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Objectives To describe the imaging findings in a series of patients with mesothelioma of the tunica vaginalis testis. Methods We reviewed clinical data, imaging findings and follow-up information in a series of 10 pathology-proven cases of mesothelioma (all had US; 2 had MR) of the tunica vaginalis. Results A variety of patterns could be observed, the most common (5/10) being a hydrocele with parietal, solid and hypervascular vegetations; one patient had a septated hydrocele with hypervascular walls; one had multiple, solid nodules surrounded by a small, physiological quantity of fluid; one a cystic lesion with thick walls and vegetations compressing the testis; two had a solid paratesticular mass. MR showed multiple small nodules on the surface of the tunica vaginalis in one case and diffuse thickening and vegetations in the other one; lesions had low signal intensity on T2-w images and were hypervascular after contrast injection. Conclusions A preoperative diagnosis of mesotheliomas presenting as solid paratesticular masses seems very difficult with imaging. On the contrary, the diagnosis must be considered in patients in whom a hydrocele with parietal vegetations is detected, especially if these show high vascularity. Key Points • Mesotheliomas of the tunica vaginalis are rare, often challenging to diagnose preoperatively . • Most common finding is a complex hydrocele with hypervascular parietal vegetations . • Septated hydrocele, nodules without hydrocele, a thick-walled paratesticular cyst are less common . • Preoperative diagnosis may allow aggressive surgical approach and, possibly, a better prognosis .

Mechanisms designed to implement good clinical governance in the British National Health Service (NHS) have highlighted a need to integrate systems for clinical and non-clinical risk management. Making such integration a reality will require the marriage of two different cultures--the 'clinical' and the 'management'. As in any such union, expectations and perceptions may have a significant part to play. This paper briefly reviews a study which examined the perceptions of two of the key stakeholders in the NHS--nurses and managers--and considers some possible implications. Findings reveal differences in the levels of perceived risk between the two groups. These differences give rise to concerns that those who have greater knowledge of practical risk may have different perceptions of risk levels than those who are charged with policy-making. It is proposed that a tool be developed to help bridge the gap between policy and practice (between, respectively, manager and nurse) and to provide objective evidence of where to focus a hospital's risk management and education policies.

Concentrating solar power (CSP) technology is poised to take its place as one of the major contributors to the future clean energy mix.Using straightforward manufacturing processes, CSP technology capitalises on conventional power generation cycles, whilst cost effectively matching supply and demand though the integration of thermal energy.

A 5-year-old girl presented with hypertension, with no perceived blood pressure differential between the lower and upper extremities. Doppler ultrasound revealed a tardus-parvus pattern with diminished systolic acceleration and peak systolic velocities in the abdominal aorta and both main renal arteries. Doppler interrogation of the suprasternal aorta showed a normal waveform, suggesting a partial obstruction distally. Echocardiography and aortography confirmed severe discrete aortic coarctation with transverse arch hypoplasia. Because classic findings of aortic coarctation may not be present, especially in the older child, the radiologist must be aware that a tardus-parvus Doppler waveform in the abdominal aorta and bilateral renal arteries is suggestive of proximal aortic stenosis, which may be localized by spectral Doppler of the aortic arch.

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The procedures used in the organization and operation of a special study on diarrheal diseases involving federal, state, and local agencies are outlined. The integration of such a project into a local routine program is discussed and the possible benefits derived by the various agencies are briefly evaluated.