Adrenal and pituitary incidentalomas in a case of Cushing's syndrome.

Cushing's syndrome is a pathological condition where surgery may be lifesaving. The proper diagnosis depends upon the hormonal pattern of the patient, various dynamic tests and imagistic investigations. We report a case of a patient with Cushing's syndrome, with bilateral adrenal tumors and a pituitary microadenoma. She presented increased levels of basal cortisol, unsuppressed during a low and a high dose Dexamethasone test. She underwent right laparoscopic adrenalectomy and developed acute adrenal insufficiency. Two years after the intervention, she still requires adrenal substitution therapy. Acute adrenal crisis is a serious complication of adrenal surgery, with high mortality if unrecognized.

Pheochromocytoma--from endocrinologist to surgeon.

We report the case an asymptomatic patient who underwent left adrenalectomy for a incidentally discovered large, cystic adrenal tumor. The patient presented no hypertension before or during the intervention. The hystopatological exam revealed a pheochromocytoma, with signs suggesting malignancy. One year after the surgery, the patient is still asymptomatic, the metanephrine levels are normal, and the 1231-metaiodobenzylguanidine scintigraphy showed no metastases. The indications and limits of laparoscopic adrenalectomy are presented.

Effect of viral preinfection upon cell adherence in some staphylococcus strains from specific infections or carriers.

The adherence of bacteria to eukaryote cells has been largely investigated as an essential step in the occurrence of bacterial infection. Some clinical and epidemiological studies have revealed the frequent association of certain viral infections with bacterial infections originating in the same ecological niche. Therefore, we investigated the effect of the viral preinfection (ADV4) of some cultivated cells (HEp-2 and IC.SK-27) upon the adherence of staphylococcus to these cells. The analysis of cell adherence within the mentioned conditions, estimated by flow cytometry, allowed of the following conclusions: 1. bacterial adherence to cultivated and virally preinfected cells is augmented by the viral preinfection, and its value on a given cell substrate may characterize a bacterial strain; 2. bacterial adherence to the investigated cell substrates does not correlate with the origin of the tested staphylococcus strains (infections or carriers) and some cell lines can differentiate bacterial strains depending upon the ecological niche or inside it.

Viral etiology of acute respiratory infections in infants and young children.

114 children with acute respiratory infections were investigated to detect the viral etiological agents. The following methods were used: the direct immunofluorescence technique for the rapid diagnosis from tracheobronchial aspirates and the serological reactions--hemaglutinoinhibition and complement fixation reaction--to determine the increase of antibodies titres. Of 55.2% respiratory infections with a viral etiology, 60.3% represent acute infections of the lower respiratory tract. Due to the influenza epidemic reported between October 1996 and February 1997 (with a higher number of cases than in the last 5 years), most viral respiratory infections were caused by influenza viruses (57.14%). The direct immunofluorescence technique proved to be sensitive and specific in detecting the viral etiological agents which caused respiratory infections. Thus, using this technique, a positive diagnosis was made in 68.2% of cases, of which 49.2% were positive by the hemagglutination and complement fixation reactions, too. The test specificity could have been higher if the pathological products had been prelevated within the first three days after the onset of the disease.

[ELISA in the rapid diagnosis of influenza using as the detecting antibodies polyclonal antinucleoprotein sera]. / ELISA in diagnosticul rapid al gripei utilizând ca anticorpi detectori seruri policlonale antinucleoproteina.

Hyperimmune polyclonal sera were obtained in order to use them as capture and detecting antibodies in rapid diagnostic of influenza A and B viruses by ELISA. The test shown 100% specificity. The sensitivity in directly detection of influenza viruses in human samples compared of influenza isolations was 49,25% for type A and 53,33% for type B. The sensitivity was increased after 48 hours from inoculation of human samples in cell culture-86,75% for type A detection and 80,0% for type B detection from supernatant mammalian tissue culture (MDCK).

[False-positive ELISA reactions for the hepatitis C virus and the human immunodeficiency virus after anti-influenzal vaccination]. / Reactii ELISA fals pozitive fata de virusul hepatitei C si virusul imunodeficientei umane dupa vaccinarea antigripala.

Possible appearance of ELISA false-positive results for hepatitis C virus (HCV) and human immunodeficiency virus (HIV) after vaccination against influenza was studied on 402 volunteers before, and 30 and 90 days after that. Our results prove that influenza vaccine can sometimes induce false-positive ELISA for HCV, but not for HIV. Their frequency is relatively small--0.96% in 10-20-years-old group and 3.1% in over 60 years age, while in 3-6 years age there were not registered this kind of reactions. The surveillance of individual ELISA-positive cases over time proves that cross-reacting antibodies HCV raised after vaccination against influenza are present only in second sera, that means 30 days after vaccination, but these antibodies disappeared 90 days later.