Receptors for IgA on human thymus cells in myasthenia gravis.

Specific surface receptors for the Fc region of human immunoglobulin A (Fc alpha R) were identified on the thymus cells of all 15 patients affected by myasthenia gravis. A large variation of the percentage of Fc alpha R bearing thymus cells was recorded (9 . 5-66 .

[Complications of colonic diverticulitis [apropos of 22 cases)].

After establishing the nosologic frame of the notions of diverticulosis, diverticulitis and the complications of the latter the authors make an analysis of 22 cases with complications of colic diverticulitis, and stress the frequency of this complication in the aged. Ten of the complication consisted in haemorrhagia, 8 were perforations and 4 were obstructive. The authors establish the attitude which should be adopted when confronted with confirmed diverticulitis, and make an analysis of each type of complication from the viewpoint of the diagnosis and of the therapeutic attitude.

[Intrahepatic lithiasis (considerations on 20 cases)].

The authors present an analysis of 20 cases with intrahepatic lithiasis, stressing the possibility of the development of lithiasis inside the liver as a result of either metabolic disturbances (one case), or secondary to congenital obstacles (2 cases), or following surgery (3 cases). In the remaining 12 cases intrahepatic lithiasis was secondary to lithiasis in the hepato-choledocus canal through a mechanism of ascending obstruction - identified in 5 cases -,or it was due to ascending migration of calculi (in 7 cases). The diagnosis is made with the aid of good quality intra-surgery cholangiographia.

[Duodenal ulcer and a short common bile duct. Significance of duodenocholedochal reflux].

In connection with 8 cases of congenital short choledochus, associated with duodenal ulcers, of which 5 were diagnosed before surgery on the basis of duodeno-choledociab barium reflux, the authors review the data in the literature, confronted to their own experience. The frequency and the functional consequences are discussed, of the congenital short choledochus, the relationships of the papilla with the ulcerative lesion depending on the variants of the papilla, and the topography of the ulcers, the problems of diagnosis raised by the duodeno-biliary barium reflex, the preoperative complementary investigations, the intra-operative exploration, as well as the elements of operative tactics and techniques. The importance of intravenous cholangiography is stressed, on a routine basis in ulcerous patients, as well as the usefulness of intraoperative cholangiography in difficult cases of duodenal ulcers, that have a close relationship with them main biliary pathway.

[Sacrococcygeal teratoma in the adult].

Problems of diagnosis, classification, and histologic definition, as well as possibilities of evolution are discussed, of teratomas or of tumours resulting from the disturbed development of the sacro-coccygeal area, in connection with a case of recidivating sacro-coccygeal teratoma in a woman aged 40 years. The therapeutic principles are also discussed The risk of malignant degeneration of these lesions, in parallel with their evolution in time, make necessary surgical exeresis immediately after making the diagnosis. Surgery should be performed with a maximum amount of comfort, under general anesthesia, preferably in the Kraske position, in view of the complete extirpation of pathological tissues.

[The Hartmann type of operation].

In spite of the contemporary progresses in the field of surgical therapies, of the use of antibiotics, and of resuscitation techniques, resection of the colon with closure of the distal end and terminal colostomy, as suggested by Hartmann at the start of the century, has still some indications. Moreover, beside the original indications, this type of intervention can also be aplied in the case of some other benign lesions, and extension of the colon resection may involve other areas beside the recto-sigmoid zone. The specific indications of the intervention are the severe, very extensive and usually complicated lesions of the colon, frequently associated with a general biologic deterioration, conditions that make highly improbably the success of other surgical procedures.