[Primary and secondary ovarian hypoplasia]

In 98 young women with lack of maturity, with menstrual disturbances and with insufficiency of the primary and secondary sexual signs an the basis of clinical and hormonal investigations in 61.2% the primary and in 38.8% the secondary ovarian hypoplasia was established. This allowed in spite of great clinical resemblance of the investigated persons to the proper diagnosis and to the choice of the suitable therapy.

[Diagnosis and treatment of congenital adrenal hyperplasia in women]

In 32 women with signs of androgenization, menstrual disturbances and distinct elevated values of 17-KS, DHEA, pregnantriole, testosterone and very reduced level of 17-OHCS congenital adrenal hyperplasia was diagnosed which established 12.5% individuals with intersexualism. The method of conservative or/and operative treatment and the prognosis were discussed.

[New aspects in diagnosis and therapy of Turner's syndrome]

In the last 35 years we noticed 91 cases of Turner's syndrome. To the obligatory symptoms of the syndrome belong primary amenorrhoea, sexual infantilism, elevated values only of FSH and very reduced levels of estrogens, chromosomal aberrations in karyotype, most often 45, X and presence of streak gonads. The facultative symptoms of the syndrome belong short stature (94.5% of patients), presence of congenital defects (short webbed neck in 44.4%) and sterility (98.9%). Therapy above 15 years excepting to cause the menstrual cycles have to development the second sexual symptoms by giving enough large doses of oestrogens and gestagens. The best effects we obtain nearly in 100% in the development of breasts, in slowly growth of sexual hair and in the growth of the stature which does not cross the height of 150 cm and only in six patients attained in average 152.5 cm.

[Diagnosis of sex differential disorders treatment in teenagers]

Inter-sexuality is diagnosed in the age between 8-19 years in 58.5% among all 253 individuals with the signs of hermaphrodite. The diagnosis requires clinical, hormonal, cytogenetic and sometimes histopathological investigations. At the youthful patients with signs of hermaphrodite there are confirmed in 66.3% different kinds of gonadal dysgenesis, in 15.5% androgen insensitivity syndrome, in 12.2% congenital adrenal hyperplasia, in 3.4% transsexualism and in 1.3% adrenal virilizing tumours. To call attention to the specific and different treatment of every kind of hermaphrodite it is necessary a very early proper diagnosis of the disease.

[Differential diagnosis of hirsutism in girls between 15-19 years old]

On the basis of clinical and hormonal investigations of 58 girls with hirsutism aged between 15-19 years there were confirmed congenital adrenal hyperplasia in 3.4%, late onset adrenal hyperplasia in 24.1% and polycystic ovary syndrome in 72.4%. The proper diagnosis were established above all on endocrinological investigations especially on determinations of 17- ketosteroids, of DHEA, of 17 OH-corticoids in urine and RIA of total and free testosterone in blood.

[Surgical treatment of polycystic ovary syndrome. B. Postoperative examinations]

After the wedge resection of the ovaries the authors obtained the normal menses in 100%, the reduction of total testosterone in blood of 41.8% and of 17-KS in urine of 20%, an increase of fertility of 62.5% and in hirsutism a correction only of 12%, the stopping of 12% and no correction of 76%. The authors conclude that the cause of the healing or of the correction is placed in the resection of 3/4 of the changed ovaries with cysts follicles with distinct thecal layer what is accompanied by the reduction of testosterone on average of 41.8%. On contrary a weak correction in hirsutism has the explanation that the existent hirsutism is supported even by the normal level of testosterone in organism.

