[When to prescribe scintigraphy in the exploration of thyroid nodules?]. / Cand prescriem scintigrama tiroidiana în explorarea nodulilor tiroidieni?

Scintigraphy is employed almost systematically in current medical practice for initial thyroid nodules investigation. More and more authors observed that scintigraphy has lost importance confronted with others modern exam, but there are no statistical essay to demonstrate this fact. The aim of our work was to study, on 369 patients, the real contribution of scintigraphy to establish diagnosis and therapeutical strategy. Scintigraphy was truly useful only in 47 (12.7%) patients. We may conclude that thyroid scintigraphy ought to be indicated only in low TSH thyroid nodules, ectopic goiter and, eventually, in metastasis uptake radioactive iodine.

[Surgical treatment of thyroid nodules. The immediate results after different thyroidectomy methods]. / Tratamentul chirurgical al nodulilor tiroidieni. Rezultate imediate dupa diferite tipuri de tiroidectomie.

The extension of the resection for thyroid nodules depends both on nodules' nature and immediate or late postoperative complications risks. This clinical study analyzed the immediate complications appeared after partial thyroidectomy comparatively with those developed after total thyroidectomy. We studied 1411 patients operated in two clinics (from Romania and from France) which have two different attitudes concerning the width of the resection. Paralysis of recurrent laryngeal nerve occurred in 1.0% of patients with partial thyroidectomy and 3.0% of patients with total thyroidectomy, while only one patient (0.6%) developed permanent hypoparathyroidism after total thyroidectomy. In conclusion, total thyroidectomy can be performed by experimented surgeons with a recurrent or parathyroid injury risk similar to partial thyroidectomy. However, the surgeon should take into account the patient survey capacity and the discomfort produced by life substitutive treatment.

[Treatment of hernias and eventrations with alloplastic material (Mersilene type mesh)]. / Cura herniilor si eventratiilor cu material aloplastic (plasa tip Mersilene).

Between 1973 and 1979 the authors have performed 126 interventions, as follows: 27 hernias (18 of the inguinal type and 9 umbilical ones), and 99 eventration. They used alloplastic materials for consolidation or substitution of the musculo-aponevrotic wall of mediocre quality. In practice the "Mersilene" alloplastic material was used, made of dacron fibers, which provides a series of advantages: good tolerance, efficient sterilisation without undergoing degradation, possibility for use in reparation of large wall defects, high resistance. The net was applied for consolidation purposes in most of the cases (111 in all), and was placed either above the aponevrosis, or pre- or intra-peritoneally. In 15 patients it was used for substitution, when eventration resulted in a large muscular-aponevrotic defect. The results were very good, and a single recidive was noted, as well as two partial rejections, that did not however result in recidives.

[De-epidermized free skin graft in the treatment of eventrations and hernias]. / Grefa de piele libera dezepidermizata în tratamentul eventratiilor si herniilor.

The study investigated the efficiency of the non-epidermic free skin graft in the treatment of eventration and of hernia. It includes an experimental and a clinical stage. The experimental study investigated the biological integration of the autograft and of histological changes that take place. The authors attempted to determine the optimal site for the insertion of the graft between the parietal anatomic layers, as well as to evaluate their role as a prosthesis. The experiments demonstrated a perfect integration of the dermal auto-graft, as well as the new solidity that it will impart to the wall. The non-epidermic free skin graft was used over a period of 15 years (1964--1978) in a total of 134 patients. The use of the dermic graft is simple from the technical viewpoint, and the post-operative morbidity is not significant. A retrospective clinical study was carried out in 62 patients over a period of 1 to 12 years. Only two relapses were noted (3,2 percent of the total). In the remaining cases the abdominal wall was very solid and there was no sign of eventration.

[Therapy of lithiasis of the main biliary passages]. / Terapia litiazei caii biliare principale.

On the basis of a total of 3692 surgical interventions performed on biliary pathways, of which 431 (11,6%) for lithiasis of the hepato-choledocus, the authors discuss the indications, the limitations and the results of surgical treatment in this affection. The postoperative death rate was 10,3% in the first 10 years of the period during which these interventions have been performed and decreased to 5,5% in the last 10 years. The late results were good and very good in 85% of the cases. In view of the continuing decrease in the death rate after surgery, and for improving late results, the authors stress the necessity of early interventions in the lithiasis of main biliary pathways. They also stress the correct exploration of the hepato-choledocus in the course of all surgical intervention upon the biliary pathways.

[Thyroid radiography and thyroid lymphography]. / Tiroidografia si tiroidolimfografia.

A detailed representation is made of the technique used in the performance of thyroidography and an analysis is carried out of the authors' personal experience Thyroidography and thyroido-limphography have been applied in 40 patients with various diseases of the thyroid gland. The authors evaluate the method as being simple to perform, accessible, well tolerated and capable to provide significant morphological data (size of the lobes, the presence of retrosternal thyroid tissue, structure of the gland), also allowing for visualization of the cervical limph-nodes.

[Limits of hemodilution in the treatment of hemorrhagic shock]. / Limitele hemodilutiei în tratamentul socului hemoragic

Clinical analysis of 168 cases of hemorrhagic shock of the 230 cases of hemorrhage and injuries admitted to the 2nd Surgical Clinic of Timisora between 1970 and 1973, showed that the administration of blood substitutes (crystalloid and colloid solutions) may be extended with good results in the management of hemorrhagic shock up to a hematocrit of 20%, respectively 7 g Hb. This treatment implies a careful selection of the cases, based upon objective criteria (listed in the text), so that the none administration of blood should not involve any risks. Even in the cases in which blood tranfusion is indispensable, hemodilution reduces to a great extent the amount of blood required.