[Pathogenesis of thyroalgia]. / K patogenezu tireoalgii.

The authors analyze thyroalgias occurring in various thyroid diseases and diseases of the adjacent organs and tissues. They come to a conclusion that as far as thyroid diseases are concerned, true thyroalgias are the most incident in various thyroiditis forms, thyroid tumors, postoperative cicatrices, and are explained by the pathologic process impact on glandular capsule (stretching, intergrowth, pressure, etc.). Of diseases not directly related to thyroid but causing thyroalgias (pseudothyroalgias) laryngitis, pharyngitis, and osseous conditions are the most incident, which indirectly influence pain development. Pseudothyroalgias should be differentiated from such osseous changes in the neck as deforming spondylosis, spondylarthrosis, extra cervical ribs (a developmental abnormality), and structural specificities of temporal bone styloid processes.

[Fine needle puncture biopsy and methods to image the thyroid gland in the diagnosis of nodular goiter]. / Tonkoigol'naia punktsionnaia biopsiia i metody vizualizatsii shchitovidnoi zhelezy v diagnostike uzlovykh form zoba.

A retrospective analysis of the findings of fine needle puncture biopsy of the thyroid in 256 patients operated on for nodular goiter is presented. Cytologic findings coincided with the histologic in 84.8% of cases. The coincidences were the most frequent in (multiple) nodular colloid goiter and thyroid cysts (95.7 = 100%) and the least so in solitary adenoma (65.4%) predominantly of a follicular structure. In thyroid cancer the data correlated in 75% of cases. The presence of cystous changes in adenoma made the investigation less informative. Findings of ultrasonic examination of the thyroid coincided with operative findings in 87.5% of patients with (multiple) nodular goiter and in 86.1% of those with adenomas. Ultrasonography as a method for thyroid imaging is preferable to scintigraphy (scanning) and is an optimal supplement to puncture biopsy of the thyroid.

[Antithyroid antibody dynamics in patients with Hashimoto's goiter receiving conservative treatment and after surgical interventions]. / Dinamika antitireoidnykh antitel u bol'nykh zobom Khashimoto na fone konservativnogo lecheniia i posle operativnykh vmeshatel'stv.

The content of antithyroid antibodies (AtAb) in the blood of patients with Hashimoto's goiter was studied over time, namely during the treatment with thyroid drugs and after surgical interventions of different scope. The patients' groups with diverse changes in the AtAb titers during the conservative treatment were revealed. The analogous types of the time-course of changes in antibodies to thyroglobulins (AbTg) were discovered after a surgical intervention irrespective of the operation scope whereas the persistence of antibodies to microsomal antigen (AbMa) after the operation depended on the mass of the remaining thyroid tissue. A correlation was found between the high titers of AbTg (rather than AbMa) and the elevated content of thyrotropic hormone in untreated patients with Hashimoto's goiter and after large-scope surgical interventions.

[Assessment of the effectiveness of conservative therapy of autoimmune thyroiditis using echographic study of the thyroid]. / Otsenka éffektivnosti konservativnoi terapii autoimmunnogo tireodita s pomosch'iu ékhograficheskogo issledovaniia shchitovidnoi zhelezy.

A thyroid enlargement was noted during ultrasound investigation of 41 patients with autoimmune thyroiditis. The structure of glandular tissue was inhomogeneous with zones of rarity and density. Repeated echography of the thyroid in 20 patients with autoimmune thyroiditis after prolonged thyrotherapy (thyroiodine at a daily dose of 0.1-0.2 g and 1.2 tablets of Thyreocomb daily) revealed diminished sizes of the thyroid in 9 patients, unchanged sizes of the thyroid in 11, unchanged echostructure of the thyroid in 17, in 3 patients thyroid tissue echogeneity was increased, its structure became more homogeneous, sizes became less. This method provides additional information on the topography, sizes and echostructure of the thyroid, assessing the effectiveness of conservative therapy.

[Association of antigens of the HLA system and Hashimoto's thyroiditis]. / Assotsiatsiia antigenov sistemy HLA i tireoidita Khashimoto.

A total of 18 patients with Hashimoto's thyroiditis aged 20 to 57 were examined (16 females and 2 males). The control group included 267 healthy donors. Antigens of A, B, C and D loci of the HLA system were determined in all the patients. HLA Dr3 was determined in 14 (77.8%) of 18 patients (p less than 0.01). The relative disease risk in carriers of this antigen was 12.6. At the same time a 6-fold decrease in the frequency of HLA Dr2 was found in the patients. The authors discussed the problem of the predisposing role of HLA Dr3 in the development of autoimmune diseases and of the "protective" properties of HLA Dr2.

[Surgical treatment of autoimmune thyroiditis]. / Khirurgicheskoe lechenie autoimmunnogo tireoidita.

The authors used combined modality therapy including clinical, laboratory, x-ray, radiological, immunological and histological methods to diagnose autoimmune thyroiditis. Enlargement of the thyroid up to the 3-4 th degree, signs of compression or shift of the trachea and esophagus, the presence of nodes, progressive goiter growth and suspected malignant transformation served as indications for surgical intervention. Subfascial extirpation of the thyroid can be an operation of choice in surgical treatment of Hoshimoto's thyroiditis. A question of the time of surgical intervention cannot be considered completely solved.