[Surgical treatment of polycystic ovary syndrome. A. Preoperative examinations]

The aim to study was the determination the effect of operative treatment of 31 patients with polycystic ovary syndrome. Before the operation primarily the authors confirmed at the patients the presence of menstrual abnormalities in 96.8%, of infertility in 100%, of hirsutism I. in 9.7%, II. in 61.8%, III. in 29% and the average level of 17-ketosteroids 16.0 +/- 6.9, of DHEA 3.7 +/- 1.5 mg and of estrogens 39.0 +/- 15.1 mcg in 24 urine, of total testosterone 0.98 +/- 0.24, of FSH 3.4 +/- 1.5, of LH 44 +/- 2.4, of prolactin 11.4 +/- 5.4 and of estradiol 0.32 +/- 0.35 ng/ml in blood. On the basis of clinical, hormonal or/and ultrasonographic examinations the diagnosis of the polycystic ovarian disease was performed.

[Results of the medical treatment of sciatica of disk origin in a hospital melieu]

In an attempt to find out the becoming of patients with sciatica who have been medically treated, 112 previously hospitalized patients have been questioned and examined by the same physician, two to eight years later. The criteria used were the presence of pain and the level of social and professional activity. The good and excellent results (58%) were slightly better than the poor results and failures (42%). However, painful sequelae were very frequent (83.5%) in the form of lumbago, sciatica or a combination of both, and obliged one subject out of three--manual workers or laborers--to change their occupation. Neither age nor sex, ethnic origin nor occupation, nor the circumstances surrounding the onset (whether or not an accident at work) influenced the course. On the other hand, a long standing history of sciatica decreases the chances of a cure and the older the history, the worse the long-term prognosis. Thus, it seems reasonable not to prolong medical treatment over two months and to advise surgery after a well conducted course of treatment in the recurring cases of sciatica, and in those that do not respond to the usual therapeutic measures. To persist in following a medical treatment threatens to leave definite sequella from prolonged radicular compression.

[Primary biliary cirrhosis as seen by the rheumatologist. Apropos of 2 cases]

The authors report 2 cases of primary biliary cirrhosis associated with scleroderma (calcinosis, Raynaud's syndrome, sclerodactyly, telangiectasia) in one case, and associated with pseudopolyarthritis in the other; they recall the conditions under which the rheumatologist may be led to make the diagnosis of this disease. Apart from liver diseases including acute or chronic rheumatic signs, one may observe in primary biliary cirrhosis without symptoms certain other rheumatological syndromes: e.g. scleroderma, Sjögren's syndrome, rheumatoid arthritis, Charcot's joint. The laboratory examinations may give unexpected results: e.g. high levels of IgM, the presence of antinuclear antibodies or may give unexpected results: e.g. high levels of IgM, the presence of antinuclear antibodies or cryoglobulins which sometimes orient wrongly the diagnosis in other directions. One may thus note that a high level of alkaline phosphatase should suggest in any case of inflammatory rheumatism, primary biliary cirrhosis, and attempt to prove this by seeking antimitochondrial antibodies.

Intestinal development in insulinoma containing Psammoma bodies. Recapitulation of ultrastructural features

Extensive junctional complex formation was observed between cells of an insulinoma with an acinar pattern. Cytolysosomes, multivesicular bodies, and small vesicles were present in the luminal aspect of acinar cells that were shedding cytoplasm. These and other ultrastructural features suggest a recapitulation of intestinal development by this tumor and this is consistent with an endodermal origin of pancreatic beta-cells or their precursors. Psammoma body formation, a rare occurrence in apudomas, was probably due to the accumulation of intraluminal cytoplasmic debris.

Efficacy of nylidrin hydrochloride in the treatment of cognitive impairment in the elderly

A double-blind study was conducted on the effects of nylidrin hydrochloride versus placebo in 60 patients with mild to moderate symptoms of chronic brain syndrome. Their ages ranged from 65 to 99 years. Preliminary results indicated that nylidrin HCl (a vasodilator) is a relatively safe therapeutic agent and more effective than placebo in ameliorating the symptoms of cognitive impairment associated with aging, on both a short term (3-month) and a long-term (9-month) basis. In a dosage of 24 mg daily, it reached its peak effectiveness after 3 months of use.