[Recurrent adenoma of the hypophysis]. / Retsidiviruiushchie adenomy gipofiza.

Adenoma recurrences were established in 24 (9.7%) of 247 patients with operated pituitary adenomas; 7 of them were with chromophobic non-secreting adenomas, 9 patients with acromegaly, 5 female and 3 male patients were with prolactinomas. Transcranial operations were performed on patients with large-size tumors and transsphenoidal ones on patients with small-size adenomas. Our experience has shown that adenoma recurrence was more frequent in larger tumors. Our results are supported by those of other authors. Early diagnosis and surgical treatment of pituitary adenomas prevent their recurrences.

[Pituitary apoplexy]. / Gipofizarnaia apopleksiia.

Ten patients with pituitary apoplexy were treated at the Institute of Endocrinology, Gerontology and Geriatrics in Sofia over the last 5 years. They represented 5.06% of the total number of patients with pituitary adenomas treated at the Institute during the same period. The highest frequency of pituitary apoplexy was noted among patients with Nelson's syndrome. In 5 patients of this group pituitary apoplexy was the first sign of a tumor. Headaches combined with nausea and vomiting were the earliest symptoms of pituitary apoplexy, and ptosis and ophthalmoplegy were the most common symptoms in the patients. The disease was not correctly diagnosed in 7 patients who immediately after apoplexy were treated in neurological and ophthalmological departments.

[Principles of selection of the method of treating Itsenko-Cushing disease]. / Printsipy vybora metodov lecheniia bolezni Itsenko-Kushinga.

Various methods for therapy of Icenko-Cushing's disease: radiotherapeutic, surgical and medicinal were evaluated. A total of 184 patients were treated. The authors have been of opinion that therapeutic methods depended on function of the neuroendocrine system and adrenal cortex, e. g. reserpine used after gamma-therapy alone or in combination with unilateral adrenalectomy increased the efficacy of therapy and reduced the time of remission. Parlodel used alone or in combination with chloditan could be used in therapy of early forms of the disease in young patients. Transsphenoidal adenomectomy and proton beam therapy of the hypophysis were recommended in hypophysial adenomas. Proton beam therapy of the hypophysis was an effective method for therapy of patients with diffuse hyperplasia of the adrenal cortex and could be used in diffuse nodular hyperplasia of the adrenal cortex in combination with unilateral adrenalectomy.

[Treatment of Cushing's syndrome with large doses of reserpine]. / Lechenie bolezni Itsenko-Kushinga bol'shimi dozami rezerpina.

The effectiveness of high doses of reserpine was studied in two groups of patients, suffering from Icenko-Cushing's disease. The patients of the first group received gamma-beam therapy combined with high doses of reserpine. The patients of the second group were treated with gamma-beam radiation associated with unilateral adrenalectomy plus high doses of reserpine. The controls were treated as described above, but without reserpine use. The results obtained have shown that reserpine monotherapy is not recommended in Icenko-Cushing's disease. High doses of reserpine combined with gamma-beam radiation alone or coupled with unilateral adrenalectomy shortened the period of the appearance of remission. The arterial blood pressure was significantly lower in patients treated with high doses of reserpine.

[Effect of heparin, heparin derivatives and heparinoids on blood sugar levels of diabetes mellitus patients]. / Vliianie geparina, geparinovykh proizvodnykh i geparinoidov na uroven' sakhara v krovi u bol'nykh sakharnym diabetom.

The effect of heparin, its derivatives--sodium iodoheparinate (dioparin), diethylaminoethyltheophylline heparinate (milheparin), and also heparinoids--eleparon, "thrombo" Goltzinger and Sp-51 degrees on the blood sugar level in patients with diabetes mellitus and in healthy persons was studied. The preparations were administered by drop intravenous infusion for 4 hours in a dose corresponding to 10 000 U of heparin activity. Glycemia, lipoproteid lipase, blood lipid fractions, and blood endogenous heparin levels were studied before and after the drug administration. In diabetic patients these preparations decreased the blood sugar level and effected the blood lipid fractions level. Potential mechanisms of the influence on the blood sugar level are discussed; four action mechanisms are assumed--the effect on insulin secretion and on the sensitivity to it, the effect on the liver, on disturbances of fat metabolism, and on increase of glucose use in the peripheral tissues.