[Recurring secondary hyperparathyroidism: case report].

The authors report a rare case of persistently recurring secondary hyperparathyroidism concomitant with chronic renal insufficiency. The patient underwent multiple surgical interventions (parathyroidectomy, implantation of parathyroid autograft into a forearm muscle, removal of hyperplastic autograft tissue). Results of clinical, laboratory, instrumental, and morphological studies are presented. Possible causes of relapses and problems of morphological diagnosis are discussed.

[Subtoxic diphtheria of the oropharynx with neurologic complications in an adult man]. / Subtoksicheskaia difteriia rotoglotki s nevrologicheskimi oslozhneniiami u vzroslogo muzhchiny.

A case is reported of subtoxic local diphtheria in a male of 43 complicated by the development of cardiosclerosis and polyradiculoneuropathy as a result of late diagnosis and hospitalization, alcohol abuse. Pulmonary thromboembolism was a cause of death.

[State of the liver in patients with obesity at distant periods after formation of a "small stomach"]. / Sostoianie pecheni u bol'nykh ozhireniem v otdalennye sroki posle operatsii formirovaniia "malogo zheludka".

Histological study of biopsy specimens taken from the liver of 96 patients during operation for formation of a "small stomach" revealed fatty dystrophy of the liver in 93 patients (96.9%) which was attended by marked inflammatory and fibrous changes in 68 (70.8%) of them and by disturbed lobar structure of the liver (cirrhosis) in 2 patients (2.1%). Biochemical blood tests failed to show the pattern of the pathological changes before the operation. Study of the hepatobiliary system with methionine-75Se was the only method by which protein and pigment metabolism in the liver could be appraised. Examination of patients during 3 postoperative years showed a positive dynamics of changes in biochemical blood tests and improved protein metabolism in the hepatocytes according to the results of scanning of the liver with methionine-75Se. Thirteen repeated studies of the hepatic tissue collected from patients in different periods after operation for the formation of a "small stomach" showed a significant diminution of fatty dystrophy and inflammation of the parenchyma. The level of portal tract inflammation and portal fibrosis did not change. The findings suggest that there is an improved functional and morphological condition of the liver in weight loss caused by operation for the formation of a "small stomach", which allows this type of surgical intervention to be recommended for the treatment of patients with alimentary-constitutional obesity and initially diminished compensatory capacities of the liver.

[Generalized calcinosis of the internal organs associated with multiple endocrine adenomatosis]. / Generalizovannyi kal'tsinoz vnutrennykh organov na fone mnozhestvennogo éndokrinnogo adenomatoza.

A rare observation of associated universal calcinosis of the internal organs and multiple adenomatosis is described. The patient was diagnosed to have renal cystadenoma with a high content of neutral lipids in the cells; medullary thyroid carcinoma; nodular adrenal hyperplasia; microadenoma of eosinophilic cells and basophilic cell hyperplasia of the anterior hypophysis; microgangliocytoma of the hypophyseal peduncle; atrophy of the parathyroid gland. Symptoms of hypercalcemia, hypercorticoidism, and some features of the carcinoid syndrome were clinically observed. It is suggested that the clinical symptoms were due to the increased production of vitamin D3 active metabolites by the renal tumour.