[Neurologic disorders in insulinoma]. / Nevrologicheskie narusheniia pri insulinomas.

Three cases of insulinoma-related neuropsychic disturbances and literature data are considered. Special emphasis is given to polymorphism of epileptiform syndrome, concomitant disphoric paroxyms and lethargy. A case of a rare syndrome coma vigil is described in the advanced stage of the disease. The discussion covers pathogenetic mechanisms and differential diagnosis.

[Value of echography in the differential diagnosis of benign and malignant corticosteromas]. / Znachenie ekhografii v differentsial'noi diagnostike dobrokachestvennykh kortikosterom.

Altogether 34 patients with corticosteroma were examined. In 29 (85%) of them accurate topical diagnosis was established as a result of ultrasonic investigation. All erroneous results were obtained only for corticosteromas of small sizes (4 cm and less in diameter). Tumors not exceeding 4 cm in diameter were benign in 88% of cases. If tumor sizes were over 4 cm, they were malignant in 89%. The earliest possible investigation for the presence or absence of a tumor was indicated to patients with hypercorticism.

Morphological changes in the adrenal cortex in different variants of low-renin hyperaldosteronism. Comparison with the functional state of certain hormonal systems.

On the basis of morphological and histochemical examination of adrenal tissue of 45 patients with arterial hypertension and low-renin hyperaldosteronism, the following five morphological variants of this disease were differentiated: 1) with adenoma of the adrenal cortex and atrophy of surrounding cortical tissue; 2) with adenoma and hyperplasia of elements of the zona glomerulosa and(or) the zona fasciculata and the zona reticularis; 3) with multiple adenomatosis of the adrenal cortex; 4) with isolated diffuse or focal hyperplasia of the zona glomerulosa; 5) with nodal, diffuse-nodal or diffuse hyperplasia of all cortical zones. In tumours, three structural variants, corresponding to their histogenesis, were identified. A correlation was found between morphological variants and hormonal diagnosis of different forms of low-renin hyperaldosteronism.

[Use of echography for diagnosing aldosteromas]. / Primenenie ékhografii dlia diagnostiki al'dosterom.

Altogether 23 patients were examined to assess the value of echography in the diagnosis of aldosteromas. Tumors were diagnosed at operation in 21 (2 malignant tumors) and adrenal hyperplasia in 2. The accuracy of diagnosis with regard to the presence or absence of aldosteromas was 82.6%. An analysis of the causes of erroneous results showed that they were noted in small size formations less than 2 cm in diameter, in corpulent patients and in the left-side tumor site due to more complicated anatomotopographic interrelationships of the organs in this area.

[Familial forms of chromaffinomas]. / Semeinye formy khromaffinom.

The familial chromaffinoma forms were seen in 13 members of 4 families. Eight of these patients (6 females and 2 males), aged 15 to 43 years old, were operated for disseminated bilateral chromaffinomas. Seven patients had malignant tumors. In 3 families there were patients with Sipple's syndrome. Extensive laparatomy is rather preferential by surgeons. In view of the autosomal-dominant form of the disease transmission it is necessary to investigate thoroughly the familial history and to examine purposefully the children and relatives of patients with chromaffinomas, especially, with Sipple's syndrome.

[Dynamics of EKG changes in patients with Itsenko-Cushing disease before surgery, and following the 1st and 2d stages of adrenalectomy]. / Dinamika izmenenii EKG u bol'nykh bolezn'iu Itsenko--Kushinga do operatsii, posle pervogo i vtorogo étapov adrenaléktomii.

The results of examination of ECG in 44 patients suffering from Itsenko-Cushing's disease at different stages of surgical treatment are presented. The data obtained were compared with the blood potassium and sodium levels, 17-KS, and 17-OCS levels in the urine, arterial pressure and cholesterol content. Various ECG changes before the operation were revealed in 39 patients. Signs of enlargement of the left ventricle and deformity of the end part of the ventricular complex (negative T wave and or reduction of S-T segment in I, II, avL V5-6 leads) were found in 8 patients, and deformity of the end part of the ventricular complex without any signs of enlargement of the left ventricle--in 18 patients. There proved to be a significant dependence of the changes in the end port of the ventricular complex on increased urinary excretion of 17-OCS, hypokaliemia and hypernatriemia. Negative ECG changes after bilateral total adrenalectomy was significantly connected with postoperative hypocorticism.

[Dynamics of changes in the indicators of electrolyte metabolism after surgical treatment of Cushing's syndrome]. / Dinamika izmenenii pokazatelei elektrolitnogo obmena posle khirurgicheskogo lecheniia bol'nykh bolezn'iu Ishchenko-Kushinga

The authors present the results of study of the state of the water-electrolyte metabolism at the early postoperative period in 58 patients suffering from Itsenko-Cushing's disease with consideration of the potassium deficiency correction. Potassium and sodium level was studied in the plasma and the erythrocytes. Besides, in 31 patients potassium and sodium content were examined in the muscular tissue obtained during the operation. Hypoglycemia was revealed in 48.2% of the cases, and hypernatriemia--in 19.0%. A reduction of potassium level in the erythrocytes was revealed in 50%, and a rise of sodium--in 52% of cases. The muscle tissue potassium level fell in parallel to the reduction of this electrolyte level in the erythrocytes. Disturbances of the electrolyte balance proved to be most pronounced at the early postoperative period in the patients given no potassium preparations. Separate use of potassium preparations, or (particularly) together with veroshpiron, prevented potassium deficiency at the early postoperative period.