Prenatal diagnosis of a stable de novo centric fission: a case report

Adenosine has become the treatment of choice for paroxysmal supraventricular tachycardia because of its safety and efficacy. There have been no reports of malignant arrhythmias occurring after adenosine administration. This case report presents the occurrence of a malignant wide complex tachycardia after intravenous adenosine administration in a 10-year-old boy 2 days after a Fontan procedure. Thus the administration of adenosine in a critically ill postoperative patient can have morbidity or potential mortality and must be monitored closely.     

Osteoid osteoma in a three-year-old child--a case report

Osteoid osteoma is an uncommon tumour in the very young. We present a case of osteoid osteoma in a three-year-old boy, who was treated as a case of sclerosing osteomyelitis of the femur. Because of persistent pain and lack of response to treatment, further radiological investigation confirmed the diagnosis to be that of an osteoid osteoma.     

Ivory osteoma of the cervical spine: case report

OBJECTIVE AND IMPORTANCE: We report a unique case of ivory osteoma of the cervical spine. CLINICAL PRESENTATION: The clinical presentation was one of polyradicular deficit without myelopathy after trauma. The imaging characteristics and histology of the lesion were those of a classic ivory osteoma. INTERVENTION: A complete surgical excision of the lesion was accomplished. CONCLUSION: We think we have recorded the only well-documented case of ivory osteoma affecting the spine.     

Prenatal diagnosis of a highly undifferentiated brain tumour--a case report and review of the literature

Intracranial tumours, often presenting with progressive hydrocephalus, are rare congenital diseases accounting for 0.5-1.5 per cent of all cases of brain tumours diagnosed during childhood. The differential diagnosis includes vascular malformations, infarctions, and haemorrhages. Sonographic signs suggestive of glioblastoma, teratoma, and astrocytoma do not establish the histological diagnosis, however. We report a case of an undifferentiated fetal glioma detected at 29 weeks' gestation. The diagnosis of an undifferentiated brain tumour was suspected by sonography because of the lack of normal brain structures in conjunction with a diffuse echogenic central lesion and an external hydrocephalus. Because of the very poor prognosis, we induced labour by intravaginal and intravenous administration of prostaglandin E2 and achieved the vaginal delivery of a stillborn child whose head circumference corresponded to 38 weeks of pregnancy. Histological and immunochemical features of this undifferentiated congenital glioma (glioblastoma) are presented.     

Prenatal ultrasonographic findings of intra-abdominal cystic lymphangioma: a case report

The integrity and functional capacity of the urethral sphincter is one of the important prerequisites of urinary incontinence in women. Urodynamic investigations revealed repeatedly that the maximum closure pressure in the median portion of the urethra corresponds to the maximal thickness of the external urethral sphinctor (rhabdosphincter urethrae). This striated muscle is adapted to maintain a relatively steady tonus which assists the closure mechanism of the urethra [4]. In the submitted study the authors focused attention on the ultrasonic visualization of the internal urethral sphincter in order to assess the relationship between the size of this sphincter and the stress type of incontinence (genuine stress incontinence-GSI). The investigation comprised thirty women with confirmed GSI and a control group of thirty asymptomatic volunteers. During perineal ultrasonic examination of women in a supine position by means of an ACUSON 128 XP 10 apparatus using a convex probe with a frequency of 5 MHz the authors recorded statistically significant differences in the areas and maximal thickness of the urethral sphincter in women with stress incontinence and symptom-free women. From the results ensues that the size of this muscle is much smaller in women suffering from GSI.     

Prenatal ultrasonographic diagnosis of the cerebro-costo-mandibular syndrome: case report and review of the literature

Oxethazaine (OXZ), a potent topical anesthetic, was found to induce red blood cell (RBC) lysis in vitro, depending upon concentrations of OXZ, RBC and Ca2+. In a 2% RBC suspension, 100 microM OXZ caused almost complete hemolysis in the presence of 1.3 mM Ca2+ with only a minimal effect in its absence, while higher concentrations of OXZ (400 microM<) produced hemolysis without Ca2+. The hemolysis induced by OXZ plus Ca2+ was preceded by a rapid increase in 45Ca2+ uptake by RBCs, with both the hemolysis and Ca2+ uptake being inhibited by 1 mM CoCl2, NiCl2, and quinine. Together with the Ca2+ influx, rapid influx of Na+ and efflux of K+ occurred, and an increasing external K+/Na+ concentration ratio inhibited both hemolysis and Ca2+ influx. Morphologically, OXZ plus Ca2+ caused rapid transformation to spheroechinocytes, the formation of blebs and the pinching-off of blebs, whereas OXZ alone produced membrane invagination. SDS-PAGE analysis of the ghosts prepared from the RBCs treated with OXZ plus Ca2+ revealed derangement of cytoskeletal components. OXZ is a rare drug that exhibits a Ca2+ ionophore-like action, increasing the Ca2+ permeability of plasma membranes.     

Prenatal diagnosis of intra-atrial cardiac echogenic foci

Intra-atrial echogenic foci were detected in 3 out of 15,706 fetuses (prevalence 0.019 per cent). In all cases, they were located in the right atrium. Normal chromosomes and negative TORCH titres were observed in all affected cases. Fetuses with intra-atrial echogenic foci demonstrated adequate intra-uterine growth and had normal neonatal outcome. Intra-atrial echogenic foci seem to represent a normal variant of fetal cardiac development.     

In utero fetal cardiac resuscitation: a case report

A patient presented at 21 weeks gestation with nonimmune hydrops of her singleton fetus. A cordocentesis confirmed fetal anemia. During the course of the procedure, fetal cardiac arrest occurred. The fetus was resuscitated with intracardiac epinephrine and fetal transfusion was performed. The resuscitation was initially successful, however the fetus died 12 h later.     

