[Diagnosis and surgical treatment of pheochromocytoma].
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Biomedical subjects
Publications and source records attributed to T Todorov.
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An enzyme-linked immunosorbent assay (ELISA) for the serological differentiation of cystic (Echinococcus granulosus) and alveolar (E. multilocularis) echinococcosis in man has been evaluated. A discrimination rate of 95.1% was found for 82 sera from patients of geographically disparate endemic areas. This rate was essentially the same as that found for 57 Swiss patients, indicating that inter- and intraspecific strain differences do not influence the test results. The assay method is suitable for immunodiagnostic purposes as well as for seroepidemiological studies.
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Fifty seven patients with primary hyperparathyroidism are reported to be successfully operated. The pneumomodiastinography and hypotensive esophagoscopy, according to Reimberg--Semzov, were used for preoperation localization of the pathologically changed para thyroid glands. Operation technique applied in adenoma, hyperplasia and carcinoma of parathyroid glands is described. The lethality of the operations performed is 0 per cent. The early and late postoperative results are analyzed as well as the favourable effect on the alterations in the osseous, gastrointestinal and excretory system. The necessity of early diagnosis of the disease is stressed upon as well as the timely performance of the operation.
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Three children with primary hyperparathyroidism, confirmed at operation, are reported. The generalized skeletal changes with pathological fractures are leading in two of them, necessitating a long-term orthopedic treatment. Big solitary adenomas were found at operation. The disease, in the third child, had the course of nephrolithiasis. Hyperplasia of all four parathyroid bodies with light cells was established at operation. The biochemical deviations are typical in all three children undergone operations: hypercalcemia, hypophosphatemia, elevated alkaline phosphatase with increased excretion of calcium and phosphorus in urine.
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A comparison of immunoglobulin concentrations between 136 patients with surgically proved echinococcosis and control persons revealed significantly higher concentrations of immunoglobulins only in the IgG class, a phenomenon, which was more pronounced in patients with secondary echinococcosis. In the first twelve months after surgical treatment the IgG and IgA values decreased faster than the IgM values, however, in the postoperative period the IgG persisted longer than the other immunoglobulins. Antibody titers and IgG concentrations observed showed a positive correlation in the follow-up time. From these results it is suggested, that the antibodies before and after surgical treatment of echinococcosis belong to the IgG class.
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Although lysozyme and penicillin are different in their molecular action on cell wall murein they produce similar morphological changes in Erysipelothrix rhusiopathiae grown on agar media. 2,000--5,000 micrograms/ml lysozyme and 0.1--2 IU/ml penicillin induce filament formation. Filaments are able to divide in rods, which shows that only cross wall formation and separation are inhibited. Higher doses of lysozyme (10,000 micrograms/ml) and penicillin (less than 1 IU/ml) inhibit cell wall synthesis and induce L-form growth. The propagation of this protoplast type L-form was investigated by microphotographic series in phase contrast microscope during L-form induction and in the stable L-form state. In both cases L-form cells propagate by formation and growth of small granular elements of about 0.2--0.6 micrometers in diameter, which spread in different directions in the agar medium. The multiplication process may be explained by the plasticity and flexibility of the L-form cell and its cytoplasmic membrane and by the structural and functional interaction between the "folded chromosome" and the surrounding cytoplasm.
Protein antigens were obtained from Br. abortus 99 and Yersinia enterocolitica, type 9, and were titered on guinea-pigs infected with a living culture from these microbes. It was proved that the guinea-pigs infected with Yersinia reacted with a skin-allergic reaction only to an antigen obtained from Yersinia and not from Brucella. Conversely, the animals infected with Br. abortus B-19 reacted during skin treatment only to an allergen from Brucella, but not with an allergen from Yersinia. In a rabbit anti-yersinia serum were proved precipitins through the immunodiffusion test against the protein allergen from Yersinia, whereas no Brucella precipitins were detected with a protein allergen. In anti-Brucella rabbit serum (Brucella amboceptor or agglutinative serum, no precipitins were proved with Brucella and Yersinia protein allergens. In a hiperimmune rabbit serum against Brucella and Yersinia were proved precipitins against a polysaccharide both from Yersinia and Brucella. It was adopted that protein antigens in the case of Brucella and Yersinia were specific and that specificity could be used for differentiation of these two infections.