Arteriovenous malformation of the stomach

A patient with chronic anemia is presented who radiologically showed prominent rugae of the stomach. Angiography demonstrated an arteriovenous malformation with a large feeding artery and prominent draining veins.     

Third trimester placental grading by ultrasonography as a test of fetal wellbeing.

In a study of 2000 unselected pregnant women the development of a mature placental appearance (grade 3) on ultrasonography by 34-36 weeks'' gestation, observed in 15% of cases, was associated with maternal smoking, low parity, low maternal age, and being white. These women had an increased risk of problems during labour and their babies had an increased risk of low birth weight, poor condition at birth, and perinatal death. The women were randomly allocated to two groups: in one group the result of the placental grading was reported to the clinician responsible for care; in the second the result was noted but not reported. There was a significant decrease in the risk of perinatal death in the group where the grading was known. This reduction was responsible for a difference in the principal outcome index, a heterogeneous group of measures of mortality and morbidity, but this difference was not significant. This study alone does not justify routine late scanning, and further, larger trials are required. Nevertheless, the results do provide a basis for the reporting of placental grading when ultrasound examination is performed during the third trimester.     

Changes in the levels of pituitary and steroid hormones in ovine and human ovarian follicular fluid

Changes in the protein and steroid hormones of follicular fluid, aspirated from different follicles of sheep and human ovaries, have been measured and correlated with the size of the follicles. As the fluid contains a number of proteins, steroids have been measured directly and after ether extraction. The follicular fluid concentrations of progesterone and 17 beta-oestradiol measured directly in the fluid increased with the size of the follicles. The levels of free testosterone remained constant in all sizes of follicles, while those of bound hormone showed a 10- to 15-fold increase over the free testosterone concentrations in both the sheep and human follicular fluid. A decrease in the levels of bound testosterone in the fluid of large follicles (LFFL) coincided with the increase in bound 17 beta-oestradiol, suggesting the possible conversion of bound testosterone to oestrogen as the follicle attained maturity. The ratio of follicle-stimulating hormone (FSH) to luteinizing hormone (LH) varied in the fluid obtained from different size follicles, being 1:7 in small (SFFL), 1.3.5 in medium (MFFL) and 1:2.3 in large (LFFL) follicles of sheep ovaries. The LH content of follicular fluid of different size follicles appeared to be the same, with LFFL showing a minor increase over SFFL. In the human, the fluid from medium follicles contained very little LH compared to LFFL. These differences in the pattern of LH levels present in the fluid from different size follicles between human and sheep ovaries presumably reflect species variations in the entry of LH into the follicles.     

In vivo EMG biofeedback in violin and viola pedagogy

In vivo EMG biofeedback was found to be an effective pedagogical tool for removing unwanted left-hand tension in nine violin and viola players. Improvement occurred rapidly and persisted throughout a 5-month follow-up period. Further studies will be necessary to assess the effect of biofeedback independent of placebo effects. The brevity of the method and the magnitude of improvement warrant further investigation.