RESUMO
Right lower quadrant abdominal pain is a common presentation to the Emergency Department. While appendicitis is a frequently diagnosed pathology associated with this complaint, there are multiple, well-documented alternatives that must be considered. The authors present a unique case of a 20 year old active duty male who presented with 3 days of acutely worsening right lower quadrant abdominal pain, right flank pain, and anorexia. Following a detailed work-up, computed tomography and magnetic resonance imaging (MRI) demonstrated a bland thrombus within the inferior vena cava (IVC) secondary to a vascular web. This case highlights the difficulty in astutely diagnosing appendicitis utilizing clinical examination and scoring metrics. While IVC thrombosis is a rare phenomenon, it should be considered in the emergency physician's differential for right lower quadrant abdominal pain, particularly when additional nonspecific symptoms are present.
RESUMO
The genetic mechanisms underlying learning and memory remain mysterious, but many of the genes are likely to be expressed in the hippocampus, a region pivotal to this process. We used a 9,000 gene microarray to examine differences in hippocampal gene expression between two F1 hybrid mouse strains that perform well on the Morris water maze and two inbred strains that perform poorly. This resulted in identification of 27 differentially expressed genes, which could be used to place the F1 hybrid and inbred strains into separate clusters based on singular value decomposition. Most of the genes have unknown function, but those with known functions may provide clues to the molecular mechanisms of learning. Using multiple strains to narrow down the number of candidate genes should be a useful general approach to genome-wide studies of behavioral and other complex traits.
