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Vol 40, No 5 (1994)

Clinical endocrinology
Limited mobility of the joints: a complication of diabetes mellitus in children and adolescents
Lebedev N.B., Kuraeva T.L.

The incidence of a specific complication, limited mobility of the joints (mainly of interphalangeal joints of the hand), was estimated in 108 patients aged 6 to 22 with insulin-dependent diabetes of 5 and more years duration. It was found to be high: 44%. This complication more frequently develops in cases of poor metabolic control and longer disease duration. Limited mobility of the joints in children and adolescents with insulin-dependent diabetes permits predict in them with a 50% probability early manifestations of retinopathy and nephropathy. A classification of this complication by three degrees is offered.

Problems of Endocrinology. 1994;40(5):4-7
Activities of antioxidant defense enzymes in children with insulin-dependent diabetes mellitus
Scherbachyova L.N., Lebedev N.B., Knyazeva A.P., Mischenko B.P.

Activities of superoxide dismutase and glutathione peroxidase were measured in 60 children aged 5 to 15 with insulin-dependent diabetes of various degrees of compensation and duration. Measurements of glutathione peroxidase were found to be the most informative marker of the status of antioxidant defense system.

Problems of Endocrinology. 1994;40(5):7-9
Lipid peroxidation parameters and activities of lysosomal enzymes in diabetics
Chugunova L.G., Dubinina I.I.

The processes of lipid peroxidation and activities of lysosomal enzymes were studied in 56 patients with type I and II diabetes mellitus. The rate of lipid peroxidation of red cell membranes was assessed from the activities of enzymatic (NADPH-dependent) and nonenzymatic (ascorbate-dependent) . lipid peroxidation, from accumulation of acylhydroperoxides, in- termolecular joints, and from spontaneous red cell hemolysis. Activities of lysosomal enzymes (cathepsines, acid DNAse, and P-galactosidase) were measured in leukoconcentrate. The activity of enzymatic system of lipid peroxidation and acylhydroperoxide content in red cell membranes were found increased. In parallel with this, a deficiency in leukocytic lysosomes of P-galactosidase and DNAse was revealed. The detected metabolic disturbances may be regarded as one of the pathogenetic mechanisms of development of diabetic angiopathies. A relationship was revealed between changes in lipid peroxidation parameters and activities of lysosomal enzymes, on the one hand, and diabetes mellitus type and duration, on the other.

Problems of Endocrinology. 1994;40(5):9-11
Analysis of nuclear families with two and more diabetic siblings with insulin dependent condition
Domuschiev I.P., Kuraeva T.L., Sergeyev A.S., Yazdovsky V.V., Denisov L.N., Maximova V.P., Smirnova O.M., Romanovskaya G.A.

HLA haplotype distribution was analyzed in nuclear families of patients with insulin-dependent diabetes mellitus. Sixteen families with two or more diabetic siblings were examined, a total of 69 subjects, 33 of these diabetic siblings and 36 normal subjects (siblings and parents). The data were processed using the involved sibling pairs method based on a mixed model making use of a conditional probability approach. The ratio of diabetic sibling pairs concordant by 2 haplotypes, 1 haplotype, and discordant by 2 haplotypes was 9:5:2 vs. 1:2:1 expected according to Mendel’s accidental distribution (p< 0.025). Increased incidence of siblings concordant by 2 haplotypes proves the presence in the HLA domain of one or several genes responsible for the development of diabetes mellitus. Siblings identical by two HLA haplotypes with the diabetic proband are at a higher risk of developing this disease.

Problems of Endocrinology. 1994;40(5):11-13
Usage of plasmapheresis in combined therapy of diabetics
Sokolov Y.I., Podachina S.V., Zabotnov V.I., Zanina Y.B.

