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Background: The abdominal wall is the commonest site of extrapelvic endometriosis, which usually develops in association with a prior surgical scar. Case: A 28-year-old woman with two endometriomas in the recti abdominis, which developed in a scarless abdomen. Conclusions: Abdominal wall endometrioma can develop spontaneously in the absence of prior surgical scar and should be considered in the differential diagnosis of abdominal wall masses.

In a review of 5424 colonoscopies performed in the last ten years at Bronx-Lebanon Hospital Center, 14 perforations related to the procedure were found. Seven perforations occurred during therapeutic colonoscopies (polypectomies) and seven during diagnostic colonoscopies. Eight patients were treated surgically and six nonsurgically. The decision about whether or not to perform surgery for a colonoscopically induced perforation depends on the clinical condition of the patient. Nonsurgical management is indicated if the patient's general condition remains stable, if the perforation has been diagnosed late, if the pneumoperitoneum that led to the diagnosis does not increase in size, if there are no signs of peritonitis, if the patient does not have a distal obstruction, and if the patient's condition improves in response to conservative treatment.

Serum C-reactive protein was measured in 56 patients hospitalized with a suspected diagnosis of acute appendicitis. Based on these determinations, four groups of patients were defined: Group A = 26 patients with acute appendicitis who had a C-reactive protein level higher than 2.5 mg/dl. Group B = 4 patients with a C-reactive protein level lower than 2.5 mg/dl who, after surgery based on a presumed diagnosis of acute appendicitis, were found to have a normal appendix. Group C = 22 patients with nonspecific abdominal pain, 18 (72 percent) of whom had an elevated C-reactive protein level, although in only 4 (7.1 percent) were these levels higher than 2.5 percent mg/dl. Group D = 4 patients who had diseases other than acute appendicitis. It is concluded that an increase in C-reactive protein levels to more than 2.5 mg/dl is not a definite indicator of acute appendicitis. However, if the C-reactive protein level in blood drawn 12 hours after the onset of symptoms is less than 2.5 mg/dl, acute appendicitis can be excluded.

A close relationship between pulmonary ventilation and blood flow exists in the normal functioning of the lungs. Thus, primary alterations in one of these processes are difficult to distinguish from secondary changes in the other. In order to study these two functions in the intact animal, we have separated them by utilizing a technique which allows us to induce alterations in pulmonary blood flow while keeping ventilation constant in rate and tidal volume. This report describes changes observed in the pulmonary circulation and respiratory gas exchange of dogs in whom blood flow was decreased by hemorrhage and then restored by blood replacement.Studies on experimental animals and human subjects have indicated that all pulmonary vessels are not open at the same time (1), and that the pulmonary circulation is able to accommodate a marked increase in blood flow with little rise in the pulmonary arterial blood pressure (2-7). An increase in blood flow, then, must be accompanied by a decrease in vascular resistance, presumably due to expansion of the pulmonary bed. However, the mechanisms by which such accommodation occurs have not been fully elucidated, and questions remain as to the relative importance of physical forces, the effectiveness of vasomotor control and the significance of local pressor and chemo-reflexes. Moreover, only fragmentary