A case of Schönlein-Henoch Purpura (SHP) in a 32 year-old female, showing gastrointestinal manifestations including acute vasculitic cholecystitis was reported. In the course of hospitalization urgent laparotomy was performed because of the severe abdominal pain. The gallbladder was inflamed with a brownish-red edematous wall and subserosal hemorrhage, and was resected. Histological examination of the resected gallbladder specimen revealed leucocytoclastic vasculitis. The patient was treated with prednisolone postoperatively, and symptoms abated over two weeks. Acute cholecystitis with SHP is extremely rare, and as far as the authors know this is the second case of this disorder documented by histological examination. Patients with acute abdomen associated with SHP should be managed with consideration of the complications of acute cholecystitis.

No abstract

No abstract

Weevaluated insulin resistance and assessed the effect of gliclazide on insulin resistance in a patient with diabetes mellitus associated with Turner's syndrome. Insulin-induced glucose metabolism markedly decreased compared with 12 healthy subjects. The insulin dose-response curve of this patient shifted to the right and down, and recovered somewhat after the administration of gliclazide. This patient had exhibited marked insulin resistance, which seemed to be caused by a defect at the receptor and/or post-receptor levels. Gliclazide reduced her insulin resistance, which suggests that this agent is suitable for treating the insulin resistance in diabetic patients with Turner's syndrome. (Internal Medicine 33: 560-563, 1994)

No abstract