Hypomagnesaemia-hypocalcaemia syndrome in the postpartum period. A case report

A black woman had amoebic dysentery for 5 days before delivery of her 7th child. The day after delivery at home she was admitted to hospital with puerperal sepsis, vaginal bleeding and dysentery. The patient received gentamicin from the 4th to the 10th day after admission and the diarrhoea continued until the 11th day, when she developed tetany. Investigation revealed hypocalcaemia, hypomagnesaemia and hypokalaemia; urinary magnesium excretion was at the upper limit of the reference range; infusion of parathyroid hormone adenosine monophosphate excretion. Magnesium replacement therapy was instituted and normal serum calcium, magnesium and potassium levels were re-established on this treatment alone. These findings are interpreted as being consistent with magnesium depletion by diarrhoea and gentamicin therapy, resulting in the induction of a functional hypoparathyroidism.

Hyperthyroidism in gestational trophoblastic neoplasia

The thyroid status of twenty-seven African patients with gestational trophoblastic neoplasia (GTN) was studied. Fifteen patients were found to be biochemically hyperthyroid (eight patients with choriocarcinoma; seven with hydatidiform mole). Of these fifteen patients, nine were clinically thyrotoxic. The most serious complication of thyrotoxicosis was life-threatening acute pulmonary oedema with associated cardiac failure. It was found that when serum levels of the human chorionic gonadotrophin (hCG) reached a level of about 0.1 X 10(6) iu/1, thirteen of sixteen patients were biochemically hyperthyroid; at serum levels of 0.3 X 10(6) iu/1 of hCG most patients were clinically thyrotoxic. A feature of hyperthyroidism associated with GTN is that whereas T4 is invariably raised the T3:T4 ratio tends to be low (0.015 +/- 005); rT3:T3 ratios were high in this group. TSH levels were not increased.

Fetal prostaglandin levels in twin pregnancies

Umbilical venous plasma and amniotic fluid concentrations of prostaglandins E2 (PGE), F2 alpha (PGF) and 13,14 dihydro-15-keto-F2 alpha (PGFM) were measured in 31 twin pregnancies by specific radioimmunoassays. There was no significant difference between twins I and II in the same pregnancy but PGE and PGFM were significantly increased during labour in fetal blood. This rise was not manifest in the latent phase. PG concentration in amniotic fluid rose with advancing gestational age but was more pronounced in the case of PGE than for PGF and PGFM. No significant differences between amniotic sac concentrations of PGs of twin I and II were found during the prelabour period, but in all four patients in labour with intact membranes, the PG levels were increased in twin I. The fetal plasma and amniotic fluid levels of PGE and PGFM were significantly correlated in the prelabour group.

Gonadotrophin-sparing hypopituitarism. A case report

A 32-year-old Indian woman presented with amenorrhoea and symptoms of inadequate secretion of the anterior pituitary hormones after the birth of her second child. Investigation 2 years later revealed deficient secretion of prolactin, thyroid-stimulating hormone, adrenocotricotrophin and growth hormone. However, there was an unimpaired response of luteinizing hormone and follicle-stimulating hormone to gonadrophin-releasing hormone. This patient unequivocally demonstrated preservation of gonadotrophin function in association with deficient secretion of the other anterior pituitary hormones.

Rheumatic syndromes in endocrine disease

It is not widely appreciated that endocrine disease may present primarily as rheumatic syndromes, sometimes spectacular in onset, more commonly insidious and subtle, making their true recognition difficult. The underlying hormonal, biochemical, and metabolic events have understandable reflection in the structure and function of bone, joint, and muscle.

Six years' experience of symphysiotomy in a teaching hospital

One hundred and sixty-one symphysiotomies were performed at Harari Maternity Hospital, Rhodesia, over a 6-year period. Indications for the operation are discussed and fetal and maternal results reviewed. Seventy-two patients suffered from postoperative complications but the majority of these were minor and of short duration. Multiparous patients did not have a higher morbidity than did primiparous ones. It is concluded that symphysiotomy has a useful role to play in a teaching hospital, provided it is performed by an experienced surgeon on carefully selected patients.

Classical conditioning with auditory discrimination of the eye blink in decerebrate cats

Cats were subjected to complete lower brainstem transection, and were then tested for learning ability according to a classical conditioning paradigm. An auditory stimulus was systematically paired with a brief shock to the eyelid. Within a few weeks after the operation, the decerebrate cats could learn the conditioned response with a tone frequency discrimination and then a discrimination reversal. Our results support the notion that the brainstem reticular formation can support a conditioned response which isbehaviorally similar to that obtained in the intact animal.

Functional congruence: an index of neural homogeneity and a new measure of brain activity

Extremely high correlation between the probability that a single cell will fire and the amplitude of microelectrode electroencephalogram was established in on-line, real-time computer experiments. Such congruence between spike and wave shows orderly biological variation under sensory control. Congruence, as a measure of brain activity, provides an immediate estimate of regional neural homogeneity of function of cell populations in brain.

Thyroxine: Effects of Neonatal Administration on Maturation, Development, and Behavior

In the report, "Thyroxine: effects of neonatal administration on maturation, development, and behavior," by S. Schapiro and R. J. Norman (10 Mar., p. 1279), the first line of Fig. 2 should read: "Fig. 2. Electroencephalograms from the cortex of thyroxine-treated and control infant...."

Thyroxine: effects of neonatal administration on maturation, development, and behavior

Thyroxine was administered to infant rats within the first 3 days of postnatal life; controls receiving 0.01N NaOH were from the same litter. Thyroxine accelerated the maturation of the pituitary-adrenal response to elec tric shock. The "startle response" ap peared earlier in the experimental ani mals, as did the development and re sponse of the electroencephalogram to novel stimuli. The thyroxine-treated rats, when 16 to 18 days old, acquired a conditioned-avoidance response faster than did controls.