[The copper concentration in the blood serum of women with ovarian tumors (a preliminary report)]. / Kontsentratsiia na medta v kruvniia serum pri zheni s ovarialni tumori (predvaritelno suobshtenie).

The aim of the present study was to evaluate serum copper concentration changes in patients with benign cysts or carcinomas of ovary, and to compare these concentrations with the normal reference serum copper levels. Patients included in the study were as follows: benign ovarian cyst cases (n = 19), endometrial cyst cases (n = 5), ovarian carcinoma cases (n = 6), female patients with no ovarian disease (n = 161). Reference serum copper levels in apparently healthy subjects were 16.8 +/- 4.15 mumol/l (mean +/- SD). Serum copper concentration were significantly increased in ovarian carcinoma patients (22.98 +/- 3.90 mumol/l) in comparison with benign cyst patients (18.40 +/- 4.61 mumol/l) (p < 0.05), in with endometrial cyst patients (15.94 +/- 4.24 mumol/l) (p = 0.02), and in comparison with normal levels in controls (p < 0.001). Copper/zinc ratios were highest in ovarian carcinoma patients--1.68, intermediate in benign cyst patients--1.42, and lowest in endometrial cyst patients--1.08. The mechanisms underlying serum copper concentration variations in the different groups are briefly discussed with special emphasis on these in ovarian carcinoma patients.

[Multiple pregnancy and microelements: zinc (preliminary report)]. / Mnogoplodna bremennost i mikroelementi: tsink (predvaritelno suobshtenie).

The aim af the study was to define the concentration of zinc in sera of women with multiple pregnancies during the last trimester and to compare it with the values in normal pregnancies. The study included 12 women with gemini and 67 with single fetus pregnancies. A statistically significant decrease was found in the mean zinc concentration in twin pregnancies--8.1 +/- 1.72 mcmol/L compared to the mean values in normal pregnancies--10.5 +/- 1.90 mcmol/L (p < 0.001). Various mechanisms, possibly responsible for the stated changes, their relation to some complications of multiple pregnancy and delivery are discussed, as well as their prophylactics.

[The concentration of selenium in the maternal serum in cases of missed abortion]. / Kontsentratsiia na selen v maichiniia serum pri sluchai s missed abortion.

The changes in the serum level of selenium in cases with pathologic pregnancies are still not clear. The aim of the present study was to determine whether serum selenium in cases with missed abortion differed from selenium concentration in serum during first trimester of normal pregnancy. Twenty-three women with missed abortion and 61 with normal pregnancy were included in the study. We found a statistically significant (p < 0.001) elevation of serum selenium level in cases with missed abortion (928 +/- 335 nmol/l) comparing with those with normal pregnancy (568 +/- 77 nmol/l). We discuss the possible mechanisms of the observed changes.

[The zinc concentration of the blood serum in women with ovarian tumors (preliminary report)]. / Kontsentratsiia na tsinka v kruvniia serum pri zheni s tumori na iaichnitsite (predvaritelno suobshtenie).

The aim of the study is to determine the concentration of blood serum zinc of women with ovarian tumors. The patients included in the study are as follows: 15 women with benign ovarian cysts, 5 with endometrial cysts and 5 with ovarian carcinoma. The control group consists of 157 healthy women whose serum zinc concentration was 13.50 +/- 2.60 mmol/L. We could not demonstrate a significant difference in serum zinc concentration of different groups: benign cysts, endometrial cysts and ovarian carcinoma in comparison control group.

[The lead level in the blood of pregnant women from the city of Sofia]. / Suderzhanie na olovo v kruvata na bremenni zheni ot grad Sofiia.

The study was aimed at establishing the relation between blood lead, nutrient intake and smoking habits of pregnant and nonpregnant women in Sofia. Forty four pregnant in the last trimester of pregnancy and 14 nonpregnant women were examined. There are no differences between the mean blood lead level of the groups. 22.72% of the pregnant and 37.7% of the nonpregnant women studied had blood lead above the accepted tolerable value of 0.48 mumol/l. It was established low intake of calcium, zinc and iron, minerals that contribute to lead bioavailability. A positive correlation between the number of cigarettes smoked and blood lead concentration was established. Based on this study it can be concluded that non-professional external exposure of lead in Sofia is significant. Smoking is eventually one contributing factor that can be excluded to reduce lead exposure.

[Tocolytic substituent treatment with Magnerot in threatened abortions and premature labor from the 16th to the 36th gestational week]. / Tokolitichno zamestitelno lechenie s Magnerot pri zaplashvashti aborti i prezhdevremenni razhdaniia ot 16-ta do 36-ta gestatsionna sedmitsa.

The Mg's low level in the sera and the urine correlate with clinical symptoms of uterine contraction in pregnant women from the 16th-36th gestation week. The authors present their experience with the use of removal tocolytic curing with Magnerot tabl. in the cases of 60 pregnant women with uterine pain and contractions from 16th to 36th gestation week and Pelvic Score after Bishop under 4. The effect of the curing is remarkable till from the beginning in the first 4-7 days of it, which is demonstrated with disappearing of the objective and subjective contractions (overviewed in obstetric monitor) and there is normalising of the paraclinical levels of the Mg in the sera and the urine, with normal pregnancy and birth of a healthy and alive child.

