Ultrasonographic diagnosis of a fetal abdominal mass: A case of a mesenchymal liver hamartoma and a review of the literature

A case of a prenatally recognized hepatic mesenchymal hamartoma is presented and the literature reviewed. These tumors are benign and usually present in early infancy with symptoms that are related to the mass effect on adjacent organs. Radiologic methods used in the past to image this tumor include angiography and ultrasound. However, there is no specific radiologic finding, and, therefore, the diagnosis is usually made during surgery. Once the tumor is removed, the prognosis is generally good. With the increasing use of high resolution ultrasound in prenatal diagnosis, this rare tumor should be considered in the differential diagnosis of any multicystic mass found in the fetal abdomen. The recognition of a mass should then alert the physician to the need for early neonatal intervention.     

Variation in prenatal cytogenetic diagnosis: Policies in 13 european countries, 1989–1991

The livebirth prevalence of autosomal chromosomal anomalies is determined by several factors, including maternal age distribution and the impact of prenatal cytogenetic diagnosis (PCD). The impact of PCD varies between countries, as the indications and the uptake vary. In a previous study we described differences in Down syndrome prevalence and the proportion of older mothers. We have now made a survey of the official PCD policies in 25 regions in 13 European countries for the period 1989–1991. In two countries, termination of pregnancy was not available. In the other 11 countries, international agreement existed on five indications: advanced maternal age, a previous child with a chromosomal anomaly, parents who are carriers of a balanced translocation, mothers who are carriers of an X-linked disorder, and malformations at ultrasound. The exact limit for advanced maternal age varied from 35 to 38 years. There was a considerable variation for the indications advanced paternal age, amniocentesis for AFP or DNA, parental anxiety, a previous child with a congenital anomaly, abnormal maternal serum markers, and exposure to radiation/chemotherapy. The PCD uptake for mothers above the maternal age limit varied from 10 to 88 per cent. International harmonization of the indications for PCD is not considered feasible at present, because of the rapid changes in PCD policies even within countries.     

A large retinoblastoma detected in a fetus at 21 weeks of gestation

The facial tumour described here is the first reported case of a large retinoblastoma detected early in pregnancy and adds another item to the differential diagnosis of facial tumours visualized by prenatal ultrasound examination. Ultrasound examination of the fetal eyes can be offered in cases of retinoblastomas where prenatal DNA diagnosis is otherwise impossible.     

Feeding and associated electrical behavior of the Pacific electric ray Torpedo californica in the field

The predatory behavior of 74 Pacific electric rays (Torpedo californica), studied between August and December during 1988 through 1991 in situ off the Palos Verdes Peninsula, southern California, consisted of two feeding modes: an ambush from the substratum during the day and a more vigorous attack from the water column at night. Predatory motor patterns and electric organ discharges (EODs) were recorded on the video and audio channels of a housed camcorder. Predatory motor patterns included four phases: (1) jump (simultaneous with EOD initiation), (2) pectoral-fin cupping, (3) orientation to prey, and (4) ingestion. The initial electrical activity of the rays was a train of 46 to 414 5-ms monophasic EODs that lasted 0.45 to 7.06 s; the maximum number of EODs produced during an attack was >1200. Maximum output, measured on only one ray, was 45 V. Fifty-five rays were presented one of four types of prey stimuli: live fish (LF), freshly-speared fish (FSF), frozen fish (FF), or a simulated bioelectric field (SBF). The percent frequency of attacks for the LF, FSF, and FF treatments ranged from 70 to >90%, but was <30% for the SBF. The interval between prey presentation and attack was 30 s for the LF, FSF, and FF and over five times longer for the SBF; intervals averaged <4 s for the three rays tested at night. Attacks by rays on energized electrodes provide the first evidence that electric rays use electroreceptors to detect their prey. However, the lack of clear differences among the four prey treatments in five characteristics of the initial pulse train suggests that a suite of sensory stimuli cooperate in triggering an attack and regulating the electrical output during the attack.     

Availability of phosphorus to algae from eroded soil fractions

A study was conducted to determine the concentrations of algal-available P (P_aa) in unfractionated samples and size-classified separates of soil eroded from wheat stubble plots during a simulated rainfall experiment conducted in Warren County, Indiana, U.S.A. Run-off samples were collected, concentrated, dispersed by sonification, separated according to size and incubated with algal cells (Selanastrum capricornutum) in P-free nutrient medium for 2 weeks. Algal-available P in soil separates was determined by decreases in sediment inorganic P (P_i) over the incubation period. The initial concentrations of dissolved molybdate-reactive P_i (DMRP), P_i extractable with NaOH (NaOH-P_i), P_i extractable with HCl (HCl-P_i), organic P (P_o, and total P increased with decreasing particle size. A higher proportion of P_i was HCl-extractable in fractions > 2 μm than in clay-size separates. The level of P_aa in samples increased with decreasing particle size. Available P concentrations in separates < 0.2, 0.2–2, 2–50, > 50 μm and unfractionated samples averaged 447, 282, 113, 26 and 261 μg g^?1, respectively. From 42 to 69% of the P_i and 20–37% of the total P in unfractioned samples was P_aa. A lower proportion of P_i in the > 50 μm fraction was P_aa than in the other size fractions (34 vs. 50%). There was no relationship between particle size and the proportion of total P that was available. The majority (> 84%) of P_aa originated in the P_i fraction extractable with NaOH, whereas HCl-P_i only contributed small amounts of P_aa. The proportion of initial NaOH-P_i assimilated by algae in 2 weeks ranged between 43 and 77%, whereas an average of 16% of HCl-P_i in separates was P_aa. On average, a greater proportion of NaOH-P_i was assimilated by algae in samples from no-till plots as compared to those from chisel-plowed plots.     

Prenatal ultrasound diagnosis of gastric outlet obstruction due to a pyloric web

Gastrointestinal tract atresia has an incidence of 1 in 10 000 live-births, while gastric outlet obstruction comprises only approximately 1 per cent of these malformations. A prenatally diagnosed case is described, followed by a discussion regarding the diagnosis and possible associated abnormalities.     

Genetic amniocentesis at 7–14 weeks of gestation

Genetic amniocentesis performed at 7–14 weeks of gestation was studied in a series of 138 patients of whom 50 wanted termination of pregnancy (⩽ 12 weeks). The material for analysis consisted of 132 samples due to two sampling failures and four samples being handled incorrectly. Forty-eight samples (36 per cent) were taken at 7–12 weeks of gestation, mainly transvaginally (36/48:75 per cent). The success rate of culture and karyotyping increased with the duration of pregnancy, but was only satisfactory from week 11 onwards. The time until harvest was then 14–15 days. The transvaginal approach is easy to perform and was accepted by the women, but we experienced bacterial or fungal overgrowth in 17 per cent of these samples, whereas no infection occurred in the samples taken transabdominally (n = 96). We conclude that genetic amniocentesis is feasible from week 11, but further studies concerning side effects, especially focusing on the procedure-related abortion risk, should be carried out before early amniocentesis is routinely applied.