[The thyroid volume and methods determination].

PURPOSE: to work-out method of the determination the volume of functioning thyroid tissue on the base of experimental investigations and to appreciate its accuracy. To analyze the clinical results of determination of the volume of the thyroid volume for different clinical groups with the use I123. MATERIAL AND METHODS: experimental investigations of the phantoms of different sizes were conducted, and also there were conducted the investigations of the phantoms with different diameters spheres which were inside the phantoms. On the base of conducted investigations there was suggested a method of the determination of the volume functioning thyroid tissue paying attention to the organ sizes and the microtexture of the picture. Summary error of this method with taking into consideration different factors was 7.02%. There were examined 36 patients with different kinds of thyroid diseases and patients of conditionally control group. Every patient was made planar method and SPECT with the use I123. RESULTS: the experimental investigations showed that for the determination of the volume of functioning tissue according SPECT data it should use the variable level of cut out of the background during analyzing the data paying attention to the organ sizes. The clinical investigations pointed out that there were trustworthy differences between signs indices among different clinical groups. Some signs are specifically for cancer, adenoma, Graves' disease. The most volume of nonfunctioning thyroid tissue is at cancer patients. CONCLUSION: there was worked out the method of determination of volume functioning thyroid tissue according to SPECT data. On the base of the received results there were offered integral indices which can be used for differential diagnose of the thyroid diseases.

[Comparative assessment of the hormonal status during N2O and xenon anesthesia using similar methods]. / Sravnitel'naia otsenka sostoianiia gormonal'nogo fona pri odnotipnoi metodike anestezii N2O i ksenonom.

The hormonal status of 38 surgical patients during anesthesia with nitrous oxide and Xe administered by similar methods showed that in contrast to anesthesia with N2O, Xe anesthesia helped not only preserve the adaptive potential, but even increase the defense potential of the organism during surgery. Xe anesthesia was associated with a 1.5 times less requirement in fentanyl, with the levels of stress hormones being better; Xe is the best alternative to nitrous oxide.

[The evaluation of the vasomotor cerebrovascular action of vasoactive substances by using gamma scintigraphy]. / Otsenka vazomotornogo tserebrovaskuliarnogo deistviia vazoaktivnykh sredstv s pomoshch'iu gamma-stsintigrafii.

A method of assessing relative changes in the head blood content under the influence of medicines is described. The method is based on an analysis of deviations of the equilibrium part of the radioactivity curve recorded with the aid of gamma-scintigraphy and injection in the form of bolus of the radiopharmaceutical agent 99mTc-pertechnetate to the ulnar vein. Changes in the blood content under the influence of nitroglycerin, duzodril, adalate and cavinton were examined in 37 patients suffering from dyscirculatory encephalopathy.

[The state of bronchial ciliated epithelium and mucociliary transport during chronic bronchitis in long-term smokers]. / Sostoianie mertsatel'nogo epiteliia bronkhov i mukotsiliarnogo transposta pri khronicheskom bronkhite na fone dlitel'nogo kureniia.

Endoscopic examination of the bronchial tree and investigation of pulmonary mucociliary transport by aerosol scintigraphy of the lungs were carried out in 40 patients and 10 controls. All the patients had exacerbation of chronic obstructive bronchitis. 20 of these were smokers and 20 nonsmokers. Healthy controls without lung pathology have never smoked. The findings indicate that in chronic sufferers with bronchitis and long history of smoking the rate of mucociliary clearance is reduced to 44% of the normal value and to 65% of the value for nonsmoking patients. This evidence is confirmed by the data obtained on the involvement of bronchial mucosa epithelium and at histologic examination of biopsy specimens.

[Determination of effective renal blood flow and the rate of glomerular filtration by sequential administration of I-131 hippuran and Yb-169 DTPA]. / Opredelenie éffektivnogo pochechnogo krovotoka i skorosti klubochkovoi fil'tratsii putem posledovatel'nogo vvedeniia 131 I-gippurana i 169 Yb-DTPK.

