Search

Ectopic locations of parathyroid adenomas are a rare condition and can cause difficulty in their diagnosis and surgical treatment. We report two cases of intrathyroid parathyroid lesions. In the first patient, preoperative localization studies suggested the possibility of a parathyroid adenoma outside the thyroid gland. When a pathological gland is not found during surgery for primary hyperparathyroidism, an ectopic parathyroid gland was found in the thyroid tissue. In the second patient, in an existing thyroid nodule was found an ectopic normal parathyroid gland postoperatively.

The age of menopause in women is a key point, because early menopause is associated with increased risk for many diseases. The purpose of this study was to collect data on age of menopause in Bulgarian women and to detect possible changes in it. 6017 women aged 50 years and over were included, 5363 of them were postmenopausal. Mean age of menopause in the whole study group was 49.3 years. In younger menopausal women (age 51-59 yrs.) mean age of menopause was 47.7 yrs., whereas in elderly women (71-79 yrs.) it was 49.2 yrs. This shift down of the menopausal transition is due also to the increasing part of women with early or premature menopause, including iatrogenic causes. The main consequence is the "growing younger" of many common and socially important diseases among Bulgarian women, which require active prevention.

The andropause (andropaenia) or PADAM-syndrome represents a combination of clinical and laboratory symptoms, developed during aging. The most frequently reported clinical feature is erectile dysfunction. From the laboratory parameters the most typical finding is low normal or reduced serum testosterone levels. Very useful questionnaires have been developed helping in diagnosing the PADAM syndrome. Nowadays the hormonal replacement therapy with testosterone derivatives is considered to be the "gold standard". It has positive impact on the cardiovascular risk profile and its different components. This therapy is being prescribed on clear indications and according to strict rules. Available preparations in our country are the injectable and oral ones. Replacement therapy with other hormones is still not a part of clinical practice.

The early menopause is well known to have deleterious effects on bone mass. Trabecular bone is thought to be mainly affected. Aim of this study was to produce evidence on charges in forearm total, cortical and trabecular bone density in women with early menopause. The study included 40 women menopaused before the age of 43 years and 44 age- and size-matched healthy controls, menopaused after the age of 45 years. Bone densitometry was carried out on a single X-ray DTX-100 densitometer. A special calculation procedure was used to determine bone density of cortical and trabecular bone. The early menopaused women had low bone density both at the Distal (mainly trabecular) bone. We conclude that early-onset menopause affects mainly trabecular bone and causes premature ageing of bone.

Unlabelled: The present prospective study is aimed to estimate the effect of a low-dose combined oestrogen drug Cyclo-Menorette on climacteric syndrome in women with early menopause., Material and Methods: The criteria for inclusion in the study were ac follows: 9-12 months of menopause, increased FSH levels, moderately expressed climacteric syndrome confirmed by the menopausal index of Kupperman and Hamilton-Anxiety-Scale /HAMA/. According to acceptance of hormone replacement therapy /HRT/ the women were divided into 2 groups--control T /n = 31/ and Cunder treatment T /n = 35/. The degree of climacteric syndrome expression after Kupperman and HAMA was estimated in all patients at the beginning as well as on the 3-d, 6-th 12-d months. The presence and dynamics of side effects were followed in the patients treated with HRT., Results: Spontaneous improvement of complaints was found out in the control group with an increase of intragroup differences during the follow-up period. Most expressed improvement in the group under treatment was established during the first 3-6 months, the beneficial effect being preserved until the end of the study., Conclusion: The use of 1 mg oestradiol valerat in combination with 2 mg oestriol results in a significant decrease of climacteric syndrome manifestation with slightly expressed and transient side effects.

The concentrations of testosterone, estradiol, LH and FSH were studied in blood plasma of 84 healthy males and in the seminal plasma of 22 fertile males. The results obtained are juxtaposed to the concentrations of the indicated hormones in seminal fluid of 35 males with oligoasthenospermia and of 46 males with azoospermia. The concentration of the hormones in the seminal plasma was established to be equal to their concentrations in blood plasma. That enables their investigation in the seminal fluid in parallel with the spermogram. Normal fertility is admitted to be that fertility with a concentration of testosterone ranging from 250-550 mg%, of estradiol from 40-60 pg/ml, of LH-25-35 mlU/ml and of FSH from 20-30 mlU/ml. Reduced fertility has the concentrations of testosterone and estradiol reduced with more than 50% of the normal level, and that of gonadotropic--elevated with more than 50% of the normal level.

Twenty six patients with Kleinfelter syndrome were examined with the following tests being made use of: 1. J131 cumulation in thyroid gland. 2. Glycemia prior to and post loading with 100 g glucose at the 0 minute, 60th minute, 120th minute and 180th minute. 3. Dosage of protein conjugated iodine in blood. 4. Perchlorate test. 5. Dosage of thyroid hormone of blood level by radioimmunologic method. The results correlate withthe normal values of iodine cumulation and protein conjugated iodine as well as with the negative perchlorate test. The thyrotropic hormone level shows a tendency towards moderate elevation, without significant statistical correlation. No carbohydrate disturbances were found in any of the patients examined. Finally, the results obtained could be said to provide evidence for a euthyroid state and absence of disorders in carbohydrate metabolism in case of Kleinfelter syndrome.

The endothelial vascular desquamation was studied in 32 diabetic patients and 150 healthy controls. In the diabetic patients a significantly high desquamation was found. No differences in the desquamation due to the type of diabetes, I or II, and its duration were found. The authors are of the opinion that the early vascular desquamation is the result of the high glycemia.

A case of pseudohypoparathyroidism is reported. The case presents with unusual features: primary hypogonadism (a rare feature) and several features undescribed until now with the syndrome--changes in the amino acid composition, coxae valgae, shallow fossa olecrani as well as normal values of the parathyroid hormones which is considered as a "phase state" due to the exhaustion of the secreting function of the parathyroid glands. The role of the G-unit in the etiology of the disease is discussed.

The results from the carried out investigations on fertility indices of ejaculate are reported as well as on the spermatogenic activity test with radioactive phosphorus and on the determination of total gonadotropic excretion in urine of males with high degree of obesity. A statistically significant decrease of all investigated in dices of ejaculate and the test of spermatogenic activity was found. The decreased gonadotropic activity in over half of the patients investigated with obesity, as well as the manifestations of diencephalic alterations in them made the authors admit the secondary character of the gonad disorders.

The authors examined 48 males, with alcohol disease aged 20-50 and 10 healthy males. The dosing of testosterone was performed by radioimmunologic method with double antibodies. A significant increased level of serum testosterone was established when alcohol patients were examined. Serum testosterone is with the highest values in patients with sexual disturbances and in rather more advanced stages of the disease. The authors explain that paradoxical, at first sight, increase of testosterone in alcoholics by shifting of testosterone metabolism from oxidative way towards reductive way of metabolization.

The analytical reliability of the immunoenzyme methods for determination of the thyroid hormones thyroxin, triiodothyronine, thyroid-binding globulin, thyrotropic hormone and the thyroid-binding capacity was examined by the peroxidase activity of the marker enzyme of "Specol-11" 28 healthy controls, 28 patients with subcompensated insulin-dependent diabetes with mean duration of 8.4 years and 11 patients with hypogonadism were examined. In the diabetic patients were found changes in their thyroid state characteristic for hypothyroidism--increased thyroxin and a decrease of the thyroid-stimulating hormone with a lowered level of the binding proteins. The patients with hypogonadism showed changes mainly in the binding proteins level, a decrease of the thyroid-binding capacity with 70%. The results reveal interrelations between the thyroid gland hormonal state and other hormonal disorders.