[Prolonged pregnancy and trace elements: iron]. / Prenosena bremennost i mikroelementi: zheliazo.

Iron is an essential trace element and it is well known that the iron requirement steadily increase during pregnancy. The aim of this investigation was to compare the serum iron levels in normal and serotine pregnancy. Twenty-six women with serotine pregnancy (19 in 42 and 7 in 43 gestation week (g.w.)) were included in the study. The control group is consisted from 74 women with normal pregnancy. The serum iron concentration is elevated in the women with serotine pregnancy (24.59 +/- 11.60 mmol/(l), but the difference was not significant. The group with serotine pregnancy in 42 g.w. has even lower serum iron concentration than the women with normal pregnancy (19.44 +/- 6.52 mmol(l). The serum iron concentration was significantly elevated (p < 0.001) in serotine pregnancy in 43 g.w. compared with normal pregnancy as well as with serotine pregnancy in 43 g.w. The possible pathogenetic mechanisms of the observed changes are discussed.

[The zinc concentration of the maternal serum and the amniotic fluid in pregnancies with fetal neural defects in the second trimester]. / Kontsentratsiia na tsink v maichin serum i okoloplodna technost pri bremennosti s nevralni defekti na ploda vuv vtori trimestur.

The object of the investigation are 120 pregnancies in the second trimester, 38 of which are with prenatally proved neural tube defects of the fetus (anencephaly, spina bifida, hydrocephaly) and 82 with morphologically normal developed fetuses. There have been examined vein blood of the pregnant woman and amniotic fluid after transabdominal amniocentesis as there has been determined zinc status in both of the biological fluids. The average serum's zinc concentration at malformed pregnancies is without statistically considerable difference in comparison with this of the group--healthy pregnancies. Amendable zinc's concentration at cases with neural tube defects are statistical considerably higher than these in the control group. A survey of literary data, devoted to the theory of zinc deficiency as a teratogen in the human pregnancy, has been made during the last years. Up to the author's opinion, there have been represented the most acceptable explanations about the abnormal values of the zinc amenable concentration at neural tube defects in the fetus.

[Calcium-phosphorus metabolism and calcitrophic hormones in patients with active acromegaly with and without osteoporosis]. / Kaltsievo-fosforen obmen i kaltsitrofichni khormoni pri bolni s aktivna akromegaliia sus i bez osteoporoza,

Calcium-phosphor metabolism was studied in patients with active acromegaly with or without osteoporosis, mean age 45.2 +/- 11.4 years and mean duration of the basic disease 5.52 +/- 3.6 years. No significant deviations and no direct relation with the high serum growth hormone and prolactin levels were found. The normal basic secretion of the calcitrophic hormones--parathyroid hormone and calcitonin and their normal response to the hypercalcemia after intravenous calcium load of the patients with and without osteoporosis reject their direct participation in the pathogenesis of osteopenia. The changed skeletal sensitivity to calcitrophic hormones closely connected with the patients' age and the duration of the basic disease in combination with many other factors probably plays a major role in the pathogenesis of osteopenia.

[Treatment of patients with postmenopausal and steroid-induced osteoporosis using sodium fluoride combined with vitamin D2 and calcium gluconate]. / Lechenie na bolni s postmenopauzalna i steroidindutsirana osteoporoza s natriev fluorid v kombinatsiia s vitamin D2 i kaltsiev gliukonat.

9 patients with postmenopausal and 5 patients with steroid-induced osteoporosis, mean age 57.9 +/- 7.76 years, were treated in the course of one year with sodium fluoride (Fluosen) in a dose of 45 mg/24 h in combination with calcium gluconate (2 g/24 h) and oil solution of vit D2 (2 mg/week). In the course of the treatment a considerable easing of the pains in the most affected parts of the skeleton was found and the height remained at the same level before and after the treatment. This correlates with the statistically significant increase of the serum levels of the total alkaline phosphatase and its bone isoenzyme by keeping a normal kalium phosphorous balance as well as with the x-ray data for retaining the bone changes liked with the osteoporosis.

[The serum concentration of trace elements in chronic kidney failure]. / Serumna kontsentratsiia na niakoi oligoelementi pri khronichna bubrechna nedostatuchnost.

The serum copper, zinc, selenium and magnesium levels were studied in 37 patients with chronic renal failure of various degree. The examination of the oligoelements and magnesium was performed on flame and electrothermal atomic absorption spectrophotometry. Reference values from 345 clinically healthy persons were used in the interpretation of the results. The serum, zinc, selenium and magnesium concentrations are lowered and the differences are statistically significant (for zinc p less than 0.01, selenium--p less than 0.001, magnesium--p less than 0.05). These changes are not directly related to the degree of impairment of the excretory renal function. The serum copper concentrations are statistically significantly elevated and this correlates with the degree of impairment of the excretory renal function. The possible pathogenetic mechanisms of these changes are discussed.

