Hemorrhoids: a plea for nonsurgical treatment

There are numerous different forms of treatment for hemorrhoids. Conservative therapy with suppositories and stool softeners is usually effective. However, many patients still come to surgery and it is u nuclear which of the many methods of active treatment should be used. Surgery is still widely performed, but other possible methods include injection therapy, elastic band ligation, cryosurgery, anal dilatation and lateral subcutaneous sphincterotomy. The scanty literature on comparative controlled trials of these methods is reviewed. These studies indicate that formal hemorrhoidectomy should rarely be necessary, as results of elastic band ligation and anal dilatation compare very favorably with surgery. It is suggested that elastic band ligation and anal dilatation are very effective forms of treatment in patients not responding to conservative therapy.

The diagnosis and management of hyperparathyroidism during pregnancy

Hyperparathyroidism during pregnancy is rare and very few cases have undergone parathyroidectomy during the course of gestation. In reviewing the literature it is apparent that surgery during the second trimester should be the treatment of choice. The complication rate of untreated cases may reach 80% and include spontaneous abortion, fetal death and neonatal tetany. The paper is illustrated with appropriate cases.

Inflammatory fibroid polyp of sigmoid colon

A case of inflammatory fibroid polyp of the sigmoid colon is presented. This is the eight case of this type of polyp in the colon and, to the best of our knowledge, the first one involving the sigmoid and producing intussusception. Symptomatology of the inflamed fibroid polyp in this part of the gut closely simulates gastrointestinal malignancy. The treatment is surgical excision of the polyp, or colonoscopic resection when it is possible. Intraoperative colonoscopy helps the surgeon to localize the lesion and to role out the existence of other lesions.

Traumatic rupture of a left-sided liver and postoperative acute respiratory failure in a patient with Kartagener's syndrome

A case is described of abdominal trauma and rupture of a left-sided liver in a patient with Kartagener's syndrome (situs inversus, bronchiectasis, sinusits). Exploratory laparotomy, left thoractomy, cholecystectomy and hepatic artery ligation were necessary to control hemorrhage. Special attention was paid to the patient's respiratory condition postoperatively via physiotherapy and analgesia. The importance of identifying this three-part syndrome and especially the bronchiectasis is emphasized.

Finite Elastic Deformation for a Class of Soft Biological Tissues

The stress response of soft biological tissues is investigated theoretically. The treatment follows the approach of Wu and Yao [1] and is now extended for a broad class of soft tissues. The theory accounts for the anisotropy due to the presence of fibers and also allows for the stretching of fibers under load. As an application of the theory, a precise form for the strain energy function is proposed. This form is then shown to describe the mechanical behavior of annulus fibrosus satisfactorily. The constants in the strain energy function have also been approximately determined from only a uniaxial tension test.

Post-thrombotic leg ulcer and its surgical treatment

The post-thrombotic syndrome is a complex disease to whose development at least three factors contribute: (1) incompetence of the venous valvular system; (2) opening of the local arteriovenous shunts; and (3) disturbances in the lymphatic system. Our surgical treatment considers all three factors by providing: (1) stripping of the saphenous veins; (2) wide excision of the ulcerated region with the fascia, followed by immediate skin graft; and (3) large excision of subcutaneous tissue and fascia. Of fifty-one patients with chronic post-thrombic leg ulcers operated on according to these principles, only one had recurrence, a recurrence rate of only 0.5%. This compares favorably with other published results.