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Polycystic kidney disease represented by autosomal dominant polycystic kidney disease (ADPKD) and autosomal recessive polycystic kidney disease (ARPKD) have a major impact of mortality in children. We conducted a study of a premature infant with an estimated gestation date of 32 weeks with a presumptive prenatal diagnosis of right polycystic kidney. A 28-year-old primigravida with pre-eclampsia was admitted at the gynecology unit of Clinical Emergency County Hospital of Craiova. The clinical examination revealed a large abdominal distention due probably to the right polycystic kidney, suspected on prenatal ultrasound and radiography. The preterm neonate undergone right nephrectomy 5 days after birth. Histopathology of the kidney was performed in the Pathology Department of the Emergency County Hospital of Craiova and in the Center for Microscopic Morphology and Immunology of U.M.F. of Craiova. Microscopy revealed dilated cysts lined by simple cuboidal or flattened epithelium, and islets of remnant kidney parenchyma separated by edematous stroma. Immunohistochemistry for CD34 revealed incomplete blood arcades which did not seem to be in contact with all the tubular elements of the parenchyma, when compared to a control age-matched kidney. The patient had a favorable postoperative evolution, she was clinically stable on discharge from the hospital with a follow-up strategy including genetic testing.

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A comparison was made between the results of an analysis of humoral immunological changes in 64 cases of inflammatory diseases of the connective tissue of children (32 cases of ACJ, 5 cases of systemic lupus erythematosus, 2 cases of polymyositis, and 25 cases of systemic vasculitis), and data reported in recent literature, the authors conclude as follows:--changes of the immunological parameters that were tested support the hypothesis of a humoral immunopathogenic mechanism in systemic lupus erythematosus, in some of the manifestations of ACJ, and in systemic vasculitis;--of particular value for the immunological diagnosis of ACJ is the detection of FR in the patients' serum (and especially of FR from the IgG and the IgA class), as well as changes of immunological parameters of the articular fluid (the presence of FR, of immune complexes, a reduction of the titer intra-articular complement, the presence of ragocytes);--demonstration of humoral immunological changes (polyclonal hypergammaglobulinemia, the presence in the serum of circulating immune complexes, and of cryoglobulins, the low titer of serum complement in active stages, the presence of antinuclear antibodies, and especially of antinative DNA, the presence of LE cells in peripheral blood, and of a varied range of autoantibodies) is mandatory for the diagnosis of systemic lupus erythematosus;--in the present stage of our knowledge humoral immunologic changes are not an absolutely certified criterion for the diagnosis of polymyositis, and of some cases of systemic vasculitis (Henoch-Schoenlein purpura).

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Sclerosing of the gastric mucosa with a 60% fresh sterile solution of glucose was applied in 60 selected patients with chronic conflictual duodenal ulcers, hyperacidic gastritis by vagal neurogenic hyper-reactivity, associated with ischaemic gastropathy developed on an sympathico-adrenergic background. The immediate operatory results were good. The late results (between 1 and 5 years) were as follows: the clinical, radiological and metabolic results were good in 57 patients. Gastric chemical analysis, the values of the hourly basal output remained high in 16,6% of the patients, and those of acidity stimulated by histamine administration remained high in 13,3% of the patients. No peptic recidive was recorded. Unsatisfactory late results were noted in 3 patients (of which forced indication of the method in one patient and non-association of drainage in two patients).

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The variations of catecholamines, cortisol and aldosterone in mixed shock (traumatic, hemorrhagic and septic) were studied experimentally and clinically. In the stage of collapse adrenaline decreased by 81.4% and noradrenaline by 62.6% as compared with the preoperative values. These decreases were found to be directly proportional to the decrease of arterial blood pressure, pulse amplitude and diuresis as well as to the slowing down or even stop of microcirculation. The value of plasma cortisol increased in the stage of collapse by 98.3% and that of aldosterone by 66.27% as compared with the preoperative values. Treatment with a pharmacodynamic sympatheticolytic-vasopressor-adrenocortical mixture is recommanded when the blood pressure remains below 50--60 mm Hg for 1--2 hrs and when the treatment for the correction of hypovolemia with fluids and sympatheticolytics has failed. Clinically, this treatment gave good results in 34 of the 58 cases studied (58.6%).

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In cases with postoperative shock and collapse a constant fall in the concentration of serum cathecholamines was noted. Thus adrenalin was reduced by 77%, noradrenalin by 86.5%, in direct proportion with the fall in the blood pressure, of the pulse amplitude and with the slowing-down (or the arrest) of the microcirculation. The reduction of serum cathecholamines also coincided with a decrease in the amount of buffer bases and of the diuresis. The adrenocortical vasopresor sympathicolithic mixture is indicated in the prolonged arterial hypotension following failure of therapy aimed at filling of the vascular bed associated with the administration of sympathicolytic drugs.

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The authors statistic concerns 370 interventions for adenomatous polyps and rectocolic polyposis (105 segmental exereses, 32 total or sub-total rectocolectomies, 233 direct, endo-anal or laparocolotomy electroresections). The necessity is stressed of the early detection of isolated, or of multiple polyps, or of potentially malignant polyposis, either genetically inherited or acquired, and on their radical extirpation from the beginning, an attitude that improved late oncologic prognosis (98% survivals after 5 years).

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With reference to 6 cases of carcinoid tumours of the digestive tract the authors discuss the clinical aspects, emphasizing the utility of the paraclinical tests and the benefit of an early diagnosis, in the premetastatic phase, when surgery gives the best results.

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