[Turner's syndrome--case report of a female patient with chromosome mosaicism]. / Turnerov sindrom--prikaz bolesnice s kromosomskim mozaicizmom.

A 45-year old woman with the typical Turner's phenotype (short stature, short and broad neck, shield chest and low hairline) and signs of ovarian failure started at the age of 37 with menopause at the age of 44, is presented. The cytogenetic analysis showed the presence of three different cell lines with 45,X, 46,XX and 47,XXX karyotypes. It is a rare type of mosaicism, combining Turner's and triple-X syndrome. Interestingly, the became pregnant and gave birth to a healthy child. Second pregnancy resulted in a miscarriage in the first trimester.

Transvaginal sonography and hysteroscopy in women with postmenopausal bleeding.

OBJECTIVE: To make a prospective comparison between endometrial thickness determined by transvaginal sonography (TVS) and hysteroscopic findings in women with postmenopausal bleeding with histologic findings obtained by dilatation and curettage (D&C). METHODS: Eighty-one patients who had not received hormonal replacement therapy were scanned by transvaginal probe, and double-layer endometrial thickness was measured 1 day before hysterectomy and D&C. RESULTS: The histologic diagnosis was atrophy in 12 cases, irregular proliferative changes in 21, endometrial polyps in 16 hyperplasia in 16 and endometrial carcinoma in 16. TVS detected 46 of 48 pathologic conditions, including all cases of endometrial carcinoma if the endometrial thickness (both layers) was > or = 5 mm (sensitivity 95.8%, specificity 4.5%). Hysteroscopy also detected the endometrial pathology in 46 of 48 cases but with a higher specificity (sensitivity 95.3%, specificity 93.9%). CONCLUSION: TVS and hysteroscopy are complementary diagnostic methods and could be accurately used to discriminate normal and pathologic conditions in patients with postmenopausal bleeding.

[Polycystic ovary syndrome: a disorder of insulin action and an increased risk for onset of non-insulin-dependent diabetes]. / Sindrom policisticnih jajnika: poremecaj djelovanja inzulina i povecan rizik nastanka inzulin-neovisne secerne bolesti.

Hyperandrogenemia may be the most common endocrinopathy in women, affecting up to 10% of all women and as many as 30% of certain subgroups. Women with polycystic ovary syndrome have a unique disorder of insulin action and are at increased risk to develop NIDDM. NIDDM in women with PCOS has earlier age of onset than it does in the general population. Insulin-induced receptor autophosphorylation is diminished in 50% of PCOS women. PCOS may be a disease of abnormal protein tyrosine kinase receptor signaling. IGF-I and IGF-II play an important role in regulating ovarian androgen production via receptors.

Fetal transverse cerebellar diameter/abdominal circumference ratio in assessing fetal size.

OBJECTIVE: To test the usefulness of the fetal transverse cerebellar diameter/abdominal circumference (TCD/AC) ratio in predicting known small-for-gestational-age (SGA) infants. METHOD: The relationship between fetal TCD and AC throughout the second half of pregnancy was investigated in 635 well-dated, normal pregnancies and examined with regard to gestational age and infant birth weight percentiles. RESULTS: One hundred eighteen (19%) fetuses were excluded due to inadequate visualization of the fetal cerebellum. A strong correlation was noted between gestational age determined by the last menstrual period and both fetal TCD (r2 = 0.91338) and AC (r2 = 0.89361) in fetuses with birth weights between the 10th and 90th percentiles (n = 407; mean 14.4, S.D. 1.2). Although the TCD/AC ratio showed a poor correlation with gestational age (r2 = 0.15788), a slight increase was noted during gestation. A TCD/AC ratio greater than 15.5 was present in 80% of SGA infants when measurements were performed within 1 week of delivery. CONCLUSION: Fetal TCD/AC ratio as a gestational age-independent method could improve diagnostic sensitivity and specificity in the early detection of fetal growth abnormalities.

[The effect of menopause and age on bone mineral density in women living in an urban environment in northern Croatia]. / Utjecaj menopauze i dobi na mineralnu gustocu kosti zena urbane sredine u sjevernoj Hrvatskoj.

The results of measurement of bone mass in three areas (lumbar spine, femoral neck and radius) where osteoporotic fractures most commonly occur are presented. The sample of 103 women was divided into three groups: premenopausal, early menopausal (up to 5 years of menopause) and late menopausal (more than 5 years of menopause). Both menopausal groups were additionally divided in two subgroups regarding the previous fractures. A statistically significant difference (p < 0.01) was found between bone mineral density (lumbar spine, femoral neck) and bone mineral content (radius) among all the groups. No difference was established for bone mass between postmenopausal women with and without fractures (> 0.05) by using the Kruskal-Wallis analysis of variance. A significant negative correlation (p < 0.01) was found between bone mass in all three tested regions on one side vs age of women as well as the period of menopause on the other. These results indicate that bone mass is significantly decreased in postmenopausal women. Therefore, the authors recommend densitometry to be employed in all postmenopausal women.

[Radical treatment of pilonidal disease]. / Radikalno lijecenje pilonidalne bolesti.

A pilonidal disease is an illness which appears in younger population (second and third life's decade), dominantly in male and especially in hairy, pilous persons. Besides symptoms and troubles this disease causes, from time to time, the disability to the work, so that its economical aspect is not to be disregarded. As the number of recurrences following the surgery could be important (accordingly to the world referencies from 15 to around 30%), the choice of an appropriate surgical treatment still remains open! Based on an analysis of their own patients operated upon in the last ten years, authors present their observations concerning the surgical treatment of chronic forms of pilonidal disease, taking into consideration a radical surgical procedure they have applied last years, which has shown certain advantages in comparison with other ones, regarding fairly reduced number of postoperative recurrences.

Ultrasound diagnostics as a method of investigation of plastic induration of the penis.

Using the ultrasound technique of visualization (grey-scale technique) and a method of 'water bath', the authors obtained echograms of plastic indurations of the penis. The echograms can be immediately photographed and interpreted. By their quick, painless and simple performance, without contrast medium and hazardous irradiation, the authors gain an advantage over some other diagnostic methods.

An approach of ultrasound diagnostic techniques of the skin and subcutaneous tissue.

The authors have examined ultrasound echograms and photographs of the skin and subcutaneous tissue changes in some skin diseases, reporting their findings. In spite of the preliminary clinical casuistry, this quick, simple and painless technique without irradiation hazard to the patient shows the advantage relating to the other techniques, routine roentenography especially. In conclusion, it is the authors' opinion that the improved scanning technique and greater experience should offer such valuable results, used as an additional method in dermatological diagnostics.