[Superior vena cava syndrome--surgical solution--case report]

The patient of 52-year-old smoker was admitted in emergency with headaches, dyspnea, oedema and cyanosis of the cephalic extremity and of the superior members. This signs and symptoms suggest a superior vena cava sindrom. Thoracic CT scan shows the thrombosis of the superior vena cava and a tumor localized in the Bariety's Lodge of about 30/40 mm witch is around the right lateral wall of the traheea.This tumor is also tangent to the superior the superior vena cava. The patient was operated by total median sternotomy. By this approach we performed a complete excision of the mediastinal tumor mass. After that we effected a longitudinal cavotomy, we took out the endoluminal clot and we sutured the superior vena cava. The histological diagnosis of the mediastinal tumor was adenocarcinoma tubular-papillary moderately differentiated. The evolution post operative period was favorable the superior vena cava sindrom was a complet remission. The thoracic CT scan control after 9 months later didn't show a local relapse and blood flow was normally throw the superior vena cava.

[Hyperthermic intrapleural chemotherapy--another modality for the treatment of malignant pleural neoplasia]

The high frequency and the severity of malignant pleurisies, despite their etiology, make the problem to be of great importance. At national level, the problem of neoplastic pleurisies was and still remains a medico-surgical problem with socio-economic implications, especially in the situation when cancer represents a major health problem for the national health system. Treatments are mostly palliative aiming to relieve dyspnea and thoracic pain. The increasing incidence of malignant pleurisies enforce a better knowledge of pathogenic mechanisms that led to a new therapeutic approach with promising results--cytoreductive surgery combined with intraoperative hyperthermic intrathoracic chemotherapy. Recent studies about compared results of different types of treatments, function of survival period and side-effects, demonstrate the advantages of association between surgical treatment with the intrapleural administration of hyperthermic chemotherapy, which may have control on pleurisy and pleural involvement. It is considered that hyperthermia represents a hope in increasing the quality of patient's life with radiotherapy and chemotherapy, as well as surgical treatment, resistant neoplastic pleurisy. It is necessary to be made in accordance with classical oncological treatments.

[Mediastinal tuberculous lymphadenitis of adult]

The authors report a case of primary tuberculosis with exclusively pulmonary hilar lymphadenitis and mediastinal lymphadenitis at an adult woman in which the non-invasive investigation headed to the diagnosis of sarcoidosis with a very large probability. The histopathological confirmation was made by mediastinoscopy.

[Multiple primary cancers with different localizations and histologic types. Clinical case]

The authors describe the case of male patient of 46 years old, which was diagnosticated with 4 cancers of different localization and histopathological types in the course of 6 years. In chronological order these 4 neoplazias were: the Hodgkin's disease with mixed cellularity, the malign parieto-frontal right meningioma, a Grawitz renal tumor and a lung adenocarcinoma with bilateral lung and pleural metastasis. For both cerebral and renal tumors the patient was given a surgical treatment and for the Hodgkin's disease and lung cancer given chemotherapy and cobalt therapy.

[Multiple, paravertebral Pott's abscesses]

The authors describe a case of vertebral tuberculosis with multiple localizations, high thoracical (T2-T6) and of the sacrum (S1-S4) at a young woman with nonspecific clinical symptoms and with CT examination suggestive of the diagnosis, where the diagnostical certainty was obtained by the bacteriological examination for bK of the pus (purulent liquid) extracted by CT guided fine needle biopsy performed in the posterior mediastinal tumor.

[Paraneoplastic thrombosis of subclavian and right internal jugular veins. Clinical case]

A clinical case of the "Paraneoplasic thrombosis of subclavian vein and right internal jugular vein", is presented at a young patient, with right lung carcinomatous lymphangitis, clinically confirmed by BAL with probable prostatic point of start.

[Pulmonary tuberculosis and Kaposi syndrome in HIV positive patient]

The authors point out the case of a young woman with AIDS who presents at the same time the test HIV (+), the secondary caseoextensive bilateral pulmonary tuberculosis confirmed by the bacterial examination (bK(+) culture), the skin's and pulmonary histological manifestations of the Kaposi disease, clinically suspected, was confirmed only at the autopsy. Clinical manifestations began with skin's modifications, followed 2-3 months later by the diagnosis of a pulmonary tuberculosis, the demise decease 4-5 month after the appearance of the first skin's lesion.

["Pseudomalignant" lung tumors--a permanent diagnostic and treatment challenge]

A clinical case of dysembryoplasic benign tumor, respectively a lung hamartoma, is presented. In this case, the pre-operational diagnosis was malignant tumor at the operationally limit, but the histopathological examination of the operational specimen was of lung hamartoma.

[Thyroid tuberculosis--a clinical case]

We present the case of a 38-year-old male patient with tuberculosis of the thyroid; the diagnosis was established on histological examination after surgery.

[A profile of the smoker with pulmonary tuberculosis]

A group of 485 subjects suffering from lung tb admitted in the Institute of Pneumophthisiology "M. Nasta" has been studied as for the relationships between found the lung disease and smoking. High frequency of smoking has been among these patients: 87.7% in males and 68.2% in females. These figures marquedly exceed the frequency of smoking in the whole population. The increase of frequency among females is more evident. No difference has been found as for the type of lesions between smokers and non-smokers. Smoking increases the gravity of associated diseases (e.g. chronic ethylism) evidencing the lack of health education of people in preventing this condition as well as the difficulties met by physicians in the implementation of smoking abandonment programs.

[Survey of the prevalence of smoking in Rumanian teachers]

214 teachers and headmasters of Bucharest high schools were questioned in respect of their smoking habits to find out how widespread smoking is among teachers and how this influences the pupils. 33% of the teachers and 38.9% of the headmasters smoked. 69.2% of the smokers belonged to the age group above 35 years, i.e. the majority, whereas the age group below 20 years included 56.9% smokers. Although 93.8% of the teachers and headmasters are convinced that smoking is harmful to health, 7.4% of them smoke in the classroom and 37% in the presence of pupils. The results of this investigation show that attention should be paid to the smoking habits of teachers since setting a good example for adolescents is as important in the case of teachers as it is in the case of physicians.

[Pulmonary involvement in scleroderma]

The paper deals with 3 cases of sclerodermia with pulmonary determinations detected by clinical, radiological, functional and histopathological means, of diffuse interstitial fibrosis type. The association with bronchopulmonary cancer is pointed out in one case only.

[The therapeutic prospects of patients with bronchopulmonary cancer]

By means of a retrospective analysis on 405 cases found out as having bronchopulmonary cancer, the therapeutical possibilities on fixing the diagnosis were evaluated. The therapeutical attitude indicated by pre-established criteria and the therapeutical line adopted were also analysed. The low percentage (25%) of cases with favourable therapeutical perspectives at case finding, as well as the high percentage (75%) of cases found out in stages therapeutically beyond treatment are pointed out. Several non-concordances between recommended and applied therapies are discussed.