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Vol 44, No 4 (1998)

A family of xenobiotics that stimulate the secretion of growth hormone, and a new physiological system for its regulation
Bulatov A.A.
Abstract

The history of discovery of low-molecular xenobiotics of peptide and поп-peptide origin selectively stimulating growth hormone (GH) secretion is presented and the properties of this family are described. Results of study of these synthetic GH secretogogues, their physiological effects and mechanisms of in vitro and in vivo action, relationships with GH releasing hormone (GH- RH) and somatostatin (SS), classical natural regulators of GH secretion, underlie the discovery of a heretofore unknown physiological system regulating normal pulsatile secretion of GH in interactions with GH-RH and SS and their receptors. This system includes a unique G-protein coupled receptor which was detected in the pituitary, hypothalamus, and hippocampus and was recently cloned, and endogenous ligand of this receptor, apparently a structural and functional analog of the above xenobiotics.

Problems of Endocrinology. 1998;44(4):3-6
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The results of the use of argon laser coagulation in the treatment of dibetic retinopathy
Milenkaya T.M., Terentyev V.S., Bessmertnaya E.G., Dedov I.I.
Abstract

A total of 182 patients (95 men and 87 women) aged 15-49 years with insulin-dependent diabetes mellitus were treated using argon laser coagulation. Late results of laser therapy were followed up for 6 months to 3 years. In the patients with nonproliferative diabetic retinopathy (DR) on the fundus oculi the improvement consisted in partial resolution of solid exudative foci and retinal hemorrhages in 20%o of cases. In patients with preproliferative DR, soft exudative foci partially resolved and the number of retinal hemorrhages and microaneurysms decreased in 17%o of cases. In patients with proliferative DR, regressive development of proliferative tissue, desolation of newly formed vessels, and resolution of preretinal hemorrhages were observed in 13.9%o of cases. Stabilization for 3 years was attained in 75%) of patients with nonproliferative and proliferative and in 72.5%o of those with preproliferative DR.

Problems of Endocrinology. 1998;44(4):7-12
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Angiotensin-converting enzyme gene polymorphism and a genetic predisposition to diabetic nephropathy in insulin-dependent diabetes mellitus
Kondratev Y.Y., Chugunova L.A., Shamkhalova M.S., Shestakova M.V., Demurov L.M., Chistyakov D.A., Vikulova O.K., Nosikov V.V., Dedov I.I.
Abstract

Insertion/deletion (ID) polymorphism of angiotensin I converting enzyme (ACE) as a potential marker of genetic susceptibility to diabetic nephropathy (DN) is studied in 45 insulin-dependent diabetic patients and 168 healthy subjects from the general Moscow population. Fourteen proteinuric patients with relatively short diabetes duration (< 15 years) and 31 patients with a longer diabetes duration (>20 years) without clinical signs of DN were the “case” (DN+) and control (DN-) groups, respectively. The DN+ group virtually did not differ from healthy subjects in the ID/ACE allele and genotype distribution, whereas in the DN- and healthy controls and, more so, in the DN+ and DN- groups the incidence of this polymorphic marker differed significantly, and hence, it can be considered as a genetic risk factor for DN. Allele I had a dose-dependent protective effect with regard to DN (maximal in the carriers of homozygotic genotype II). Such non-genetic risk factors as glycemic control, diastolic blood pressure, and sex of patients interfere with ID/ACE polymorphism and contribute to susceptibility to DN in a synergistic or antagonistic manner. Use of the “extreme” variants of DN phenotype helped decrease the masking effect of non-genetic risk factors and detect the genetic component in the etiology and pathogenesis of this multifactorial angiopathy.

Problems of Endocrinology. 1998;44(4):12-15
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The use of sulodexide in obliterating atherosclerosis of the lower extremities in patients with diabetes mellitus
Bregovsky V.B., Zalesskaya A.G.
Abstract

