Renal Involvement in Mediterranean Spotted Fever: Clinical and Histopathological Data.

Objective: Mediterranean spotted fever (MSF) is a tick-borne rickettsial infection endemic to the Mediterranean coastline countries. As a result of growing tourism, imported cases have been registered in many nonendemic countries and regions. We present clinical laboratory parameters and histopathological data on renal impairment in patients with MSF.

Bisphosphonate-associated osteonecrosis of the jaws -- report of three cases in Bulgaria and review of the literature.

A severe complication of the administration of bisphosphonate-containing medications is known as bisphosphonate-associated osteonecrosis of the jaws (BONJ). A case series of three patients affected by BONJ is presented. These patients currently represent the only described cases of BONJ in Bulgaria.

[Adenocarcinoma of the pancreas with distant meningeal metastasis].

The incidence of meningeal metastasis from pancreatic cancer is extremely low. In our country patients die rapidly from pancreatic cancer and are extremely rarely subjected to autopsy--they either die at home, or complications from primary tumor result in low clinical interest. We had the rare chance to perform an autopsy on a female patient with meningeal spread of pancreatic carcinoma, in which the patient initially developed signs of neurologic disorder without exhibiting any symptoms of pancreatic disease.

[A rare case of low grade endometrial stromal sarcoma of the uterus].

Endometrial stromal sarcoma (ESS) is a rare disease. Low-grade endometrial stromal sarcoma (LGESS) is characterized by proliferations composed of cells with endometrial stromal cell differentiation and typically show extensive worm-like vessel invasion. We present a case of a 38-year-old woman with complaints of abdominal pains and ultrasound findings of a tumour formation in the pelvis.

[A case or operative treatment of a rare lung tumor (sclerosing haemangioma)].

Sclerosing hemangioma of the lung is a rare tumor, defined as benign, but it has the propensity for recurrence and metastases. We present a case of operative treatment of a 37-years-old female patient with such tumor, with preoperatively assessed clinical and X-ray evidence for tumor formation in the right lung. At the operation we found a tumor in the third segment of the right lung, resembling visually and histologically (frozen section) a metastase.

[Incidence and structure of pediatric pathology according to autopsy files at the University Hospital "St. George" Plovdiv, Bulgaria during 1985-2001].

The present study is aiming at sharing our problems and experience with pediatric autopsy cases. The incidence of pediatric cases as part of total autopsy activity is estimated. Criteria such as coincidence between pediatricians' and final pathological diagnosis are considered.

Low-grade pulmonary myxoid liposarcoma.

Primary pulmonary liposarcoma is extremely rare. There are only 12 cases reported in the literature. We presented a case of low-grade primary pulmonary myxoid liposarcoma, which was diagnosed and underwent surgery in our clinic.

A rare case of epidermoid cyst of the scrotum with signs of malignization--clinical and morphological features.

Proceeding from the fact that epidermoid cysts of the scrotum are rare and often histologically proven to display evidence of malignization in the underlining epithelium, the authors present a case of scrotal epidermoid cyst from their clinical practice. Epidermoid cysts are given a detailed pathohistologic assessment. The finding was a productive granulomatous inflammation containing multinucleated giant cells of foreign body type in the overlying dermis and intraepidermal "horn pearls" (keratin substance of Queyrat) showing unequivocally signs of malignization of the epidermoid cyst.

[Trophoblast expression of EGFR (epidermal growth factor receptor) in the preeclampsia placenta].

Unlabelled: Placental pathology in preeclampsia and retarded fetuses is associated with changes of the pattern of expression of EGFR. The purpose of this study was to investigate the expression of epidermal growth factor receptor in trophoblast populations of preeclampsia and retarded fetuses in comparison with normal controls. Tissue microarray with paraffin sections containing a general of 90 placental specimens including 30 preeclamptic cases, 30 retarded fetuses and 30 normal pregnancies (controls) were studied immunohistochemically for epidermal growth factor receptor in the syncytiotrophoblast and villous cytotrophoblast.

[Proliferation of villous trophoblast and stroma in normal and pathologic pregnancies (preeclampsia)].

Pregnancies, complicated with preeclampsia, present with intrauterine growth retardation of the fetus and small (in size and weight) placentas. The present study aims at establishing the expression of proliferative nuclear antigen Ki-67 in the villous trophoblast and stroma, and to compare the results between study (preeclamptic cases n = 30) and control (normal n = 30) groups. The number of Ki-67 positive nuclei both in the preeclamptic trophoblast and stroma significantly increases those of the controls.

Experimental study of the morphological and electromyographic characteristics of the most frequent iatrogenic lesions of the recurrent laryngeal nerves in thyroid surgery.

Introduction: Iatrogenic lesions of the recurrent laryngeal nerves remain one of the most severe and frequent complications in thyroid surgery. According to Eisele (Laryngoscope 1996;106:443) their incidence varies between 1% and 12% depending on the size of surgery.

Aim: The aim of the study was to examine experimentally the type of neural lesion and the efficiency of stimulation electromyography for immediate evaluation of the recurrent laryngeal nerve function in the most common surgical traumas.