Clinical observations have repeatedly proved that myocardial infarction in patients with diabetes mellitus (DM) is much more difficult, gives greater mortality, its complications such as acute heart failure, arrhythmia, and relapses are more often observed. The basis of the atherosclerotic process both in diabetes and without it, the main place is given to hyperlipoproteinemia (hypercholesterolemia, hypertriglyceridemia and hypoalpha-cholesterolemia). Most patients with severe type I diabetes mellitus (insulin-dependent, IDDM) and type II diabetes mellitus (non-insulin-dependent, NIDDM) showed an increase in plasma levels of low and very low density lipoprotein cholesterol (cholesterol-LDL and cholesterol-VLDL, respectively) and a decrease high density lipoprotein cholesterol (HDL-C; anti-atherogenic factor).

The use of lipid-lowering drugs for the correction of hyperlipoproteinemia in patients with diabetes is often ineffective or the effect obtained is short-term in nature, side reactions often develop. In recent years, in order to reduce the level of lipids in blood plasma (coronary heart disease, familial hypercholesterolemia, etc.), extracorporeal methods aimed at massive removal of the plasma lipid pool have begun to be used. According to the authors, the rapid and massive removal of atherogenic lipid fractions from plasma contributes to the release of the steroid from the tissue pool.

In the pathogenesis of the development of vascular complications in patients with IDDM and NIDDM, a significant place is given to dysfunction of erythrocyte membranes. Functional disorders are directly dependent on violations of the structure of membrane lipids. Changes in the structure of the lipid bilayer of the erythrocyte membrane in patients with diabetes contribute to increased microviscosity of membranes, reduced deformability, and hinder their passage through the microcirculation system, which can be the cause of tissue hypoxia and one of the links in the pathogenesis of angiopathy in patients with diabetes.

The aim of this work was to study the possible correction of the lipid spectrum of blood plasma and erythrocyte membranes in patients with diabetes when the plasmapheresis method is included in the complex therapy.

Problems of Endocrinology. 1994;40(5):13-16
Prolactin and TSH secretion in functional tests in patients with primary hypothyroidism and hyperprolactinemia
Chernova T.O., Kolesnikova G.S., Mudretsova S.V., Serpukhovitin S.Y., Goncharov N.P., Goncharov G.A.

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 В 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.

Problems of Endocrinology. 1994;40(5):16-18
Specific features of adaptation of the newborns born of mothers with endemic goiter
Zeltser M.Y., Chuvakova T.K., Mezinova N.N., Bazarbekova R.B., Kobzar N.N., Nurbekova A.A., Akyshbayev A.A., Kurmanova A.K., Zhubanysheva K.B., Kiam G.G.

Relationships between chronic iodine deficiency and, among other things, endemic goiter in women and adaptation of their babies in the early neonatal period were studied. A total of 125 women with endemic goiter of the Ist-IInd degrees and their newborns were examined. The diagnosis of endemic goiter was verified by the findings of an objective examination, ultrasonic examination, and puncture biopsy of the thyroid. Blood levels of triiodothyronine and thyroxin were measured in the women on days 3-4 postpartum. In the newborns Apgar score, body mass and length at birth, degree of maturity, physiologic body mass loss, duration of the icteric syndrome, time of umbilical cord drop off, and immunity status from the data of NBT test were assessed. Forty-five women without goiter and their newborns were controls. Postpartum measurements of triiodothyronine and thyroxin levels in the blood of patients with endemic goiter brought the authors to a conclusion that subclinical hypothyrosis was characteristic of them. Adaptation processes in the early neonatal period were found disordered in the newborns of mothers with endemic goiter. This manifested by a higher, vs. controls, incidence of asphyxia, hypotrophy, signs of the CNS involvement, and respiratory distress syndrome. Initial body mass recovery, disappearance of the icteric syndrome, umbilical cord loss were delayed in these newborns in comparison with the controls, and statistically reliable deviations in their immune status were revealed.

Problems of Endocrinology. 1994;40(5):18-20
The thyroid in anemic pregnant women under conditions of endemic goiter
Zeltser M.Y., Mezinova N.N., Kobzar N.N., Bazarbekova R.B., Nazyrov A.T., Kim G.G., Nurbekova A.A., Nugmanova M.I.

