The distal rectum is supplied by the superior rectal artery. The supplying arteries of the corpus cavernosum recti are not confined to the strict locations described in the literature. This finding is of importance in surgical treatment of haemorrhoidal disease.

The authors' findings confirm that the hemorrhoidal artery ligation procedure significantly reduces signs and symptoms of hemorrhoidal disease. The authors' data also show that the Doppler transducer does not contribute to this beneficial effect.

Health professionals need to recognise that patients who have undergone major surgery (such as cardiothoracic surgery) are prone to develop pressure ulcers. Despite the fact that pressure ulcers do not necessarily extend hospital stay, monitoring the skin condition remains of crucial importance for prevention and early detection as well as treatment of pressure ulcers and to minimise patient discomfort. Moreover, as pressure ulcers often originate in the operating room, prevention in the operating room should receive more attention.

We report the case of a 71-year-old man with acute back and left flank pain caused by a large pseudoaneurysm of the left renal artery. The pseudoaneurysm resulted from a complete fracture of a stent that had been placed at the origin of this vessel 10 months earlier. Because the left kidney had no residual function, the patient was treated by percutaneous occlusion of the left renal artery with a vascular plug. The symptoms rapidly subsided, and he remained symptom free at the 6-month follow-up. Stent fractures, their complications, and management are discussed.

Objective To assess the predictive role of the bone markers alkaline phosphatase (ALP) and urinary deoxypyridinoline (DPD), as indicators of bone turnover, at baseline in patients with prostate cancer. Patients, subjects and methods Urinary DPD, serum ALP and prostate-speci®c antigen (PSA) were evaluated in 23 patients with benign prostatic hyperplasia (BPH), 115 with prostatic carcinoma, of whom 21 had bone metastasis, and in 16 age-matched control subjects. Results Patients with newly diagnosed prostate cancer and bone metastasis had a higher urinary excretion of DPD, and a higher serum PSA and ALP than had patients with BPH and those with prostate cancer but no metastasis. Receiver operating curve analysis for PSA, ALP and DPD showed a signi®cant discriminating ability for positive and negative bone scans (P=0.0684). However, from logistic regression of the combinations, only serum ALP was a signi®cant independent predictor of bone metastasis in patients with prostate cancer. Conclusion Serum ALP or urinary DPD are the best predictors of bone metastasis in patients with prostate cancer; further studies with more patients are required.