[Prolactin and TSH response in functional tests in patients with primary hypothyroidism in a context of hyperprolactinemia]. / Reaktsiia prolaktina i TTG v funktsional'nykh probakh u bol'nykh pervichnym gipotireozom na fone giperprolaktinemii.

It was previously proposed that hyperprolactinemia in primary hypothyroidism is caused by enhanced release of hypothalamic TRH leading to elevation of both TSH and prolactin levels. Since the dopaminergic system is involved in regulation of prolactin and TSH secretion, we attempted to evaluate the origin of hyperprolactinemia in patients with primary hypothyroidism using tests with metoclopramide, a dopaminergic blocker (10 mg, i.v.) and TRH. Two groups of patients were examined: 20 women with primary hypothyroidism and normal prolactin levels (group A) and 10 women with primary hypothyroidism and hyperprolactinemia (mean basal prolactin level 1514.8 +/- 300.8 mIU/ml). Prolactin reaction in metoclopramide test in group A was markedly increased vs. control group (1131 and 776%, respectively). In group B prolactin reaction in metoclopramide test was blurred (299%), similarly as in patients with microprolactinomas. We came to a conclusion that hyperprolactinemia in patients with primary hypothyroidism is unlikely to be caused by excessive TRH release, but possibly by the presence of subclinical microadenoma which manifests by the hypothyroid state or, possibly, by disturbed dopaminergic regulation of prolactin and TSH secretion in patients with primary hypothyroidism.

[Computed tomographic diagnosis of substernal goiter]. / Komp'iuterno-tomograficheskaia diagnostika zagrudinnogo zoba.

The authors analyze the results of computer-aided tomographic (CAT) diagnosis in 25 patients with restrosternal goiter. They claim that CAT is a method of choice in the preoperative diagnosis of retrosternal goiter, permitting the solution of a problem on the volume of surgical intervention and of the type of anesthesia. CAT helps specify the site, size, and dissemination of goiter beyond the sternum and assess its relations with the adjacent organs and tissues.

[The hypothalamo-hypophyseal system in patients with multinodular colloid euthyroid goiter]. / Sostoianie gipotalamo-gipofizarnoi sistemy u bol'nykh s mnogouzlovym kolloidnym éutireoidnym zobom.

Eighty patients with multinodular colloidal euthyroid goiter were examined. Thyrotropin-releasing hormone (TRH) test was carried out in 22 patients and 7 healthy women. The results of the test indicate a clear-cut tendency to reduction of hypophyseal TTH reserve in patients with multinodular euthyroid goiter with enlarged thyroid. In other words, clinical diagnosis of an euthyroid condition in the examinees appears to be groundless, particularly in patients with stage IV multinodular euthyroid goiter who may be referred to latent hyperthyrosis group on the basis of TRH test results. Three types of STH reaction were revealed by TRH test in these patients. The authors put forward a hypothesis on STH contribution as a growth factor to the pathogenesis of multinodular colloid euthyroid goiter.

[Surgery of pituitary microadenoma, complications and treatment]. / Khirurgiia mikroadenom gipofiza, oslozhneniia i ikh lechenie.

The authors analyze their observations of 118 patients with hypophyseal microadenomas in 1990-1992. Forty-four patients had prolactinomas, 35 somatotropinomas, 29 corticotropinomas, and 10 mixed tumors of the hypophysis. Operative interventions via a transseptal approach developed by the authors were carried out in all the patients. Complications of such operations are analyzed and methods of their treatment presented. The results lead the authors to a conclusion that selective microsurgery should be a method of choice in the treatment of hypophyseal microadenomas.

[Diagnosis and surgical treatment of microcorticotropinomas]. / Diagnostika i khirurgicheskoe lechenie mikrokortikotropinom.

Microsurgical selective removal of hypophyseal adenomas is more and more frequently used in the treatment of Itsenko-Cushing's disease of late. This permits complete cure of approximately 90% of the patients. Ten patients with this disease, induced by corticotropinoma, were observed. The hormonal methods, as well as computer-aided tomography and NMR tomography, were used to diagnose the condition. A high resolving power of these methods for the diagnosis of this disease is noteworthy. The authors describe the method for microadenoma detection during the operation and present the data of hormonal studies after selective adenomectomy. They emphasize that in cases when clinical data are supported by the hormonal and x-ray findings that confirm the presence of a microcorticotropinoma in Itsenko-Cushing's disease transsphenoidal adenomectomy must be the method of choice for the treatment of such patients.

[Obtaining and morphological characteristics of primary monolayer cell cultures of human somatotropinomas]. / Poluchenie i morfologicheskaia kharakteristika pervichnykh monosloinykh kletochnykh kul'tur somatotropinom cheloveka.

This paper describes the development of method of preparing cell suspension obtained from surgical material of patients with pituitary adenomas and acromegaly as well as the procedure of subsequent long-term cultivation in monolayers of the cells isolated. As judged by visual inspection and measurement of growth hormone and prolactin secretion, tumor pituitary cells kept viability and functional activity for at least 6 days of growing in vitro. Immunocytochemical visualization of somato- and lactotrophs of the same histological preparations permitted us to show that vast majority of cultured cells is represented by somatotrophs; however, a small portion of cell population is represented by lactotrophs and lactosomatotrophs. The peculiarities of cytoarchitectonics in two types of cell cultures of human somatotropinomas were studied.

[Regulation of hormone secretion in primary cell cultures of human somatotropinomas]. / Reguliatsiia gormonal'noi sekretsii v pervichnykh kletochnykh kul'turakh somatotropinom cheloveka.

