Plasma D-lactate levels in diagnosis of appendicitis.

We investigated the possible use of D-lactate as a predictor in the diagnosis of appendicitis. C-reactive protein level (CRP) and leukocyte counts were also evaluated. Venous blood D-lactate, CRP, and leukocyte counts were measured preoperatively in 53 patients undergoing surgery for appendicitis, as well as in 20 healthy subjects. Levels of all three parameters in the surgical patients were significantly higher than in the control group (p <.05). Previous studies have shown that venous D-lactate is more specific to the intestine than CPR or leukocyte count. Based on our data, venous D-lactate, which had the lowest false-negative rate among these laboratory parameters, may be a useful diagnostic marker for appendicitis. None of these parameters were helpful in identifying the type of the appendicitis.     

Isolated idiopathic ovarian vein thrombosis: a rare case

This article describes the case of a 36-year-old woman who presented with a 2-day history of abdominal pain and nausea. Laboratory investigations revealed no abnormalities. Ovarian vein thrombosis was detected on ultrasound examination, and computed tomography of the pelvis and abdomen confirmed this finding. The patient was placed on anticoagulant therapy with unfractionated heparin and warfarin. Within 40 days her thrombosis improved. Laboratory testing for coagulation disorder revealed nothing abnormal. Ovarian vein thrombosis must be recognized and treated early to reduce the risk of serious complications. This case of idiopathic ovarian vein thrombosis underlines the importance of including this condition in the list of differential diagnoses for abdominal pain.     

Characteristics of Polycystic Ovarian Syndrome and Relationship with Ghrelin in Adolescents

ObjectiveSome points of pathogenesis in polycystic ovarian syndrome (PCOS) are still unknown. In this study we evaluated the characteristics of this disease and its relationship with ghrelin in adolescence.DesignA prospective case control study was designed. Four groups: obese PCOS (n = 13), lean PCOS (n = 13), obese control (n = 10) and lean control (n = 10) were formed. Oral glucose tolerance tests (OGTT) were performed on all subjects. Laboratory and clinical features of groups were compared.SettingUniversity pediatric endocrinology clinic.ParticipantsAdolescents with PCOS.InterventionsNone.Main Outcome MeasuresInsulin resistance, ghrelin, delta ghrelin (difference of ghrelin between basal and 120^th minute after OGTT), androgensResultsInsulin resistance ratios were 93.3%, 46.6%, 50% in obese PCOS, lean PCOS and obese controls respectively. Ghrelin levels were lower in obese PCOS group but statistically different only between obese and lean PCOS groups. Ghrelin was correlated negatively with HOMA-IR (P < 0.001), 17 OH progesterone (P = 0.05), total (P = 0.015) and free testosterone (P = 0.013). Ghrelin suppression was blunted in PCOS groups. Ghrelin suppression ratios after glucose load were 24.4%, 28.7%, 36%, 35% obese PCOS, lean PCOS, obese control and lean control groups respectively.ConclusionLow ghrelin levels in obese PCOS patients, correlations between insulin resistance, androgens and ghrelin, blunted suppression of ghrelin after glucose load in PCOS have been considered as evidences of ghrelin role in pathogenesis of this syndrome.     

Levamisole: Might It Be used in Treatment and Prevention of Atopic Diseases?

As an antihelmintic and Th₁-biased immunostimulant, levamisole has been used to restore impaired cell mediated immunity. We sought to explore whether the Th₁ driving effect of levamisole may also have an influence on the course of allergic diseases, by shifting the Th₂ dominant immunity more toward Th₁-mediated response. BALB/c mice were sensitized intraperitoneally on days 0, 7, and 15 with ovalbumin (OVA). After the sensitization, they were challenged intranasally with OVA once a day for 6 consecutive days. Levamisole (2.5 mg/kg) was administered orally three times a week during sensitization and challenge. After the last challenge, differential cell counts were performed, and IL-4 and IFNγ levels were measured in the bronchoalveolar lavage fluids (BALF). Serum total IgE level was determined, and lungs were examined histologically. The present study establishes that mice administered with oral levamisole gave significantly lower IL-4 levels on sensitization with OVA; however, IFNγ production, eosinophil infiltration, and serum IgE levels remained unaffected. In conclusion, use of levamisole may have important implications in the management of the allergic inflammation.     

An unusual localization of massive portasystemic collaterals: CT angiographic demonstration

This article presents a patient with portal hypertension in whom an unusual localization for portosystemic collaterals have incidentally been found. Upper abdominal sonography revealed tubular structures filling the whole perirenal and partially the perihepatic area, and their venous nature was demonstrated with duplex Doppler sonography. Spiral CT angiography identified the right-sided retroperitoneal location and mesenteric–lumbar route of the collaterals. Upper gastrointestinal endoscopy with antral biopsy and percutaneous liver biopsy were performed. Laboratory results and specimen evaluation revealed chronic active hepatitis due to hepatitis-B infection. Attention is drawn to the abnormal location of these vessels, together with the noninvasive nature and competence of CT angiography in demonstrating vascular pathologies. Received 19 February 1997; Revision received 9 May 1997; Accepted 5 June 1997     

Salpingitis isthmica nodosa in infertility and ectopic pregnancy.

Excised tubal segments from 94 infertile women with tubal obstruction, with a mean infertility duration of 5.3 years, and 40 women with ectopic tubal pregnancy were studied histopathologically to evaluate the association with salpingitis isthmica nodosa (SIN). The mean age of the 94 infertile women with tubal obstruction was 24.5 years. Hysterosalpingographies and laparoscopy were performed on all of them. Only the women with ectopic pregnancies we performed salpingectomy on were included in the present study. The incidence of SIN in women with tubal obstruction was 7.4%, in women with ectopic tubal pregnancy 10%, and in the control group the incidence was 0.2%. In 60% of the cases, SIN was present in both of the tubes. Based on this study, we conclude that SIN is significantly associated with infertility and ectopic tubal pregnancy.     

Antiproliferative activity of pentadeca-(8E, 13Z) dien-11-yn-2-one and (E)-1,8-pentadecadiene from Echinacea pallida (Nutt.) Nutt. roots

Several species of Echinacea, a perennial plant which belongs to the Asteraceae family, possess medicinal properties and are currently used in phytotherapy. In the present study, antiproliferative activity of methanol extract and isolated structures of pentadeca-(8E, 13Z)-dien-11-yn-2-one 1 and (E)-1,8-pentadecadiene 2 from Echinacea pallida roots on C6 cells (Rat Brain tumor cells) and HeLa cells (human uterus carcinoma) was investigated in vitro. Antiproliferative effect of the extract, isolated compounds, and cisplatin were tested at 5, 10, 20, 30, 40, 50, 75, and 100 μg ml^?1 using BrdU Cell Proliferation ELISA. The methanol extract and Compound 1 significantly inhibited proliferation of HeLa and C6 cancer cell lines.