[Current aspects of diagnosis and treatment of adult GH-deficiency].

Adult growth hormone (GH) deficiency (AGHD) is a condition characterized by alterations in body composition, lipid and carbohydrate metabolism, bone mineral density and poor quality of life; however, clinical presentations of AGHD are mostly non-specific. Untreated AGHD is associated with increased cardiovascular morbidity and mortality. Stimulation tests are used for the diagnosis: insulin tolerance test, glucagon stimulation test, growth-hormone releasing hormone and arginine stimulation test. Moreover, in 2017 FDA approved the use of macimorelin (oral GH secretagogue) for the diagnosis of AGHD. In childhood GH-deficiency, apolipoprotein A-IV, CFHR4 (complement factor H-related protein 4) and PBP (platelet basic protein) were identified as potential biomarkers of the disease, however, this was not investigated in AGHD. GH treatment starts from the minimal dose, which allows minimizing the adverse effects. According to published meta-analyses, AGHD treatment generally does not lead to increased risk of malignancy and recurrence of sellar neoplasms in adult patients. Published data on GH receptor polymorphism associations with treatment efficacy remains controversial. Development of long-acting GH formulations is a currect perspective for the increase of treatment compliance.

[The role of magnetic resonance tomography in the diagnosis of an "empty" sella turcica]. / Vozmozhnosti magnitno-rezonansnoi tomografii v diagnostike "pustogo" turetskogo sedla.

A total of 110 patients were examined using magnetic-resonance (MR) tomography of the brain and a special MR myelographic method. An 'empty' sella turcica was diagnosed in 29% of cases. MR tomographic criteria permitting the diagnosis of this condition were defined: a crescent-shaped hypophysis, presence of a low-intensive signal area with a glow phenomenon on MR myelogram, this area being localized intrasellarly. Different clinical variants of the empty sella turcica syndrome are demonstrated, including variants resultant from substitution therapy of thyroid hypofunction, from dopamine agonist therapy for hyperprolactinemic hypogonadism, from radiotherapy of hypophyseal adenoma. Hence, the studies have demonstrated a high efficacy of MR tomography in the diagnosis of empty sella turcica and in dynamic monitoring of patients with various hypothalamohypophyseal dysfunctions over the course of therapy.

[Magnetic resonance tomography of the sellar region in patients with endocrine diseases]. / Magnitno-resonansnaia tomografiia selliarnoi oblasti u bolnykh s éndokrinnymi zabolevaniiami.

The authors discuss the present-day problems of radiotherapy. They show the major prospective trends in this field and describe the OS3Dplan system, made in this country, that represents a working place of a radiologist and serves for the development, analysis and storage of the schemes of long-distance gamma-beam therapy of oncologic patients. The OS3Dplan system is realized via the IBM PC/AT-286/287 computer but can operate with any of the IBM PC/XT/AT/PS-2--8086/80486 computers, made before 1986 with the videoadapter EGA/VGA, and functioning under MS-DOS, Microsoft (version 3.3 or older). The mathematical provision of the videodigitizer (distance control and videocamera) permit the introduction of videoinformation into the personal computer in the 256 x 256 format, 512 x 512 pixels. The mathematical provision of the OS3Dplan proper permits a volume planning of long-distance gamma-beam therapy. This module type system will be of interest for various specialists (radiologists, roentgenologists, oncologists, students, etc.), for it permits a collection and maintenance of a data bank on patients with imaging of roentgenograms, CT, NM tomography, ultrasonic data on the computer display and printing these data, perform metric analyses and reconstruct the volume.