The authors present the results of the determination of the effective renal blood flow (ERB), the effective renal plasma flow (ERP) and the rate of glomerular filtration (GRF) by sequential administration of 131I-hippuran and 169Yb-DTPK assessing the contribution of each radionuclide in blood plasma specimens with the help of a multichannel pulse analyzer. The mean values of ERB (738.4 +/- 27.3 ml/min), ERP (391 +/- 22.4 ml/min) and GRF (128.9 ml/min) were in full accord with the literature data. The difference between GRF values calculated in the presence of 131I in plasma and after its decomposition, did not exceed 5% (6.4 +/- 1.8 ml/min), and the ratio of correlation between them was 0.948, p less than 0.01. A possibility of simultaneous determination of ERB and GRF under clinical conditions was shown.

[Guarantees of the quality of the training of specialists in nuclear medicine]. / Nekotorye aspekty garantii kachestva podgotovki spetsialistov po iadernoi meditsine.

The absence of a social order for specialists in nuclear medicine hampers the process of making curricula and programs directed to achieving professional skills. The category of a specialist in nuclear medicine was not envisaged in the system of medical education and in the Nomenclature of physician's posts. It is proposed that a specialist in nuclear medicine should be introduced in the Nomenclature. The system of control of knowledge and skills should be worked out on a uniform basis in order to become a guarantee of the training of such specialists and raising their professional skills.

[A comparative evaluation of methods for determining the glomerular filtration rate by 169Yb-DTPA clearance]. / Sravnitel'naia otsenka metodov opredeleniia skorosti klubochkovoi fil'tratsii po klirensu 169Yb-DTPK.

The authors present the results of comparative analysis of 7 radionuclide clearance methods for the determination of glomerular filtration rate (GFR), based on single administration of 169Yb-DTPC. A reference method was based on the determination of GFR by a curve of a decrease in plasma concentrations with subsequent biexponential analysis on a DVK-2M computer. Methods of the determination of GFR based on 2 blood drawing tests after achieving a uniform distribution of the indicator in its volume of dilution (1) and extracorporal labeling of gamma radiation by a precordial detector (2) showed the highest degree of correlation with the reference method (r = 0.918, p less than 0.001 and r = 0.920, p less than 0.001, respectively). The use of both methods based on a single-chamber model of renal clearance, led to good results, provided the measurements were to start not earlier than 1.5 h after administration of the indicator.

[Evaluation of the severity of damage of the lungs in chronic nonspecific diseases based on a microstructural analysis of scintigrams]. / Otsenka tiazhesti porazheniia legkikh pri khronicheskikh nespetsificheskikh zabolevaniiakh na osnove mikrostrukturnogo analiza stsintigramm.

Structural analysis of scintigraphic images was used for assessment of the severity of lung affection in 57 patients with mild, average and severe types of asthma and chronic pneumonia. The results of common methods and microstructural analysis were compared. The use of the latter made it possible to reveal structures which were typical of a various degree of severity in chronic diseases.

[Ultrasonic diagnosis of nodular lesions of the thyroid]. / Ul'trazvukovaia diagnostika uzlovykh porazhenii shchitovidnoi zhelezy.

Real-time echography was used for investigation of 100 patients with thyroid nodes. In order to determine the potentialities of differential diagnosis of benign and malignant thyroid nodes by echography its findings were compared with the results of histological examination. Analysis of the accuracy, sensitivity and specificity of certain symptoms and their combinations made it possible to propose a combination of symptoms for differential diagnosis of benign and malignant nodular lesions of the thyroid with the accuracy of 80.6%, the sensitivity of 82.5%, and the specificity of 79.2%.

[Localization of left ventricular myocardial lesions using 201Tl chloride scintigrams]. / Lokalizatsiia porazheniia miokarda levogo zheludochka po stsintigrammam s 201Tl-khloridom.

The authors propose some methodological approaches including stereometric methods, for determination of visible left ventricular walls in different projections of a gamma-chamber detector with relation to a position of the left ventricular anatomical axis (LVAA) in space to improve topographic diagnosis of left ventricular myocardial lesions with 201Tl. The above method can be implemented on computer.

[The microstructural analysis of scintigrams]. / Mikrostrukturnyi analiz stsintigramm.

A method of assessment of a zone of scintigraphic image based on a textural analysis was proposed. The method was tested by means of an analysis of synthesized images and assessment of 285 scintigrams of various hepatic lesions. The use of the method made it possible to improve the accuracy of differential diagnosis at the expense of defining the structures typical of diffuse and multiple small focal lesions which were undetectable by visualization.