Prenatal diagnosis of prune belly syndrome at 12 weeks of pregnancy: case report and review of the literature

Cancer is primarily a disease of ageing epithelia, and of ageing individuals. We now possess detailed insights into the changes in cell regulatory genes and DNA repair systems which accumulate with time and which manifest in malignancy. These demonstrate how cancer is frequently characterized by degenerative change in the genotype, from the most subtle base pair mutations to gross aneuploidy, and by deterioration in cell and tissue regulatory control, be it of proliferation, programmed cell death or signalling. Cancer may thus be as much a phenomenon of loss or deterioration of normal genomic control as of the acquisition of new, neoplastic functions. This distinction may be more than semantic, not least because it governs our approach to the search for therapeutic strategies. This essay considers the concept of cancer as a degenerative disease and its implications, and proposes the neologism aldoplasia to describe this phenomenon of cancer biology.     

Prenatal sonographic diagnosis of Treacher Collins syndrome: a case and review of the literature

We report the prenatal ultrasonographic diagnosis of a fetus with mandibulofacial dysostosis (Treacher Collins syndrome). Sonographic findings included: polyhydramnios, microcephaly, abnormal fetal facial features (slanting forehead, microphthalmos, micrognathia), and abnormal fetal swallowing. A review of the current literature pertaining to prenatal diagnosis of this condition is presented.     

Prenatal diagnosis: methods--indications--risks

The demands made on prenatal care in terms of fetal anomaly recognition and full and early counseling have become more and more sophisticated over the last few years. Today, a range of non-invasive and invasive procedures are now available for the detection of fetal anomalies, genetic disorders and e.g. infection. The most important of the former are ultrasound and triple test (determination of alpha feto-protein, HCG and unconjugated estriol), while amniocentesis remains the major invasive measure. The indications, the information they provide, and possible risks of these procedures are discussed.     

Fine-needle aspiration cytologic diagnosis of lymphocutaneous sporotrichosis: a case report

A case of lymphocutaneous sporotrichosis initially diagnosed by fine-needle aspiration (FNA) cytology and confirmed by tissue biopsy and culture study is presented. Asteroid bodies and yeast cells with budding, highly suggestive of the disease, were seen in the cytologic and histologic preparations. The pathology of this unusual fungal disease and the role of cytology in the diagnosis are discussed. This is the first case of lymphocutaneous sporotrichosis reported in the cytologic literature as diagnosed by FNA cytology.     

Prenatal diagnosis of supernumerary chromosome derivative (22) due to maternal balanced translocation in association with diaphragmatic hernia: a case report

An aneuploid fetus was detected prenatally by cordocentesis at 27 weeks' gestation following ultrasonographic diagnosis of severe fetal growth retardation and a large diaphragmatic hernia. The fetal karyotype was revealed to be 47,XX,der(22)t(11;22)(q23.3;q11.2) after parental bloods confirmed a balanced reciprocal translocation in the mother. Approximately 85 cases with an unbalanced karyotype 47,XX(or XY),+der(22),t(11;22) due to 3:1 meiotic disjunction in the parental translocation carrier have been reported in the world literature and only one of them was diagnosed prenatally. This is the first detailed case report of a supernumerary derivative (22) chromosome abnormality diagnosed prenatally in association with diaphragmatic hernia.     

Prenatal management of fetal cardiac tumors. Two case reports

Although primary cardiac tumors are extremely rare, their prenatal and neonatal management is very important because fetal arrhythmia is a frequent complication and such tumors may be the only manifestation of tuberous sclerosis. We present 2 cases of fetal cardiac tumor in which cardiac function was assessed by color Doppler ultrasonography. In both cases, there was no evidence of tuberous sclerosis or cardiac failure and tumor regression was noted 8 months after birth. Ultrasonographic examination of fetal cardiac function was useful in the management of these tumors.     

Gerstmann-Straussler syndrome clinical and neuromorphofunctional diagnosis: a case report]

The Syndrome of Gerstmann-Straussler is a constellation of typical symptoms that affects the parietotemporal crossroad and also involves the contiguous parts of the occipital lobe of the dominant hemisphere. Is a family ailment that starts with an espinocerebellar ataxy followed by dementia. Diagnosis options such as EEG, TC, RM and brain SPECT-99mTc-HMPAO have been carried out in an adult with Gerstmann Syndrome. RESULTS: The brain SPECT disclosed a disminution of the flow at the parietotemporooccipital areas of both hemispheres. The results revealed a clinical and a neuromorphofunctional correlation. CONCLUSION: Brain SPECT is a complementary test to the structural neuroradiological examinations, such as TC and RM, that occasionally is useful not only to clarify but also to widen the information that these offer.     

Application of heparin-coated PCPS for traumatic cardiac rupture: report of a case

OBJECTIVES: This study examined whether primary care physicians provide education and counselling on head injury prevention as part of their routine health care discussions with patients. METHODS: A preventive health care practices survey was distributed to 678 physicians in the Central Virginia area. Data regarding respondents' age, gender, medical specialty, patient population and counselling practices were obtained. RESULTS: Fifty-one per cent of those surveyed responded. Ninety-five per cent of physicians reported providing health care counselling 'in most cases' or 'commonly'. Less than half (46%) of physicians discussed head injury prevention with their patients. In contrast, almost all respondents (97%) discussed smoking. Physician age, specialty, and patient population did not affect head injury counselling practices. CONCLUSIONS: Prevention strategies for head injury are discussed much less frequently than other health risks such as heart disease and cancer in the primary care setting. Strategies for educating primary care physicians on head injury should be considered in order to increase their efforts toward prevention.