Does MRI add to ultrasound in the assessment of disorders of sex development?

OBJECTIVE: The objective of the study was to evaluate the need of magnetic resonance imaging and using different approaches (transabdominal, endoluminal and transperineal) in the proper assessment of disorders of sex development regarding gonadal detection and gender differentiation. SUBJECTS AND METHODS: Twenty five patients with abnormalities of sex disorders were included. They were classified into two groups according to the time of clinical presentation: Group 1 (early onset) included eight cases. Their age ranged from one month to 12 years (mean age=3.0). They presented with overt genital ambiguity of clitoral hypertrophy in a phenotypic female, non palpable testes or micropenis in a phenotypic male. Group 2 (late onset) included 17 cases. Their age ranged from 16 to 33 years (mean age 18.1). This group presented by distressing puberty symptoms of primary amenorrhea in a female phenotype or undescended testis and behaving as a male. Cases were subjected to Ultrasound and MR imaging examinations. Imaging results were correlated results of chromosomal and hormonal assays as well as laparoscopy findings. RESULTS: The study included: 10/25 cases (40%) of female pseudo-hermaphroditism, 13/25 cases (52%) of male pseudo-hermaphroditism, one case (4%) of true hermaphroditism and one case (4%) of pure gonadal dysgenesis. The accuracy of multi approach ultrasound was 89.8% compared to 85.7% in MR imaging. CONCLUSION: Ultrasound should be considered the initial screening modality in the assessment of developmental sex disorders. MRI examination could be reserved for gonad identification when ultrasound examination fails to do so and for corrective surgery guidance.

Ozone formation in the greater Cairo area.

Ozone formation in the greater Cairo area was studied in 1990 in a 3-week measurement period performed at three sites (Shoubra El-Kheima, Mokattam Hill, Helwan), covering a north-south direction of 27 km, and in 1991, from the beginning of April until the end of October, by measurement of the seasonal variation of ozone at one site at El-Kobba. The sinusoidal shape in the diurnal volume fraction plots with peak values of 120 ppb and daily mean value of 50 ppb throughout the year indicate a substantial contribution of photochemistry to the ozone content of the atmosphere. Ozone is produced predominantly over the industrial area in the north and in the centre of Cairo and transported southward by the prevailing northerly winds. Contrary to many urban areas in Europe and in North America, fairly high average ozone levels of 40 ppb are observed during the night throughout the spring and the summer. This may imply that health hazards and crop damage are higher in the greater Cairo area than in Central Europe.