In addition to presentation of five personal observations of lipomas of the digestive tract (1 esophageal, 3 gastric, 1 jejunal), the authors review over 1 400 cases published in the literature. No cases of degeneration were found. Esophageal lipomas are extremely rare (1.5 p. cent of digestive tract lipomas) and are often confused, prior to anatomical proof, with leiomyomas, which are much more frequent. Lipomas represent 3 to 5 p. cent of all benign tumors of the stomach; the most frequent site is the antrum and the average diameter is 5 cm. From a clinical standpoint, such tumors are asymptomatic unless they are of large size or peri-orificial. The radiologic diagnosis is usually a benign tumor, lipomas being diagnosed only rarely. Lipomas of the small intestine represent 13 to 15 p. cent of all benign tumors there; the preferential site is the ileum (49.6 p. cent), followed by the duodenum (23.4 p. cent). Clinical latency was associated with 43 p. cent of the cases reviewed. Barium examinations generally led to the diagnosis of a benign tumor but provided no etiological information. Lipomas constitute the most frequent benign tumor of the colon and rectum after adenomas. When compared with all other locations, the colon accounts for 51.1 p. cent of cases. No preferential site was observed within the colon itself, and multiple forms were seen in 14 p. cent of cases. Clinical latency was associated with 30.3 p. cent of the colo-rectal cases reviewed, and radiological exams were generally unable to diagnose lipomas.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

[Critical evaluation of non-biological complementary examinations of the biliary tract before deciding on therapy (author's transl)].

A critical evaluation of non-biological complementary examinations of the biliary tract was conducted to assess their value when deciding on therapy. The published literature was reviewed, and the sensitivity and specificity of the different methods presented, emphasis being placed on the primary investigations of ultrasonography and oral and intravenous biligraphy. Secondary exploratory procedures (transparietal cholangiography, retrograde endoscopy with cholangiography and pancreatography, scintigraphy, gallbladder infusion parietography, scanography, and arteriography) are defined and their value discussed. Published data suggest that ultrasonography should be the initial investigation, this often being sufficient to enable suitable therapy to be chosen. Only approximately 5 p. cent of patients are unable to benefit from gallbladder exploration, and these require conventional radiological examinations before deciding on therapy.

Biliary Tract↗

PubMedDate not supplied

[Classification of oral contraceptives and its practical application to choice of prescriptions].

The authors have tried to classify the oral contraceptives at present in use throughout the world by their respective levels of oestrogenic and progestogenic components, taking into consideration also the relative strength of each product in use. They have based this classification on their personal experience of the several oral contraceptive products and on a profound study of the international literature. In this way it is possible to define a place for each oral contraceptive so that it can be chosen for the best possible use of a particular product for the hormonal background of the person using the contraceptive. It is true that changes have to be made to work out the oral contraceptives used for masses of people, but on the other hand in countries where there is sufficient medical personnel and education so that it is possible to think out and to prescribe for an individual, it seems to us useful that the doctor who is prescribing should try to adjust the oral contraceptive to the hormonal climate of the woman seeking it. This is true not only for the first time a prescription is made but in cases where by the accident of failure to tolerate the product something must be done to correct the troubles that are so often found in the first months after starting to use contraceptive products. This study includes a general picture of all oral contraceptives in which the products have been classified according to the total dose of oestrogens administered and according to the proportions of progesterone to oestrogens which make up the hormonal climate of the product. On the other hand this study also includes a list of the observations to make in order to adapt the oral contraceptive to the side-effects shown after the first prescription. The authors have come to the conclusion that by adapting the choice of a particular oral contraceptive to the woman who is to receive it interruptions in taking the contraceptive because of side-effects should be avoided. So unwanted pregnancies will be avoided and also the termination of these unwanted pregnancies.

Contraceptives, Oral↗

PubMedDate not supplied

Experience with immunoglobulins in thyroid autoimmunity.

The physiopathology of Graves' ophthalmopathy is poorly understood. Therefore, the best treatment of Graves' ophthalmopathy is still a matter of debate. Steroids, X-ray therapy, surgery and more recently cyclosporine, plasma exchange and somatostatine analogs have been tried. There is no doubt that we are dealing with an autoimmune process. The use of immunoglobulins has been shown to be safe and efficient.

Adrenal Cortex Hormones↗