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N Kŭtev

Publications and source records attributed to N Kŭtev.

11 recordsLinked to original sources
PubMed1995

[Differentiated thyroid cancer--a study of the pathomorphological variants in 216 patients].

Two-hundred sixteen patients presenting differentiated carcinoma of the thyroid gland are subjected to operative treatment over the period 1980 through 1993. The distribution of cases by histological type is as follows: papillary carcinoma--127 cases, follicular--58, and mixed type (papillary-follicular)--thirty one. In the group presenting papillary lesions, infiltration of the capsula is noted in nine cases, multifocal location--in five, and microcarcinoma--in twenty three. In the follicular carcinoma group a markedly expressed vascular invasion is established in four cases, multifocal location--three, and microcarcinoma--five. Assessment of the morphological patterns of differentiated thyroid carcinoma reveals a marked predomination of noncomplicated histologic variants, enabling the wide use of minor conservative operative procedures, compared to thyroidectomy, with a positive outcome. Over he past few decades, the incidence of differentiated forms of thyroid gland carcinoma shows an increase, and nowadays it caries in the range 60 to 90 per cent. Papillary forms are prevailing, while follicular carcinomas are detected in 8 to 20 per cent of cases. An overall shift of morbidity towards younger ages and female gender is observed.

Adenocarcinoma, Follicular↗
PubMed1995

[Hypophyseal-thyroid function following partial thyroid resections for euthyroid struma nodosa].

The serum levels of svT3, svT4, TTH, T3 and T4 are evaluated at two, six and twelve months after partial resection of the thyroid gland in patients with euthyroid struma nodosa. The patients are divided up in two groups: group one--given hormonal substitution therapy, and group two--untreated. The results are estimated with a special reference to the need of hormonal administration in view of precluding recurrences.

Adolescent↗
PubMed1995

[The incidence and morphological aspects of thyroid cancer].

A total of 10,736 biopsy specimens presenting diverse thyroid gland pathology are studied over the period 1974 to December 1993. The histopathological investigation shows that 5.45 per cent of them (n = 585) are with carcinoma. Comparative analysis of the incidence of thyroid carcinoma in the series reviewed, covering the two decades, points to a tendency of the incidence rate to augment from 4.03 per cent in the first decade to average 6.63 per cent in the second decade of study, with a frequency peak reached in the period 1986-1993. There is a clearcut tendency of the incidence of malignant conditions of the thyroid to rise among younger age groups. A markedly expressed tendency of the number of patients with papillary carcinoma of the thyroid, affecting mainly women and younger persons, to increase is also documented.

Adult↗
PubMed1995

[The routine immunohistochemical diagnosis and surgical treatment of medullary carcinoma of the thyroid].

Over the period 1977 through 1988, in the Research Institute of Surgery--Medical Academy a total of 372 patients undergo primary operative management for thyroid gland carcinoma. Medullary carcinoma is discovered in 18 patients of the series (4.8 per cent). The preoperative diagnosis is supplemented by thyroscintigraphy with 131iodine or technetium Tc 201. After 1981, calcitonin and carcinoembryonic antigen (CEA), specific medullary thyroid carcinoma (MTC) markers, measurements are routinely done, with substantially elevated levels in the patients under study being found, in those with metastases inclusive. Presumably, the preoperative diagnosis medullary thyroid carcinoma is very difficult, and only a combined approach, including thyroidectomy with ensuing iodine radiotherapy, may account for a good survivorship. Postoperatively, all patients with MTC diagnosis are regularly tested for serum calcitonin and CEA levels. The carefully taken family history and questioning of the patients allows to differentiate familial from cases from sporadic neoplasms.

Adult↗
PubMed1995

[Early thymectomy in the treatment of myasthenia gravis].

Over a 10-year period, 1983 through 1992, in the clinic of endocrinologic surgery--Alexander Hospital, Sofia, 89 patients with myasthenia gravis (MG), 57 women and 32 men, are subjected to operative treatment--thymectomy. The mean age in women is 32 years (range 19 to 68), and in men--45.6 years (range 25 to 70). Two age-related distributions in the series are impressive--in female patients the peak is between 20 and 30 years, whereas in men--between 45 and 55 years. The operative intervention consists in total thymectomy. Preference is given to the trans-sternal median access to the thymus gland. In the complex therapeutic approach to MG are included also a number of drugs and other agents--corticosteroids, anticholinesterase agents, immunosuppressives and the like. Patients undergoing operative thymectomy are usually given preoperative treatment with anticholinesterase drugs for different periods of time. Operation is undertaken only in stable condition of the patients. Good postoperative results are recorded in 57 per cent of those operated by the first year, with a satisfactory improvement in 29.2 per cent of them. In the third group (13.4 per cent) the postoperative results are poor, and treatment is proceeded with anticholinesterase drugs or immunosuppressives. The average follow-up term is 44.7 months. The delay in improvement is typical of patients with longer duration of the complaints, but it may be attained within 2, 3 or 5 years postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

[The surgical treatment of myasthenia gravis--the authors' own experience].

Proceeding from personal experience accumulated hitherto, the indications for both operative treatment of MG, and choice of the most adequate preoperative preparation and timing of thymectomy, are precisely determined. Pathohistologic findings and postoperative results in 47 patients, thymectomized in the period 1989 to 1994, are followed up and analyzed. The inference is reached that preliminary stabilization of the patient's condition with anticholinesterase drugs, and early and total thymectomy are essential for the successful outcome of treatment. It is preferable that thymectomy is done within six months of the occurrence of complaints or making the diagnosis.

Adult↗
PubMed1995

[Struma nodosa and cancer of the thyroid].

The disputable issue of the pathogenetic relation between struma nodosa and thyroid gland carcinoma is discussed. A total of 234 patients with definitive diagnosis thyroid carcinoma, operated in the clinic of endocrine surgery--Higher Medical Institute, Sofia, are retrospectively analyzed. Clinical, past history and pathomorphologic data are considered--123 patients present papillary carcinoma, 67--follicular, and 42--mixed form. All patients undergo operative management over the period 1980 through 1991. Later, to the aforementioned group are added further 50 patients with carcinoma of the thyroid, treated from 1991 to late December 1992, and thus the total number amounts to 284 cases--153 papillary, 79 follicular and 52 mixed forms, respectively. In 67.2 per cent of the cases the thyroid carcinoma presents clinical patterns of a solitary node, in 27.8 per cent--node of multinodular struma, and in 4.9 per cent--formation associated with another thyroid disease. Multifocal location is established in five cases. As shown by the pathomorphological study in 18 per cent of the cases it is a matter of a combination--thyroid carcinoma and struma multinodosa, and in 1.2 per cent of the cases only there is conclusive evidence of solitary adenoma malignization. The obtained results lead to the inference that thyroid carcinoma deriving from the nodose structures of the gland is an exception, rather than rule.

Adenocarcinoma, Follicular↗