Efficacy of sulodexin in diabetics with atherosclerosis obliterans of the lower limbs was assessed from changes in clinical manifestations of intermittent claudication, results of treadmill test, dopplerography of the lower limb vessels, lipidogram, and time course of coagulologic values. Twenty patients with involvement of the lower limb arteries with stages I I-1II according to Fontain were examined. After 10 intramuscular injections of Vessel Due F in a dose of 600 LRU, the drug was administered orally in a dose of 250 LRU twice a day for 12 weeks. Clinical improvement was attained in 88% of patients. The distance of painless walking increased from 152.7+22.2 to 283.6+52.4 m (by 86%), maximal distance from 221.2+29.5 to 376.6+56.9 m (by 70%). Study of changes in coagulologic values over the course of treatment showed increase of activated partial thromboplastin time from 30.7+2.7 to 38.4+1.5 sec (p<0.02), decrease of serum fibrinogen from 4.0+0.1 to 3.2+0.1 g/liter (p<0.003), and increase of thrombin time from 21.7+4.7 to 26.7+3.4 sec (p<0.006). Cholesterol decreased from 6.7+1.0 to 6.27+0.3 mmole/liter (p<.05) and triglycerides showed a tendency to decrease from 1.9+0.23 to 1.7+0.2 mmole/liter (NS). No allergic reactions or side effects were observed during therapy.

Problems of Endocrinology. 1998;44(4):16-18
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On the state of platelet membranes in patients with insulin-dependent diabetes mellitus in diabetic ketoacidosis
Nelaev A.A., Troshin I.A., Medvedev I.V., Zhuravleva T.D.
Abstract

A total of 120 patients (55 men and 65 women) aged 18-53 years with insulin-dependent diabetes mellitus were examined. Ninety patients presented with diabetic ketoacidosis and 30 without complications. The disease duration was 1-20 years, daily insulin dose 45+0.9 U. Control group consisted of 30 normal subjects. In the ketoacidosis group, 38 patients had moderate ketoacidosis, 47 were in a state of decompensated ketoacidosis or precoma, and 5 in ketoacid coma. Lipid peroxidation (LPO) products, activities of antiradical defense enzymes, phospholipid composition, and cholesterol level of platelet membranes were measured in the patients. The results showed LPO activation, disturbed phospholipid composition of platelet membranes, and decreased activity of antiradical defense enzymes. The severity of ketoacidosis, disease duration, and vascular involvement lead to destabilization of platelet membranes in diabetics.

Problems of Endocrinology. 1998;44(4):18-22
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The content of tumor necrosis factor A and interleukin-1 in the blood serum of patients with autoimmune thyroid diseases
Blagosklonnaya Y.V., Ketlinsky S.A., Krasilnikova E.I., Kotov A.Y., Babenko A.Y.
Abstract

Thyroid hormones, antibodies to thyroglobulin, and cytokines tumor necrosis factor a (TNF-a) and interleukin 1 (IL-1) were measured in 14 patients with diffuse toxic goiter (DTG) and 6 patients with Hashimoto ’s autoimmune thyroiditis (AIT). Patients with DTG were examined in the presence of hyperthy- rosis and those with AIT in the presence of euthyrosis. The data indicate a relationship between the levels of TNF-a and thyroid hormones: negative correlation in hyperthyrosis and positive in euthyrosis. In addition, patients with AIT develop a direct correlation between TNF-a and serum titer of antithyroglobulin antibodies. Serum level of IL-1 do not increase. The results of this study confirm the hypothesis about important role of cytokines in pathogenesis of autoimmune diseases of the thyroid, namely, DTG and AIT.

Problems of Endocrinology. 1998;44(4):22-24
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Reproductive function in men - participants in the aftermath of the Chernobyl accident
Goncharov N.P., Katsiya G.V., Kolesnikova G.S., Dobracheva A.D., Todua T.N., Vaks V.V., Marova E.I.
Abstract

Endocrine parameters and spermatogenesis values were assessed in 328 men aged 25-45 years who participated in liquidation of the Chernobyl aftermath and in 88 age-matched healthy controls. The mean radiation dose in liquidators was 0.16+0.006 Gy. LH, FSH, prolactin, testosterone, and hydrocortisone were radioimmunoassayed using standard WHO reagents. Spermograms were analyzed according to WHO recommendations (1992). The mean hormone levels in the blood of liquidators were within the normal range and did not differ from those in the controls. Individual deviations in hormone content did not correlate with radiation dose and their incidence was compatible with that in the control group. The most frequent disorders of spermatogenesis in the liquidators were teratospermia (29%) and oligospermia (23%). Spermogram abnormalities did not depend on the absorbed dose. Thus, there are no appreciable shifts in the mechanisms of endocrine regulation of the reproductive function and in spermatogenesis 7-9 years after radiation exposure. 

