Unexpected nature of a pelvic mass in pregnancy: Castleman's disease.

The obstetrician is rarely confronted with a pregnant patient who presents with a large suspicious pelvic mass. Diagnostic tools are not always of value and laparotomy may be performed for obstetric and histopathologic reasons. In this article we present an interesting case of an unusual pelvic mass in pregnancy secondary to benign lymphoepithelial disease (Castleman's disease). We could not find a case similar to the one reported in the medical literature.

Turkey: pressures on employment, housing, education and health care.

PIP: High population growth rates in Turkey have exacerbated problems in the areas of employment, education, housing, and medical care. Rural unemployment has caused widespread migration to major cities, resulting in a deterioration of living conditions in these centers and increasing the demand for municipal services. Since 1940 population increases have consumed most of the rise in national income and hindered economic development. Employment opportunities have not kept pace with the excess supply of labor caused by population growth, especially in the modern industrial sector. Despite overall progress in increasing literacy, educational imbalances persist between regions, rural and urban areas, and males and females. Women with at least a primary school education have an average of 2.5 children compared with 5.2 children among illiterate women. Historically, large families have been encouraged by the Turkish government. From 1927-80, Turkey's population increased 350% to 45 million and is expected to reach 65-70 million by the year 2000. 38% of the population is currently under the age of 15 years, a fact that has implications for future population trends and economic development. The 1965 Population Planning Law gave responsibility for carrying out the country's family planning services to the Ministry of Health and Social Welfare. A 1983 law legalized abortion, which had been a major cause of maternal mortality, up to 10 weeks or longer if there is a risk to the infant or mother. 1600 physicians and 6800 other health personnel have been trained to provide contraceptive services. By 1981, 4 million people had been educated in family planning and maternal-child health. As a result of all these measures, a marked decrease in fertility has been noted since 1965.^ieng