Objective To compare the efficacy of tocolysis with specific regimens of nifedipine and ritodrine. Maternal side effects and neonatal outcome also were evaluated. Design A prospective, randomised trial. Subjects Seventy‐one women, including 11 with twin pregnancies, who had uterine contractions and observed cervical changes. Main outcome measures Prolongation of pregnancy for 48 h, seven days and until 36 weeks of pregnancy were evaluated for each treatment. Maternal side effects and haemodynamic changes were compared, as well as neonatal outcomes. Results Delivery was delayed for 48 h, seven days, and until the 36th week of gestation in 83%, 67%, and 50%, respectively, of women in the nifedipine group, compared with 77%, 63% and 43%, respectively, of women in the ritodrine group (no significant difference). Maternal side effects were significantly less common in the nifedipine group (27%) than in the ritodrine group (77%) (P <0.001). The neonatal outcome was similar in the two groups. The fall in mean arterial and diastolic blood pressure, and the rise in maternal heart rate were significantly greater in the women who received ritodrine compared with those treated with nifedipine. Conclusions Nifedipine is as effective as ritodrine in suppressing preterm labour. Its use is associated with less frequent side effects.

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LAUTERIO, THOMAS J., MICHAEL J. DAVIES, MARK DEANGELO, MICHAEL PEYSER, AND JAMES LEE. Neuropeptide Y expression and endogenous leptin concentrations in a dietary model of obesity. Obes Res. 1999;7: 498-505. Objective: To determine how leptin concentrations and neuropeptide (NPY) are regulated in a model of dietary obesity in relation to relative growth (RG) and relative food consumption (RFC). Research Methods and Procedures: Sprague-Dawley rats were fed a moderately high-fat diet for 14 weeks over which time animals diverged into obesity-prone (OP) and obesityresistant (OR) populations. RG rates and RFC were calculated weekly. Following the study, an adiposity index was calculated and arcuate nucleus (ARC) NPY expression was determined by in situ hybridization (ISH) or ribonuclease protection (RPA) assays. Results: Body weights were greater in OP rats after 2 weeks on the diet compared to OR rats and remained different throughout the study. RG and RFC were greater in OP rats compared to OR rats only during the first 2 weeks of the study. Leptin concentrations rose in both groups during the experiment, but the increase was greater in OP rats than in OR rats. Insulin changes paralleled those for leptin. ARC NPY mRNA expression was not different between OP and OR rats as measured by ISH and RPA. Discussion: Although NPY expression has been reported to be different initially in OP and OR rats, this difference dissipates following divergence of body weight. RFC and RG data suggest the initial NPY elevation may contribute to increased weight gain of OP rats during the first 2 weeks of the diet. Higher relative leptin concentrations in OP rats may be necessary to normalize differences in adiposity and apparent leptin and insulin resistance of OP rats.

Congenital malignant tumours are rare. Neuroblastoma is the most common solid tumour, accounting for about 30-50 per cent of tumours evident during the neonatal period. A case of metastatic, rapidly growing neuroblastoma, diagnosed prenatally by ultrasound at 32 weeks' gestation, is presented.