Anemia is a highly prevalent condition among pregnant women in the Republic of Kazakhstan. The causes of this anemia are not quite clear, as is the problem of resistance of this type of anemia to therapy with iron preparations. The authors propose that this may be explained by the fact that many regions of the Republic are foci of endemic goiter, because tentative studies indicate a relationship between endemic goiter and hy- pothyrosis. The present study was aimed at examination of the thyroid status in pregnant women suffering from anemia in the town of Alma-Ata, a region endemic for goiter. Altogether 120 anemic pregnant women were examined, 60 of these with goiter and 60 without it. Control group consisted of 20 healthy pregnant women. Clinical and ultrasonic examinations, puncture biopsy of the thyroid, measurements of blood levels of TTH, total and free triiodothyronine and thyroxin, thyroxin-binding globulin, as well as of peripheral blood red cell counts, levels of hemoglobin, serum iron, assessment of total iron-binding capacity of the serum and saturation coefficient, were carried out. Healthy pregnant women from a focus of endemic goiter were found to represent a group at risk of anemia in the third pregnancy trimester. In anemic pregnant women endemic goiter aggravated anemia. Chronic iodine deficiency is conductive to formation in pregnant women of subclinical hypothyrosis whose severity increased in the presence of anemia, more so if anemia is paralleled by goiter.

Problems of Endocrinology. 1994;40(5):20-22
Thyroid and adrenal function in children born 5 years after the Chernobyl accident in economically unfavourable regions of Belarus
Boiko Y.N., Cherevko A.N., Petrova A.M., Zubovich V.K.

Currently, there is no doubt the need to study the comprehensive influence of ionizing radiation one the body finctions. Under the influence of ionizing radiation, the development of compensatory and adaptive-adaptive mechanisms of the most radiosensitive organs and tissues to reduce post-radiation effects is of particular importance. Under these conditions, a change in the functional activity of the pituitary-thyroid and adrenal systems is possible, the hormones of which are actively involved in the main adaptation processes. A generally recognized fact is the high radiosensitivity of the above systems, especially in a growing child’s body.

In the first days after the accident, the main biologically significant radionuclides were iodine isotopes, which caused the formation of dose loads on the thyroid gland. At present, the long-lived radionuclides 13^Cs and 90Sr have a decisive influence on the radiation situation in the republic. The greatest contribution to the radiation dose is made by cesium radionuclides.

Some authors studied the functional state of the pituitary-thyroid system in children exposed in 1986 to radioactive iodine in the ante- and postnatal periods.

Issues of the occurrence of functional changes in the thyroid gland and adrenal cortex, induced by the intake of radionuclides that are not deposited in these organs, have hardly been studied.

Of considerable interest is the study of the state of the functions of the thyroid gland and adrenal cortex in children born and living under the influence of low doses of radiation, whose mothers were exposed to radioactive iodine.

Problems of Endocrinology. 1994;40(5):22-24
The content of gamma-aminobutyric acid and its synthesis enzyme activity in the blood plasma of children exposed to ionizing radiation because of the Chernobyl power plant accident
Bolshova Y.K., Mishunina T.M., Malinovskaya T.N., Kukhta I.N., Samson O.Y.

Marked individual fluctuations in blood levels of GABA and GDC revealed in 35 to 50% of adolescents exposed to ionizing radiation several years before indicate the presence of an imbalance in the GABA-ergic system. These children (with GABA- ergic system disturbances) represent a group at risk of developing remote effects of radiation exposure presenting as disturbed rhythms and terms of sexual maturation, of growth, thyroid and adrenal abnormalities, and they should be regularly checked up.

Problems of Endocrinology. 1994;40(5):24-26
Computer-aided tomographic diagnosis of retrosternal goiter
Dedov I.I., Bukhman A.I., Putina T.V., Serpukhovitin S.Y.

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.

