[The management of acute complications in gastric cancer]

Forty-five acute complications (perforations and upper digestive hemorrhages) occurring in 650 admitted and operated gastric cancer patients were investigated. Despite all problems raised by these complication (gastric cancer, most commonly in advanced stages and invading the neighboring areas, the poor general condition of the patients, age-related deficiencies), the authors regard the removal of the complicated tumor and sometimes wide gastrectomy (the concomitant resection of gallbladder, spleen, atypical liver resection transverse colon resection) as the only solution for the complications, the postoperative complications and early recurrences of the complications as well as mortality rate being at the same time reduced.

[Splenic hydatid cyst]

The localization of hexacanth embryo at spleen level is quite rare, although, in frequency order, it is the third affected organ after liver and lung. The infestation of the spleen usually takes place by arterial route after the parasite has passed through the two other filters, hepatic and pulmonary. The retrograde venous route, which avoids the liver and lung, is also considered. The diagnosis of splenic echinococcosis is made with the clinical, epidemiological and laboratory findings. The treatment is surgical, consisting, most commonly, in splenectomy; the anastomoses of splenic hydatid cysts with the digestive tube are indicated only in those cases with peculiar evolutive forms; cystotomy, with removal of the content and drainage of the remnant cavity, surgery performed either on abdominal or lumbar route, is the method of choice in the suppurated cysts which fix, by adherences, the spleen to its lodge.

[A giant cancer of a gastric diverticulum]

An observation is presented, of a female patient aged 62 years with a large abdominal tumour. Clinical and para-clinical examinations could not establish the organic origin of the formation. Surgery disclosed a giant tumour developed in a gastric diverticulum situated under the cardia. The patient had suffered for a long time with gastric symptoms and her antecedents included upper digestive haemorrhage which was attributed to gastric ulcer according to radiological examination. In retrospect it was established that the disturbances were determined by a gastric diverticulum, complicated by haemorrhage and which later on had become malignant. In spite of its extraordinarily large size the tumour was removed by total gastric resection, in an attempt to treat radically the cancer.

[A pharmacodynamic investigation of the effect of polyholozidic substances extracted from Plantago sp. on the digestive tract]

From the leaves and seeds of some Plantago species (Plantago major, media, lanceolata) the polyholozidic fraction was separated. A statistically significant gastroprotective action was found both in the case of the polyholozide obtained from seeds and leaves in two experimental models. At higher doses a laxative action was also obtained.

[Voluminous malignant nonsecreting tumors of the adrenal cortex ruptured in thoracic-lumbar injuries]

Based on two cases of nonsecreting malignant adrenal tumors the authors make some clinical and therapeutical considerations. These tumors are rare, have a longer evolution without significant clinical manifestations, may reach considerable size and may become complicated, most frequently by intratumoral hemorrhages and necroses, which usually favour an infection, and more rarely by their rupture. The diagnosis is based on the clinical and laboratory findings. The treatment is surgical, associated with chemotherapy and radiotherapy. The survival interval is long, sometimes exceeding 10 years.

Quantitative determination of rheumatoid factors in serum and synovial liquid of patients with rheumatoid arthritis using lyophilized standard products

The rheumatoid factors constitute one of the major autoantibodies in rheumatoid arthritis (RA). In this study, for the quantitative determination of the RF IgM class, in serum and synovial liquid of patients with RA and JRA, we used the hemagglutination principle and both liquid and lyophilized reagents. The results we obtained demonstrated the superiority regarding the stability, the reproducibility and the possibility of micromethod standardization with lyophilized reagent.

[Cancer of the rectosigmoid junction]

The authors present a statistics on 32 cases of proctosigmoid junction cancer and discuss diagnostic and management aspects. This localization of the colorectal cancer has certain characteristic features, among which most important are its severe complications. The treatment of choice is the high anterior proctosigmoid resection with restoration of digestive passage, with or without colostomy. In the complicated cases the interventions will be performed in two or even three stages. Hartman's surgery is also indicated in the complicated cancers and in the compromised patients. The postoperative mortality remains high.

[Edentation of the 6-year molar tooth. Clinical aspects and treatment]

The problem of the 6 year molar tooth edentation has been approached from an unilateral point of view. The present paper deals with the complex factors that contribute to the onset and evolution of the 6 year molar tooth edentation. The group studied included 2000 subjects making it possible to establish the frequency of the affection in terms of age, general condition of the body environmental factors, caries prevention, out-patient follow up, previous dental treatment. The study continued with 100 cases of molar edentation without prostheses, establishing the clinical and complementary signs of the 6 year molar syndrome. Likewise discussed are the favourable elements and errors in the concept and treatment of previously applied prostheses. A complex treatment was applied in 50 cases of 6 year molar edentation showing the preprosthetic, proprosthetic and prosthetic treatment applied and certain therapeutical techniques applicable by the practitioner.

Uterine microcurettage with combined endometrial histopathology and cytology. An alternative to conventional curettage

A new disposable mechanical curette, the Inocurette, was used to obtain endometrial samples for histopathology and cytology. The instrument was tested on 120 patients; 37 patients were known from a previous conventional curettage (D & C) to have an endometrial cancer and 83 patients were referred to the County Hospital of Trelleborg for curettage because of dysfunctional bleedings. In all 120 patients a D & C followed the microcurettage procedure. The samples were randomized, coded and analyzed blind without any clinical information. In all but 3 patients with a known endometrial cancer, sufficient microcurettage sample material for either histopathology or cytology was obtained. In all but one of these 34 patients either a malignant diagnosis or seriously atypical cells were found. Using only cytology five out of 34 samples were designated adequate but normal. In a further 5 of the 37 patients the samples obtained at the subsequent D & C were inadequate for diagnosis; one sample was denoted as normal. In the 83 patients with dysfunctional bleedings, sufficient material for diagnosis after microcurettage, cytology and D & C was obtained in 74, 83 and 79 patients respectively. One endometrial cancer was disclosed by all three methods. Inocurette sampling causes little discomfort and requires no special training. The combined microcurettage--cytology procedure may be recommended as an alternative to conventional curettage, though, for the time being, D & C should not be replaced for cytology alone.