Chisholin (GD. Benign prostatic hyperplasia: the best treatment. 1BMI7 1989;299:2 15-6. 2 Neal DE. Irostatectom\-an open or shut case. Br7 Urol 1990;66:449-54. 3 Wrennburg J E, Roos N, Sola L, Schori A, Jalfe R. Use of claims data s\stcms to cvaluatc he:alth care ouitcomes. Mortality and re-operation aftcr prostatectormr. J.1IA 1987;257:933-6. Design-Comparison of extended fetal echocardiography with the standard four chamber view in detecting abnormalities. Extended echocardiography comprised the four chamber view and visualisation of the left ventricular outflow tract, the right ventricular outflow tract, and the main pulmonary artery and its branches. In cases with abnormal results complete echocardiographic studies were performed by a paediatric cardiologist using M mode, Doppler, and colourflow mapping techniques.25 Matthews JNS, Altman DG, Campbell NIJ, Royston P. AnalNsis otf serial mcasturcmcnt in medical rescarch. HBl] 1990300:230-5. 26 Perkins JB, Miller HC. Blood loss diuring transurethral prostatctotny. LUrol 1969;101:93-7. 27 Flechnlcr SM, Williams RD. Continuotis flow anid cotiventiontal resectoscope mcthods in tranisuretliral prostatectomy;Setting-Obstetric ultrasonographic unit at Shaare-Zedek Medical Centre, Jerusalem.Subjects-5400 fetuses in low risk pregnancies between 18 and 24 weeks' gestation (mean 21 weeks); 53 were lost to follow up.Main outcome measures-Detection of abnormality before and after birth.

A total of 105 premature infants met the above criteria. Thirty-six of these 105 infants had echocardiographic signs of a PDA (34.3%). Those with PDA were less mature (gestational age, 28.9 +/- 2.6 vs 30.3 +/- 2.6 weeks, respectively) and tended to be smaller (1060 +/- 270 vs 1166 +/- 261 g). Of the 36 infants with PDA, 15 (42%) resolved spontaneously and 21 (58%) were symptomatic and required treatment with indomethacin. There were no differences in gestational age or birth weight between infants whose PDA resolved spontaneously and those requiring indomethacin therapy. Four of the 21 (19%) treated infants remained unresponsive to indomethacin and required ductal ligation. Of 17 infants with PDA who responded to indomethacin therapy, 1 (6%) was treated with a single course of bolus indomethacin, to which he responded, and 16 (94%) were treated with continuous indomethacin and responded promptly. The differences in therapeutic responsiveness to initial treatment with continuous vs bolus indomethacin were not significant. Of the 105 infants, 29 were exposed to indomethacin tocolysis. Those who were exposed to antenatal indomethacin and those who were not were well-matched with respect to birth weight and gestational age. Fifteen (52%) of the 29 exposed infants versus 18 (24%) of the 76 infants not exposed to antenatal indomethacin developed a PDA postnatally (relative risk = 2.1; 95% confidence interval: 1.22-3.74), and 45% of the antenatally exposed infants versus 12% of the nonexposed infants were symptomatic and required indomethacin (relative risk = 1.9; 95% confidence interval: 1.17-3.20). Four of the exposed infants versus none of the unexposed infants required surgical ligation. (ABSTRACT TRUNCATED)

Thirty-seven children and adolescents on renal replacement therapy (11 on haemodialysis, 14 on continuous ambulatory peritoneal dialysis and 12 after renal transplantation) were studied by echocardiography, echo-Doppler and phonocardiography. Right and left ventricular (R/L V) diastolic functions were measured by transmitral and transtricuspid flow velocities and by LV isovolumic relaxation time (LVIRT). Thirty-seven age- and sex-matched healthy subjects served as controls. R/L V diastolic dysfunction was only observed in the dialysis patients. In these patients LVIRT was prolonged. LV and RV peak inflow velocities were increased both in early (E) and late (A) diastole with a reduction in the E/A ratios. This pattern of diastolic dysfunction is compatible with the combined effects of a hypercirculatory state (volume overload, anaemia, arteriovenous fistula) and an abnormality of cardiac relaxation. The transplant patients showed no major cardiac abnormalities.

Ectopia cordis is a rare malformation presenting as an isolated lesion or as part of the Cantrell's pentology syndrome. Prenatal ultrasonographic diagnosis of ectopia cordis must be followed by a careful search for associated anomalies, since the prognosis may vary accordingly. A case of prenatal diagnosis of ectopia cordis in the early second trimester is presented. Routine sonographic examination at 18 weeks of gestation revealed protrusion of the heart into the amniotic fluid, ventricular septal defect and omphalocele. The perinatal evaluation and management are discussed.

Familial occurrence of membranous subaortic stenosis (MSS) is described in three families. The defect was found in 2 siblings in two of these families, and in 3 siblings of the third family. The importance of early diagnosis and treatment of MSS is emphasized. We suggest early evaluation of first-degree relatives of patients with MSS for the possibility of this defect.