Investigation--including computed tomography and ultrasonography--of the renal transplant patient with hypercalcaemia.

One hundred and eleven stable renal transplant patients were investigated, using sensitive methods, for the effect of hypercalcaemia on renal function and for the presence of nephrocalcinosis. Twenty-five patients (22.5%) were hypercalcaemic but this had no effect on renal function. Nephrocalcinosis was detected in a small percentage of patients using ultrasonography and computed tomography.

[The ultrasonic demonstration of gas in the endometrial cavity--an aid for the diagnosis of puerperal endometritis]. / Die ultrasonografiese aanduiding van gas in die endometriumholte--'n hulpmiddel vir die diagnose van puerperale endometritis.

A pilot study was undertaken to determine the prevalence of gas in the puerperal endometrial cavity and to determine whether this finding has any relationship to the mode of delivery or to the development of puerperal endometritis. On the first day after delivery 192 patients were examinee ultrasonographically and gas was demonstrated in 26 (13.54%). Gas was found significantly more often in relation to caesarean section and intra-uterine manipulation than in normal vaginal deliveries (P less than 0.0001). On the third puerperal day the gas disappeared in 12 patients but persisted in 14, of whom 7 had signs of endometritis. Endometritis was diagnosed in a total of 8 patients and only 1 did not have signs of gas in the endometrial cavity. Although the figures are small it is concluded that ultrasonography of the puerperal uterus might assist in the diagnosis of puerperal endometritis.

In vitro fertilization and embryo transfer in Pretoria.

Details of the in vitro fertilization and embryo transfer programme at the Department of Obstetrics and Gynaecology of the H. F. Verwoerd Hospital and the University of Pretoria are presented. From 1 March 1982 to 30 November 1983, 67 cycles in 47 patients were induced using clomiphene citrate and human chorionic gonadotrophin (hCG) (46 patients) and human postmenopausal gonadotrophin/hCG (1 patient). In 5 patients ovum recovery was unsuccessful owing to severe adhesions. In the remaining 42 patients 59 oocyte recoveries out of a total of 62 attempts were successful, a 95% recovery rate. One hundred and seventy-nine ova were recovered (2,9 per laparoscopy), of which 143 (80%) were viable. Forty-six per cent of fertilized ova cleaved actively. Forty-one transfers of 66 embryos (average 1,6 embryos per transfer) resulted in 5 pregnancies (12% pregnancy rate per transfer). Three preclinical pregnancies aborted spontaneously. Two pregnancies are ongoing at 30 and 32 weeks' gestation. Thus, the programme has so far led to 2 third-trimester pregnancies. Consolidation and refinement of techniques should lead to a steady increase in success at this centre.

Digoxin withdrawal in patients with sinus rhythm.

The need for maintenance treatment with digoxin was assessed in 10 elderly outpatients with sinus rhythm. Digoxin was withdrawn on the first day of the trial but any other treatment remained unchanged. The participants were seen once weekly on the same day for 5 consecutive weeks and assessed clinically, by the calculation of systolic time intervals and by M-mode echocardiography. In 2 patients the clinical condition deteriorated but in the rest digoxin was stopped without detrimental effects. Therefore, in the patient population selected, maintenance treatment with digoxin was deemed unnecessary in 90% of cases.