[Radionuclide evaluation of the mucociliary function of the mucosa of the nasal cavity in chronic lung diseases]. / Radionuklidnaia otsenka mukotsiliarnoi funktsii slizistoi obolochki nosovoi polosti pri khronicheskikh zabolevaniiakh legkikh.

The authors presented their first experience of radionuclide assessment of the nasal mucosal transport (NMT) in 39 patients with chronic bronchopulmonary pathology (14 adults and 25 children) to detect patients among them with suspected syndrome of primary ciliary dyskinesia (SPCD). In 18 patients the test was positive excluding SPCD as a cause of a chronic inflammatory pulmonary process. In 21 patients NMT was absent, 2 of these patients had Kartagener's triad serving as a kind of model confirming the data on NMT. The authors proposed the method as a screening test due to its non-invasiveness and simplicity in patients with chronic inflammatory pulmonary diseases in order to detect among them patients with suspected SPCD for further examination using invasive methods.

[Cholescintigraphy of gastroduodenal pathology in children]. / Kholestsintigrafiia pri gastroduodenal'noi patologii u detei.

The results of cholescintigraphy with 99mTc-HIDA in 245 children were analysed. The relationship of a latent time period with the state of the stomach-duodenum system was revealed. The specificity of this index was 82%, sensitivity 70%, accuracy 75% and pathology predictability 85%. The scintigraphic picture of a duodenobulbar reflux in the form of a RP "depot" in the ascending and upper horizontal part of the duodenum manifested itself with the specificity of 90% and predictability of pathology in 75%. Duodenogastric refluxes were revealed with the specificity of 94%, accuracy of 88% and pathology predictability of 90%. A low specificity of 34 and 43% was associated with a possibility of reflux detection in the lower horizontal part of the duodenum only.

[Scintigraphic semeiotics of gallbladder anomalies in children]. / Stsintigraficheskaia semiotika anomalii zhelchnogo puzyria u detei.

Altogether 103 children with different variants of gallbladder abnormalities (deformities, bends, contractions, septa, diverticula) were examined using radionuclide cholescintigraphy with 99mTc-HIDA. Scintigraphic signs of organic lesion were characterized by symptoms associated with the unevenness of the filling of the gallbladder, its shape and contours. Their frequency depended on anatomical defect site. Changes in the cervical part (70%) and in the body area (60%) were better diagnosed. Changes in the gallbladder fundus (12.5%) were practically undetectable. The calculation of quantitative indices of gallbladder filling and motor function made it possible to objectify the gravity of organic change of the organ, the nature and degree of its functional compensation.

[Carbohydrate antigen (CA-19-9) in the blood serum of patients with benign and malignant liver diseases]. / Uglevodnyi antigen (CA-19-9) v syvorotke krovi bol'nykh s dobrokachestvennymi i zlokachestvennymi zabolevaniiami pecheni.

The concentration of a new tumor marker CA-19-9 was determined in the blood serum of 51 patients with different diseases and in 38 healthy persons. In 95% of the examined persons, the concentration of CA-19-9 in the blood serum did not exceed 15 Units/ml in health. In the patients with benign focal and diffuse liver diseases and in the patients with rectal cancer without metastases to the liver, the level and frequency of the elevated CA-19-9 content in the blood serum did not practically differ from those in health. In primary and metastatic liver cancer, the CA-19-9 content was considerably elevated in all the patients. The combination of the CA-19-9 and CEA tests did not add to the efficacy of differential diagnosis between benign and malignant liver lesions.

[Tumor markers in focal and diffuse liver diseases]. / Opukholevye markery pri ochagovykh i diffuznykh zabolevaniiakh pecheni.

The level of tumor markers (alpha-fetoprotein, carcinoembryonic antigen, ferritin, beta 2-microglobulin) in the blood serum was determined in 147 patients with benign and malignant hepatic diseases, 105 patients with cancer of extrahepatic site, Stage I-IV, without liver metastases (a control group) and 36 practically healthy persons. An analysis of the results obtained allowed one to establish that an increase in the concentration of tumor markers as compared to the normal one, is noted in both malignant and benign hepatic diseases as well as in the control group. However hepatic tumors were caused by a more frequent rise of the concentration of tumor markers in the blood serum with higher absolute values. Among benign hepatic diseases the most frequent increase in the level of tumor markers was noted in hepatitis and cirrhosis.