[Age-related changes in the level of serum bone markers in healthy children].

Age-related changes in the blood level of bone metabolic markers were compared in healthy children living in different geographical regions. The absolute value of carboxy-terminal telopeptide of type 1 collagen type 1 (beta-CrossLaps) and that of total procollagen type 1 amino-terminal propeptide (PINP) were found to depend on living conditions and the nature of changes in the serum markers of bone metabolism was related to the processes of natural growth and development in children. A child's individual growth curve can be used to identify target groups for the prevention of osteopenia.

[Level of aminoterminal type 1 procollagen propeptide--the bone formation marker--in the sera of healthy males].

The biochemical bone formation marker aminoterminal type 1 procollagen propeptide (total P1NP) was determined in 91 serum samples from healthy male donors aged 19 to 60 years, by using an "Elecsys Total P1NP" kit of reagents ("Roche-Diagnostics", Germany) on an "Elecsys 2010" electric chemiluminescence analyzer ("Roche-Hitachi", Japan). A relationship was found between the serum concentration of total P1NP and the age of the examined males. At the age of 19-20 years, the content of the propeptide is highest, at the age of 21-24 years, it decreased by 1.5-2 times, by the age of 30 years, there is its moderate decrease, which is then followed by its stabilization. The detected age-related changes reflect accelerated bone metabolism in young males during formation of the bone mass peak. The findings may be used as references in measuring male total P1NP on Elecsys automatic analyzers.

[The role of hormone analysis in the nosologic diagnosis and in the control of treatment of congenital primary hypothyroidism]. / Rol' gormonal'nogo analiza v nozologicheskoi diagnostike i v kontrole terapii vrozhdennogo pervichnogo gipotireoza.

A total of 125 children and teenagers, aged 1 to 15 (including 74 patients with primary congenital hypothyroidism--CH--and 51 healthy children), were investigated in the city of Moscow for the purpose of elaborating new approaches towards the differentiated diagnostics of CH and of optimizing the assessment of the adequacy of its substitutive hormonal therapy (SHT). The concentrations of the thyrotropic hormone (TTH), free fractions of triiodothyronine and thyroxin (cT3 and cT4), thyreoglobulin (Tg) and of thyreoid peroxidase (hard-phase test-tube method, electro-chemiluminescent reaction, i.e. magnetic microparticles, based on the streptovidin-biotin technology; ruthenium mark at the "Elecsys 1010" analyzer with reagents manufactured by "F. Hoffman--La Rosh Ltd.", Switzerland.) were determined early in the morning on the empty stomach. On the basis of the above mentioned, the thyroid reserve index (TRI = Tg/TG), integral thyroid index (ITI = [cT3 + cT4]/TTG), and the integral of peripheral conversion (IPC = cT3/cT4) were calculated. The thyroid gland (TG) was visualized by the "Acuson-128 XP" ultrasonic device, "Acuson Corp.", USA, with a linear sensor of 10 Mhz, as well as by the "Toshiba-90B" gamma-chamber, Japan, with a low-energy collimator in 24 hours after an oral intake of sodium iodide marked by the iodine 123-isotope with an activity of 50 Mbc and after the cessation of SHT 3 to 5 weeks before. The complex diagnosis revealed 8 variations of primary CH; aplasia and TG dystopia and defects of the synthesis of the sodium-iodine symporter or Tg-concentration were found to belong to the most severe disease types according to hormonal parameters. As for Tg, in 52% of cases it was normal, undeterminable--23% and higher--25%. A simultaneously implemented ultrasonic scanning (USS) ensured a final diagnosis in subgroups, respectively, in all cases, in 25% and in 75% of patients. On the whole, after the two diagnostic stages (Tg + USS/ITR), the indications for isotope scanning left only for 23% of CH patients, i.e. a) if the Tg values could not be determined because the organ was not located in its typical place (17%); or b) if the Tg level was higher or if there was a goiter at the TG normal volume (6%). An in-depth hormonal analysis showed that, should CHT be monitored less than once in three months, it failed to secure a total compensation of the disease in above one third of CH children (39%). Therefore, a three-stage algorithm of nosological diagnostics is recommended for primary CH; it should comprise the determination of Tg level, and USS (for all patients) as well as TG scanning (according to rare indications). The result point at the necessity of hormonal monitoring of CH children and teenagers at least one in 2-3 months. The objectivity degree of CHT goes up as a number of estimated indices, i.e. ITI and IPC, are used alongside with absolute hormonal values.

[Preoperative preparation for abdominal delivery of pregnant women with fetal distress]. / Podgotovka k abdominal'nomu rodorazresheniiu beremennykh so stradaniem ploda.

A complex of the methods currently available for examining the fetoplacental system was used in 36 patients with severe extragenital and obstetric abnormalities, which allowed the authors to diagnose fetal affections such as hypoxia, hormonal dysfunction of the fetoplacental system before abdominal delivery. The employment of differential drug preparation for cesarean section with due regard to the severity of the fetus' status, maturity and the pattern of an obstetric and extragenital abnormality enhanced the adaptabilities of the fetus and improved perinatal parameters in cesarean section.

[Hormonal diagnosis of endocrinopathies in the early neonatal period]. / Gormonal'naia diagnostika éndokrinopatii v rannem neonatal'nom periode.

Based on the summarization of the results of hormonal examination of the newborn during the early neonatal period it has been revealed that early diagnosis of endocrinopathies can only be made with the use of the laboratory measurements of the concentrations of the appropriate hormones. For early diagnosis of congenital endocrine diseases the screening made according to the specific hormonal test is the most effective approach. It is necessary to differentiate between alterations associated with congenital endocrine diseases and transitory hormonal reactions due to the derangement of the child's status in the ante-, intra- or postnatal periods.