Over the past century pituitary surgery has undergone multiple revolutions in surgical technique and technological advancements that have resulted in what is now recognized as modern transsphenoidal surgery. Although the procedure is well established in the current neurosurgical literature, the historical maze that led to its development continues to be of interest because it allows us to appreciate better the unique contributions made by the pioneers of the technique as well as the innovative spirit that continues to fuel neurosurgery.

Diabetic neuroosteoarthropathy is complication of diabetes associated with high rates of amputations and mortality. The development of diagnostic methods may identify diabetic neuroosteoarthropathy at early X-ray negative stage before the development of radiographic changes. Treatment at this stage can prevent the development of progressive bone and joint deterioration. However, there is no unified approach to diagnose of X-ray negative stage. The timing of immobilization of the affected limb is still controversial among experts, and where is no objective methods for determining the completion of the acute stage of diabetic neuroosteoarthropathy. This review focuses on the current state of knowledge about the diagnosis, classification and criteria for completion of the active phase of diabetic neuroosteoarthropathy.

Background. Taking into consideration new data on the increased detectability and more exact diagnostic methods, revision of classical ideas of clinical picture and criteria of diagnostics of a pheochromocytoma (Ph) is required. Aim. To study current features of clinic manifestation, results of instrumental methods and factors, which influence on treatment efficiency of patients with confirmed diagnosis of Ph. Matherials and methods. There were studied 9 patients with histologically confirmed diagnosis of P (1 man 56 years old; 8 women who were 37.6 ± 5.5 years old). Next parameters were evaluated: presence of arterial hypertension (AH), specific features of P (sympathetic attack); indications for screening of Ph, the time from the appearance of indications for screening till the laboratory confirmed diagnosis, characteristics of CT (native density, size, contrast washout, specific features (cystic, heterogeneous structure with areas of necrosis and hemorrhage)), features of preoperative preparation, presence of intraoperative complications, efficiency of the surgery. Used descriptive statistics were percentage, mean M, standard deviation SD and 95% confidence interval CI. Results. AH was presented in 6 patients (67%), among whom 4 patients had specific features which indicated symptomatic AH. These 4 patients had the classic triad of Ph (44%). Indications for screening of Ph in 4 patients were specific features of Ph (time from screening indication appearance till laboratory confirmed diagnosis was 41 ± 14 mnths. (95% CI 18;63), in other 5 - adrenal incidentaloma (AI) (time from the detection of AI until the laboratory confirmed diagnosis was 13 ± 9 days (95% CI 2; 24). CT characteristics were the next: native density - 49,9 ± 12,8 HU (95% CI 40; 59,7), lesion size - 5,4 ± 1,8 cm (95% CI 4; 6,7), contrast washout - 30,1 ± 11,1 HU (95% CI 21,6; 38,6). Only 2 patients had so called specific CT features. All patients received adequate preoperative preparation with alpha-blockers. There were no any specific intraoperative complications in all cases. After surgery metanephrine and normetanephrine were within reference range. Conclusions. 1/3 of patients with Ph had not clinical manifestations. Specific CT features presented in a smaller percentage. The success of surgery entirely depends on adequate preoperative prescription of alpha-blockers.

One of the most difficult in diagnostic and treatment options for endogenous Cushing is the ectopic ACTH syndrome, which causes the development of tumors of different histogenesis localization producing adrenocorticotropic hormone (ACTH), and much less - corticotropin hormone (CRH). ACTH-secreting tumors varied in location, morphological structure and the degree of malignancy. Most of these tumors are characterized by an aggressive course with a propensity to metastasize and relapse. The article presents data of the prevalence, pathogenesis of ectopic ACTH tumors localized in the thymus, analyzis of clinical, morphological features, the methods of diagnosis and treatment. Based on the current literature, the world and our own experience on the diagnosis and treatment of patients with ectopic ACTH syndrome with localization of hormone production in the thymus, we want to highlight the current state of the problem in order to create the most efficient algorithm for diagnostic search and treatment of this difficult group of patients.

In a discussion paper a number of Russian proposals in the draft Recommendations for the diagnosis of nodular goiter is proposed by the position of radiological diagnostics specialist. The ultrasound diagnostic section introduces the concept of an integrated ultrasound, which assesses not only the gray-scale features, but also color Doppler mapping and vascular elastography of the focus and organ. Fine-needle aspiration biopsy is proposed to carry out only under ultrasound navigation and multifocally. The problem of calcitonin should be considered from the perspective of false-positive and false-negative data and its optimal results after fine-needle aspiration biopsy.