Problems of Endocrinology. 1994;40(5):26-28
Use of long-acting contraceptives in therapy of mastopathy
Khomasuridze A.G., Manusharova R.A., Marsaghishvili N.G.

Effects of long-acting contraceptives on mammary glands of patients with diffuse fibrocystic mastopathy were under study. A total of 206 women aged 17 to 38 were examined. In 50 of them fibrocystic mastopathy was detected by palpation, noncontrast mammography, and ultrasonic examination. On days 5-7 of the cycle the patients were injected 1 ml of depot prover or noristerate or subcutaneously implanted norplant. Injections of the two former agents were repeated in 3 months if necessary. Control examinations were carried out 3 months to 5 years after the contraceptives were started. The results indicate that long-acting contraceptives did not cause any negative changes in the course of mastopathy in 32 of 50 women. In 18 women the general status improved (pain and induration in the mammary glands disappeared), mammographic, thermographic, and ultrasonic data improved, this prompting us to continue our research.

Problems of Endocrinology. 1994;40(5):29-30
Growth effect of GH therapy administered for a year to children with Terner’s syndrome. Analysis of international data base on growth monitoring of the Kabi Farmacia company
Ranke M., Guilbaud O.

To study the parameters that determine the effectiveness of treatment with growth hormone (GH) in Turner syndrome (TS), we examined the results of a survey of 175 children with this disease who were younger than 11 years old and were on therapy (GH) for the first year. Before the start of GH therapy, the median for age was 7.9 years, and the medians for SDS (standard deviation) growth, calculated relative to the norms for healthy children and patients with TS, were 2.5 and 0.3, respectively. The median for the dose of GH was 0.8 IU / kg per week, 86% of patients received the drug 6 or 7 times a week. Multiple regression analysis showed that growth rate was positively correlated with the dose of GH, the number of GH injections per week and the mass-growth index, but inversely correlated with age. These four most important indicators of prognosis determine the variability of the growth effect of therapy in 38% of cases. There are significant differences in this prediction model compared with idiopathic GH deficiency, in which the expected growth is the single most important predictive factor in the first year of SDS therapy. (The data obtained confirm the hypothesis that with TS there is no “growth jump"). The relative uncertainty of the prognosis indicates the need for a further search for indicators that determine the growth effect of therapy for TS.

Problems of Endocrinology. 1994;40(5):31-36
For practitioners
Differential diagnosis of hyperthyroidism with highly sensitive assay of blood TTH: clinical review and practical recommendations for use in Russia and USA
Figge J., Gerasimov G.A.

Highly sensitive methods for determining the level of TSH, carried out using test kits of the second and third generation, make it possible to differentiate with high accuracy the normal and subnormal levels of TSH in the blood and are currently widely used to examine patients with thyroid pathology. These methods have been used for a long time in clinical practice in the United States of America, and recently they are also increasingly used in Russia. The level of TSH below normal values ​​is determined in almost all cases of hyperthyroidism (with the exception of cases of TSH-secreting pituitary adenoma or resistance of the pituitary to thyroid hormones), which makes it possible to do without additional testing with tyroliberin (TRH). Methods for determining second generation TSH usually have a lower sensitivity limit of about 0.1 mU/L. When using the third generation methods, it is possible to accurately determine the level of TSH up to 0.01 mU/L. The fourth generation methods, which are still under development, will have a lower limit of determination of 0.001 mU/L, but they are unlikely to be used for routine clinical studies in the near future. At the Endocrinology Research Center of the Russian Academy of Medical Sciences in Moscow, third-generation methods are currently being used for routine clinical research (the Amerlight system, produced in Russia by the Amerkard joint venture). In addition to this system, other test systems of both domestic and foreign production are also available in Russia. In the USA, methods for determining TTG of the second and third generation are used. Third-generation systems are noticeably more expensive than second-generation systems. Given that in most patients with hyperthyroidism, the TSH level is in the range of less than 0.1 mU/L, methods for determining the third generation are more preferable. In general, the normal level of TSH in the blood of individuals in a state of euthyroidism is from 0.5 to 5.0 mU/L, although there are some interlaboratory differences in the standards for the level of TSH.

