Diagnosis of fallopian tube patency.

Objectives: To evaluate and compare the diagnostic value of hysterosalpingography (HSG) and laparoscopic chromopertubation (LCP), in the diagnosis of fallopian tube patency.

Design: A comparative prospective study.

Setting: The infertility clinic of the Department of Obstetrics and Gynaecology, Ga-Rankuwa hospital (Medical University of Southern Africa), Pretoria, South Africa.

Narcolepsy caused by acute disseminated encephalomyelitis.

Background: Narcolepsy with cataplexy is caused by a selective loss of hypocretin-producing neurons, but narcolepsy can also result from hypothalamic and rostral brainstem lesions.

Patient: We describe a 38-year-old woman with severe daytime sleepiness, internuclear ophthalmoplegia, and bilateral delayed visual evoked potentials. Her multiple sleep latency test results demonstrated short sleep latencies and 4 sleep-onset rapid eye movement sleep periods, and her cerebrospinal fluid contained a low concentration of hypocretin.

Pleuropulmonary blastoma--case report of a patient presenting in a moribund state.

A 4-year-old girl presented with an intrathoracic tumour that was pleural in origin, invading the right lower lobe. The patient underwent urgent right thoracotomy and surgical excision of the tumour and right lower lobectomy as the tumour was invading that lobe. The histological report initially reported it as a rhabdomyosarcoma, embryonal type, but after consultation it was changed to type III pleuropulmonary blastoma.

Nephroblastoma in horseshoe kidney.

A case of nephroblastoma arising in a horseshoe kidney is reported. Clinically a bilateral nephroblastoma was suspected. Pre-operative diagnosis of horseshoe kidney, once a mass has arisen, may be difficult even with radiological investigation.

Childhood liver diseases in Ga-Rankuwa Hospital, South Africa.

Objective: To determine the pattern of liver diseases diagnosed in children at Ga-Rankuwa Hospital Histopathology Laboratory.

Design: A retrospective study.

Setting: Ga-Rankuwa Histopathology Laboratory.

Paroxysmal kinesigenic choreoathetosis because of cryptogenic myelitis. Remission with carbamazepine and the pathogenetic role of altered sodium channels.

Lesions of the spinal cord causing paroxysmal kinesigenic choreoathetosis are rare and most of the reported cases have been because of multiple sclerosis. We now describe this movement disorder occurring in a patient who developed a myelitis of unknown aetiology. A typically striking remission followed treatment with carbamazepine.

TC99m MIBI scintigraphy in well-differentiated thyroid carcinoma.

Objectives: To review our experience and assess the role of TC99m MIBI thyroid scintigraphy in patients with well-differentiated thyroid carcinoma.

Design: Cross sectional descriptive study comparing the results of TC99m MIBI and TC99m pertechnetate scintigraphy with histology.

Setting: Ga-Rankuwa Hospital, a tertiary referral centre, MEDUNSA, South Africa.

Evaluation of thyroid nodules with technetium-99m MIBI and technetium-99m pertechnetate.

Background: Most thyroid centers use fine-needle aspiration (FNA) and technetium-99m pertechnetate for the preoperative assessment of thyroid nodules. This approach is sufficient in most cases other than follicular neoplasm, and follicular carcinoma is more common than papillary carcinoma in developing countries such as in our center. Technetium 99m-methoxyisobutylisonitrile (MIBI) proposed for myocardial perfusion was also found to be taken up by a variety of tumors including thyroid cancer.

Cervical lymphadenopathy at Ga-Rankuwa Hospital (South Africa): a histological review.

Objective: The main aim of the study was to review the pathology of lymph nodes removed from patients with primary cervical lymphadenopathy.

Design: A retrospective study.

Settings: Department of Anatomical Pathology at Ga-Rankuwa/Medunsa Academic Complex.

Multiple infarcts in a patient with cerebral phaeohyphomycosis: CT and MRI.

