[Clinical and morphologic characteristics of low-renin hyperaldosteronism]. / Kliniko-morfologicheskie osobennosti nizkoreninovogo giperal'dosteronizma.

A comparative assessment of the results of differential-diagnosis load tests and morphologic changes in adrenal tissue removed at surgery has been carried out in patients with arterial hypertension and low-renin hyperaldosteronism. Assessment of plasma aldosterone variations in response to load tests has shown this parameter to be unrelated to the structure of aldosteroma, either before or after the test. Different patterns of aldosterone production control were demonstrated in cases of diffuse-nodular and adenomatous adrenal changes. The study has provided additional information on the pathogenesis of this condition.

[Crisis of arterial hypertension in patients with primary aldosteronism]. / Krizovoe techenie arterial'noi gipertonii u bol'nykh pervichnym al'dosteronizmom.

A clinical picture of the disease was analyzed in 55 patients with primary aldosteronism due to adrenal aldosteronoma. A crisis variant of the course in arterial hypertension was detected in 50% of the patients. Its comparison with morphological signs of the adrenals enabled the authors to reveal that the crisis of arterial hypertension was accompanied by adrenal medullary hyperplasia and hyperfunction.

[Neurological changes in insulinoma]. / Nevrologicheskie izmeneniia pri insulinome.

Hypoglycemic disease is characterized by neurasthenic and encephalopathic syndromes. Three stages, an initial one, a stage marked by pronounced alterations and rehabilitation one (after insulinoma removal) were distinguished. Hypoglycemic paroxysms manifest themselves by syncopal, epileptic, pseudostroke and psychomotor excitation. Of paramount importance for diagnosis are EEG studies during fasting or rastinon test. Surgical removal of insulinoma results in normalization of neurological disturbances.

[Surgical treatment of different forms of hyperaldosteronism with low renin activity in the blood plasma]. / Khirurgicheskoe lechenie bol'nykh s razlichnymi formami giperal'dosteronizma i nizkoi aktiv ost'iu renina v plazme krovi.

The clinical picture and biochemical values in patients with arterial hypertension and concomitant hyperaldosteronism and low renin activity in blood plasma due to adenoma of the adrenocortical glomerular zone and in its absence were studied before and after surgical treatment. An attempt is made to substantiate the expediency of surgical or nonoperative treatment of patients with aldosteroma or bilateral hyperplastic process in the adrenals.

[Residual hypertension after removal of a pheochromocytoma (morphologic study of the kidneys)]. / Rezidual'naia gipertoniia posle udaleniia feokhromotsitomy (morfologicheskoe issledovanie pochek).

Renal parenchyma, and the juxtaglomerular apparatus in particular, was studied in 23 patients with verified diagnosis of pheochromocytoma. Intraoperative renal biopsy was performed in 21 cases, and kidneys obtained at nephrectomy or autopsy were examined in 2 cases. Twenty-one patients were examined following the removal of pheochromocytoma (2 patients died). Arterial BP returned to normal in 86.4%, and residual hypertension due to continuous hyperfunction of the juxtaglomerular apparatus in the presence of hypertensive angiosclerosis was recorded in 13.6%. Tubular epithelial atrophy of varying markedness, associated with renal ischemia, was detected in all cases. The pathogenetic contribution of the renin-angiotensin system to pre- and postoperative hypertension in pheochromocytoma patients is discussed.

[Permeability of the erythrocyte membrane for sodium in hypertension and symptomatic hypertension]. / Pronitsaemost' membrany éritrotsitov dlia natriia pri gipertonicheskoi bolezni i simptomaticheskikh gipertenziiakh.

Sodium permeability of erythrocyte membranes was examined, using the recording of maximum rates of sodium-lithium countertransport, in patients with essential hypertension of stages II and III by the WHO classification, renal arterial hypertension, Itsenko-Cushing disease, pheochromocytoma, Conn's syndrome and in subjects with normal arterial pressure who made up a control group. Hypertensive patients demonstrated a more than 60% increase in erythrocyte membrane permeability, as compared to normotensive controls. In patients with pheochromocytoma, the permeability values were almost 40% as low as the control ones. No changes in sodium erythrocyte membrane permeability could be demonstrated in patients with renal hypertension, Itsenko-Cushing disease and Conn's syndrome. It is believed that the erythrocyte membrane permeability parameters can be used for the identification of essential hypertension in the differential diagnosis of hypertensions.

[Application of echography to the diagnosis of chromaffinomas of extra-adrenal localization]. / Primenenie ékhografii dlia diagnostiki khromaffinom vnenadpochechnikovoí lokalizatsii.

Sixty-one patients with chromaffinoma were examined by echography. Of these, 6 patients (9.8%) had extraadrenal tumors. Application of echography permitted a correct topical diagnosis to be made in 5 patients. In 2 persons, the tumor was located in Zuckerkandl's fascia, in 2 in the paraaortal ganglia at the level of the splenic vein and the left hilus renalis, and in 1 patient, it was located in the urinary bladder. In one of the cases, no chromaffinoma was found. Since the majority of extraadrenal chromaffinomas (96%) are located in the retroperitoneal space echography can successfully be used for diagnosing such tumors with the exception of intrathoracic tumors which cannot be visualized in connection with the presence of air in the lungs. In such cases use should be made of computer-aided tomography.

[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.

[Pheochromocytoma with infarction-like changes in the heart and marked proteinuria]. / Feokhromotsitoma s infarktopodobnymi izmeneniiami serdtsa i vyrazhennoi proteinuriei.

The authors provide a clinical example illustrating difficulties in the diagnosis of pheochromocytoma in a patient with infarction-like lesions in the heart, marked proteinuria, and diverse symptomatics due to excess catecholamine secretion by the tumor.

[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.

[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.

[Indirect lymphography in the preoperative diagnosis of thyroid and parathyroid diseases]. / Nepriamaia limfografiia v predoperatsionnoi diagnostike zabolevanii shchitovidnoi i okoloshchitovidnoi zhelez.

The authors come to a conclusion that indirect lymphography is an effective method for the diagnosis of alterations in the thyroid gland (thyroiditis, malignant tumor, diffuse and nodular goiter). It can be also used in order to establish the state of its regional lymph nodes more exactly. The thyroid gland lymphography added by contrasting the esophagus is a simple and effective method for topical preoperative diagnosis and determination of localization of the altered parathyroid gland.