Problems of Endocrinology. 1994;40(5):36-39
Automonitoring Principles and Methods in Endocrine Diseases
The role of diabetes-adapted behavior in efficient conduct of treatment and education programs in diabetes mellitus type I
Starostina Y.G., Galstyan G.R., Dedov I.I.

Previous publications highlighted the role of diabetes education as a basis for the success of their treatment, discussed the effectiveness of the intensive care and education of diabetes patients programs in compensating for carbohydrate metabolism, eliminating diabetic ketoacidosis and reducing indicators of temporary disability, as well as preventing the increase in the number of severe hypoglycemia against the background of achieving a near-normal level of glycemia. We have already noted that this improvement was not achieved due to a change in the regimen of insulin therapy, the insulin preparation, its dose, and moreover not due to a stricter diet.

This article discusses one of the specific mechanisms through which education can improve the quality of diabetes care. The success or failure of treatment is based on the so-called “diabetes-related behavior” or patient compliance (the English term “compliance” means active, informed, positive perception of medical recommendations by patients and their use in everyday life, but not on passive , but at a qualitatively higher level, with analysis of the real situation and the development of independent, adequate solutions based on the knowledge gained).

Problems of Endocrinology. 1994;40(5):39-40
Experimental endocrinology
Transcortin interaction with human syncytiotrophoblast
Kiselyova Y.P., Vashkevich I.I., Strelchenok O.A.

Interactions of transcortin (corticosteroid-binding globulin, CBG) variants, nCBG and rCBG, present in the blood of pregnant women, and microvesicular fraction of the brush border membrane of human placental syncytiotrophoblast at 23 + 2° C were studied. Interaction of nCBG in complex with a steroid with each of the two types for specific binding was found associated with transmcmbranous transfer of glycoprotein. Interaction of rCBG with binding sites of both types did not involve subsequent glycoprotein transfer through the membrane. Possibility of penetration of only one CBG variant through syncytiotrophoblast membrane suggests the presence of different mechanisms of these glycoproteins' participation in the hormonal effects of steroids associated with them.

Problems of Endocrinology. 1994;40(5):41-44
Neuromediator bioamines in the histogenesis of corpora lutea
Pogorelov Y.V., Dindyayev S.V.

The role of neuromediator bioamines in histogenesis of corpora lutea was under study. Cryostate slices of ovaries from 27 cats were treated after A. Bjorklund’s fluorescent histochemical method modified by V. N. Shvalev and N. I. Zhuchkova. The content of serotonin and catecholamines was measured cytospectrofluorometrically in varicose dilatations and intervari- cose sites о perivascular plexuses and terminals, in membranous and parenchymatous macrophages of corpus luteum. A reliably increased content of the examined neuromediators was found in all the tested nervous structures at the stage of glandular metamorphosis and corpus luteum maturity. Serotonin and catecholamines are believed to be needed for glandular metamorphosis and corpus luteum maturation. A higher level of catecholamines at the stage of corpora lutea maturity in comparison with serotonin may be explained by an activating effect of these neuromediators on progesterone synthesis. Catecholamines may be necessary for luteolythic action of prostaglandines. Macrophages seem to inactivate mediator excess.

Problems of Endocrinology. 1994;40(5):44-46
Specific features of triiodothyronin reception under 131I incorporation
Nikolayeva L.A., Danilova L.I., Kholodova Y.A.

Effects of incorporated 131I in combination with intake of fodder contaminated with 134,137CS on triiodothyronin reception by peripheral blood lymphocytes in rats aged 2 and 6 months were examined. Incorporation of 131I was found to cause specific binding of the hormone, particularly marked in young animals.

Problems of Endocrinology. 1994;40(5):47-48
Triiodothyronin recepton in exposure to low-dose ionizing radiation
Nikolayeva L.A., Danilova L.I., Kholodova Y.A.

