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Submucosal tumors of the colon are rare and require alertness on the part of the physician for early diagnosis. These tumors may not cause symptoms before attaining large size. In most cases the clinical histories are atypical. Because of the possibility of malignancy, adequate diagnosis and treatment are necessary. This report deals with 25 cases of submucosal tumors of the colon. The tumor series included seven leiomyomas, one granular-cell myoblastoma, two leiomyosarcomas, seven carcinoid tumors, six lipomas, one lymphangioma, and one neurofibroma. Five of the tumors were asymptomatic. The endoscopic appearances of the tumors, although not diagnostic, may give some indications as to their natures. Endoscopic removal is possible, although it is indicated for high-risk patients only. Because submucosal tumors may be malignant, and because differentiation from secondary tumors (metastases) or tumor-like lesions is difficult without histologic examination, complete removal of the tumor is the treatment of choice.

A case report of a patient suffering from diffuse leiomyosarcomatosis of the gastrointestinal tract is presented. The endoscopic features of the lesions localized in the stomach, the small bowel and the colon are compared with the radiological data. A description of the pathology of these polypoid lesions is given. The origin of this widespread leiomyosarcomatosis of the gastrointestinal system is discussed.

A randomized trial comparing the efficacy of BICAP electrocoagulation and YAG laser photocoagulation was carried out in 100 patients presenting at endoscopy with peptic ulcer and a spurting or oozing vessel or a nonbleeding vessel. Fifty patients were enrolled in each treatment group. All lesions were pretreated with injection of epinephrine 1:10,000. Subsequently, 1-sec pulses of 80 watt YAG laser power were applied to the vessel or 1- to 2-sec pulses of electrocoagulation of 25 watt BICAP at a setting of 10. The 10 F BICAP probe was always used. Definitive hemostasis after one treatment amounted to 72% in both the laser and in the BICAP group. After two sessions the cumulative success rate was 88% in the laser group and 86% in the BICAP group. Emergency surgery and mortality were also comparable. One perforation occurred in each treatment group and both patients were operated upon without complications. It is concluded that both YAG laser and BICAP are highly and equally effective in the treatment of severe bleeding from peptic ulcers. This study stresses the importance of repeated treatment sessions in order to obtain optimal results.

In order to evaluate the frequency of ileitis in a population of patients with spondylarthropathy, an ileocolonoscopy with biopsies was performed in 88 consecutive patients with back pain and/or asymmetric oligoarthritis. Ileitis was more frequent in both the oligoarthritis group (7/36), especially in the non-Reiter's subgroup without known distant infection (5/17), and in the spondylitis group (12/28), when compared to the control group (1/24). This was statistically significant only in the latter group (chi squared 10.317, df1, p less than 0.005). These results do not confirm the very high frequency of ileitis in oligoarthritis reported by others. The clinical significance of this ileitis needs further research.

An analysis as to etiology and complaints of 486 cases of male sexual impotence was performed and is presented. Psychological factors are dominant in 68%. Physico-organic or iatrogenic causes accounted for deviations in 26% of the patients examined. Educational factors took an important part mainly in ejaculation disturbances. Primary anejaculation as a consequence of educational flaws occurred in 15% of the patients. Erection disturbances were often the consequence of physico-organic affections. The loss of libido was a real complaint in 19% of the patients.

The functional characteristics of rat liver mitochondria after cryopreservation with and without the addition of the cryoprotectant dimethyl sulfoxide (Me2SO) were evaluated. As criteria of functional integrity, polarographic measurements of substrate-linked oxygen consumption and luminescent assay of adenosine triphosphate (ATP) synthesis were considered before and after cryopreservation. The results demonstrated that mitochondrial damage after freezing was indicated by the polarographic studies but was not evident when ATP synthesis was considered. Me2SO present during cryopreservation was partially protective for mitochondrial substrate-linked oxygen consumption; however, simple exposure to and dilution from Me2SO effected some changes in mitochondrial function.

The clinical, radiological, and endoscopic aspects of Yersinia enterocolitica infections in man were studied in a group of 37 adult patients observed in a 4-year period in a single gastrointestinal unit. The diagnosis was based on isolation of the bacterium in all but 1 patient. Abdominal pain and diarrhea were the most prominent symptoms, occurring in 80% of the patients. A syndrome simulating appendicitis was observed in 40%. The duration of symptoms before diagnosis varied from 1 or 2 weeks in 32 patients to several months in 5. On radiological examination the terminal ileum was involved over a distance of 10 to 20 cm in 21 of 24 patients. A coarse, irregular, or nodular mucosal pattern and pictures suggestive of ulcerations were the most prominent and early radiological signs. Endoscopic observations in 13 patients with marked diarrhea showed signs of colitis in 6 and aphthoid ulcers in 2 patients. On pathological examination, ulcerations and a nonspecific acute inflammatory cell infiltrate were observed. Although treatment with tetracycline or chloramphenicol resulted in 4 to 6 weeks in the disappearance of most symptoms and signs, pictures of "follicular ileitis" persisted for several months.

Endoscopic laser therapy (ELT) for palliation of cancer of the esophagus and the gastroesophageal junction was evaluated in 31 patients with far advanced disease. Initial technical success (94%) and initial improvement of symptoms (81%) were comparable to data reported previously. Complications were bleeding (6%), sepsis (6%), and tracheoesophageal fistula (6%). This analysis, however, addressed the impact of ELT on the remaining life of the patients. In 9 patients (29%) ELT was the only palliative alternative, and in 7 of these patients a fair functional success was achieved. In 13/21 (63%) of the patients with good initial functional result palliation could be preserved by repeated ELT until death from cachexia. Eight patients, however, were intubated in the follow-up period because of failure to keep the esophagus open. The dysphagia-free interval was only 4 weeks, and repeated ELT became progressively more difficult because of increased tumor load and increasing debility of the patient. 32% of the patients experienced ELT as more difficult than repeated dilations. Our data also suggest that duration of palliation after ELT alone lasts longer than palliation after dilation followed by ELT. Results of ELT were best in patients with recurrent cancer at the esophagogastric or esophagojejunal anastomosis.