[Clinical difficulties and errors in making a diagnosis of chronic papillo-odditis]. / Klinichni trudnosti i greshki pri postaviane na diagnozata khronichen papiloodit.

138 patients with chronic papillooditis were investigated, 15 of them in a stage of decompensation. In 83.3% of the cases, the diagnosis was not clinically determined (including 68 of 92 endoscoped before their hospitalization--82.9%). 34 patients were diagnosed as having chronic gastroduodenitis, 15--ulcer, 42--chronic cholecystitis, 11--chronic pancreatitis, 4--cholangitis, 9--postcholecystectomic status. All these diseases developed simultaneously with the papillitis. In a second endoscopic check-up with an examination of papilla Vateri, the patients were in all the cases diagnosed without difficulties and the diagnose was confirmed by biopsy. In 21 patients there was confirmed primary papillooditis and in 127--accompanying disorders: chr. gastroduodenitis--29, chr. atrophic gastritis--18, ulcer--15, chr. cholecystitis--42, postcholecystectomic status--9, choledocholithiasis--14, chr. pancreatitis--11. Most often misdiagnosis occurs if: 1) during the routine endoscopic investigation the endoscopist does not examine papilla of Vater; 2) chr. papillitis exists simultaneously with one of the already mentioned diseases that are easier of approach for diagnostics and explanation of the disorders; 3) the clinical picture of papillitis cannot be differentiated from the one of the basic or accompanying disease; 4) the bile drainage is not prevented; 5) the result of the venous biligraphy does not lead to the diagnosis and ERCP is carried out only in a case of a clinical suspicion.

[Dental changes in patients treated with calcium antagonists]. / Zubni promeni pri bolni, lekuvani s kaltsievi antagonisti.

For a period of 7 years the dental status of 160 patients has been investigated and followed. These patients have been treated with calcium channel blockers and selected in age between 22 and 50 years. Their diagnoses are: m. hypertonicus I-II stage--106, WPW-syndrome--10, stenocardia--18, atrial extrasystolia--26. Duration of treatment--from 1 to 7 years (corinfar, nifedipin, adalat--tabl. 40 mg, taken peroral or chewed, respectively suck; isoptin, verapamil--tabl. 40 mg, diltiazem--tabl. 30 mg, taken peroral. A control group of 60 clinically well people at age from 20 to 48 years was investigated. Under continuous treatment with calcium antagonist (> 1 year) the examined patients are found to have considerable decalcination of the dental enamel and caries more frequent (87.5%) compared to the group of clinically healthy people (65%), also increased number of caries in the same patient in comparison to his dental status before starting the therapy in 108 of 160 (67.5%). The differences in the results are statistically significant (p < 0.001). The number of the discovered caries in patients treated with calcium channel blockers and in the studied groups is also large (4 to 2 on average, i.e. two times more). The results allow to recommend a continuous stomatological control for patients treated with calcium antagonists.

A unique case of naturally occurring mummification of human brain tissue.

When skulls and bones were exhumed from a mass grave in Bulgaria and subjected to medicolegal examination they were found to originate from 39 humans aged 36-60 years old who had been buried approximately 45-50 years ago. Solid structures which strongly resembled shrunken human brain tissue were found inside 2 intact skulls. Among other bones 5 similar structures were found one of which was an almost entirely preserved human brain, and the others were fragments from different regions of the human brain. Samples of these structures were immersed in 15% aqueous glycerol solution to soften and were examined by light and electron microscopy. Samples of this material and of fresh human brain were subjected to elementary atomic spectral analysis. These complex studies indicated the samples to be naturally mummified human brain tissue and that this process had occurred due to specific conditions within the cranial cavities after burial.

[The clinical importance of determining aldosterone in the ascitic fluid]. / Klinichno znachenie na opredelianeto na aldosteron v astsitna technost.

A method for determination of aldosterone in ascitic fluid is worked out. In 20 patients with advanced liver cirrhosis and ascites the aldosterone level in the blood plasma and in the ascitic fluid was higher than in the healthy controls. The finding of elevated aldosterone level is important for the selection of diuretic since the efficacy of the diuretic treatment in patients with liver cirrhosis depends to a great extent on the level of renin activity and aldosterone.