T. Golaszewski

Treatment of menopausal keratoconjunctivitis sicca with topical oestradiol

Objective To investigate the effect of 17β‐oestradiol ophthalmic drops in comparison with a traditional

Cystic adenomatoid malformation of the lung : Prenatal diagnosis, prognostic factors and fetal outcome

Aim: To evaluate 14 cases of cystic adenomatoid malformation (CAM) of the lung with regard to antenatal management and fetal outcome. Results: Intrauterine shunts were placed in 3 fetuses to avoid pulmonary hypoplasia. Prenatal sonography showed that the lesions had a tendency to resolve in 4 cases. Of the 9 infants who survived, 5 were treated surgically (lobectomy). Conclusions: The antenatal evolution of these lesions is highly variable; the lesions may even resolve spontaneously, therefore the diagnosis of CAM types II and III should be followed by a period of observation. Intrauterine drainage is recommended in cases of CAM type I if unfavorable prognostic factors are encountered.

The effects of hormone substitution in depot form on the uterus in a group of 50 perimenopausal women — a vaginosonographic study

The aim of our study was to examine the effects of hormone replacement on the size of the uterus and the development or increase of myomatas. Fifty perimenopausal women were included in the study (53.8 +/- 5.0 years). Patients received a substitution therapy composed of a combination of 4 mg estradiovalerate and 200 mg prasteronenantate (Gynodian Depot cartridges) given as a muscular injection in 6-10 week intervals (mean 7 weeks +/- 4 days). Prior to the onset of therapy with Gynodian and after a period of 12 months (+/- 13 days) vaginosonography was performed. Measurements taken were length, thickness, height of endometrium, size of ovaries and of myomas. Data obtained were correlated with baseline findings. Within 1 year, significant increases in uterus length from 73.4 mm to 88.2 mm, in uterus thickness from 33.9 mm to 43.5 mm and in endometrium height from 4.1 mm to 6.7 mm were observed (median values). There was an increase in both the number (from 2.2 to 3.5) and the size of the myomatas (29.4-35.0 mm diameter). A statistical analysis conducted by means of the Wilcoxon matched pairs signed-rank sum test showed P < 0.001. No significant change occurred in the size of the ovaries. Our study shows that hormone substitution may have an impact on uterus growth and that therefore vaginosonographical monitoring can be recommended.

Management of supraventricular tachycardia during hexoprenaline therapy for preterm labour : benefit of cardioselective beta blockade ?

A 29-year-old woman presented with preterm labour at 32 weeks of gestation. Tocolytic treatment was started with intravenous hexoprenaline. Twenty-four hours after initiation of treatment, the patient developed supraventricular tachycardia, resistant to digoxin and verapamil. Medical treatment with metoprolol finally restored sinus rhythm. We observed no adverse effects on the fetal heart rate nor on the umbilical cord blood flow.

Ultrasound diagnosis of fetal tooth anlagen and their histologic correlates

AIM The present study was to examine the radiographic and histologic correlation of the respective ultrasonographic findings. METHODS Histologic examinations were performed in 12 fetuses who had died in utero between 16 and 34 weeks of gestation. The fetuses had been examined by intrauterine sonography for tooth germs and had been subjected to additional radiographic examinations post abortum or partum. During autopsy, the tooth germs were again examined sonographically and radiographically, and non-decalcified histological sections were obtained by means of the sawing and grinding technique. RESULTS The results obtained by histologically examining the 12 fetal jaws in the ultrasonic plane corresponded in all cases to those examined by sonography and radiology. CONCLUSION Sonographic proof of tooth germs might gain increasing importance in future because agenesia of tooth germs is one of the principal signs of a variety of hereditary syndromes, particularly those of ectodermal origin.