Sonographic diagnosis of a retroperitoneal dermoid cyst in a young girl.

We describe the detection and management of a retroperitoneal dermoid cyst in a young girl. Transabdominal ultrasound revealed in the pelvis a complex mass with anechogenic and echogenic components characteristic of a dermoid cyst. Initially, it was presumed to be of ovarian origin, because extragonadal dermoid cysts are very rare in adolescence; however, the findings on physical examination were normal.

WHO and the mental health of children.

WHO's work on child mental health began with John Bowlby's classic on the subject, written for WHO in the early 1950s. In the mid-1970s the Division of Mental Health was created, and this led to major advances in establishing a sound epidemiological and scientific basis for child mental health services. Significant contributions were made to the establishment of "biobehavioural" interventions to tackle the major causes of childhood mortality and morbidity throughout the world, and to provide better care for children with mental disorders at primary level.

Ovarian cysts in children and adolescents: their occurrence, behavior, and management.

Study Objective: To evaluate the characteristics and symptoms of ovarian cysts, their connection with the methods of treatment, and the effectiveness of the therapy.

Methods: A retrospective analysis of data on girls with ovarian cysts was performed at a university clinic. Participants included 119 girls in whom 144 ovarian cysts were found by ultrasound examination performed either routinely or for a specific purpose.

Quality of life assessment: The world health organization perspective.

Assessment of quality of life (QoL) and use of this information towards improvement of health care services is an important area of activity of the World Health Organization (WHO). This paper briefly discusses the conceptual basis and the methodology used in WHO's Quality of Life Project (WHOQOL). It describes the simultaneous development of instruments in widely different cultures to assess subjective QoL.

Culturally appropriate measures for monitoring child development at family and community level: a WHO collaborative study.

Culturally appropriate techniques for monitoring child psychosocial development were prepared and tested in China, India and Thailand on a total of 28,139 children. This is the largest study of its kind ever undertaken. Representative groups aged between birth and 6 years were examined and the results were used to produce national development standards-separately for rural and urban children in China and India, and for all children combined in Thailand-which are considered to be more satisfactory than foreign-based standards.

Modern imaging methods in paediatric breast examination.

Study Objective: To diagnose premature or prepubertal breast development or breast diseases.

Design: Harmless, non-invasive examinations were conducted on young girls by the use of ultrasound and liquid crystal thermography with discs of various sensitivity.

Setting: The study was conducted at the Radiological Department of the Postgraduate Medical University in Budapest, Hungary.

Abnormal psychosocial situations. Preliminary results of a WHO and a German multicenter study.

The World Health Organization (WHO) provided instructions for field trials with the completely revised psychosocial axis of the MAS (Multiaxial classification scheme in child and adolescent psychiatry). A description is given of the purpose, the stages and the procedures of the field trials, the participating centres and the samples. The results of the studies concerning applicability and reliability are given and discussed, as well as those of a quasi validity study, in a comparison of anxiety disorders and disruptive behaviour disorders.

Development of a WHO Child Care Facility Schedule (CCFS): a pilot collaborative study.

This paper describes the research conducted by a WHO collaborative study group for the development of a questionnaire method for the assessment of quality in child-care settings. The results of an inter-rater reliability study undertaken in Greece and Nigeria suggest that the Child Care Facility Schedule (CCFS), composed of 80 items, offers a satisfactory system of rating, especially after modifications were made to refine certain items, alter the scoring system so as to grasp nuances, and clarify the instructions in the users' manual, including revisions in the interviewing technique. A validity study to confirm the usefulness of this method is being carried out in Athens.

Classification of abnormal psychosocial situations: preliminary report of a revision of a WHO scheme.

A WHO working group undertook a radical revision of the psychosocial axis for the classification of abnormal psychosocial situations. The rationale for the revision and the approach taken is described, together with the overall structure of the coding scheme and the subcodings within each category.

Detection of late-onset adrenal hyperplasia in girls with peripubertal virilization.

We investigated the value of serum levels of adrenal steroids (dehydroepiandrosterone sulphate, testosterone, 17-hydroxyprogesterone, cortisol) in the identification in peripubertal females with late-onset congenital adrenal hyperplasia owing to 21-hydroxylase deficiency. Among 68 females (age 3-18 years) with virilization in childhood, peripubertally or postpubertally, we selected 21 girls for an ACTH test by measurement of basal blood-spot or serum 17-hydroxyprogesterone (17-OHP) levels. Eight of 21 patients had supranormal post-ACTH serum 17-OHP concentration (57-153 nmol/l) with low normal cortisol concentration.

Levels of expressed emotion and relapse in depressed patients.

The relationship between spouses' levels of expressed emotion (EE) and relapse was examined in a sample of 39 depressed psychiatric hospital patients. Over a nine-month follow-up, 59% of patients with high-EE spouses relapsed, although no patients living with low-EE spouses did so. The results replicate the association found by Vaughn & Leff between EE and depression, and suggest that the EE construct has predictive validity in both schizophrenic and depressed populations.

A nonhuman primate model for evaluating the potential of antihypertensive drugs to cause orthostatic hypotension.

The potential of several classes of antihypertensive drugs to cause orthostatic hypotension in man was evaluated in a conscious cynomolgus monkey model. Supine and erect blood pressure and heart rate were continuously monitored before and after administration of chlorisondamine (a ganglionic blocking agent); phentolamine and prazosin (alpha-adrenergic blocking agents); propranolol (a beta-adrenergic blocking agent); and minoxidil (a vasodilator). Substantial validation of the model was accomplished when it was observed that these drugs evoked cardiovascular responses in the animal model which were similar to those which had been described in the clinical literature.

Tetrahydro-2-benzoxepins: a novel family of hypotensives.

A novel series of 1-(alkylamino)-1,3,4,5-tetrahydro-7,8-dimethoxy-2-benzoxepins shows hypotensive activity. A typical example is 1-[2-(1,3,4,5-tetrahydro-7,8-dimethoxy-2-benzoxepin-1-yl)ethyl]-4-(4-fluorophenyl)piperazine. This compound is an alpha blocker with peripheral and central activities.