[The use of clomiphene and menotropins as inducers of multiple follicular growth in a program of in vitro fertilization]

In our IVF & related techniques program, clomiphene 50 mg was used from days 2 to 6 of the cycle in 20 patients and 20 cycles. (17 IVF patients and 3 GIFT patients) menotropins were also used in 2 different schemes: a) 2 ampules in alternated days (12 cases) and b) one ampule daily (8 cases). The patients with the daily scheme required lesser total dose of menotropins and developed higher estradiol levels, although this had none statistic significance, and they also developed a greater number of follicles. There were 16 laparoscopies for ovum capture and 53 oocytes were retrieved (30.2% mature) 10 oocytes were from the GIFT patients. 16 oocytes were fertilized and 8 cleaved. There was only one pregnancy from and IVF patient with the alternated scheme that ended with a first trimester abortion.

[Mediastinal teratomas. A clinical and pathologic study of 3 pediatric cases]

Mediastinal teratomas are reported in three children. Two cases: an eighteen-month-old female and a twelve-years-old female, were diagnosed of mature cystic teratoma. Third patient was a twelve-year-old male with an immature mediastinal teratoma. All tumors were located in anterior mediastinum. Mediastinal mature cystic teratomas were completely excised and their evolution were favourable. However, immature mediastinal teratoma infiltrated lung parenchyma and great blood vessels; in this case only a biopsy was performed. This patient died a month after surgical procedure. Clinical, radiological and pathological findings of mediastinal teratomas in childhood are commented. Prognostic factors and evolution of different histological types of mediastinal teratomas are evaluated.

[Hepatic lesions caused by alpha 1-antitrypsin deficiency in childhood. Review of 14 cases]

Fourteen cases of alpha-1-antitrypsin deficiency are presented. All of them had a PIZZ phenotype except two in which a PIMZ phenotype was found. It must be pointed out that histological findings show a great variability among the different patients most of which did not have intracellular PAS-positive amylase inclusions in liver biopsy specimens. Clinical course did not correlate with either the age of onset of the disease or the phenotype found, thus indicating that other additional factors are involved in determining prognosis. We insist on the importance of a careful study of all neonatal hepatitis syndromes in order to rule out a alpha-1-antitrypsin deficiency.

Histogenesis of adenomatoid tumour associated to pseudofibromatous periorchitis in an infant with hydrocele

An 18-month-old infant with recurrent congenital hydrocele presented with a mass in the caput epididymis. The tumour and several fragments of the tunica vaginalis were removed and studied by light and electron microscopy. The tumour showed the characteristic histological pattern of an adenomatoid tumour of mesothelial origin. The histological appearance of the tunica vaginalis was not uniform; some areas resembled the adenomatoid tumour to the epididymis, others exhibited histological and ultrastructural features of a haemangioma, whilst elsewhere, the two patterns were intermingled. Finally, areas of pseudofibromatous periorchitis with vascular proliferation and slit-like structures lined by mesothelial cells were recognized. These features suggest that the adenomatoid tumour originated from a localized reactive process with inflammation and vascular proliferation enclosing occasional slit-like structures originating from the mesothelial lining of the tunica vaginalis. Subsequent regression of vascular proliferation and inflammatory infiltration and continued mesothelial proliferation would give rise to the typical mesothelial pattern of adenomatoid tumour.