Prolactin and pituitary gonadotropin values and responses to acute luteinizing hormone-releasing hormone (LHRH) challenge in patients having long-term treatment with a depot LHRH analogue.

Sixty patients with advanced prostatic carcinoma were treated with monthly subcutaneous injections of a depot formulation of goserelin, a luteinizing hormone-releasing hormone (LHRH) analogue (Zoladex, ICI Pharma, Destelbergen, Belgium). All patients were regularly evaluated with measurements of luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone (T), and prolactin (PRL) levels. In 15 patients among them who could be treated for more than 42 months, an LHRH stimulation test was performed at the end of each 28-day period and before the next administration of the depot formulation. A complete and maintained suppression of both T and LH levels was seen. FSH levels also decreased, but to a lesser extent than LH levels, and showed a small escape after reaching a minimum value after 1 month of therapy. The LHRH challenge after 42 months of therapy elicited no significant responses of LH and FSH levels. The PRL values showed a small decrease.

Ultrasound in urological oncology.

Transabdominal, transrectal and transurethral ultrasonography play a major role in the diagnosis and staging of urological tumors. The practical limitations and possibilities of the several techniques are evaluated in the oncological work-up of tumors of the kidney, bladder, seminal vesicles, prostate and testis. Ultrasonography has become an important diagnostic tool in urological oncology.

[376 amniocenteses performed under continuous ultrasonic control]. / 376 amniocentèses sous échoguidage continu.

The authors report 376 amniocenteses carried out early and late in pregnancy under real time ultrasound at the University Clinic of St Pierre. The ability to watch the needle during the whole procedure of puncture makes it possible, as compared with amniocentesis that has been carried out without ultrasound or without real time ultrasound, to lessen significantly: perinatal mortality (0.26%), several attempts (0.9%) and the risk of accidental haemorrhage (1.6%). Particularly diminished are risks when it would be inevitable to have to put the needle through the placenta (31% of cases). The number of spontaneous abortions linked to the technique has virtually disappeared. When the operator has become very experienced in carrying out amniocentesis under real time ultrasound he becomes much more able to carry out other antenatal diagnostic procedures. Even when for certain indications amniocentesis is replaced by chorion villus biopsy in the first trimester or cord puncture in the third trimester, real-time ultrasound makes it less risky to carry out the procedures and the technique becomes a very useful one in the armamentarium of antenatal diagnostic methods.