Objective To compare the sonographic findings of the nasal bone in fetuses with trisomy 21 with pathomorphological findings to determine whether the bone is truly absent.Methods Seventeen first-trimester fetuses with trisomy 21 were identified; the median gestational age was 12 weeks (range, 11-14) and the median maternal age was 38 (range, 27-47) 'present' and 'absent', but instead between 'normal' and 'hypoplastic'. For reproducible results it is necessary to standardize the sonographic examination. The sonographic landmarks of the fetal nose are: the nasal bone, the skin above and the cartilaginous tip of the nose.

Tumoral calcinosis is a very rare benign soft tissue calcification. It occurs in all age-groups and prefers the shoulder, hip and elbow region as localisation. In most cases, local pain is the leading symptom. The aetiology remains unclear, so far, however, a certain connection to an imbalance of the calcium-/phosphate homeostasis is proposed. The adequate therapy is the complete surgical removal. Our presented case describes an extended occurrence at an unusual localisation and discusses characteristic signs in contrast of the differential diagnoses.

Peritoneal serous papillary carcinoma is a rare primary tumor of the peritoneum. We report here a case diagnosed by laparoscopy, and summarize the clinicopathological features previously reported in patients with this tumor. Laparoscopy was performed in a 66-year-old woman with high-protein ascites and a three-month history of lower abdominal pain. Macroscopically, the parietal and visceral peritoneum was studded with prominent white nodules up to 5 mm in diameter. Multiple biopsies revealed a tubulopapillary serous adenocarcinoma. After exclusion of metastatic peritoneal carcinomatosis (especially ovarian cancer) and malignant mesothelioma, the diagnosis of peritoneal serous papillary carcinoma was established. The patient was placed on chemotherapy (first-line: 5-fluorouracil, adriamycin, and mitomycin C; second-line: paclitaxel). She died 22 months after diagnosis. The present case is also remarkable for the coexistence of granulomatous peritonitis overshadowing the malignant nature of the process. This case report emphasizes the importance of laparoscopy with multiple biopsies in the workup of undetermined exudative ascites.

The author's study of 74 pregnancies where an IUD had been inserted was unable to find any tangible reason for the failure of the contraceptive in 40 cases. In 26 cases, dislocation of the spiral was established, while in eight cases anatomical changes were presumed to be the reason for conception. Of the 154 "spiral pregnancies" recorded in Upper Austria in the study period (1984-1985), 92 (i.e., 77.3% of the 119 intact intrauterine pregnancies) culminated in termination, while there were 35 extrauterine pregnancies (22.7%). Of the remaining 27 pregnancies which went to term, there was not a single case of septic complication in the mother or of abnormality in the child. In the author's opinion this argument would seem to present a well-founded challenge to the widespread view that, for the sake of the mother or the fetus, termination is to be recommended if an IUD has been inserted.

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