A total of 79 infants born at less than 32 weeks' gestation were studied with serial renal ultrasound scans to assess the incidence of nephrocalcinosis. Twenty one infants developed renal calcification giving an overall incidence of 26-6% in the study group. Affected infants were significantly smaller (mean (SD) birth weight 940 (323) g) and significantly less mature (mean (SD) gestation 26.9 (19) weeks). In 17 patients the calcification was represented by hyperechogenic renal pyramids alone, and in four patients renal calculi were demonstrated. Factors associated with renal calcification included hypophosphataemia, hypercalcaemia, hypercreatininaemia, and prolonged oxygen requirement during the first month of life. Multivariate analysis showed that the strongest clinical indicator of calcification was duration of oxygen treatment. Infants who still required oxygen treatment at 28 days had a 62% chance of developing renal calcification.

SENIOR RESIDENT OPFICER, BRISTOL ROYAL INFIRMARYALTHOUGH torsion of the gall-bladder is reputed to be a rare condition, it ought not to be left out of mind by the surgeon. We have had three cases under our care within the past four years, so it seems probable, as with other so-called ' rare ' conditions, that a good many cases go unreported. Four surgeons have reported two each, and one (Henschen, of St. Gall) has seen three.We believe that it should often be possible to make a diagnosis before operation, and if this is done it will probably open the way to save the patient's life by timely surgery.Although nine cases have been described by British surgeons in addition to our own, there does not appear to be any detailed account of this disease in English literature, and widely read text-books of surgery which we have consulted make little or no reference to it. HISTORYThe first case on record was published by A. V. Wendel in America in 1898, and is, with one exception, the youngest patient reported ; also it is the only one in which the gall-bladder perforated. Ten years later, three cases were described from Germany. The best descriptions of acute torsion of the gall-bladder are those of A. M. Shipley (American), P. Costantini (Italian), and P. Brocq (French).

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