Testicular relapse after chemotherapy for malignant teratoma.

She was followed up regularly for almost two years and showed no signs of relapse. She stopped taking antithyroid drugs several times and suffered brief relapses of hyperthyroidism, but without any psychosis. Comment Hyperthyroidism commonly presents with mental changes such as irritability and anxiety, but psychotic symptoms like hallucination and delusion are rare. The review by Ellis and Mellsop shows that de C1erambault's syndrome is also rare. Our case satisfied all the criteria of the syndrome, but it did not run a chronic course. The prognosis of the primary disorder is generally poor,23 but in this case of secondary erotomania the outcome was good. Asphyxiation by a child's dummy All dummies sold in the United Kingdom conform to British Standard 5239. We report a case in which a dummy caused asphyxia in an 8 month old boy. Case report An 8 month old boy, who had used a dummy for seven months, presented with cyanosis but was still making some respiratory effort. The flange of a dummy was wedged behind the posterior tonsillar pillar, and there was a small amount of intraoral blood. The handle (ring) of the dummy was missing, having broken off at the hinge adjacent to the flange. Intraoral digital pressure on one side of the flange caused it to pivot, its edge was gripped with a towel clip, and the dummy was extracted. Suction removed the oropharyngeal blood, and he cried and became pink. He was given oxygen by facemask. His chest was clear on auscultation, and an x ray film four hours after admission showed no swelling of the soft tissue in the upper airway. Observation for 24 hours was uneventful. Before presentation he had often had part of his dummy's flange in his mouth, behind either the upper lip or the superior alveolar ridge. Occasionally only the ring would be visible out of his mouth. This time cyanosis was noted when odd gurgling sounds alerted his parents. The ring, still visible between his lips, moved gradually further into his mouth as if he were swallowing it. His father attempted to remove the dummy by grasping the ring and pulling. The ring detached at the flange, which filled out most of his mouth so his father could not extract it. The ambulance crew, attempting digital removal by inverting the child and using the Heimlich manoeuvre, failed to dislodge it. He was given oxygen, and oral …