Two cases of Strongyloides stercoralis hyperinfestation syndrome accompanied by Gram negative bacteraemia and meningitis were studied. Both occurred in non-immunosuppressed West Indian women.

A case of hypophosphataemic osteomalacia occurring in association with a carcinoma of prostate is described. Although only palliative treatment to the primary tumour was possible, worthwhile remission of bone symptoms, due to osteomalacia, was achieved with pharmacological doses of vitamin D. The presence of extensive skeletal metastases modified the radiological features of osteomalacia. Major alterations in the distribution of calcium within the skeleton were observed during a period when total body calcium remained unaltered. This observation may be of relevance to other cases in which osteosclerotic metastases develop.

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SYNOPSIS Two newborn babies with an intact atrial septum are described. In one, the two components of the atrial septum appeared to have become fused after relatively normal initial development; the left side of this heart was hypoplastic. In the other baby the formation of the atrial septum appeared to have been completely anomalous; this heart showed mitral atresia, absence of the left ventricle, and transposition of the great vessels. There was also pulmonary lymphangiectasis in the second case, and it is suggested that this was due to the cardiac malformation obstructing pulmonary venous drainage.A patent atrial septum is essential for the normal foetal circulation, and an intact septum at birth has rarely been reported. Lev, Arcilla, Rimoldi, Licata, and Gasul (1963) were able to find only 19 cases in the literature, and reported 11 more from their series of 1,150 hearts with congenital malformations submitted to pathological examination.It is reasonable to suppose that the malformation may be due to the atrial septum forming without a patency in the first place or to closure at a later stage. It might be expected that the first of these possibilities would be associated with a higher incidence and greater severity of other cardiac malformations. We believe the two cases reported in this paper illustrate these points.CASE REPORTS CASE 1 The baby was stillborn at 43 weeks by dates to a primiparous mother aged 22 years. Wassermann reaction was unknown, Rh positive. Pregnancy was uneventful. Labour lasted 36 hours with a vertex presentation and forceps delivery. The placenta weighed 383 g. and was unremarkable apart from meconium staining of the cord and membranes.External appearance The body was that of a female baby, of weight 3,191 g., length 50 cm., head circumference 34 cm. There were petechiae over the thorax and there was generalized cyanosis. The perineum was covered with meconium.Internal examination There was meconium in the stomach and a small amount in the trachea and bronchi. The liver (164 g.) was slightly enlarged and congested, and there was a slight excess of serous fluid in the peritoneal cavity. Both pleural cavities contained a small amount of blood-stained fluid and there were many petechiae on the lungs and heart.Received for publication 9 June 1966. The systemic veins were engorged and there was a small amount of slightly blood-stained fluid in the pericardial cavity. The heart (23 g.) was slightly enlarged and slightly rotated towards the left because of enlargement of the right side. The right atrium was greatly dilated. The tricuspid ring was 4 cm. in internal circumference and its cusps were normal. The right ventricle was markedly dilated and hypertrophied, the wall measuring up to 0-8 cm. in thickness (Fig. 1). The pulmonary ring, 2-9 cm. in circumference, and the pulmonary trunk were dilated, and the ductus arteriosus was wide with an internal circumference of 1-5 cm. The aortic insertion of the ductus was opposite the origin of the left subclavian artery. The pulmonary veins w...