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Although the cousience and character of a good doctor are sufficient on their own to allow us to discuss and make decisions regarding very difficult ethical subjects in transplantation, basic ethical principles commonly used in medicine must also be applied to various aspects of organ donation. Some system has to be adopted that assesses the weight that must be given to various possible solutions. For example, would live donor transplantation still be acceptable if there were a surfeit of cadaveric organs? If animal organs can be transplanted successfully, is that more desirable than using human organs: particularly if human donation involves interventional ventilation or non-heart beating donors? Is interventional ventilation more "ethical" than live donor liver or lung transplantation? No doubt future developments in transplantation, opening more opportunities for the successful treatment of more patients, are likely to produce increasingly difficult ethical issues. Discussions of these issues must be firmly based on principles of medical ethics, although accepting that whilst absolute principles may be available, absolute answers are more difficult to come by.

The authors present the surgical treatment of gallstones with special instruments and technique through a mini laparotomy, as developed in Kaposvár (Hungary). Despite the fact that the widespread use of laparoscopic cholecystectomy (LC) has succeeded over open cholecystectomy (OC), in their opinion, there are some instances where cholecystectomy through a mini laparotomy (MLC) would be advantageous. Last year (1996), in the authors' department, 32 MLCs were performed in addition to 72 OCs and 176 LCs. Due to unspecified techniques and differing criteria used to define MLC, it is difficult to find any data related to this subject in the literature available. In Hungary, there are two cities--Kaposvár and Szolnok--where only MLCs are performed for the surgical treatment of gallstones. Conversely, the University hospital of Szeged and the County hospital of Békéscsaba use all three procedures i.e. OC, LC and MLC; as is the case in the authors' hospital. In the article, the pros and cons of MLC are compared to those of LC. (The MLC being more cost effective, enables quick conversion to an OC if required, and provides the surgeon with a three dimensional picture, it is also suitable for the surgical treatment of common bile duct stones. However, it is cosmetically worse, obesity can cause technical difficulties, the incidence of hernia formation is higher, and wound healing is affected.) In the authors' opinion, it would be important to establish set criteria in order to screen patients that are unsuitable for LC, and they attempt to do so in this article.

The authors present the use of ROMICRO set (originally developed for mini laparotomy) for thoracic and lumbar sympathectomy. They review 3 thoracic and 2 lumbar sympathectomy operations that had good effects and uneventful recoveries. The advantage of the method is that no special instruments are needed and it can be done as a conventional operation.

The author reviews the rules of conduct to be followed in lectures and he identifies a number of advices, useful for young colleagues. The fundamental ethical goal of lectures is to serve the audience as well as possible. The author touches upon the most important general rules of oral communications such as punctuality, discipline of remaining within time limitations, but he also describes advices how to work and deliver talks lectures. In conclusion he elaborates on his own view regarding the lecture opportunities that grow in our days, the effectiveness of which, however, leaves much to be desired.

The author discusses some ideas concerning the sharing of scientific informations. The fundamental goal of the latter is to serve the readers as perfectly as possible. A physician of research ambitions may valuable contribute to the progress of applied sciences but this must not jeopardize the medical care of the patients. Reading relevant literature is one of the prime obligations of all doctors. The author raises some dilemmas and question concerning how to write publications while he attempts to clarify matters. He emphasizes that the importance of correctness of a publication is second to none. The problem of fragmentation and that of "double publication" is also briefly discussed. The author elaborates on how to identify the co-authors and the sequence they appear in the publication. He provides some hands- on advice as to the concise language and abbreviations. He enters the list for the qualitative improvement rather than quantitative increase of publications in Hungary.

The infrequent case of gallbladder torsion and accompanying Meckel's diverticulum in a 3-year-old girl, is described. Detorquation, cholecystectomy and resection of the diverticulum were performed. Condition of the development of the disease as well as its clinical aspects and therapy are discussed. It is suggested to explore the abdominal cavity for other developmental anomalies in the course of the operation. The patient recovered without complications and left the hospital 14 days after the operation.

The pathological role of megakaryocytes has been studied during adult respiratory distress syndrome (ARD) in the formation of intraalveolar oedema, microthrombi and hyaline membranes. The giant cells of the bone marrow are also thought to be involved in the development of peribronchial, perivascular and interalveolar oedemas. Heparin produced by tissue mast cells appears to counteract the clotting disturbances and to promote fibrinolysis in the acute phase of ARD. Vasoactive substances liberated from mast cells enhance oedema formation. Heparin has an influence on the lipid metabolism of type II pneumocytes. During regeneration the stimulating effect of heparin on fibrosis becomes predominant in the connective tissue ground substance. No fundamental morphological difference was found between ARD and the infantile respiratory distress syndrome.