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Maternal diabetes is one of the most common and dangerous risk factors during pregnancy, as often there are no generalized signs. Diabetic fetopathy is a severe, poorly defined complication of gestational diabetes or preexisting maternal diabetes mellitus, with an ill-defined histological spectrum of changes. Herein we report a case of severe diabetic fetopathy diagnosed upon autopsy of a recently miscarried fetus. On histology, the liver revealed severe generalized macrovesicular steatosis and number of small cysts. The pancreas revealed not only Langerhans isle hyperplasia, but also Langerhans amyloidosis, evident of the severity of maternal diabetes and fetal hyperglycemia. The adrenal glands revealed hyperplasia in zona glomerulosa, due to aldosterone overproduction, evident of fetal hypertension. The current case is an extreme example of an undiagnosed and untreated gestational diabetes mellitus. The severity of histological changes, in this case, is suggestive of further extension of the diagnostic criteria of diabetic fetopathy to include more subtle changes that can be observed clinically and even a combination of maternal-newborn factors.

В кардиологична клиника постъпва 70-годишна жена с гръдна болка. Ангинозният характер на болката, наличните ЕКГ промени и дискинезия на сърдечния връх насочват към остър коронарен синдром. Проведената коронарна ангиография не установява промени в епикардните съдове. След няколко дни настъпва пълно възстановяване на кинетиката. Приета е диагноза стрес-индуцирана кардиомиопатия.

AIM: The human laryngeal complex has been an endoscopic sight since the late 19th century, however despite the technological advances little has changed in the standard observational methodology, with optical distortion of the image being a major setback in all endoscopic studies. The aim of this study is to evaluate different endoscopes and image correction algorithms in the endoscopic imaging of the laryngeal complex. METHODS AND MATERIALS: Conventional rigid 00, 300, 700 and 900 endoscopes and a flexible otorhinolaryngoscope with two-dimensional imaging capabilities, a digital camera and a direct laryngoscope were used together with an intubation mannequin to obtain endoscopic images of the laryngeal complex. Images of a custom made lens distortion grid were taken to compare the different optical systems and used as a benchmark for image correction. Both sets of images were superimposed in order to digitally correct for angle and lens distortion and to show the true size and proportions of the human laryngeal complex, so far seen only during an intubation or autopsy. RESULTS: After comparing the fiber optic and rigid endoscope obtained images, the rigid endoscopes proved to have better imaging qualities and therefore a better potential for future in depth study of laryngeal anatomy. The rigid 700 endoscope, compared to other rigid systems, allowed for an atraumatic perpendicular to the glottis view of the laryngeal complex, best suited for the study, despite the higher image distortion. CONCLUSION: Based on the collected data the 700 rigid otorhinolaryngoscope together with a standard software correction is an affordable, atraumatic and reliable method for anatomical and proportionate measuring of the human laryngeal complex in a model study.