[Unusual late complication after esophagoplasty type Gavriliu II for esophageal stenosis from chemical burns--cancer of the esophagoplasty tube]. / Complicatie tardiva rara dupa esofagoplastie tip Gavriliu II pentru stenoza esofagiana postcaustica--cancerul tubului de esofagoplastie.

We present the case of a 56 year old female, who in 23 years after esophagoplasty type Gavriliu II, with pre-sternal tube for esophageal chemical burn stenosis, develops a cancer in the upper third of the gastric tube, with a fast evolution to malnutrition, through lumen obturation. The evolution post-esophagoplasty was marked by malfunction of the neo-esophagus, characterized through dysphagia and distal dilatation, requiring many abdominal and pre-sternal reinterventions. The objective of the present surgical intervention was to assure a way for enteral nutrition (gastrostomy for feeding) and to extirpate the gastro-esophagoplasty tube. It is discussed the characteristic feature of the case: the difficulty of the stage-evolutive integration of this malignant disease location, the etiopathogenic factors that contributed to the malignant evolution of the antral portion of the gastro-esophagoplasty tube, the limits of the surgical treatment.

[Coloesophagoplasty, a choice operation for postcaustic esophageal stenosis]. / Coloesofagoplastia, interventie de electie pentru tratamentul chirurgical al stenozelor esofagiene postcaustice.

OBJECTIVE: To evaluate the problems of approach, of technique and of care as a 20 years experience demonstrates. MATERIAL AND METHOD: a retrospective study including 45 operated cases where the large-bowel served as reconstructive material (in 33 cases the transverse colon and in 12 cases right ileocolon). RESULTS: Healing was obtained in 42 patients. Early postoperative evolution presented: peritonitis caused by anastomotic leakages--2 cases, hemoperitoneum--2 cases, cervical fistula --1 case, wound infection--6 cases, evisceration--1 case, acute respiratory failure--6 cases. Cervical anastomosis reconstruction for late stenosis--1 case. There were 2 postoperative deaths by haemorrhagic shock and peritonitis--mortality 4.4. DISCUSSIONS: Reconstruction by using the large-bowel was justified through anatomic argumentation (sufficient vascular supply), technic argumentation (easy anastomosis, tension free, short time of execution), functional argumentation (good compliance of large-bowel to the new function). CONCLUSION: Coloesophagoplasty is an efficient method on the condition of a strict planning: continent gastrostomy and evolvement of vascular arcades due to previous vascular "carving".

[Therapeutic management of neoplastic occlusions of the colon]. / Atitudinea terapeutica in ocluziile neoplazice ale colonului

The authors present their experience in 39 cases of occlusions occuring in a number of 142 neoplasies of the colon hospitalized between 1965 and 1973. The major attention was given to the treatment of the occluding complication. In cases where the occlusions are due to neoplasies of the right colon, right hemicolectomy should be carriet out in preference, while in cases with neoplastic occlusions of the left colon the attitude will be differentiated. The authors are not partisans of the emergency left hemicolectomy.

Histochemical and enzymatic study of the thyroid nodule.

Twenty-four cases of uninodular and polynodular thyreopathy subjected to partial or total thyroidectomy in 1980--1981 were studied. At the same time with the general morphological study, the activity of the following cellular enzymes in the thyroidian tissue were assayed: lactic dehydrogenase (LDH), glutamic oxalacetate transaminase (GOT), glutamic pyruvate transaminase (CPT) and creatine phosphokinase (CPK). Correlations between the morphophysiopathology of the thyroid nodule and its enzymatic activity have been made.

Investigation of thermic transition and renaturation of high polymerized DNA extracted from thyroid nodule.

The study was carried out on 16 cases of mixed thyroid hypertrophy in which total or partial thyroidectomy was performed. Fragments collected intraoperatively from the thyroid nodule were used for extraction of high polymerized DNA. At the same time with quantitative evaluation of DNA, RNA and proteins were also assayed. The thermic transition mean temperature of the DNA extracted from the thyroid nodule is compared to other standards (DNA-HP-standard, calf thymus DNA, normal leukocytic DNA) and the thermic transition curves are presented. Hyperchromicity after thermic denaturation and renaturation is analysed and expressed in per cent values.

[Pleuropulmonary diffusion in some subdiaphragmatic suppurations]. / Difuziunea pleuropulmonara în unele supuratii subdiafragmatice

Two cases are presented of subphrenic suppurations (right perinephretic phlegmon and suppurated hepatic hydatic cyst), that developed fistulae in the lung and the pleura. The evolutive modalities are discussed the diagnostic difficulties and the corresponding therapeutic attitudes.