Correlations between arthroscopic findings and synovial membrane histology in patients with rheumatoid synovitis of the knee joint.

Unlabelled: Correlation and agreement between the diagnostic results of arthroscopic and histological examinations of the synovial membrane in rheumatoid synovitis of the knee joint have been discussed in small number of studies with contradictory conclusions.

Aim: The aim of the present study was to determine the correlation between the arthroscopic characteristics and histology of the synovial membrane in patients with rheumatoid arthritis and synovitis of the knee joint.

Methods: Sixty-four arthroscopies of the knee joint with guided multiple synovial biopsies were performed in patients with rheumatoid synovitis.

[Socio-economic characteristics of pregnant women with preeclampsia: a gypsies population survey].

Preeclampsia as a serious syndrome affecting both the mother and the baby is associated with a number of socio-economic, demographic and clinical characteristics. We have filed the distribution of major epidemiological parameters in two gypsy groups, comprising 58 preeclamptic and 118 control cases. Only the classical features of preeclampsia as well as single liveborns were included in our study.

Recurrence of epidermoid cyst in the third ventricle. Case report.

The authors present the case of a 34-year-old man. The patients was admitted for the second time in the clinic. A year before an epidermoid cyst of the third ventricle, obstructing the two foramen Monroe and causing acute hydrocephaly, was surgically removed.

Acute hemolytic anemia as an initial clinical manifestation of Wilson's disease.

Wilson's disease is an inherited disorder of copper transport in the organism, transmitted in autosomal recessive fashion. It is caused by dysfunction in homologous copper-transporting adenosine triphosphatases. The main clinical symptoms are usually due to hepatic (42%) or/and neurologic (34%) involvement, which is the reason for the name hepatolenticular degeneration.

Incipient perisinusoidal fibrosis in an adult patient with Dubin-Johnson syndrome.

The present paper describes a rare case of incipient perisinusoidal fibrosis of perihepatocellular type occurring in the Dubin-Johnson syndrome in a 63-year-old patient operated on six months previously for chronic calculous cholecystitis. The source of collagen formation was the activated sinusoidal Ito cells. Excluding chronic virus hepatitis and reactive cholecystic hepatitis, we believe that the fibrosis in this patient can be associated with the relatively old age of the patient and the duration of the disease.

In vivo testing of Enterogenin for a mutagenic activity of bone marrow hemopoietic tissue of mice.

The purpose of the present study was to test Enterogenin for genotoxicity. The micronuclearic test of Schmid W. was used.

[The assessment of arsenic exposure in copper smelting].

The arsenic exposure in the main departments and occupational groups of the copper smelter in Pirdop has been estimated in the present study. The contents of arsenic is measured in the air and in biological samples--urine and nails. At most of the workplaces the time-weighted average (TWA) concentrations do not exceed the threshold limit value (0.

[The assessment of the occupational risk to workers in electric steel production].

These studies, centering on occupational environmental factors, biologic monitoring, and toxicodynamic investigations, involved a total of 105 workers distributed into eight job groups, who were 45 years, of age on the average and had from 5 to 10 years of special occupational experience at "Electrosteel" Works. Evidence was obtained for presence of unfavorable microclimate conditions, elevated equivalent levels of noise, excess of general and local vibrations, exposure to manganese aerosols, carbon monoxide, and nitrogen oxides; some of the subjects and deviations in hepatic status and connective tissue. Job groups found to be at risk were those of steel founders, crane workers, and pourers.

[An evaluation of the biological action of carbon disulfide in clinico-laboratory studies of exposed workers].

A representative group of 122 workers from shop "Predilen" with 7 to 15 years length of service in specialty is taken. The professional groups are formed on the basis of measured average-shift concentrations of carbon bisulphide in the air of the working place, which vary from 4 to 50 mg.m-3.

Factors influencing prognosis of patients with CNS supratentorial astroglial tumors who underwent postoperative radiotherapy.

To find the association between survival and various prognostic factors such as age, extent of surgical intervention, duration of complaints, site of tumour, histologic grade of the tumours and the Karnofsky performance status, we studied retrospectively 179 patients with histologically proven cerebral gliomas treated postoperatively in the Radioisotopic Center from 1976 to 1989. The patient's histologic tumour grade, the Karnofsky performance status and age proved to be particularly very indicative for longer survival time. The obligatory treatment with postoperative radiation therapy has been discussed in our previous works in connection with irradiated volume and a total radiation tumor dose.

[Skin reactivity and the biological assessment of chromium exposure].

Subject to the examination are 140 workers from the plant for hydraulic products "Iv. Tenev", town of Yambol. The dermatological examination embraces 57 workers from shop 21, 49 from shop 24 and control group of 24 persons.

[Toxicokinetic exposure tests for chromium].

In cases of occupational exposure to chromium, very often in the organism enters increased quantitatively or six-valent form of metal, possessing high toxicity, cancerogenic and allergenic effect. Concentrations of the element in urine (CrY), erythrocytes (CrE) and nails (CrH) are chosen as suitable tests for evaluation of the exposure. The studies are performed on 151 exposed and controlled persons.