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BackgroundDementia with Lewy bodies (DLB) is underrecognised in clinical settings.AimsTo investigate whether performing a 123I-ioflupane injection (123I-FP-CIT also called DaTSCANTM) single photon emission computed tomography (SPECT) scan in patients with possible DLB would lead to a more certain diagnosis (probable DLB or non-DLB dementia).MethodWe randomised 187 patients with possible DLB 2:1 to have a scan or not (control group). The outcome measure was a change in diagnosis to probable DLB or non-DLB.ResultsThere were 56 controls and 114 scanned patients, of whom 43% had an abnormal scan. More patients in the imaging group had a change in diagnosis compared with controls at 8 and 24 weeks (61% (n = 70) v. 4% (n = 2) and 71% (n = 77) v. 16% (n = 9); both PConclusionsImaging significantly contributed to a more certain diagnosis, proving to be a useful adjunct in the work-up of patients with possible DLB.

T HE condition of the cervix might be termed the controhing factor of pelvic pathology. The prompt recognition and treatment of cervical infections wouId do much to eradicate many of the diseases of the femaIe pelvis since infection of this portion of the uterus is one of the most frequent causes of poor heaIth in women. cases is of vital importance. To quote from Jones, “It has been demonstrated conclusively that only in the most exceptiona instances does carcinoma develop in damaged cervices when prompt and adequate treatment is given foIIowing childbirth.”

T HE probIems associated with uterine proIapse have heId for the gynecoIogist an interest which has existed over a period of many years. This has resuIted in numerous and definite achievements. Chief among these, is the marked reduction in the occurrence of this condition and the deveIopment of an operative procedure which not onIy restores the proIapsed peIvic organs to their norma position and reIationship, but reestablishes their physiologic function as well. The treatment of uterine proIapse, previous to the period of operative procedure, often proved to be a difficuIt and intricate problem. The retaining pessary, being the soIe means of treatment, was rendered useless when tissue contro1 was inadequate. This fact naturally led to operative attempts towards securing support for the pessary. Some of these were directed toward utihzing the tissues of the anterior vaginal waI1, whiIe others advocated the use of posterior coIporrhaphy. However, neither of these operations proved to be of great value. DonaId of Manchester, appreciative of the inadequacy of these operations as separate procedures, and also recognizing the need of more permanent support without the use of the pessary, decided to combine these operations with amputation of the cervix, and in so doing, accompIished NEW YORK

Treatment of patients with multiple injuries involves the clinician's judgement in establishing treatment priorities, and certain mechanical skills which are outlined in this article. Resuscitation, treatment, management, and transportation priorities are described, with illustrative case histories. This article is written primarily for the physician practicing outside a metropolitan centre.

Three cases of true unicornuate uterus have been reported in the literature. A new case associated with unilateral renal agenesis is described.