Esophageal porto-caval anasthomosis. Critical view of the hypothesis of F.C. Carvalho.

The apparition and the breakage of esophageal varices et the level of cardioesophageal junction in the portal hypertension still represents a problem of pathological surgery. The presence of these varicose dilatations in this region is due to an important zone of porto-caval anastomoses. Angioarhitectonical study of lower abdominal esophagus represents a disputed problem in the specialty literature. The hypothesis of south American anatomist F. C. Carvalho (1966) looks to be the best model that could explain the appear of cardioesophageal varices. Studies realized in the past within the Anatomy Department of Medicine "Carol Davila" Bucharest tried to demonstrate the validity of Carvalho's theory, and the results of these researches are exposed in the present paper.

Hepatocellular carcinoma among cirrhotics--utility of screening and surveillance programs--review article.

Screening of known cirrhotics for hepatocellular cancer (HCC) has long been a contentious topic. Studies to date have failed to conclusively prove or disprove the validity of α-fetoprotein (AFP) and hepatic ultrasound as screening mechanisms for HCC among cirrhotics. It is not clear whether these screening mechanisms provide any benefit in terms of reduced morbidity and mortality. Screening for HCC among cirrhotics by using AFP and/or imaging at every 6 months correlate with HCC diagnosis, thus portending better treatment options and an improved prognosis. Screening all the known cirrhotics for HCC may lead to decreased mortality.

[Cajal interstitial cells identification]. / Identificarea celulelor interstitiale Cajal si plasarea lor in contextul structural al peretelui intestinal.

Cajal interstitial cells are cells that are found in the abdominal digestive system wall, between neurons and smooth muscular tissue. They are considered to be pacemakers for slow intestinal waves. The paper discuss about the electron-microscopic identification of Cajal interstitial cells in the rat small intestine wall, cell morphology, placement of these cells in the muscular layer and the relation between Cajal interstitial cells and the components of the nervous plexus. Fragments of rat small intestine have been prepared for electron microscopy examination. Cajal interstitial cells have been found in different locations: in the circular muscular layer, around the nervous nodes and between the muscular layers (longitudinal and circular). The main morphologic characteristic of these cells is the aspect of cytoplasm, with numerous vacuoles and long extensions, some of them very thin, with a tendency to divide. Some Cajal interstitial cells form a network that surrounds the nervous nodes. Other form junctions with the muscular cells and with the interstitial neurons.

[The psycho-relational aspects of the psychopathological dynamics and profile in postpartum mental disorders in the county of Iasi in 1988-1993]. / Unele aspecte psiho-relationale ale dinamicii si profilului psihopatologic ale tulburarilor psihice postpartum din judetul Iasi, în perioada 1988-1993.

642 cases of mental disorder occurring or aggravating during the evolution of a pregnancy or postpartum assisted at the "Socola" University Hospital of Psychiatry in the interval 1988-1993 were analyzed. In 91 (38.39%) of these cases the postpartum mental disorders occurred in the absence of a psychotic psychiatric history. Based on a computerized record, the psycho-social factors with a potential pathologic risk were analyzed dynamically. The influence of social dynamics on the incidence and psychopathologic profile of mental disturbances with onset in the postpartum was evidenced, a somewhat paradoxical correlation of the frequency of these disorders with the dynamics of abortions and not with that of deliveries being underlined. Characteristic to these patients would be a lower education level, a more labile biological and psychological structure, the absence of obstetrical history and marital relational problems. An increased incidence of some postnatal complications in the evolution of these women' newborns was also found.

[Small renal cell carcinoma- an update and management]. / Cancerul renal de mici dimensiuni--actualitati si management.

The detection of small renal cell carcinomas has increased after the introduction of ultrasonography (US) and computed tomography (CT) in the current practice. Their early detection has been extremely important for therapy and prognosis but has opened new diagnostic problems including differential diagnosis, surgical or non-surgical management and imaging follow-up. Small renal carcinomas can be either solitary or multiple, synchronous or metachronous. A synthetic review of incidence, clinical findings, imaging modalities and differential diagnosis of the small renal cell carcinoma will be presented.

[Correlations between the type of distribution of the branches of the inferior mesenteric artery and the aspect of the mesocolon]. / Corelatiile dintre tipurile de distributie a colateralelor arterei mezenterice inferioare si aspectul mezoului.

Emergence pattern of inferior mesenteric artery (IMA) branches leaded to description of 6 types of arterial distribution, each of them being correlated with a certain mesocolon aspect. The height of mesosigmoid depends on coalescence pattern and grade, and has a particular importance in terminal colic and retroperitoneal viscera's surgery. For each of the 6 types of distribution are described different ways of differential ligatures, for elongation and descending the colon, initially establishing the predominant collateral trunks. For practicing these ligatures we have to take count of preoperative paraclinic investigations, general and particular haemodynamic conditions and some intraoperatory parameters.