most cases of mediumchain acylcoa dehydrogenase deficiency escape detection in france dna from 414 french blood donors from the paris area was assessed for the a985g mutation responsible for most cases of autosomal recessive mediumchain acylcoa dehydrogenase mcad deficiency the mutant gene frequency averaged 1140 predicting a frequency of mutant homozygotes of 119 000 discrepancy between the numbers of expected 42 per year and recorded cases of mcad 6 per year suggests that most mcaddeficient patients escape detection in france real time ultrasonic evaluation of the paediatric abdomen technique and anatomical variations a personal view most of the paediatric abdomen can be evaluated ultrasonically by a realtime subcostal approach a basic technique is given using four standard sites the anatomy that is visualised at these sites is described in simple detail the major differences between adults and children are listed problems of recognition between normal and paediatric variations are commented on and size measurements of various organs at different ages are tabulated