[The effect of oral calcium loading on the serum concentrations and urinary excretion of uric acid in patients with recurrent calcium nephrolithiasis and hypercalciuria]. / Vliianie na oralnoto obremeniavane s kaltsii vurkhu serumnite kontsentratsii i urinnata ekskretsiia na pikochna kiselina pri bolni s retsidivirashta kaltsieva nefrolitiaza i khiperkaltsiuriia.

The authors have established that to higher calciuria in patients with calcium nephrolithiasis correspond higher vales of uric acid serum concentrations and urine excretion than in the controls. In the oral calcium tolerance test a significant correlation was found between the changes in the uric acid urine excretion and those in the diuresis. The following conclusions are put forward. I. In the patients with recurrent calcium nephrolithiasis and hypercalcinosis one should look for active impairment of uric acid metabolism which should be kept in mind when an antirecurrence treatment is planned. 2. The established parallel increase of uricosuria and calciuria in the oral calcium tolerance test means that to patients with recurrent calcium nephrolithiasis and gout a rich calcium diet should not be prescribed since it increases the risk of formation of calcium oxalate stones.

[The interrelationship between calcium and magnesium homeostasis and its significance for the relapse-prevention treatment of calcium nephrolithiasis]. / Vzaimozavisimost mezhdu kaltsievata i magnezievata khomeostaza i znachenieto ì za protivoretsidivnoto lechenie na kaltsievata nefrolitiaza.

The correlation between the renal excretion of calcium and magnesium after an overload with 1000 mg of calcium is studied. The significant interrelations between the calcium and magnesium urine excretion point that there are close interrelations between their active tubular transport in the kidneys. The significantly higher magnesuria and the tendency toward a low serum magnesium level in patients with renal hypercalciuria require to take into account the hypermagnesuria. The oral treatment with magnesium which was prescribed in the past indiscriminantly to all patients with relapsing calcium nephrolithiasis is necessary only for patient with renal hypercalciuria.

Magnesium, schizophrenia and manic-depressive disease.

Plasma magnesium (Mg) levels were estimated in 15 schizophrenic, 10 depressed, 6 manic and 6 presenile Alzheimer's disease patients and compared with those in 303 healthy controls. The schizophrenic and depressed patients showed lower levels, but the levels were normal in the other two groups. Mg levels increased on achieving clinical remission in the schizophrenic patients. A hypothesis is proposed according to which the high level of stress found in severely ill psychiatric patients can lead to marginal Mg deficiency in susceptible individuals. This could exacerbate symptoms such as anxiety, fear, hallucinations, weakness and somatic complaints.

[The effect of oral calcium loading on the serum magnesium concentration and its urinary excretion in patients with recurrent calcium nephrolithiasis and hypercalciuria--differential diagnostic potentials]. / Vliianie na oralnoto obremeniavane s kaltsii vurkhu serumnite konsentatsii na magnezii mu v urinata pri bolni s retsidivirashta kaltsieva nefrolitiaza i khiperkaltsiuriia--diferentsialnodiagnostichni vuzmozhnosti.

The study deals with 13 healthy controls with normal basic indices for calcium-phosphorus metabolism and 25 patients with recurrent calcium nephrolithiasis and hypercalciuria, 13 of them with renal hypercalciuria and 12 patients with absorptive hypercalciuria. The oral calcium-tolerance test was carried out in all persons. The changes in the serum and urine calcium and magnesium concentrations following the calcium loading are recorder. A statistically significant increase of magnesium urine excretion was found in all persons examined, the highest being in the patients with renal hypercalciuria, considerably higher than in the healthy controls. The conclusion is reached that the magnesium urine excretion gives valuable information for the diagnosis of patients with renal hypercalciuria.

[Treatment of patients with postmenopausal osteoporosis and steroid-induced osteoporosis with the preparation Rocaltrol (1,25/OH/2 vitamin D3)]. / Lechenie na bolni s postmenopauzna osteoporoza i steroidindutsirana osteoporoza s preparata rokaltrol (1,25/OH/2 vitamin D3).

A clinical trial of the drug "Rocaltrol" was carried out on 16 patients with osteoporosis, II of them with menopause osteoporosis and 5 with steroid-induced osteoporosis. The mean age of the patients was 53.1 +/- 11.1 years. The mean daily dose of the drug was 0.46 +/- 0.08 mg/24h. The treatment lasted 6 months. All patients showed improvement of the general condition and of calcium balance. Reliable increase of the total calcium and phosphorus levels and of the 24-hour calcium urine excretion were established, the maximal values being at the end of the third month. The X-ray examination showed stabilization of the bone changes and lack of new compression fractures. It is supposed that the drug improves the intestinal resorption of calcium and phosphorus and suppresses the bone resorption. This is proved by the reliable decrease of serum alkaline phosphatase level after the 6 month treatment. In all patients clinical improvement was established with diminishing of the bone aches and retaining the body height before and after the treatment.