We have analyzed the chromosome abnormalities found in 2,500 amniocenteses for prenatal diagnosis; 1,887 (75%) were performed because the maternal age was 34 years or more. Chromosome abnormalities were detected in 1.80% of those referred for advanced maternal age, 1.2% between ages 34 and 39 years and 4.6% 40 years and over. Of these, four occurred in women who would have been 34 years at delivery (2.9%). Trisomy 21 accounted for 50% of the chromosome abnormalities; sex chromosome abnormalities, for 25%; the remaining 25% was divided equally between trisomy 18 and partial trisomies and mosaics. Unexpected translocations were found in 0.4%, of which two-thirds were balanced and identified in one parent. The accuracy was 99.6%.

Gray-scale ultrasound was used to evaluate patients with primary hyperparathyroidism. Twenty-one of the 25 parathyroid glands shown pathologically and anatomically to be greater than 5 mm in diameter were identified and varied between 6 and 15 mm. Although the nosological sensitivity was poor, the false-positive rate was low. Important anatomical limitations and pitfalls are described. The role of ultrasonography is compared to that of other noninvasive diagnostic modalities and related to specific clinical situations and surgical approaches.

Clinical differentiation of the various pathological conditions which affect the scrotal contents can be difficult. The value of gray scale ultrasonography was assessed prospectively in 55 patients (110 testes) with specific clinical presentations and was compared to the reported results of other noninvasive imaging procedures. The homogeneous texture of the testes and the coarser pattern of the epididymal region were normally more clearly separable with gray scale signal processing. In this series, a clear differentiation of the origin of an abnormality was possible in 80% of the cases. A negative sonogram was highly reliable. However, the benefits of scrotal ultrasonography can only be evaluated after consideration of the clinical setting and alternative noninvasive diagnostic modalities.

Cholecystitis and cholelithiasis should be considered in the differential diagnosis of abdominal pain in children. Ultrasonography should be a primary screening test because it allows rapid evaluation of the gallbladder and identifies other possible causes of the symptomatology. The presence of a thickened gallbladder wall, cholelithiasis, or a nonvisualized gallbladder indicates gallbladder disease. Since acalculous cholecystitis is more common in children than it is in adults, it is particularly important to examine the gallbladder wall carefully for evidence of thickening.

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