Effects of ionizing radiation in doses 0.5 and 1 Gy on triiodothyronin reception by rat peripheral blood lymphocytes were examined 3, 10, and 30 days after exposure. Binding capacity of 125-1 labeled triiodothyronin by lymphocyte receptors was found to change depending on the dose of external irradiation and time elapsed since the exposure. The most marked and earliest changes in the parameters of hormonal-receptor interaction were observed after irradiation in dose 1 Gy.

Problems of Endocrinology. 1994;40(5):48-50
The function of the hypothalamothyroid system after cainate injection to the ventrolateral portion of medulla obtongara
Dudina T.V., Yeolkina A.I., Kandybo T.S., Azev O.A., Kulchitsky V.A.

Contribution of the bulbar structures to mechanisms of realization of the hypothalamothyroid system feedback was studied in experiments on 73 adult male Wistar rats. Histologically confirmed unilateral destruction of neurones in the caudal part of medulla oblongata ventral portions after injection of 0.65 pg of cainate as soon as 30 min after injection was paralleled by a trend to increase of the blood serum levels of triiodothyronine and thyroxin-binding globulin, this increase attaining reliable values by day 7 after destruction, when the effects of operation stress levelled. During the same period wc observed activation of glucocorticoid-dependent choline-, serotonin-, and noradrenergic- processes in the mediobasal zone of the hypothalamus, this indicating the presence of functional relationships of medulla oblongata ventral portions with the hypothalamothyroid system realized by disinhibition of this system during destruction of neurones in the caudal part of the ventral portion of medulla oblongata.

Problems of Endocrinology. 1994;40(5):50-52
Glycolysis intensity and activities of energy metabolism enzymes in the rat brain during repeated exposure to hypoglycemic doses of insulin
Telushkin P.K., Potapov P.P.

Renewable conditions of hypoglycemia are a frequent complication in the treatment of diabetes mellitus, determine the clinic of pancreatic insulinomas, are observed in diseases of the kidneys, liver, gastrointestinal tract and alcoholism, leading to the development of posthypoglycemic encephalopathy. At the same time, a single, even severe, insulin coma is accompanied by reversible metabolic changes in the brain.

Therefore, the pathological features of metabolism in the nervous tissue, which are the result of repeated hypoglycemia, in particular possible disturbances in energy metabolism, require further study.

In this work, we studied the main ways of glucose metabolism - the intensity of glycolysis and glycogenolysis, the activity of Krebs cycle dehydrogenases, alanine and aspartate aminotransferases in the rat brain in setting of multiple hypoglycemia.

Problems of Endocrinology. 1994;40(5):53-54
Dopaminergic control of prolactin secretion regulation (review of experimental and clinical trials)
Gubernatorov Y.Y., Gerasimov G.A.

Prolactin secretion (PRL) is under complex neuroendocrine control. in which factors of various nature are involved: neurotransmitters, biologically active neuropeptides, as well as hormones of peripheral endocrine glands. However, the dominant role belongs to dopamine, which is the most important of endogenous prolactin inhibiting substances. Convincing evidence of this was obtained after the discovery and study of the tuberoinfundibular dopaminergic system of the hypothalamus, which is a part of a complex neuroendocrine system for regulating the secretion of PRL.

Problems of Endocrinology. 1994;40(5):55-59
Somatoendocrine disorders in nervous anorexia
Chazova T.Y., Kalinchenko S.Y.

Anorexia nervosa (AN) is expressed in the extremely stubborn desire to lose weight through targeted, long-term self-restraint in food, sometimes accompanied by intense physical exercise or taking large doses of a laxative. If it is impossible to withstand prolonged starvation, patients resort to a method such as inducing artificial vomiting.

AN is a pathology characteristic of adolescent girls and young girls, although it can sometimes occur in males of puberty or adolescence. AN is more common at the age of 15-25 years. The incidence among women is on average 10 times higher than among men. There is no information on the prevalence of AN in our country. According to foreign authors, the frequency of AN is 112 per 100,000 of the population. However, these data are underestimated, since only patients with severe, protracted forms of the course of AN go to the hospital and are subject to accounting. Patients with "mild" forms of AN remain outside the field of vision of doctors.

