Urethral prolapse in 14 young female patients

Fourteen cases of urethral prolapse were observed between April 1967 and January 1987. The authors analyze the pediatric aspects of the physiopathology, the clinical problems, and the treatment of this rare affection observed with predilection in black girls. Vulvar hemorrhage (80%) and dysuria (20%) are the principal symptoms.     

Exophthalmus--prenatal ultrasonic features for diagnosis of Crouzon syndrome

Prenatal real-time ultrasonographic diagnosis of exophthalmus is presented. Diagnosis was made at the 35th week of gestation in a fetus of a patient affected with Crouzon syndrome (craniofacial dysotosis). Recognition of exophthalmus as a part of Crouzon syndrome and the easy visualization of the eye balls and palpebrae in the third trimester made the diagnosis possible.     

Gastric duplications in children. Apropos of a case manifested in a newborn infant

We report a case of gastric duplication with neonatal manifestations. Diagnosis of this infrequent malformation is readily established in most cases upon roentgenologic and ultrasound examinations. Etiopathogenesis is unknown. Therapy is surgical. Complete exeresis involves mutilation because the supernumerary stomach shares the vascular supply to the normal stomach, and because a cleavage plane is lacking. Therefore, incomplete resection should be performed as the condition is benign and good results are consistently achieved with this procedure.     

Sinusoidal fetal heart rate pattern due to massive feto-maternal transfusion

A 30-year-old woman presented with mild abdominal discomfort and decreased fetal movements in the 34th week of her third pregnancy. Fetal monitoring revealed a sinusoidal heart rate pattern, and abdominal delivery was promptly performed, with the newborn having a hematocrit of 7% due to massive fetomaternal transfusion. Fetal resuscitation was followed by a favorable outcome. The sinusoidal heart rate is discussed, with emphasis on the need for proper and prompt recognition of its significance.     

Prenatal diagnois of uropathies. Ten case reports

Obstructive uropathies are a frequent cause of child renal failure. The prenatal diagnosis of such abnomalities should lead to appropriate management. OBJECTIVE: To evaluate the interest of ultrasonographic prenatal diagnosis of urinary tract malformations. PATIENTS AND METHODS: Retrospective study of 10 cases of urinary tract malformations diagnosed in utero. The mean age of the patients was 34.9 years and the mean gestational age at the prenatal diagnosis was 28.2 weeks of amenorrhea. The abnormalities diagnosed were: 2 cases of ureteropelvic junction obstruction, 3 cases of posterior urethral valves and 5 cases of mild hydronephrosis. The fetal karyotype, realised in 8 cases, was normal. In one case the urinary abnormalities was part of a multiple malformation syndrome and led to the termination of the pregnancy. 7 cases had a post-natal follow-up: 5 had a surgical management and two new borns had transient pyelectasies. The prediction of postnatal renal function is made by ultrasonographic appearance of the kidney and the amniotic fluid. Although the analysis of fetal urine for the assessment of renal function leads to conflicting results, it seems that sodium and beta-2 microglobulin urinary rates provide useful informations.     

Adenoid cystic carcinoma in the head and neck. A retrospective study of 12 cases

Basing themselves on a series of twelve cases of cervicofacial cylindromas, the authors review the different clinical data pertaining to the evolution of these tumors, which they find to be prevalent in females aged around sixty. Cylindromas predominantly occur in the submandibular and accessory salivary glands. Out of twelve cases, the report mentions three local recurrences and two pulmonary metastases. Management was surgical in all instances.     

Cysts and fistulas of the lateral neck. Apropos of 18 cases with a review of the literature

Lateral cysts and fistulas of the neck are branchial cleft malformations. Lateral fistulas occurring at the basis of the neck account for about 5% of all congenital neck fistulas. Concerning 18 personal case observations of 2nd and 3rd branchial arch cysts, the authors report the chief clinical findings in this type of malformation, as well as discussing fistulography as a valuable investigational technique. They present the characteristics of surgical therapy as the sole possible solution.     

The effects of serum from women with miscarriages on the in vitro development of mouse preimplantation embryos

It is generally believed that some human miscarriages result from embryotoxic factors existing in the sera. To study the embryotoxicity of such sera, 3.5-day-old mouse blastocysts were cultured for 72 h on 80% sera from different groups of women. After 72 h there was no blastocystic development in 53.2% of the cases grown on sera from women after two or more miscarriages, and none in 33.6% of the blastocysts grown on sera from women after one miscarriage, as compared with 8.2% and 12% respectively on control sera. Sera from women with miscarriages were divided into 'high risk' (50% or more embryotoxicity) and 'low risk' (less than 50% embryotoxicity) sera. The 'high risk' sera from two or more miscarriages caused an average of 72.1% undevelopment, while the 'low risk' sera (less than 50% embryotoxicity) from the same group caused 33.6% undevelopment. The 'high risk' sera from one miscarriage were embryotoxic to 55.8% of the blastocysts and the 'low risk' sera from the same group caused only 8.7% undevelopment. No significant differences were found in the mean serum concentrations of folic acid, zinc and copper of many of the experimental groups, in comparison with controls. The embryotoxic factor/s which exist in the 'high risk' sera from women with miscarriages are still not known.     

Cytogenetic and cryobiology of human cocultured embryos: A 3-year experience

Purpose Coculture, which allows good-quality human blastocysts with good yields to be obtained, has been designed mainly to select the best embryos for transfers.Methods In a first attempt during coculture, we have studied by fluorescent in situhybridization the chromosomic content of the in vitroblocked embryos, using centromeric probes for chromosomes 1, 12, and 18. Close to 37% of the arrested embryos show aneuploidymosaicism.Results Freezing cocultured blastocysts gives good recovery rates after transfer (83%). The ongoing pregnancy rates per transfer (19%) are high, and the implantation rate per embryo is 13%. This compares favorably with freezing at an early stage.Conclusions We observed that the quality of the endometrium is always the limiting step, as first of all we observed wide variations according to the hormonal preparation of the patients. Moreover the implantation per embryo in the pregnant patients is very high (57%), indicating that most of the losses are directly related to the receptivity of the endometrium.Presented at the 50th Annual Meeting of the American Fertility Society, San Antonio, Texas, November 5–10, 1994.