Biliary sludge and recurrent ketoacidosis: a case report

A five year old boy, weighing 14 kg with no family history of diabetes, presented in frank diabetic ketoacidosis. He recovered, but continued to have episodes of ketoacidosis. He was diagnosed to have biliary sludge, which recovered with insulin treatment

Laparoscopy in the context of lower abdominal pain in young women

The management of lower abdominal pain in young women carries up to 45% chance of diagnostic error. Laparoscopic management may be particularly beneficial in this subset of patients. This study reviews the authors’ experience with laparoscopy as a potential diagnostic and therapeutic tool in young women with lower abdominal pain. The authors analyzed 121 consecutive female patients, with a mean age of 30 years, who were evaluated from June 1995 to October 1997. All patients were managed by early laparoscopy within 24 h from the onset of symptoms. Radiographic imaging, including computed tomography and ultrasound, was performed in 79 patients (65.2%). Laparoscopy was diagnostic in all cases. In 58 patients (48%), multiple pathologic conditions were identified. Acute appendicitis was the most common diagnosis (82.6%), and benign gynecologic disorders was the predominant reason for multiple pathologic conditions (clinical evaluation was erroneous in 15% of patients). In 96% of patients, definite surgical treatment was provided laparoscopically. The mean hospitalization time was 2.0 +/- 1 days, and the mean operative time was 59.8 +/- 21 min. The overall complication rate was 2.5%. In young women, early laparoscopy can offer a safe and effective alternative for the definite diagnosis and treatment of lower abdominal pain

Stress through handling for vaginal screening, serotonin, and ACTH response to ether

The effect of duration of handling for vaginal smear screening on the adrenal weight and acute ACTH response to ether were examined in 4-day-cycling female rats, sacrificed at 97-103 days of age on diestrus-2 after evaluation of resistance to handling, thymus weight, and hypothalamic serotonin (5-HT) and 5-hydroxyindoleacetic acid (5-HIAA). Prolonged handling paralleled increased resistance (behavioral response) to handling and adrenal weight but was inversely related to thymus weight. The hypothalamic 5-HT, 5-HIAA, and 5-HIAA/5-HT ratio, compared to controls with similar conditions of handling, were not modified after 2.5 min of ether despite the ACTH rise. In ether-stressed rats, the ACTH response to ether was lower after prolonged handling compared to short handling paralleling decreased thymus weight. In contrast, 5-HT, 5-HIAA, and the 5-HIAA/5-HT ratio were higher, paralleling increased resistance and adrenal weight. The results suggest chronic activation of the hypothalamo-pituitary-adrenal axis with positive serotonergic involvement after prolonged handling and resistance during vaginal screening and a negative implication of this activation on the acute ACTH response to ether

Effect of green tea on angiogenesis and severity of atherosclerosis in cholesterol-fed rabbit

Background and Aims: Since the development of the atherosclerotic plaque requires the growth of new microvessels in the plaque itself (vasa vasorum), we postulated that green tea may exert an anti-atherogenic effect. Methods and results: Thirteen male New Zealand white rabbits were studied for 17 weeks. All rabbits were fed an hypecholesterolemic diet. After 2 weeks of adaptation rabbits were randomly assigned into two groups. Animals in Group A were fed the hypercholesterolemic diet and received plain tap water ad libitum. Animals in Group B were fed with the same diet and furthermore received 2.5% (g/g) green tea for 17 weeks. Conclusion: According to our results the atherosclerotic lesions were more severe in Group B than in Group A specimens. Also, the number of VEGF positively stained foam cells and smooth muscle cells of Group B were significantly greater than in Group A. About 30% less plaque was found in Group A than in the control group (Group B). So, our study showed that the consumption of green tea leads to a reduction of atherosclerosis as well as a significant decrease of VEGF expression in the atherosclerotic plaque of rabbit aorta. The hypothesis that probably green tea may produce its anti-atherogenetic effect through an anti-angiogenetic mechanism needs more investigation. © 2006 Elsevier Inc. All rights reserved