Diagnosis and conservative treatment of tuberculous spondylitis – with contribution of one clinical case – 42, 2006, No 4, 103-105.
K. Kostov and Iv. Petrov
Clinic of Neurology, Medical Institute – Ministry of Internal Affairs - Sofia
Summary: Tuberculous spondylitis is the most common form of skeletal tuberculosis. Certain approval of the diagnosis is not always possible even with the most modern diagnostic facilities. We describe a clinical case of conservative treatment of tuberculous spondylitis which is diagnosticated late at the stage of marked bone destruction with signs of neurological deficit. We discuss the diagnosis, clinical manifestation and treatment.
Key words: tuberculous spondylitis, clinical manifestation, diagnosis, treatment
Address for correspondence: K. Kostov, M. D., Clinic of Neurology, Medical Institute of Ministry of Interior, 79, Scobelev Blvd., Bg – 1606 Sofia, tel. +359 2 9821576, Fax: +359 2 9531235, e-mail: email@example.com
Fracture of processus styloideus – presentation of a clinical case - – 42, 2006, No 4, 110-111.
R. Kolarov and A. Djorov
Specialized Hospital of Maxillo-Facial Surgery-Sofia
Summary: Presented is a clinical case of an 80-year-old woman with a fracture of processus styloideus. After a fall and hiting in the occipital area, a characteristic symptomatic occurred that disappeared in about ten days without surgical interference. The described case contributes to the knowledge of this rare type of fractures.
Key words: processus styloideus, fracture, clinical case
Address for correspondence: Rosen Kolarov, M. D., Specialized Hospital of Maxillo-Facial Surgery - Sofia, 1, Sv. G. Sofiiski, Str., Bg 1431 Sofia
Cecal diverticulitis mimicking acute appendicitis - a case report
and review of the literature - 42, 2006, No 3, 96-99.
R. Dimov, H. Protohristov,
I. Apostolov, G. Deenichin
and E. Moshekov
Surgery, Department of General Surgery, University Hospital "Sv. Georgi"
Summary: Isolated cecal diverticulosis,
or combined diverticulosis of the right
colon is a relatively rare pathology in Europe and North America.
Hence, proper diagnosis and treatment of cecal
diverticulitis in emergency arouse some
hesitation. The aim of the article is to present contemporary aspects
of diagnosis and treatment of this disease as well as to present a
case report illustrating some problems mentioned above. As a material
for analysis, we used the patients with complicated colonic diverticulosis
for a period from 1.01.2000 to 1.09.2005. One of the six patients
operated in the clinic was with cecal diverticulitis.
The rest of them were with complicated diverticulosis
of the sigmoid. Cecal diverticulosis
and its complication are a relatively rare condition in our country.
Its diagnosis and proper treatment require adequate clinical approach
and non-standard decisions.
Key words: cecal diverticulitis, diagnosis, treatment
Address for correspondence:
Rosen Dimov, M. D., IIIrd
Surgery, Department of General Surgery, University Hospital "Sv. Georgi",
66, Peshtersko shouse Str., Bg - 4000 Plovdiv, GSM +359
888 938 220, e-mail: firstname.lastname@example.org
of type 2 diabetes mellitus and membranous glomerulonephritis
- 42, 2006, - 3, 100-102.
M. Nikolova(1), A. Iliev(1), G. Venkov(2), B. Bogov(1), T. Todorov(3), R. Djerassi(1) and B. Kiperova(1)
of Nephrology, (2)Department of Urology, (3)Department of Clinical Pathology, University
Summary: Diabetic nephropathy is one of the leading causes for the development
of end-stage renal disease. It is often associated with other conditions
leading to the development of renal failure. The authors present an
association of type 2 diabetes mellitus with membranous glomerulonephritis.
Key words: type 2 diabetes
mellitus; membranous glomerulonephritis
Address for correspondence:
M. D., Clinic of Nephrology, University Hospital Alexandrovska,
1 Sv. G. Sofiiski
- 1431 Sofia, e-mail: email@example.com
of the risk of complications and treatment with tirofiban
in patients with acute coronary syndrome - 42, 2006, № 2, 93-97.
and V. Tomova(1)
(1)Clinic of Cardiology and Intensive Treatment, UMHAT Pleven
(2)Section of Invasive Diagnostic, National Cardiologic Hospital
Summary: The inhibitors of IIb/IIIa
receptors of the platelets found place in the treatment protocols
of the patients with acute coronary syndrome (ACS) and high risk of
death and ischemic complications. The stratification of these patients
with NSTEMI is a part of the treatment plan and it must be made at
admission, during treatment time and at the patient’s discharge. Tirofiban is a nonpeptide IIb/IIIa glycoprotein receptor antagonist,
that can be used in patients with ACS. We present two clinical
cases where tirofiban was used after initial
patient’s stratification before invasive procedure and follow up therapy.
