Urine changing from clear to milky-white.

After sedation with propofol a young man developed milky-white urine. Urinalysis showed a high concentration of uric acid crystals as being responsible. This phenomenon appears to be dose-dependent and is explained in this report.

Papillary carcinoma in struma ovarii: an unusual presentation.

Struma ovarii is the presence of thyroid tissue as the major cellular component in an ovarian tumour. Papillary carcinoma in struma ovarii is exceptionally rare. We report a case of papillary carcinoma in struma ovarii in a postmenopausal 51-year-old female who initially presented clinically with hyperthyroidism.

[Melena associated with a Brunner's adenoma].

A 68-year-old woman presented at the Casualty Department due to collapse, anaemia, fatigue and progressive dyspnoea. She suffered from melena, indicative of a haemorrhage in the upper gastrointestinal tract. Gastroduodenoscopy revealed the presence of a polyp in the duodenum, which was endoscopically resected.

[A man with a classic serious milk-alkali syndrome and a carcinoma of the stomach].

A 42-year-old man was transferred to the Emergency Department after his friends had found him unresponsive and confused in his room. He had been experiencing upper abdominal complaints for a period of several months. He had taken large amounts of a calcium carbonate/magnesium subcarbonate preparation (Rennie) and had consumed at least 3 litres of dairy products per day.

[Abdominal pain following placement of an endoprosthesis in the biliary duct].

A 76-year-old man presented with diffuse progressive abdominal pain. He had undergone endoscopic retrograde pancreaticocholangiography (ERCP) 5 weeks earlier for jaundice and increased levels of liver enzymes. A dilated biliary duct with multiple concrements had been seen, and a plastic endoprosthesis was placed.

[Inhaled insulin: a new route in the optimisation of glucose regulation].

The lungs constitute an attractive route for the administration of insulin in view of their large surface area and the permeability for proteins. Inhaled insulin may greatly reduce the daily nuisance of subcutaneous injections for millions of patients. The acceptance of insulin therapy may therefore be increased, so that better metabolic control can be achieved.