Phaeohyphomycosis is an uncommon disorder caused by a variety of saprophytic fungi having distinctive morphologic features. Central nervous system infection typically occurs in the absence of predisposing factors and usually manifest symptoms and signs of abscess formation. We describe an otherwise healthy young man whose presentation with cerebral phaeohyphomycosis was subacute meningitis and stroke.

Carcinoma of the thyroid in Ga-Rankuwa Hospital, Pretoria.

Objective: To determine the pattern of thyroid carcinoma diagnosed at Ga-Rankuwa Hospital over a ten-year period.

Design: A retrospective study.

Settings: Ga-Rankuwa Hospital; a teaching hospital for the Medical University of Southern Africa.

Triplication of the thumb.

A child with triplication of the thumb is presented. Each thumb was fully developed with neurovascular bundles, flexor and extensor tendons. Although all three thumbs were triphalangeal, they shared a common metacarpal and two shared a common proximal phalanx.

MRI of the spinal cord in myelopathy complicating vitamin B12 deficiency: two additional cases and a review of the literature.

Focal spinal cord lesions have been present in all previously reported cases of MRI appearances in myelopathy complicating vitamin B12 deficiency. We describe two further cases showing mild atrophy only and review the salient features of the previous 11 publications. MRI findings reflect quite closely the known pathological changes in this condition.

Scintigraphic evaluation of craniopagus twins.

Craniopagus twinning is a rare congenital abnormality, occurring at a frequency of 4-6 per 10 million births. A case is reported in which separation was successful for both twins. The importance of pre-operative radionuclide assessment of crucial organ function (liver, kidneys, heart, brain) and crossed circulation is stressed.

Retrosternal thyroid carcinoma metastatic to the sternum: a case report.

A 75 year old female patient presented with a pulsatile sternal mass. The resected mass was a metastatic follicular carcinoma of thyroid origin. The primary tumour was found in the retrosternal area.

The surgical pathology of the appendix in South African blacks.

Objective: The aim of this study was to evaluate the type of pathology seen in appendices removed for acute appendicitis.

Design: A retrospective study.

Settings: Department of Anatomical Pathology at Ga-Rankuwa/Medunsa Academic Complex, Gauteng Province, South Africa.

The treatment of systemic candidiasis in neonates with oral fluconazole.

Fungal septicaemia has become a frequent problem in neonatal intensive care units. The usual treatment for this condition, amphotericin B alone or in combination with 5-fluorocytosine, is sometimes unsatisfactory, especially in neonates. We report our experience of fluconazole in neonates.

Lone ventricular cardiomyopathy, 1993-1996.

Objective: To identify subjects with univentricular idiopathic structural and/or functional myocardial disorders (as defined) and to describe the characteristic features.

Design: Over a period of 4 years, 1993-1996, all adult subjects were obtained consecutively from a centralised referral cardiological service. The subjects had to fulfil a set of formulated diagnostic criteria for each isolated type of univentricular disease-symptomatic or asymptomatic.

Atlanto-axial rotatory fixation.

Objectives: To analyse the causes of atlanto-axial rotatory fixation (AARF) and discuss the diagnosis and treatment.

Design: Retrospective case studies.

Setting: Medical University of Southern Africa-Ga-Rankuwa referral hospital.

Fluconazole vs. amphotericin B for the treatment of neonatal fungal septicemia: a prospective randomized trial.

Objective: Fungal septicemia is a devastating disease in the neonate, especially in the low birth weight preterm infant who is especially vulnerable to disseminated fungal sepsis. The objective of this study was to compare the efficacy, safety and overall convenience of fluconazole vs. amphotericin B for the treatment of disseminated fungal sepsis in neonates.

Tuberculosis of the cervical spine.

Tuberculosis of the cervical spine is rare, comprising 3-5% of cases of tuberculosis of the spine. Eight patients with tuberculosis of the cervical spine seen during 1989-1992 were reviewed. They all presented with neck pain.

Malignant phyllodes tumour: report of two cases.

Malignant phyllodes tumours are rare fibroepithelial tumours of the breast. The tumours consist of a benign looking epithelium surrounded by a cellular stroma with malignant features. Two cases of a malignant phyllodes tumour are presented.