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We observed a case of synovial cyst in the shoulder joint leading to spino-glenoid symptomatology in a weight-lifter. Explorations included standard radiography, echography and magnetic resonance imaging. Differentiation between a true cyst and a pseudo-cyst was basedose presence of a synovial membrane. Mechanical contraints appear to be the most frequently suspected aetiology of spinoglenoid cysts. Echography cannot always confirm the liquid nature of the formation due to the close bone. Magnetic resonance imaging gives good tissue characterization and good topographic analysis. Gadolinium injection appears to be important for differential diagnosis with neurogenic tumours.

Turnover of rat intestinal brush border proteins has been evaluated by measuring their relative degradation rates after a 75 % proximal resection. The 3H : 14C ratios determinated after an intraluminal double labeling technique show a significant decrease of the high molecular weight protein turnover rates after ileal regeneration when compared to equivalent size proteins isolated from sham-operated animals. This is interpreted as the reflect of the villus epithelial cells immaturity in the remaining ileum after a small bowel resection.

An experimental study of portal and inferior vena-caval clamping in the dog showed the respective roles of splanchnic blood sequestration and inferior vena-caval blood sequestration in the onset of the hemo-dynamic disturbances caused by vascular exclusion of the liver, with severe arterial hypotension. Stasis in the inferior vena cava is corrected by a caval shunt which, on the other hand, has no effect on splanchnic stasis. Clamping of the aorta may, however, act on both components of the hypotension, and this has proved promising.

The study is based on 20 personal cases of gallbladder cancer and 254 similar cases from five surgical departments. The contradictory results obtained by surgery are explained by the special structure of the gallbladder wall and the bipolar connections with the liver and lymphatic ducts. Personal experience and literature reports evidence the possibility of cure for various stages: macroscopic lesions, while qualified as early stages are actually already advanced and necessitate extended liver resection with considerable lymph node dissections; the so-called early stage, detectable solely by histology, is harmful since the entire thickness of the mucosa is involved and always requires enlarged cholecystectomy to include the liver and lymph nodes. In this case good survival rates are possible; in situ pre-epithelial lesions diagnosed by cytology, are amenable to cure by simple cholecystectomy. Prevention rests on a wide range of indications for cholecystectomy (lithiasis, female sex, age over 50 years).

The authors relate a case of acute functional obstruction, appearing after treatment of a cancer of rectum with extension to prevertebral plexus. The cause of the colic trouble appears to be neurological and due to a sympathetic and parasympathetic transmission block, while intrincic plexus was normal. Inefficacy of the contractions was established by radiology and endoscopy (electrical and pharmacodynamic stimulation and measure of pressure); it predominated in the left transverse colon. Caecal perforation has been avoided up till now after two years, without modification of clinical course, the patient evacuated his colon with the help of enemas. It seems probable that this case can be classified as Ogilvie's syndrome, the bibliography of which has been looked up and criticized.

Worldwide literature and ten or so personal cases are reviewed as a basis for distinction or intrication of two aspect of post-hydatid sclerosing cholangitis; that of a localized lesion of diffuse lesions of the biliary tract. In both cases the action of the hydatid cyst is not due to toxins but to pressure on biliary duct walls, very variable according to site and size. This local action may be the only cause, provoking a specific type of lesion, a true sequela of an incomplete or delayed operation. In certain regions, or in the presence of biliary stasis and angiocholitis, passage of hydatid fluid into biliary tracts, normally tolerated by healthy biliary pathways, leads to a diffuse sclerosing cholangitis. The serious consequence of this eventuality is proved by the failure of many treatments, with subsequent inevitable liver transplants. Clinical circumstances and data explaining this complication allow necessary precautions to be taken. Furthermore, early treatment of hydatidosis or as radical as possible therapy for advanced lesions is curative of localized forms of the disease.

Orthotopic liver transplants were conducted in 15 dogs, with aortic clamping during the anhepatic time of the operation and without venous shunting. Aortic clamping lasted for between 30 and 42 minutes. Immunosuppressant treatment was not given. Eight dogs died within 2 hours after the operation, 5 from haemorrhage and 3 accidentally. Seven animals survived for between 6 hours and 11 days: 3 died within 24 hours from haemorrhage, 2 from hepatic failure between the 2nd and 3rd day. One animal died on the 7th day from an acute intestinal invagination, the dog surviving for the longest period eventually dying after rejection of the transplant. These results demonstrate, as in other reported series, that the most frequent cause of death is the haemorrhagic diathesis, probably as a result of poor graft conservation. Dogs tolerate the supracoeliac aorta clamp both from the renal and intestinal points of view ; spinal cord tolerance to the ischaemia is less evident as paraplegia of the hindquarters was noted in one animal in the group. Aortic clamping considerably reduces operative time, as it avoids the need to construct a mesentericocaval anastomosis and a femorojugular shunt. It also avoids splanchnic blood sequestration and the risk of reducing cardia filling during clamping of the inferior vena cava.

Statistical results show a marked improvement in survival after surgical treatment of hepatic metastases. The possibilities of surgery are evaluated after precise analysis of the lesions seen at the time of excision and not at autopsy. The data from assessment which indicate that surgery will be successful are described and discussed. Surgical techniques consist above all of resection: metastasectomy, segmentectomy, hemihepatectomy and hepatectomy followed by transplant. Other methods are palliative. Certain resections themselves appear to be palliative and the ideal is to carry out adequate resection at the outset, adapted to the size and site of the lesions. However the possibilities of surgery form part of an overall programme: -- complete removal of the primary carcinoma in order to avoid any local recurrence, -- wide eradication of metastatic lesions, -- préventive treatment against further development of possible subclinical lesions by post-surgical chemotherapy and subsequent immunotherapy.

The therapeutic problems investigated are orientated on the good results obtained by certain hepatic resections. The reasons for their success is discussed from the point of view of the patient's state of immunity, the technic employed, and the characteristics of the tumor. Under characteristics of the tumor are discussed : biologic reactions, anatomic and histologic aspects, and especially the vascular quotient which, studied entirely from the experimental point of view, includes the arterial, venous and lymphatic aspects for each variety of cancer. These findings can be classified and compared with the results obtained. This retrospective study opens the way for a prospective classification aimed at confirming the therapeutic views. A principle preoccupation is the detection of cases with only local involvement where cure is possible, while therapeutic trials for lesions with regional extension are to be tested.