was made e i t h e r d i d n o t s u r v i v e g e s t a t i o n or t h e i n i t-i a l neonatal p e r i o d due t o i n t e r r u p t i o n of t h e pregnancy or i n t r a p a r t u m demise. GA a t d i a g n o s i s v a r i e d f r o m 2 6 t o 3 8 w k s w i t h a m e a n of 3 1 wks. Age a t d e l i v e r y v a r i e d from 32 t o 4 0 wks with a mean of 36 wks. Four of t h e s e c h i l d r e n had myelomeningocoele, 6 had hydrocephalus without o t h e r anomalies, t h r e e had i n t r a c r a n i a l c y s t s , and one had an encephalocoele. A l l of them underwent v e n t r i c u l o-p e r i t o n e a 1 shunting. Five had shunt r e l a t e d i n f e c t i o n s. S i x had Bayley mental or Stanford-Binet s c o r e s >80 (4 3 %) , 2 had s c o r e s between 65 and 80 (1 4 %) , and 6 had s c o r e s <65 (4 3 %). The poorer outcome of t h i s group i n com-p a r i s o n t o o t h e r s e r i e s of such hydrocephalus may r e l a t e both t o t h e e a r l y s t a g e a t which t h e d i a g n o s i s was made such t h a t c h i l d r e n with more s e v e r e con-d i t i o n s have survived and t h e high r a t e of i n f e c t i o n. EIOGENIC AMINE METABOLISM IN RETT'S SYNDROME, Huda. P e d i a t r i c s & Neurology, Houston, Texas. R e t t ' s Syndrome i s a progressive d i s o r d e r i n females charac-t e r i z e d by a u t i s t i c behavior, dementia, a t a x i a , l o s s of purpose-f u l use of t h e hands and s e i z u r e s. Extensive laboratory i n v e s t i-g a t i o n s a r e usually normal with t h e exception of electroenceph-alography. To d a t e no biochemical abnormalities have been reported. In an attempt t o f i n d a lead t o t h e pathogenesis of t h i s syndrome we assayed biogenic amine metabolites i n t h e cerebrospinal f l u i d (CSF) of s i x p a t i e n t s , age 2-15 y e a r s , with R e t t ' s Syndrome. The following metabolites were assayed and compared t o age matched controls: 3-methoxy-4-hydroxyphenyl-ethyleneglycol (MHPG) , homovani 11 i c acid (HVA) and 5-hydroxy-indole a c e t i c a c i d (5-HIAA). Results a r e a s follows: Mean + S.D. (nglml). MHPG HVA 5-HIAA P a t i e n t s 7.81t1.49 64.70i26.5 23.83t6.25 Controls 12.35t0.64 110.23+25.83 32.07+8.26 p-val ue 0.0005 0.0008 0.004 Thus, norepinephrine, dopamine, and serotonin metabolites a r e s i g n i f i c a n t l y reduced i n t h e CSF of p a t i e n t s with R e t t ' s Syndrome. This may provide new i n s i g h t i n t o t h e pathogenesis and f u t u r e t h e r a p e u t i c i n t e r v e n t i o n i n t h e s e p a t i e n t s. DIAcs.IOSIS OF GSEBRAL ATROPHY I N WFANTS BY THE NEAR-F I m. MErHOD: A m TECHNIQUE IN CRPNIAZl SONOC,RAPIN ' 671 by Asma Q. fischer, Medical College of Georgia, Dept. of Neurolcqy, Augusta, Georgia Cerebral atrophy in infants has been difficult to assess by cranial sonogram (CS) because the subarachnoid space has been a "blind spot" by ultrasound, yet CS is an ideal imaging methcd for infants as it is portable, non-radiative and unlike c q u t e d cranial tam-qraphy (CCT), requires no intra...

Inaccuracies in total intmuterine volumes calculated using the prolate el~ lipse equation have been reported. No previous study has examined all the sources of error. In this study, a comprehensive approach was undertaken. Measurements were obtained from scans of the pregnant uterus in the prone position using an automated water-path scanner (Octoson) and in the supine position using standard static B-mode scanners. Several conclusions could be drawn : 1) From the Octoson prone scans, uterine volumes obtained using the prolate ellipse formula were markedly different from the true uterine volumes obtained by the summation of stepped areas. This showed that the prolate ellipse formula was inaccurate. 2) From the static supine scans, many observer inconsistencies were found in uterine volumes obtained from the prolate ellipse formula. This made the prolate ellipse formula unreliable. 3) Previously published graphs calculated from the prolate ellipse equation, comparing fetal age with total intrauterine volume, were found to vary accuracy, presumably as a result of 1 and 2. A more accurate approach is proposed. Using the outer uterine wall as the boundary, the stepped areato-volume values of transverse scans taken at 3-cm intervals were found to closely approximate true volumes, with an average error ofonly 3.5 per cent. Since these measurements encompass the intrauterine contents and the myometrium , it is suggested that the term •'total uterine volume'" be used instead of "total intrauterine volume."

Seven cases of heterozygous achondroplasia were examined in utero. Although the head shape and growth were normal, the initially normal femur length showed a decrease in growth and fell below the lower 99 per cent confidence limit in all cases. The time of presentation of achondroplasia varied between 21 and 27 gestational weeks. This study suggests that the diagnosis of achondroplasia can be reasonably made when the femur is abnormally short. When the femoral length is appropriate prior to 30 weeks, more caution should be taken in interpretation. Because of the variability in presentation, the fetus could be normal or still could be affected.

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Thirty-six examples of inflammatory and neoplastic disease of the scrotum were evaluated with ultrasound. Analysis of the images suggests that sonographic differentiation of these conditions is possible in certain instances. The ability to separate testicular from extratesticular pathology is quite accurate. In some cases, neoplastic disease of the testis can be differentiated from malignancy, although surgical intervention is often required for diagnosis.