[Severe arterial hypertension due to chronic constitutional hyperadrenalism. Splanchnic sympathectomy and left adrenal medulla sclerosis with 40 percent sodium salicylate (result after 3 years--genetic chemosurgery)]. / Hipertensiunea arteriala severa prin hiperadrenalinism cronic constitutional. Spanhnicosimpatectomie si meduloscleroza suprarenala stînga cu salicilat de sodiu 40% (rezultat dupa 3 ani--chimiochirurgie genetica).

The case is presented of a male patient hospitalized for severe arterial hypertension determined by chronic constitutional hyperadrenalism. Splanchnic-sympathectomy was performed, associated to medullar sclerosis of the left adrenal with 40% sodium salicylate (genetic chemical surgery). The results after 3 years were good, both clinically and paraclinically. The constitutional background was normo-hypoadrenergic and the ecologic balance of the patient became normal after surgery.

[Chemical medullosclerosis with 40-percent sodium salicylate, combined with splanchnicosympathectomy, with or without contralateral adrenalectomy, in severe essential arterial hypertension. II. Clinical, paraclinical and technical studies. Results for a period of 2 to 20 years (original concepts and therapy)]. / Meduloscleroza chimica cu salicilat de sodiu 40%, asociata cu splanhnicosimpatectomie, cu sau fara suprarenalectomie contralaterala, în hipertensiunea arteriala esentiala severa (partea a II-a).

Unilateral medullosclerosis associated with splanchnicosympathectomy was applied in 60 cases of severe essential arterial hypertension. In 21 patients this was associated with contralateral adrenalectomy. No deaths were recorded. The late results (2 to 20 years) varied in terms of the anatomoclinical stage of the disease when surgery was performed. Systolic pressures fell to 30-50 mm Hg, hypertensive oscillations disappeared, mean adrenalinaemia values decreased by 47.9% after unilateral medullosclerosis and slanchnicosympathectomy and by 72.2% after bilateral interventions in two stage. The constitutional hyperadrenergic psychosomatic background was modified and became normohypoadrenergic. There was no case of adrenocortical insufficiency, the secretion of corticoids being insured by activity of the hexose-6-mono-phosphate dehydrogenase shunt.

[Treatment of duodenal stress ulcer by means of chemical sclerosis of the gastric mucosa induced with a 60 percent glucose solution (results after 1--5 years)]. / Tratamentul ulcerului duodenal de conflict prin scleroza chimica a mucoasei gastrice cu o solutie de glucoza 60% (rezultate la 1--5 ani).

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).

[Role of the adrenal medulla in reaction of the body to stress (clinical and laboratory studies and experimental research)]. / Rolul medularci glandelor suprarenale in reactivitatea organismului la stresuri (studii clinice, de laborator si cercetari experimentale).

The authors have carried out a clinical study of acute medico-surgical complications occuring in patients hospitalized following psychical stress, myocardial infarction, operatory shock and after the earthquake. In patients with duodenal ulcers and hyperacidity due to vagal neurogenic origins it was noted the presence of a sympatico-adrenergic constitutional background in 38% of the cases. By applying chemical sclerosis of the adrenals medullary the role of the medullary was demonstrated in the production of acute digestive lesions due to stress, as a result of standard electrical stimulus and of their influence on the bioelectrical reactivity of the brain, on the active learning behaviour by conditioned reaction and on the number of the circulating eosinophils following injections of A.C.T.H.

[Surgical shock. Acute hypocatecholaminemia and therapeutic indications of an adrenocortical vasopressor sympathicolytic drug mixture. Clinical studies and experimental research]. / Socul operator, Hipocatecolaminemia acuta si indicatiile terapeutice ale amestecului farmacologic simpaticolitic vasopresor adrenocortical. Studii clinice si cercetari experimentale.

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.

[Polyps; rectocolic polyposis. Etiopathogenic and anatomoclinical data. Results]. / Polipi; polipoza rectocolica. Date etiopatogenice si anatomoclinice. Rezultate.

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).

Medullosclerosis, contralateral adrenalectomy and splanchnicosympathectomy in severe essential arterial hypertension and thromboangiitis. Part II.

Operations were performed in 58 patients with severe essential hypertension and in 105 patients with Buerger's thromboangiitis. No postoperative deaths were recorded. The mean adrenalinemia value decreased by 70.91% and that of noradrenalinemia by 10.34%. Systolic pressure decreased by about 30--50 mm Hg and the diastolic pressure by 10--30 mm Hg. The delayed results (1--20 years) were good in 62% of the patients with IIIrd-degree eye lesions and in 17% of the patients in the organofunctional stage II, in 17% of the patients in stage II--III of restricted necrosis, and in 4% of the patients in gangrenous stage III.

[Treatment of duodenal ulcer with chemical sclerosis of the gastric mucosa. Preliminary results]. / Tratamentul ulcerului duodenal prin scleroza chimica a mucoasei gastrice. Rezultate preliminare

On the basis of experimental studies and of the results obtained, the authors have applied over the last two years, sclerosis of the gastric mucosa with fresh, sterile solution of hypertonic (66%) glucose in 25 patients with duodenal ulcers and cellular and vagal hyperacidity resistant to medical therapy. Mucosclerosis was associated with gastric drainage in 14 patients with duodenal ulcer complicated by stenosis or hemmorhage. Sclerosis of the gastric mucosa is a physiological intervention because it achieves the sclero-atrophy of the acid-secreting glands and vago-sympatic denervation in the gastric territory, while the storage function of the stomach is maintained. It was not followed by extra-gastric disturbances or antro-pyloric distonia. It is easy to perform from the technical viewpoint and has a high degree of fiability, providing constantly satisfactory clinical, functional and metabolic results. Chemical values of basal secretion have decreased in a constant manner but in 9 patients the values of induced acidity showed inconstant decreases. Gastro-antro-pyloro-duodenal transit was good and all operated patients have gained weight. No diarrhea, dumping or peptic recidives were noted.