The activity of the sympathetic nervous system and plasma norepinephrine and endothelin levels are increased during mental stress only in offspring of hypertensive parents, whereas the response to hypoxia was similar in offspring of hypertensive and normotensive parents, suggesting a genetically determined abnormal regulation of the sympathetic nervous system to certain stressful stimuli in offspring of hypertensive parents. This may play a role in the pathogenesis of essential hypertension.

IntroductionMost underlying diseases for abdominal pain in children are not dangerous. However some require rapid diagnosis and treatment, such as acute ovarian torsion or appendicitis. Since reaching a diagnosis can be difficult, and delayed treatment of potentially dangerous diseases might have significant consequences, exploratory laparoscopy is a diagnostic and therapeutic option for patients who have unclear and potentially hazardous abdominal diseases. Here we describe a case where the anomaly could not be identified using a laparoscopy in an adolescent girl with acute abdomen.Case presentationA 13-year old postmenarchal caucasian female presented with an acute abdomen. Emergency sonography could not exclude ovarian torsion. Accurate diagnosis and treatment were achieved only after an initial laparoscopy followed by a laparotomy and after a magnetic resonance imaging scan a further laparotomy. The underlying disease was hematometra of the right uterine horn in a uterus didelphys in conjunction with an imperforate right cervix.ConclusionThis report demonstrates that the usual approach for patients with acute abdominal pain may not be sufficient in emergency situations.

Introduction Four cases of sagittal synostosis combined with ossified cephalhematoma prompted the authors to present the data and to discuss the implications. Large cephalhematoma of the vertex at birth with subsequent ossification occurred in all with final sizes of 6.5-10 by 4.0-5.5 by 0.8-1.8 cm. At surgery with 2-6 months, the mean skull index was 64.75, sagittal suture completely closed, and a disfiguring bony mass present in all. Discussion In three of the original cohort of 106 sagittal synostoses, ossified cephalhematoma was removed in one piece together with the suture. In contrast to pathogenesis of common parietal cephalhematomas, cephalhematoma in sagittal synostosis is rather induced by periosteal detachment of the midline by strong shearing forces because molding is hindered in the lateral direction. Frequent and fast complete ossification is possibly directed by the same local factors (e.g., Noggin) which lead to premature fusion of cranial sutures. Some treatment principles of ossified cephalhematoma in sagittal synostosis may be applied to surgery of common types.