The effects of somatostatin and thyroliberin (thyrotropin-releasing hormone; TRH) on growth hormone (GH) and prolactin (PRL) secretion were studied in short-term (0.5-3h) or long-term (21-24h) incubations using monolayer cell cultures of somatotropin obtained from surgical material of patients with acromegaly. High sensitivity of both GH and PRL release to inhibitory action of somatostatin (10(-11) M) was established. We could not reveal the unambiguous influence of TRH on somatotropic function in the in vivo and in vitro conditions, as compared to the action of this tripeptide on PRL secretion. The results obtained permit us to propose that cell cultures of pituitary adenomata represent adequate and convenient models for studying the pathogenesis of tumor processes in the pituitary gland and for the development of new procedures of pharmacotherapy.

[Safety measures in gastrectomy for peptic ulcer of marked severity]. / Mery bezopasnosti pri rezektsii zheludka po povodu iazvennogo porazheniia povyshennoi tiazhesti.

During the period from 1981 till 1989 87 resections for ulcerous injuries of particular severity were made in connection with the inflammation, destruction or spread of sclerosis in the pyloroduodenal zone. Measures of safety were complex and came to refusal from buried sutures in closing the duodenal stump, predominant use of Billroth-II resection in modifications foreseeing the creation of the Brown anastomosis (after Balfour, Roux), drainage of the abdominal cavity and actions for the liquidation of postoperative complications. Relaparotomy resulting from complications was necessary for 9 patients. One patient of 87 died.

[Various aspects of the diagnosis and treatment of autoimmune thyroiditis]. / Nekotorye voprosy diagnostiki i lecheniia autoimmunnogo tireodita.

The authors conducted 4-year investigation of patients with autoimmune thyroiditis. All the patients were women aged 28 to 68 with the duration of disease from 5 mos to 10 yrs. Combined diagnostic methods included radioactive iodine absorption, scanning, puncture biopsy, indirect thyroidolymphography. Antibodies to thyroglobulin, T3, T4, and TTH were determined by RIA. Chronic thyroiditis was diagnosed in all the patients. The authors proposed a method of intraparenchymatous administration of steroid agents into the thyroid. This method was shown to be simple, effective, causing no complications. Conservative therapy of Hashimoto's thyroiditis should be performed not more than 2 years and not less than one year.

[Diagnosis of malignant thyroid tumors by indirect thyroid lymphography]. / Diagnostika zlokachestvennykh novoobrazovanii shchitovidnoi zhelezy metodom nepriamoi tireoidolimfografii.

Indirect thyroidolymphography was used for 38 patients with malignant thyroid tumors. A conclusion has been made that indirect lymphography of the thyroid is a simple and rather informative diagnostic method for malignant thyroid tumors and should be followed by spot biopsy.

[New possibilities of topical x-ray diagnosis of hyperparathyroidism]. / Novye vozmozhnosti topicheskoi rentgenodiagnostiki okoloshchitovidnykh zhelez.

The authors analyze materials of topic X-ray diagnosis of the parathyroid glands in 12 patients with hyperparathyroidism and in two patients in whom this disease was suspected. They consider that indirect lymphography of the thyroid gland combined with the esophagus contrasting is a simple and effective method for detecting the localization of the parathyroid gland lesions. In interpreting the roentgenogram one should take into consideration the changes in the thyroid gland capable of simulating the pathological process in the parathyroid glands. Marked deformity of the skeleton serves as a relative contraindication to topic X-ray diagnosis of the parathyroid glands.

[Indirect lymphography in the preoperative diagnosis of thyroid and parathyroid diseases]. / Nepriamaia limfografiia v predoperatsionnoi diagnostike zabolevanii shchitovidnoi i okoloshchitovidnoi zhelez.

The authors come to a conclusion that indirect lymphography is an effective method for the diagnosis of alterations in the thyroid gland (thyroiditis, malignant tumor, diffuse and nodular goiter). It can be also used in order to establish the state of its regional lymph nodes more exactly. The thyroid gland lymphography added by contrasting the esophagus is a simple and effective method for topical preoperative diagnosis and determination of localization of the altered parathyroid gland.

[Indirect lymphography of the thyroid gland. 2]. / Nepriamaia limfografiia shchitovodnoi zhelezy (Soobshcheniia 2).

Indirect lymphography of the thyroid gland was performed in 144 patients. A conclusion was drawn that the use of superfluid oil contrast preparations of lipidol, miodyl type etc. in indirect lymphography of the thyroid gland will permit to obtain the exhaustive information on the state of the endocrine organ and regional lymph nodes. Lymphography with the aid of oil contrast preparation iodolipol diluted with ether and heated to the body temperature is less informative; water-soluble contrast agents were less effective. All the test contrast agents proved to be ineffective for detection of changes in the lymph nodes. Use of iodolipol for lymphography of the thyroid gland without preliminary mixture with ether is not recommended.

[Lymphography of the thyroid gland. 1]. / Limfografiia shchitovidnoi zhelezy (soobshchenie I).

The authors carried out a lymphographic examination in 11 patients with various diseases of the thyroid gland. Lymphography proved to be an effective and harmless diagnostic method in pathological changes of the thyroid gland. Different structure of the thyroid gland tissue was revealed on the lymphograms depending on the character of the pathological process. In establishment of the diagnosis one should take into consideration the structure of the thyroid gland tissue, the structure of the cervical lymph nodes, and possibilities of their filling with the contrast agent, the amount, the rate and difficulties encountered in the administration of the contrast substance.