[Germ-cell tumors of the testis in childhood]. / Germinativnokletuchni tumori na testisa v detskata vuzrast.

Germinative-cell tumors are the most common tumors of the testis in children. For a period of 15 years (1975-1989) the authors have observed 12 children with these tumors. Leading symptoms in all children was a gradual painless enlargement of one testis; the symptomatic hydrocele may delay the correct diagnosis for several months. In young children the mothers noticed the testicular changes earlier, while in older children the diagnosis was delayed. Three quarters of the tumors were in the left testis, seldom in the right and still more seldom bilaterally. Diagnostic methods were applied mostly when metastases or recurrence were suspected; most common were computer tomography and lymphography. The most common benign testicular tumors were the mature teratomas and malignant--endodermal sinus tumors. The modern operative approach to these patients is emphasized: radical orchiectomy with pre- and postoperative determination of AMP levels, periodic control computer tomography and echography of the retroperitoneum and thorax with 2-year observation in stage I and modified lymphadenectomy in stage II. As a result of the complex surgical and oncologic therapy, the late results were good in 7 children, 2 died and 3 were lost from control.

[Retroperitoneal and pelvic-presacral teratogenic tumors in early childhood--the diagnostic and surgical treatment problems]. / Retroperitonealni i tazovo-presakralni teratogenni tumori v rannata detska vuzrast--diagnostichni i khirurgichno-lechebni problemi.

Teratogenic tumors are characteristic for childhood. For a period of 15 years the authors have observed 12 children with retroperitoneal and pelvic-presacral localization of teratogenic tumors. They were most common in girls under one year of age. The clinical symptoms, the methods applied for diagnosis are analysed; the diagnostic importance of rectal digital examination, inferior venacavography and especially of computer tomography is emphasized. Radical removal of the tumor was performed in 11 children and biopsy in 1. The most convenient operative access to pelvic-presacral-retroperitoneal tumors is a one-step double access (abdomino-sacrococcygeal). As a result of complex treatment--surgical and chemotherapy--the postoperative results were good in 9 children.

[The diagnosis and surgical treatment of teratogenic tumors of the mediastinum in childhood]. / Vurkhu diagnostikata i khirurgichnoto lechenie na teratogennite tumori na mediastinuma v detskata vuzrast.

Mediastinal tumors are leading tumors in pediatric chest oncology. Teratogenic mediastinal tumors are characteristic of early childhood. For a period of 7 years 4 children with teratogenic tumors of the mediastinum--7.8 per cent of all mediastinal tumors--have been diagnosed at the Department of Pediatric Surgery, thoracic unit. The authors analyse the clinical symptoms, the tools of diagnosis, emphasizing the diagnostic importance of computer tomography, echography and angiocardiography. All children were operated (total extirpation of the tumor). Three children had benign teratoma, 1 mature teratoma including malignant elements (ECT)). All children were in good state of well-being; in one of them chemo- and radiotherapy is still in progress.

[Functional disorders and structural changes in the liver in Amanita phalloides poisoning]. / Funktsionalni smushteniia i strukturni izmeneniia v cherniia drob pri faloidna gubna intoksikatsiia.

The liver functional disorders and structural changes were studied in 17 patients (children 6, adults 11, 4 to 70 years of age) with phalloidine intoxication. The clinical course of this severe and lethal exogenic intoxication, its characteristic clinical and laboratory features are discussed in relation to the morphological changes of the liver. The structural changes are similar in all patients independently of their age and the time of death. They are presented by fatty degeneration, acute toxic liver dystrophy and centrilobular necroses. These changes are produced by the specific action of the phalloidine toxins on the liver.

[Clinico-morphological characteristics of pulmonary thromboembolism in decompensated heart patients]. / Kliniko-morfologichna kharakteristika na belodrobniia tromboembolizum pri dekompensirani surdechno bolni.

The results from the studies on the case histories of 115 deceased decompensated cardiac patients with pulmonary thromboembolism are reported in the paper. It was established that those were mainly elderly people, both sexes almost equally engaged. The probable origin of embolism is analyzed in details as well as the concomitant diseases, anamnestic and clinical symptoms, some paraclinical deviations and the course of the disease. The involvement of the trunk or main branch and of the middle and small branches of pulmonary artery were separately discussed. Some differences are emphasized with the two localization of pulmonary thromboembolism. Finally, the various forms of the disease (cerebral, pulmonary, cardiac and abdominal) are discussed in details, with attention paid to the possible errors with them.

[Rupture of the interventricular septum in acute myocardial infarct]. / O razryve mezhzheludochkovoi peregorodki pri ostrom infarkte miokarda

The authors examined ruptures of the interventricular septum in 12 patients with acute myocardial infarction. Septal ruptures comprise 8% of all cardiac ruptures that occur within the early days of infarction, they are poorly diagnosed, and most of such patients die before the end of the 1st--5th week due to acute left-ventricular insufficiency. Characteristic features suitable for making the diagnosis are lacking. A transverse systolic murmur and "cat's purr" are important, but rare signs. Systolic murmur, maximum at the apex, is seen more often than of transverse, which makes the differential diagnosis of papillary muscle rupture still more complicated.