The beginning of a scientific study of AN was laid by W. Gull (1868) and E.-Ch. Laseque (1873). However, despite the increasing number of studies devoted to this interesting problem, AN still causes numerous discussions regarding its etiology, pathogenesis, and neuroendocrine disorders, and methods for their correction.

In this review, we tried to summarize the available data of recent years. One of the first reviews on the nature of neuroendocrine shifts in AN was made in 1984.

Problems of Endocrinology. 1994;40(5):59-62
Ya. I. Tomashevsky, A. Ya. Tomashevskaya. Foundations of Prophylactic Diabetology
Potemkin V.V.

The peer-reviewed monograph summarizes the results of many years of research by the head of the endocrinology department of the Lviv Medical Institute prof. Ya. I. Tomashevsky and his staff dedicated to the early diagnosis of diabetes mellitus (DM) using pyruvaturic, pyruvatemic and pyruvate dehydrogenase tests. The significance of these studies, both scientifically and in practical terms, is undeniable. Very important in the prevention of diabetes mellitus, especially insulin-dependent diabetes, is the ability to identify individuals genetically predisposed to diabetes with these methods. Under conditions of low-intensity Lviv radioactivity, such a predisposition in the general population was 28.77%, which is 3.77% higher compared to the literature. The authors discovered pyruvic diabetes syndrome, the frequency of which in the general population is 8.90% (the compensation phase is 6.16%, the decompensation phase is 2.74%).
The monograph consists of a brief introduction and 7 sections (chapters), the literary index contains 124 sources. A presentation of the methodology for conducting the above tests is preceded by Section 2, in which the authors evaluate the role of the pyruvate dehydrogenase system of mitochondria and the Measles cycle in the mechanism of regulation of carbohydrate metabolism.
A relatively simple biochemical method for the determination of pyruvate in urine and blood under conditions of a carbohydrate load provides very valuable information that allows for early diagnosis of diabetes. The authors also identify options for the borderline states of glucose tolerance: insufficiency of the early phase of insulin secretion, pyruvate dehydrogenase hyper- and hypotolerance, contra -insulin deficiency (relative hyperinsulinism), etc.

Problems of Endocrinology. 1994;40(5):62-63
The 60th anniversary of professor Yu. A. Knyazev

On June 10, 1994, the well-known pediatrician-endocrinologist Yuri Alexandrovich Knyazev, doctor of medical sciences, professor, honored scientist of the Russian Federation, head of the endocrinology and metabolism department of the Russian State Medical University, turned 60.

After graduating with honors from the Kursk Feldsher-Midwifery School and the Kursk State Medical Institute, Yu. A. Knyazev specializes in residency and postgraduate studies at 11 Moscow Medical Institute for Pediatrics and Pediatric Endocrinology. Candidate (1963) and doctoral (1969) dissertations are devoted to questions of pathogenesis, clinic, and treatment of diabetes in children. At the age of 36, Yu. A. Knyazev was awarded the academic title of professor of pediatrics.

Yu. A. Knyazev organized a hormone-exchange diagnostic laboratory, which was a branch of the Central Scientific Research Laboratory II MMM named after N. I. Pirogov on the basis of pediatric clinics of the Children's Clinical Hospital No. 1 (Morozovskaya). Yu. A. Knyazev was at the forefront of domestic pediatric endocrinology, clinical biochemistry, headed the pediatric endocrinological service of Kursk and Moscow; on his initiative, a specialized kindergarten-nursery was first created, medical institutions for endocrinological patients were organized, the principles of which were approved in many regions of the country. As the chairman of the Union, Republican, and interagency commissions on pediatric endocrinology, Yu. A. Knyazev integrates scientific research in this area.

Problems of Endocrinology. 1994;40(5):63-63

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