Increased signal intensity in the CST on proton-density-weighted MR images is diagnostic for motor neuron disease and correlates with the rate of disease progression. Subtle ALS changes can be differentiated from the normal CST. Low signal intensity in the motor cortex on T2-weighted images is a useful finding.

Table 1 Number of cases of cervical cancer in East AngliaCervical screening started in the East Anglian Region in the 1960s, but the programme lacked any central organisation and uptake was extremely variable. Since 1988, when the national programme was reorganised, the family health service authorities have been responsible for call and recall. This change led to a dramatic improvement in coverage, and now 80% of the eligible population participate in the programme. The East Anglian Region contains eight laboratories, and women aged 20-65 are screened at three or five yearly intervals. In East Anglia in 1994 there were nearly 620 000 women in the screening age range. MethodsIncidence data from 1971-94 were obtained from the East Anglian Cancer Registry for cases of invasive squamous cell carcinoma and adenocarcinoma of the uterine cervix. Cases of microinvasive squamous carcinoma (FIGO stages Ia 1 and Ia 2 ) were included. There are no established diagnostic criteria for microinvasive adenocarcinoma and so all stages of invasion were included. Cases of adenosquamous carcinoma were excluded.Similar incidence data from 1971-89 were obtained for England and Wales. The data were taken from the EUROCIM database of the European Network of Cancer Registries," who had obtained the information from the Office of Population Censuses and Surveys.Incidence rates, directly age standardised using the European standard population, were calculated for age bands 0-29, 30-39, 40-59, and 60+ years, over the whole study time period. Age specific incidence rates were calculated to compare patients diagnosed in 1971-76, 1977-82, 1983-88, and 1989-94. The results for the East Anglian Region were compared with those for England and Wales.The main purpose of this study was to determine whether there was an increased incidence of cervical adenocarcinoma in East Anglia. We did not consider mortality data or tumour stage at presentation.Trends in incidence were tested using Poisson (log-linear) regression, and the level of significance recorded. AbstractObjective-To determine trends in incidence of invasive adenocarcinoma of the uterine cervix in East Anglia. Methods--eervical cancer incidence data for both squamous cell carcinomas and adenocarcinomas were obtained from the East Anglian Cancer Registry for the period 1971-94. Similar data were obtained for England and Wales. European age standardised rates (ASRs) were used for comparisons. Results-The mean incidence (ASR) of cervical adenocarcinoma was 0.85 per lOS in 1971-76, rising to 2.54 per lOSin 1989-94. There has been a marked age shift, with the main increase in incidence occurring in younger women aged 30-39. The mean incidence (ASR) of squamous cell carcinoma of the cervix has decreased from 9.78 to 8.74 per lOS over the periods 1971-76 and 1989-94. Again there has been an age shift, moving from a single incidence peak in the 45-59 age band in earlier years to incidence peaks in both the 30-39 and 55-69 age bands in more recent years. Similar trends were noted when data for Eng...

Massive lymphocytic infiltration of leiomyomas may occur as a result of GnRH agonist treatment, although the mechanism is unclear.

The records of 93 women who presented with invasive squamous cell carcinoma were searched for evidence of cervical cytology during the years preceding this diagnosis; a search was also made through the files of local laboratories and contact was made with general practitioners and relevant hospital departments. Only 26 (28%) of these 93 women had had a cervical smear at any time before the diagnosis of invasive cancer, and only 11 (12%) had had regular cytological survcillance. Fifteen (60%) had had a smear taken and reported as negative within the previous 5 years, six (6%) within the previous year. Eleven of these 15 slides were obtained for review: three were regarded as positive and three more were re-classed as too scanty for conclusive assessment. In nine of the 67 women who had never had a smear, a gynaecological or obstetric examination was known to have been performed or indicated within the previous 5 years, thereby representing a missed opportunity for screening. In three patients cytological abnormalities had been reported within the previous 3 years but no action had been taken.

Summary Follicular cervicitis was recognised in 15 (44 per cent) of 34 women who were examined colposcopically and who were sexual partners of men with non‐gonococcal urethritis. Valid results of culture for Chlamydia trachomatis were obtained in 26 cases: the organism was isolated from the cervix of five of 11 women in whom follicular cervicitis had been diagnosed, but from only one of 15 whose cervices did not have this change. A similar correlation was not found for infection with Mycoplasma hominis or Ureaplasma urealyticum.