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Biomedical subjects

E Zbranca

Publications and source records attributed to E Zbranca.

At least 19 recordsLinked to original sources

[The hyperfunctional thyroid nodule].

Authors report their experience of 22 years regarding 284 patients with hyperfunctional thyroidal nodules (279 operated), representing 12.4% of the 2,289 cases of thyroidal (875 hyperthyroid) diseases treated during this period. The diagnosis was established on the basis of the confrontation of the anamnestic symptomatology and of that found at the clinical examination--which confirmed the pure character of thyrotoxicosis by showing the presence of a thyroidal nodule--with the study of the global glandular function and the scintigram, completed with dynamic tests. Among the typical clinical and scintigraphic, usually severe, forms (with cardiothyreosis) may be distinguished asymptomatic or atypical forms (with dissociated or intermittent manifestations). The treatment of the toxic thyroidal adenoma is surgical, except some contraindications of a general order. The surgical treatment is aimed at achieving the permanent cure of the disease, without sequelae or functional and/or morphological relapses. The subtotal lobectomy (210 cases) is preferred as an exeresis procedure to the enucleoresection (45 cases). In most operated cases (93%) the immediate clinical and biological results were favourable.

Adolescent

Hormonal treatment in prostate cancer.

Prostate cancer is one of the most current diseases in elderly men and contributes greatly to the increase in mortality, morbidity and cost of health care. An adequate therapeutical approach requires a whole set of methods for establishing a correct histologic diagnosis and evaluating the local and general spread of the disease. As most of the neoplastic cells in the prostate are at least partly androgen-dependent, the goal of the hormonal therapy is to deprive them of androgenic hormones and their derivatives. On this purpose, the most important means of the hormonal therapy, starting with the traditional ones (orchidectomy, hypophysectomy, adrenalectomy, androgens administration) and ending with the latest achievements (anti-androgens, antiestrogens, LH--RH analogous) are scrutinized, making specific recommendations as to their indications, way of administration and effectiveness.

Adenocarcinoma

[Differentiated thyroid cancer].

In the interval 1979-1988, out of 1070 operated goiters 77 malignant thyroid tumors were recorded, 60 of them being differentiated: papillary--32 (53.4%), vesicular--12 (20%), mixed forms--16 (26.7%). The differentiated thyroid carcinomas had peculiar clinical biological and prognostic features and were framed: stage I--60%, stage II--23.4% and state III-IV--16.6%. Only 15 cases presented lymph node metastases. In 16 cases the thyroid tumor was associated with another thyropathy: Hashimoto's thyroiditis--5 cases, Basedow's disease--1 case. The surgical intervention was performed in two times: first total lobectomy or total lobo-isthmectomy [correction of lobioistectomy] with contralateral subtotal exeresis, then total thyroidectomy. It is insisted upon a careful surveillance of postoperative evolution (clinical, biological, scintigraphy) in order to detect the recurrence and apply a proper treatment.

Adult

[Hyperthyroidism in the elderly. The clinical forms. The incidence of signs and symptoms. The evolutionary features].

The last 15 years, 1939 patients suffering from different clinical forms of hyperthyroidism were hospitalised in the Clinic of Endocrinology of Iaşi. The frequency of the disease increases with age, especially for the toxic nodular goitre. In older patients we have noted a non-typical clinical course of the disease, with prevailing cardiovascular signs and weight loss. The clinical course is also particular especially because of the associated pathology. We have made some theoretical considerations concerning the possible explanations of these phenomena.

Aged

[The "cold" thyroid nodule].

The main problem posed by an (apparent) solitary thyroid nodule is cancer identification, present in about 10% of the nodules excised surgically. This percent might increase to 25-30% in the cold scintigraphic nodules. Therefore, a combination of all the methods for nodule assessment is necessary: anamnesis, physical examination, functional tests, therapeutic test with tyrosine and thyroid imaging, but mainly the intensive active exploration including puncture-biopsy with a fine needle and exeresis with extemporaneous and paraffin morphological checking. Starting from a two decades' experience of a group of endocrinologists, surgeons, anatomo-pathologists and specialists in nuclear medicine, in 2,289 thyropathies operated--of whom 1691 (poly)nodular goitres and 1,190 non-capturing nodules--the authors suggest an investigation algorithm for achieving a differentiated surgery in terms of the pre- and intraoperative morphological findings. This attitude permitted both the improvement of the surgeries of thyroid cancers and the exeresis of benign nodules under low-risk surgical conditions or avoidance of a "non-necessary" surgery.

Biopsy

[Cases of thyroid cancer irradiated at the Iaşi Radiology-Oncology Clinic (1984-1988)].

The study is based on 35 cases of thyroid cancer treated by external radiotherapy. The analysis of these cases and especially their grouping on clinical stages according to the recent TNM classification reveal the prognostic importance of such factors as the patients' age, histopathological form and the loco-regional and at distance spread.

Adenocarcinoma

[The incidence of conjugal sterility of endocrine origin].

During a 14-year interval, 27,000 patients were admitted to the Endocrinological Clinic of Iaşi, of whom 337 (207 women and 130 men) for sterility. The endocrine disturbances that may induce sterility are reviewed.

Endocrine System Diseases

Cystic parathyroid cancer. Case report.

A patient hospitalized for the assessment of a "thyroid nodule" is presented. Scintigraphically the nodule was cold. Thin needle aspiration biopsy by which 50 ml of a clear fluid was drawn, proved the nodule to be of cystic nature. Phospho-calcium findings allowed the diagnosis of primary hyperparathyroidism though the patient presented no subjective complaints. Histologic examination of the tissue removed intraoperatively revealed a cystic parathyroid neoplasm.

Combined Modality Therapy