[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.

[Thyroid adenocarcinoma and Hashimoto's goiter]. / Adenokartsinoma shchitovidnoi zhelezy i zob Khashimoto.

A comparative analysis of 2419 case histories of patients operated on for different thyroid diseases, has shown that the frequency of adenocarcinomas in lymphadenoid goiter is almost like in nodular and multinodular goiter however they are detected usually in the form of microfoci. Thyroid cancer in patients with lymphadenoid goiter combined with nodular goiter and/or adenoma is detected twice as more frequently than in patients with (multi)nodular goiter. Routine methods of investigation do not permit preoperative detection of malignancy against a background of lymphadenoid goiter.

[The clinical "masks" of Hashimoto's goiter (the problems of diagnosis)]. / Klinicheskie "maski" zoba Khashimoto (voprosy diagnostiki).

Retrospective analysis of 240 case records of patients with histologically verified Hashimoto's disease has shown that in 62% it was masked by some other thyroid diseases, especially by multinodular and nodular euthyroid goiter. The most effective diagnosis before operation was made in patients using fine needle aspiration puncture biopsy whereas other methods were auxiliary.

[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.

[Thyroid antibodies in autoimmune diseases of the thyroid and their dependence on the presence of autoantigens]. / Tireoidnye antitela pri autoimmunnykh zabolevaniiakh shchitovidnoi zhelezy i ikh zavisimost' ot prisutstviia autoantigenov.

Autoimmune thyroid diseases (especially diffuse toxic goiter) are characterized by a higher frequency of the detection and concentration of serum thyroglobulin. The frequency of the detection of antibodies to thyroglobulin in Hashimoto's thyroiditis was higher and their concentration lower than in diffuse toxic goiter. The frequency of the detection of antibodies to microsomal thyroid antigen in autoimmune thyroid diseases was lower than that of antibodies to thyroglobulin and did not depend on a type of disease. In diffuse toxic goiter the level of antibodies to thyroglobulin showed positive correlation with the level of antibodies to microsomal antigen and negative correlation with serum thyroglobulin concentration. In Hashimoto's thyroiditis the level of antibodies to thyroglobulin correlated with the level of serum thyrotropin. One-six years after thyroid extirpation serum thyroglobulin was practically absent in patients with Hashimoto's thyroiditis, and the frequency of the detection of thyroid autoantibodies (especially antimicrosomal ones) was sharply decreased.

[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.

[Pseudohypoparathyroidism. Clinical characteristics and experience with its treatment with vitamin D 3 preparations]. / Psevdogipoparatireoz. Klinicheskie osobennosti i opyt lecheniia preparatami vitamina D3.

The paper is concerned with the literature data on pathogenesis and a clinical course of 2 types of PHPT. Clinicolaboratory findings show that PHPT is a polymorphous syndrome of which the most common signs are skeletal changes, low stature, the tetanoid syndrome in hypocalcemia, hyperphosphatemia, the normal or raised level of endogenous PTH, insensitivity to exogenous PTH, soft tissue and brain calcification, mental deficiency. An insufficient or paradoxical PTH reaction and an adequate CT reaction are noted after calcium drug loading. Therapy with I alpha OH D3 and I alpha, 25/OH2 D3 has demonstrated its superiority over other vitamin D forms leading to fast normalization of calcium-phosphoric metabolism and elimination of the tetanoid syndrome.