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Capillaroscopic pictures regarding situations of surgical interest are presented. Apart from the purely symptomatological parameter, an attempt is made to interpret the pictures, with reservations.

The most recent reports on the subject of "Hard to interpret or exceptional pneumopathies. Errors in pneumological symptomatology. Surprises at the operating table" are discussed. Attention is called to innovations in radiological and isotopic technique and to new possibilities for surgical, diagnostic or resolutive action. Personal cases of lung diseases classifiable within the subject are presented and discussed. Cases were part of isolated groups, some observed at the Saint-Feyre Centre in France, and are given as an appendix to the present publication. The intention is to lay stress on the justifiable embarrassment, or otherwise, and the responsibilities of the chest and lung surgeon. Emphasis is laid on the complexity of pulmonary surgical symptomatology.

Plastic induration is briefly described and its similarity to Dupuytren's disease is discussed in an attempt to detect a common origin. Results obtained in histochemical investigation of this question appear to suggest that changes in the polysaccharide components of the fundamental substances of the connective tissue are involved.

The surgical techniques best suited for timely management of spontaneous pneumothorax are described. Results in 266 cases are discussed and compared with the recent literature. Reference is also made to a little known technique: photothermostimulation, and the results it offers are illustrated. Encouraging results have been obtained from rapid frottage of the parietal pleura and this is described. Emphasis is placed on the advisability of early operation to forestall possible surgical and anatomofunctional complications, to ensure good recovery of respiratory capacity, and to prevent mechanical sequelae involving the cardiorespiratory system.

It is well known that a pleuropneumopathy brought on by local action of biochemical nature (amylase) can occur in the course of quiescent or unknown pancreatitis. The literature on the subject was therefore examined with respect to abdominothoracic diffusion of the pancreatic excretion. Also examined were indications for surgery in the unusual complications which may arise, often with dramatic emergency (acute abdomen in sufferers from slight persistent pleural effusion; pleuropulmonary perforative syndrome in be course of quite stabilized chronic pancreatitis). Personal experience with four successfully treated cases is reported. The literature contains only sporadic examples and some remarks and deductions are made with regard to the controversial ways of amylasic abdominothoracic transfer.

In this graduate course lecture, and attempt is made to interpret the meaning of supernumerary cervical ribs and false ribs, by classifying the phenomenon among regressive abnormalities.

The occasions on which lung embolism is likely to occur and proceed with or without initial clinical symptoms are described. Lung scintiscanning technique, complemented by special expedients and personal experience, is explained. It is felt that the method helps in the early detection of suspect or clinically silent forms, as well as in the corroboration or ruling out of a clinical diagnosis as soon as this is possible. Scintiscanning is also of assistance in showing the anatomopathological features and extent of the process. The technique is simple and readily tolerated, even by patients with slight respiratory or circulatory disturbances. On the other hand, it is not competitive with conventional and well-tried angiopneumography.

Teleangectasia is of interest to the general practitioner, though rather ignored by pathologists and hence not easily dealt with as an organic whole. The clinical pictures of congnita and acquired (idiopathic and symptomatic forms) are explained. Treatments indicated for different forms include: surgical diathermy, injection of sclerosing substances, cryotherapy and the CO2 laser.

The subject-matter and concepts of artistic anatomy are illustrated with reference to its philosophical and psychological aspects.

Modern methods of semeiological detection of bronchiogenic cancer are discussed in the light of experience gained in a hospital chest surgery centre. Emphasis is laid on the advantages offered by new advances in nuclear diagnosis and bronchial endoscopy. The limitations of exploratory thoractomy are explained. Attention is drawn to the by no means inconsiderable number of cases in which early knowledge of the nature of the process could not be obtained. A series of illustrative cases are presented.

A degree course lecture based on a review of the relevant literature and experience gained at a 1000-bed lung hospital (S. Luigi Hospital, Orbassano) is presented in a shortened form. Attention is drawn to the revival of discarded techniques due to anaesthesiological and medical advances. This has considerably extended the surgical indications.

Histochemical methods were employed to study the behaviour of connectival glycoproteins in Dupuytren's disease. Increases were observed in glycoproteins and acid glycosaminoglycans in the sections with higher cell intensity. In segments where fibrosis was more marked, a prevalence of neutral polysaccharides was encountered. A possible role of these alterations in the development of palmar aponeurosis retraction is discussed.

A description is given of the important part played by the skin as a site of electrical charges, as shown by the data offered by cutaneous electrophysiology. Personal research on 150 subjects is described. The results have useful applications in semeiotics and viscerocutaneous therapy. They also provice an explanation for the results achieved by acupuncture, a subject at present in the forefront of scientific investigation.

Echography enables a useful diagnostic distinction to be drawn between solid structures and cysts in the thyroid. Cold nodes measuring 1-5 cm in diameter, cysts (rarely malignant), and solid formations (more commonly malignant) can be differentiated to facilitate diagnosis, while changes in the size of a node can be followed without interrupting drug treatment to determine whether they are due to haemorrhage, resolution of a process, or an increase in node tissue. There is no risk to the patient and the cost of the examination is negligible. Its utility in the initial and subsequent investigation of such nodes is asserted.