CSF ascites: a rare complication of ventriculoperitoneal shunt surgery.

CSF ascites is a very rare complication of ventriculoperitoneal (VP) shunt procedure. No definite explanation has been offered for the inability of the peritoneum to absorb the CSF. Two children who underwent VP shunting for hydrocephalus, presented with ascites 3 (1/2) years and 4 months respectively, after the shunt was placed. The treatment of choice is conversion of the VP shunt to a ventriculoatrial shunt.

Isoproterenol infusion--an alternative to exercise testing.

Isoproterenol, as an exercise simulating agent, was evaluated in twenty subjects, ten normal volunteers and ten with Coronary Artery Disease (CAD). Both groups were evaluated using 0.5 ug increments of intravenous infusion of isoproterenol every 3 minutes with computerised ECG (Marquette Electronics--MAC PC) monitoring. The normal volunteers did not have significant ST segment depression even at heart rates of 130 BPM. The CAD groups showed diagnostic ischaemic ST segment depression at heart rates below 130 BPM. None of the subjects had any serious complications during or after the test. Isoproterenol infusion is a better alternative to exercise testing.

Acid inhibiton in insulin test- a preliminary report.

The initial suppression of acid secretion in Insulin Test has been a subject of various interpretaitons. A study of hypothalamic recordings in a patient undergoing sedative neurosurgery for behaviour disorders revealed marked suppression of electrical activity in the lateral hypothalamic nucleus within three minutes after the injection of insulin, followed later by spike formation corresponding to parasympathetic stimulation, when hypoglycaemia is established. It appears that the initial suppression of acid secretion is due to a direct action of insulin, suppressing electrical activities of lateral nucleus, the spike formation occurring later, corresponding to onset of hypoglycaemia with stimulation of the nucleus and consequently gastric secretion.