artery pressure increased (p < 0.001) and the renal arteries were patent on angiograms taken immediately after dilatation. In 13 patients, angiography was repeated 2-9 months later; at that time the selective renal vein renin ratio had decreased (p < 0.001). At the end of the follow-up, blood pressure was improved or normal in 14 cases. One of the eight patients with atherosclerosis was normotensive without treatment, compared with five of six patients with fibromuscular dysplasia (p < 0.05). The results in two cases with vasculitis are uncertain. The four patients with relapses, one after intimal catheter dissection, were treated successfully by redilatation. Thus, renovascular hypertension can be improved by transluminal dilatation in patients with atherosclerosis and in patients with fibromuscular dysplasia with lasting success and a low morbidity rate.THE APPLICATION of percutaneous transluminal dilatation in patients with renovascular hypertension is the most recent use for this method, which was initially used in peripheral and then in coronary arteries.'-" Although the initial results and the data from short-term follow-up studies are encouraging,2 3, 6-15 the beneficial effects should be shown to be persistent before propagating the method further. We report our experience in 16 consecutive cases, including patients with atherosclerosis, fibromuscular dysplasia (FMD) and vasculitis, observed for 6-39 months. Patients and Methods Patient EvaluationNineteen stenosed renal arteries were treated by transluminal dilatation in a group of 16 consecutive patients (table 1). Eight patients had renal artery stenosis regarded by radiologic criteria"6' 17 as due to atherosclerosis; in one (patient 7), this was found in three renal arteries. Six other patients showed angiographic signs of FMD, in one case the intimal and in five the medial type of FMD. Systemic vasculitis was suspected in two patients: in one man because of multilocular vascular lesions, including bilateral renal artery stenoses, the histologic aspect of a popliteal artery biopsy and a high erythrocyte sedimentation rate, and in one woman because of progressive bilateral renal artery stenosis, associated with lupus erythematosus discoides. Only case 15, who had vasculitis, was treated systemically (prednisone 30 mg/day). In all patients, renal vein renin was determined by radioimmunoassay.18 Selective renal vein blood samples were taken before and after dilatation after renin stimulation by daily ingestion of furosemide (120 mg) given 3 days before the examination. Betablocking drugs were discontinued for at least 2 weeks. Ischemic/contralateral kidney renin ratios ranged from 1.56-3.35 before dilatation. The patients were examined before and immediately after dilatation and every 3 months thereafter. In 13 patients, renal arteriography and selective renal vein renin determi...

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Brown tumor of the larynx is extremely rare. We describe a patient with long-standing primary hyperparathyroidism and severe skeletal involvement associated with brown tumors of the axial and appendicular skeleton and of the thyroid cartilage. Ossification of the laryngeal skeleton may explain the presence of this process in this unusual location.