[Behaviour of patients with inflammatory intracranial complications of otogenic origin]. / Povedenie pri patsienti s vutrecherepni vuzpalitelni uslozhneniia ot otogenen proizkhod.

The authors have the aim to discuss their experience in the field of treatment of otogenic intracranial complications results of inflammatory process. A short reference of the spread of this kind of pathology is made. The up-to-date methods for diagnostics, behaviour, conservative and surgery treatment of these patients are examined. A case is represented as an illustration, that regardless of the big progress in the medical knowledge and the opportunities of the surgery technique nowadays, these complications continue to be a serious problem in the otorhinolaryngology and enforced close collaboration. The publication is a teamwork of otorhinolaryngologists and neurosurgeons.

[Two cases of insulinoma treated as a psychiatric disease]. / Dva sluchaia na insulinom, tretirani kato psikhichno zaboliavane.

The insulin producing tumors are rare diseases and sometimes the diagnostics is very difficult. We present two cases of insulinoma treated as psychiatric diseases. We discuss the difficulties and particularities in the diagnostic process.

[Hyperprolactinemia--the main cause for hypogonadism and galactorrhea]. / Khiperprolaktinemia--osnovna prichina za khipogonadizma i galaktoreiata.

After describing several types of persistent galactorrhoea--dysmenorrhoea syndrome they are now classified under a common term hyperprolactinaemia. The physiology and pathology of the prolactin are discussed in this report as well as the author's opinion about the diagnostic and treatment of different forms of hyperprolactinaemia.

[Changes in the high-density lipoprotein level in patients with diabetes mellitus type II]. / Promeni v sustava na lipoproteinite s visoka plutnost pri bolni sus zakharen diabet II tip.

In 62 patients with diabetes mellitus type II, 22 patients with obesity I degree and 40 patients with normal body mass (28 with ischemic heart disease and 12 without ischemic heart disease) the blood sugar profile and the composition of the high density lipoproteins (HDL) were examined. In decompensated diabetes mellitus type II reduction of cholesterol and phospholipid contents of HDL and of apoprotein A were found. With compensation of the carbohydrate metabolism the composition of HDL becomes normal. In the obese diabetics the changes of these indices are more pronounced. In diabetic patients with ischemic heart disease the cholesterol and phospholipid contents and that of apoprotein A in HDL are lower than those in diabetic patients without ischemic heart disease. These data show that changes of HDL in diabetes mellitus favor the development of atherosclerosis changes.

[Unsaturated fatty acids in diabetes mellitus]. / Nenasiteni mastni kiselini pri zakharen diabet.

The following unsaturated fatty acids were examined in the serum and in the high density lipoproteins of 38 patients with diabetes mellitus type Il and 20 healthy controls: linolic, linolenic, eicosandienoic, eicosanetrienoic, arachidonic and eicosanepentaenoic. In decompensates diabetes mellitus a decrease of linolenic, eicosanedienoic, arachidonic and eicosanepentaenoic acids and an increase of linolic and eicosanetrienoic acids were found. After compensation of carbohydrate metabolism the last fatty acids showed a tendency toward normalization. The parallel changes of the fatty acids studied in the serum and in the high density lipoproteins suggest that the fatty acids contents of the HDL depends on the serum fatty acids. It is most probable that the variable changes of the individual unsaturated fatty acids play a role in the complex mechanism of vascular lesions in diabetes mellitus.

[Fine-needle aspiration biopsy in the diagnosis of thyroid diseases]. / Tunkoiglenata aspiratsionna biopsiia v diagnostikata na bolestite na shtitovidnata zhleza.

On 105 patients with thyroid gland diseases thin needle aspiration biopsy was performed. The cytologic examinations proved to be of great importance for the diagnosis of thyroiditis and thyroid cancer. When lymphoid cells were found immunocytochemical examination was made additionally. It allows the differentiation of the subacute thyroiditis from the chronic and recurrent thyroiditis. The thin needle aspiration biopsy is practically a harmless manipulation. The great frequency of the asymptomatic chronic thyroiditis and of thyroid gland cancer supports the recommendation of a wider application of the method in all patients with thyroid gland diseases.

[Lipoprotein and apoprotein changes in type-2 diabetes mellitus]. / Promeni v lipoproteinite i niakoi apoproteini pri zakharen diabet II tip.

Lipid metabolism indices were followed up in 62 patients with diabetes mellitus type II and in 20 healthy persons as controls. An increase of serum triglycerides, very low density lipoproteins and low density lipoproteins, a decrease of high density lipoproteins and cholesterol in the upper reference range were found. Following diabetes compensation these indices became normal. In decompensated diabetes apoprotein A increased, apoprotein B decreased. Diabetes compensation lead to normalization of these indices. A comparative study of these indices in diabetics with and without ischemic heart disease was carried out. It showed a considerable decrease of the high density lipoproteins and a parallel increase of the very low density lipoproteins and low density lipoproteins in the diabetics with ischemic heart disease. The results of the study lead to the conclusion that criterion for diabetes compensation should be not only the blood sugar normalization bur also the correction of the lipid fractions changes.

[Fatty acids in diabetes mellitus]. / Mastni kiselini pri zakharen diabet.

In 38 patients with diabetes mellitus type II and in 20 healthy controls the total amount of saturated and unsaturated fatty acids was examined in the serum and in the high density lipoproteins (HDL) as well as the following fatty acids: palmitic, stearic, oleic and arachidonic. In decompensated diabetes an increase of the saturated fatty acids with a parallel decrease of the unsaturated fatty acids were found in the serum and in the HDL. The compensation of the diabetes led to normalization of the ratio between the saturated and unsaturated fatty acids. In decompensated diabetes an increase of the palmitic and stearic acids with a parallel decrease of the oleic and arachidonic acids were found. After compensation of the diabetes was achieved the fatty acids levels became normal again. Knowing the role of the fatty acids in the atherogenesis it may be assumed that the changes of the fatty acids levels in diabetes mellitus contribute to the vascular lesions.

[Adrenal function in patients with chronic obstructive lung diseases]. / Sustoianie na nadbubrechnata funktsiia pri bolni s khronichna obstruktivna belodrobna bolest.

The hydrocortisone and ACTH blood levels, 17-hydroxycorticosteroids urine excretion and suprarenal function stimulation with Synacthen were studied in 22 patients with chronic obstructive pulmonary disease and 12 healthy persons as controls. The results show the presence of reliably higher hydrocortisone and 17-hydroxycorticosteroids levels in patients with low partial oxygen pressure as well as a higher ACTH plasma level and a strong Synacthen stimulation. After a comprehensive treatment including oxygen therapy the blood concentrations of hydrocortisone, ACTH, 17-hydroxycorticosteroids fell to levels found in healthy persons. The study shows that hypoxemia stimulates the suprarenal-cortex secretion.