The systemic effects of diabetes mellitus are well recognised. The heart, kidney, central and peripheral nervous systems, and the distal parts of the limbs are often the site of end-organ damage resulting from ischaemia. Infarction of large muscle groups in the limb, not associated with gangrene, is uncommon. There have been few reported cases other than radiological descriptions of diabetic muscle infarcts. While previous reports have illustrated some of the clinical and radiological characteristics of this condition, the paucity of published cases makes it difficult to determine the most appropriate methods of diagnosis and treatment. During a five-year period we treated 14 patients with diabetes mellitus, aged from 32 to 59 years, who were referred to a musculoskeletal oncology service for suspected soft-tissue sarcoma, but were subsequently found to have a diabetic muscle infarct. Closed needle biopsy was performed in 13 without complications. In 12 patients, the symptoms resolved without surgical treatment.

No abstract

T he systemic effects of diabetes mellitus are well recognised. The heart, kidney, central and peripheral nervous systems, and the distal parts of the limbs are often the site of end-organ damage resulting from ischaemia. Infarction of large muscle groups in the limb, not associated with gangrene, is uncommon. There have been few reported cases other than radiological descriptions of diabetic muscle infarcts. While previous reports have illustrated some of the clinical and radiological characteristics of this condition, the paucity of published cases makes it difficult to determine the most appropriate methods of diagnosis and treatment.During a five-year period we treated 14 patients with diabetes mellitus, aged from 32 to 59 years, who were referred to a musculoskeletal oncology service for suspected soft-tissue sarcoma, but were subsequently found to have a diabetic muscle infarct. Closed needle biopsy was performed in 13 without complications. In 12 patients, the symptoms resolved without surgical treatment.

TUMOURS OF THE SALIVARY GLANDS, WITH THEIR AFTER-HISTORY. '131-R . KENSOX, L n I I~I ' O O I . S \LIT 1itx7-0~ I Z U turnours, though not of frequent occurrence, sliare with sebaceous c? s t s and gcinglion a peculiar power t o elicit in their possessors a morbid delight in their I'reience, svitli its attendant self-pity. This, with the luxury of an ever-sympathetic group of friends, makes them hlind to tlic hideousness of their deformity and deaf t o thc warnings of the profession as t o the ultimate outcome of this silent death. The knowledge of siirqical failures, in patient and doctor alike, has meakened the demand for treatment : and tlie object of this research was t o inlrestigate the after-history, causes of recurrence, and the pathologiral natnre of salivary turnours, and to demonstrate that, in tlic majority o f cases, snrqerj-can cure.The rnaterial consistctl of 12 6 cases of parotid tuniours and 1 3 cases of mbniaxillary tumours, collected from the Thompson Yates l'atholoqrical IAmratory and the record-, ctc-. "abes.

n~r ; n~o o~. >I]<. E.. aged 26, was seen on thc third day of an attack of pain, tcnderness, :tncl rigidity in the right iliac fossa, with slight temperaturc. d retroczcal :tp~icndicitis was diagnosed.At operation an inflammatory mass was discmi-crecl behind the wxuin :j in. by '2 in. in extent. On turning t h e e~wuiii inward :t pale blue flaccid appeiidi\ presented itself, obviourly normal. This was removed. On further I,i~l~):1t~o1~ of the retrocmal mass, the finger eriterrd what was considered to be an ulcer cmter 4 in. in diameter with cdges heaped up and 9 in. broad.Uiiclcr the mistaken diagnosis of tuberculosis or malignant disease the iIeoc:rc.al angle was resected.Profcssor Dible, who exaniiried the specimen (Fig. 309), reported " A 1 ery beautiful divcrtieulum. The muscle IS defecstive and the floor consists \ O L \ \ --NO 79 34