Presented are the coments of the cardiologist
and invasive cardiologist and the final result. In conclusion, we
mark that the correct and dynamic stratification of patients with
NSTEMI leads to its correct treatment. An obligatory circumstance
for this is the well-timed start with IIb/IIIa
GPI in the therapy and early coronary intervention.
coronary syndrome, complications, risk groups, tirofiban
Address for correspondence: Jordan Uzunangelov,
M. D., Clinic of Cardiology and Intensive Treatment, UMHAT „Dr. Georgi Stranski”, Bg - 5800 Pleven, tel./fax +359 64 886-227, e-mail: firstname.lastname@example.org
rare case of angiocentric lymphoma - 42, 2006, № 2, 98-100.
and M. Baleva(2)
(1)Department of Internal Medicine,
Thracian University – Stara Zagora
(2)Clinical Center of Allergology,
Medical University – Sofia
Summary: We describe a patient with a rare lymphoproliferative
disease – angiocentric lymphoma. The disease began with a local lesion
of the nose, complicated by necrosis, combined with fever syndrome.
Conclusion of the first histological analysis was Wegener’s
granulomatosis. Because of lacking effect
of treatment with corticosteroid and progression of the disease a
new biopsy with immunohistochemical analysis was made, which proved the diagnosis
Key words: angiocentric
lymphoma, differential diagnosis, Wegener’s
Address for correspondence: V. Vrachev,
M. D., Department of Internal Medicine, Thracian University, 11 Armeiska
Str., Bg – 6000
radiofrequency ablation of middle coronary vein accessory pathway
in an adolescent - 42, 2006, № 2, 101-106.
B. Dinov(1), R. Dobrev(1), G. Hristov(1) and S. Stoimenov(2)
(1) National Cardiology Hospital
(2) University Hospital “Prof.St. Kirkovich” – Stara Zagora
Summary: We report the case of a 17-year-old
girl with Wolff-Parkinson-White (WPW) syndrome who underwent radiofrequency
(RF) ablation. The resting ECG revealed preexcitation pattern suggestive of a left paraseptal accessory pathway. Intracardiac
study found a large, sharp spike recorded from the proximal part of
the coronary sinus. Orthodromic circus movement
tachycardia was induced by coronary sinus pacing. An attempt at ablating
the pathway from the coronary sinus was undertaken. No left-heart
catheterization was performed. The successful ablation site was located
in the proximal middle cardiac vein where a large accessory pathway
potential with an atrioventricular conduction interval of 60
ms were recorded. Two short radiofrequency applications abolished
conduction over the bypass tract. No complications occurred. Radiofrequency
ablation from the coronary sinus and its venous tributaries as a primary
approach may be effective in children and adolescents with specific
findings from the intracardiac study even when the ECG is not suggestive of
such a location.
Key words: accessory pathway, catheter
ablation, middle cardiac vein, coronary sinus
Address for correspondence: Borislav
Dinov, M. D., National Cardiology Hospital, 65 Koniovitza Str., Bg 1309 Sofia, tel. +359 2 92 114 71, e-mail: email@example.com
and biological indices in primary and recurrent intracranial chondrosarcoma
- 42, 2006, № 2, 107-110.
St. Djambazova(1), G. Ivanov(1), I. Bivolarski(1) and B. Kalnev(2)
(1)Department of General
and Clinical Pathology, Medical University – Plovdiv
(2)Clinic of Neurosurgery, UMHAT
“Sv. Georgi” – Plovdiv
Summary: Intracranial chondrosarcoma is a rare tumor. For the present, there are
about 60 cases published in the literature. Our case of recurrent
intracranial chondrosarcoma is the first to be presented in Bulgaria.
