Shunt metastases of pineal tumors presenting as a pelvic mass

Three children with pineal area tumors and ventriculoperitoneal shunts developed pelvic masses. In two, the solid masses reflected tumor cells seeded to the Pouch of Douglas while the third developed a loculation of fluid and tumor cells at the shunt tip.     

Gonadotrophin Stimulation for Oocyte Recovery and in Vitro Fertilization in Infertile Women

Summary: The effects of gonadotrophin stimulation were investigated by urinary oestrogen and pregnanediol analyses and by timed laparoscopic examination in 14 infertile ovulatory women with total tubal destruction who were candidates for in vitro oocyte fertilisation.
An unpredictable ovarian response was obtained in 6 patients when a fixed regimen of 4 doses of FSH followed by HCG was used as described by Steptoe and Edwards (1970).
Therapy was then changed in 8 patients to larger daily doses of FSH which were monitored by urinary oestrogen excretion and HCG was given according to the response. This regimen resulted in hormone excretion patterns which resembled those found during the normal ovulatory cycle except that oestrogen peak values were higher. The laparoscopic findings were consistent with the hormone values and information was obtained relating the timing of ovulation to the patterns of oestrogen and pregnanediol excretion. It is hoped that these findings can be applied to the improved collection of follicular oocytes of optimum maturity for in vitro fertilisation.     

Spondyloepiphyseal dysplasia congenita A cause of lethal neonatal dwarfism

Spondyloepiphyseal dysplasia congenita is a form of primarily short trunk dwarfism, that is manifest at birth but generally has not been regarded as a cause of lethal neonatal dwarfism. Seven neonates with severe dwarfism are presented. The first survived the newborn period, but the other six were early neonatal deaths. All displayed the clinical and radiologic features of spondyloepiphyseal dysplasia congenita. The striking similarities between spondyloepiphyseal dysplasia congenita and achondrogenesis type 2 are discussed.     

Obstetric Care of the Very Premature Fetus

Summary: A group of 27 premature fetuses, between 27 and 35 weeks of gestation, were studied in the fetal intensive care unit. Both late deceleration of fetal heart rate and loss of beat to beat variation were associated with significantly lower Apgar scores. Four of 5 of the very premature fetuses who died of asphyxia soon after birth, showed evidence of asphyxia in the fetal heart rate trace before birth. Because of the improved short- and long-term outlook for the liveborn very premature fetus, active obstetric intervention when intrauterine asphyxia is diagnosed may further improve survival rate.     

Mucormycosis

Three cases of mucormycosis are presented; two with unusual aspects: One with previously unreported involvement of the mandible, and one presenting as a cavernous sinus thrombosis. Review of the literature reveals a limited number of survivors. Survival in two of the cases presented here suggests that early diagnosis, aggressive therapy with surgery, and amphotericin B should improve the prognosis.     

Duration of Menstruation

Menstrual length was analysed in 2,342 women attending the Shepherd Foundation. Prolonged menses were more common in Australian and New Zealand born, in women with irregular, short or long menstrual cycles, menstrual pain, high parity, and an intrauterine device. In contrast to women with premenstrual tension and menstrual pain, psychological factors, smoking and drinking were not more common in women with increased menstrual length. It is concluded that somatic factors alone control menstrual length, and results in the present study support the hypotheses that both the hypothalamic-pituitary system and prostaglandins may be involved in this control. Evidence was found that the use of the contraceptive pill reduces the incidence of premenstrual tension when menstrual length is also reduced.