Mammary gland papilloma--diagnostic and therapeutic behavior.

Papillary lesions of the mammary gland represent a serious disease and incorporate a broad spectrum of lesions. The goal of the current article is to reveal the diagnostic methods and therapeutic behavior in patients with pathological discharge from the nipple of the mammary gland. In this article we present 15 cases of histologically proven mammary gland papilloma. Mammographic, ultrasonographic and cytologic methods are applied for diagnostic specification. The chosen therapeutic behavior in all of the women is surgical. We take into consideration the possibilities of the different diagnostic methods as well as the therapeutic behavior-conservative or surgical approach. We reckon that when there is suspicion for mammary gland papilloma a surgical intervention is necessary to be carried out--due to the functional discomfort and due to the possibility intraductal carcinoma in situ to be missed out in some cases.

["M"-category as a prognostic factor in operated patients with non-small cell lung cancer].

UNLABELLED: Review of the world literature reveals more than 150 prognostic factors for the non-small cell lung cancer. Distant metastases are the most important negative prognostic factor for the long-term survival. MATERIAL AND METHODS: We present 440 patients, operated in our clinic for the period 1997-2004. Distant metastases were found in 19 of them age range: 23-74 years (4 women and 15 men). RESULTS: The 5-years survival rate was 30.40% ( 128 patients) for the patients with M0- disease and 15.79% (3 patients) for those with distant metastases. CONCLUSIONS: Selected group of patients with lung cancer and distant metastases without involvement of the lymph nodes are may be the group who will benefit from the operative treatment.

[Benign nodular formations of the thyroid gland and changes in cell and humoral immunity before and after surgical treatment].

INTRODUCTION: The main trends concerning the volume of surgery in benign thyroid disease - thyroidectomy or organ - preserved surgery, performed in detected immunological disorders, are not well motivated. The AIM of this study was to analyze changes in humoral and cellular immunity in diseases before and after surgical treatment as well as to assess the effects of surgical procedure and to precise its volume. PATIENTS AND METHODS: Changes in immune reactivity were investigated in 100 patients. They were selected with nodular (adenomatous) hyperplastic parenchymal processes in the thyroid gland, with or without hyperfunction - euthyroid or Basedowificated nodular goitre, solitary toxic adenoma and nodular form of lymphocytic thyroiditis. Serum anti - thyroglobulin and anti - microsomal antibodies were examined in these patients, and in 56 of them immunophenotypic flowcytometric analyses of peripheral lymphocytes was performed. RESULTS: Serum antithyroid antibodies gradually decrease in one year after surgery. Pre-surgical changes in lymphocyte subsets number in peripheral blood recovered to great extent. This tendency is best demonstrated in lymphocytic thyreoiditis. DISCUSSION: Study on immune parameters can help to evaluate the positive effect of organ - preserved and at the same time - radical surgical treatment. CONCLUSION: In immune thyroid disorders the organ - preserved radical resection of thyroid gland leaving normal parenchyma is method of choice compared to thyroidectomy since it allows definite treatment with hormonal compensation.

[Video-assisted thoracoscopic surgery in diagnostic and treatment of non-operable malignant pleural mesothelioma].

INTRODUCTION: Mesothelioma is characterized by aggressive follow-up, difficult diagnosis and treatment fatal issue. In one side the restricted possibility for operative treatment and the other side the resistance of tumors for chemotherapy are the mean reasons for bad results in patients with malignant pleural mesothelioma. We have aim to make a retrospective study of patients with malignant pleural mesothelioma in 3-th and 4-th stage, undergoing operation in our clinic and see VATS effectiveness. PATIENTS AND METHODS: In the clinic of thoracic surgery in University Hospital "St.George" - Plovdiv we made retrospective study in 21 patients undergoing operation in the occasion of advanced pleural mesothelioma. It was thoroughly men (14) in age between 45-72 years (58.6). In 18 (85%) patients the disease was proven intraoperative or on the final histological result after operation. Before operation in this patients in help of diagnosis, we have information by image examination (radiography, CT of thorax and if it necessary to mark pleural effusion - sonography of pleural cavity ) abdominal sonohography or CT of abdomen for exclusion of distant metastasis, fibrobronchoscopy (FBS) for confirmation or exclusion of endobronchial cancer and transthoracic aspiration biopsy (TTAB). RESULTS: We describe improvement in the most of patients. In 2 patients we have not improvement. In this situation we made Bulao drainage. Death issue in early postoperative period we have in 1 patient with increased breath insufficiency despite evacuation of pleural effusion and unfolded lung. DISCUSSION: Early diagnosis of malignant pleural mesothelioma is difficult, in some times impossible. After histological verification the diagnosis is proven. Image examination is still insufficient. The difficulty comes by insufficient cytologic and histologic verification before operation and also insufficiency of image examination. Because of the chemotherapy is insufficient, surgical treatment (radical or not) in huge number of cases help improvement of patient's condition. CONCLUSION: 1. Surgical treatment is decisive for diagnosis and treatment of malignant pleural mesothelioma even in advanced cases and have evident positive effects. 2. Surgical methods improve patient's condition, even in inoperable cases. 3. VATS surgery is modern method for diagnosis and treatment and if it necessary we can continue by conventional operation for definitive treatment of mesothelioma.