A 37-year-old man has been operated twice for intracranial blastoma
with the morphological characteristics of meningeal
chondrosarcoma. A detailed clinical investigation rejected
the possibility of metastatic or osteogenic
origin of the tumor. Thorough morphological, histochemical
and immunohistochemical study with image
analysis and morphometry of the positive
cells have been applied to measure DNA and total RNA in tumor cells
which is the first complex survey of this tumor. Prediction of the
biological behavior of the tumor is made on the grounds of the indices
Key words: intracranial chondrosarcoma, complex survey, DNA, RNA, р53,
Ki67, protein S 100, EGFR, biological behavior
Address for correspondence:
Asoc. Prof. Z. Zaprianov, M. D.,
Department of General and Clinical Pathology, Medical University,
15 A “V. Aprilov” blvd., Bg – 4002 Plovdiv
hamartoma of infancy – a case report - 42, 2006, № 2, 111-113.
E. Poryazova(1) and A. Jonkov(2)
(1)Department of Clinical
of Pediatric Surgery
University Hospital “Sv. Georgi”
Summary: Fibrous hamartoma of infancy is a rare benign tumor that occurres within the first 2 years of life. It shows a marked
predeliction for males, and most commonly
occurs on the upper body, particularly in the axillary
region, upper arm, upper trunk and inguinal region. The lesions are
circumscribed but poorly defined, occupy
the deep dermis and subcutis. We describe
a case of a 3-month-old male infant presented with a subcutaneous
tumor on the right brest;
the mass has been persistent since birth.
Key words: fibrous
hamartoma of infancy, breast
Address for correspondence: Elena Poryazova,
M. D., Department of Clinical Pathology, UMHAT "Sv.
Georgi", 15A, V. Aprilov Blvd., Bg
4200 Plovdiv, email: firstname.lastname@example.org
cardiac arrest and acute virus infection in heroin abusers on methadone
therapy – case studies
- 42, 2006, № 1, 114-119.
V. Bogdanova(1), J. Radenkova-Saeva(2),
A. Ivanov(1), Al. Minthchev(2),
S. Naydenov(1), E. Taneva(1)
and T. Donova(1)
(1)University Hospital “Alexandrovska” – Sofia
(2)MHATEM “N. I. Pirogov” – Sofia
Summary: Heroin dependence is a problem of increasing
social importance, concerning different social strata of developing
countries as well as socially and economically advanced ones. Methadone
is a drug, that proved its efficiency when used as a maintenance
therapy for long-term heroine addicts and prophylaxis of the abstinence
syndrome. At present, however, there are a lot of reports about complications
and even cases with lethal outcome, that
occurred in the course of methadone therapy. Until recently, it was considered that such unfavorable outcomes are due to methadone
overdose and intoxication as a result. New researches show that adverse
effects of methadone therapy are due most frequently to methadone
intolerance, not to methadone overdose. Clarifying
the reason for the adverse effects, occurring after initiation of
methadone medication – overdose or intolerance, is important for planning
the long-term therapeutical approach in such patients. Two
case studies are presented – cardiac arrest in a 24-year-old woman
and acute virus infection in a young man with long term heroin dependence
on methadone therapy.
Key words: cardiac arrest, heroin, methadone,
acute virus infection
Address for correspondence: Vera Bogdanova, MD, Clinic of Cardiology, Univercity Hospital “Alexandrovska”, 1 Sv. G. Sofiiski Str., Bg – 1431 Sofia, e-mail: email@example.com, firstname.lastname@example.org
Small bowel metastases of bronchogenic cancer – case reports
- 42, 2006, № 1,
D. Nikolovska(1), M. Petrova(1), V. Paskalev(2), K. Jeleva(1), D. Todorov(1) and N. Donova(1)
(1)Clinic of Gastroenterology, Medical Institute of Ministry
of Internal Affairs – Sofia
(2)Department of Pathology, Medical Institute of Ministry
of Internal Affairs – Sofia
Summary: Bronchogenic cancer is
a common and severe disease, rapidly developing and characterized
by high metastatic potential. The small bowel metastases are extremely
rare and may be clinically missed due to the unspecific symptomatology.
We report two cases of bronchogenic cancer with small bowel metastases,
clinically presented with bowel obstruction and hemorrhage of the
gastrointestinal tract, which necessitated surgical resection. Appearance
of small bowel metastases supposes an advanced stage and bad prognosis.
Key words: lung cancer, bronchogenic
cancer, small bowel metastases, small bowel obstruction, intestinal
Address for correspondence: Assoc. Prof. D. Nikolovska,
M. D., Clinic of Gastroenterology, Medical Institute of Ministry of
Internal Affairs, 79A, Skobelev Blvd., Bg
– 1606 Sofia