Problems of Endocrinology. 1998;44(4):25-28
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The effect of an aromatase inhibitor on the level of estrogen in the blood of postmenopausal women
Bershtein L.M., Gershanovich M.L., Gamayunova V.B., Tsyrlina E.V., Loskutova G.P., Blinov N.N., Maksimov S.Y.
Abstract

Effect of Femar, an imidasole inhibitor of aromatase, in a daily dose of 0.25 mg orally for 2 days, on blood estradiol is assessed in 16 menopausal women. The mean decrease of estradiol was 49.8%; this decrease was more pronounced in probands with Ketle ’s index of >30 or more than 40 kg of fat in the body in comparison with women with lower values. Gonadotropin (FSH and LH) concentrations in the blood were not much changed by femar. Possible mechanisms of endocrine changes and factors determining the sensitivity to aromatase inhibitors in vivo during the menopause are discussed.

Problems of Endocrinology. 1998;44(4):29-31
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New concepts in ovulation induction
Balen A.
Abstract

In infertility caused by anovulation, the main principles of treatment are either elimination or overcoming the cause of the lack of ovulation. For example, with hypogonadotropic hypogonadism, repeated injections of exogenous GnRH are used, and with polycystic ovary (PCN) exogenous gonadotropins are administered. The purpose of these effects is to cause ovulation of one follicle and thus restore the normal probability of pregnancy with one fetus.

Problems of Endocrinology. 1998;44(4):31-35
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The combination of aldosteroma and malignant pheochromocytoma in one adrenal gland
Bondarenko V.O., Shapiro N.A., Putilina O.A., Blagovestnov D.A., Kovalenko T.N.
Abstract

The simultaneous development of tumors of the cortical and brain layers of the adrenal gland is extremely rare. In the available world literature, only 4 cases of a combination of cortical adenoma and pheochromocytoma have been published [1–4].

We observed a patient with symptomatic arterial hypertension due to the presence of a tumor of chromaffin tissue. During surgery in the right adrenal gland, 2 neoplasms different in hormonal manifestations and morphological structure were found.

Problems of Endocrinology. 1998;44(4):35-38
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To help patients with hypothalamic-pituitary disorders (patient's school)
Romantsova T.I., Chernogolov V.A., Pavlova M.G.
Abstract

We continue our story about various diseases of the pituitary and hypothalamus. In the previous issue, we dwelt in detail on the manifestations and features of the diagnosis and treatment of the disease and Itsenko-Cushing's syndrome. Today we will discuss two diseases at once: diabetes insipidus and acromegaly.

Problems of Endocrinology. 1998;44(4):38-40
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Morphofunctional changes in the thyroid gland in laboratory animals under the action of cold
Selyatitskaya V.G., Odintsov S.V., Obukhova L.A., Palchikova N.A.
Abstract

The functional activity of the thyroid in laboratory animals exposed to extreme cooling is studied. Male Wistar rats were used. Control animals were kept at 20-22° C, experimental at —10°C for 7 days. Thyroxin and triiodothyronine concentrations in the serum and thyroid hormones and thyroglobulin in the thyroid were measured. Morphometry of the thyroid was carried out. Thyroxin level decreased and the T3/T4 ratio increased in the serum of rats exposed to extreme cooling; the content of thyroid hormones in the gland, mainly triiodothyronine and thyroglobulin, increased under the effect of cold. The thyroid enlarged under the effect of cold. The bulk of follicular epithelium in thyroid tissue increased and colloid volume decreased. Structural transformations of follicles were paralleled by increase of the vascular network and number of degranulated mast cells in the connective tissue thyroid stroma. Therefore, exposure to low temperature results in increase of the thyroid functional activity in rats, despite the exhaustion of the adaptive reactions of the organism.

Problems of Endocrinology. 1998;44(4):40-42
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Comparative evaluation of the therapeutic activity of substances of pancreatol and manninil in experimental diabetes
Kaydashev I.P., Bobrova N.A., Katrushov A.V.
Abstract

Diabetes mellitus (diabetes mellitus) is a disease caused by absolute or relative deficiency of insulin in the body, characterized by a violation of all types of metabolism and, primarily, carbohydrate metabolism. The incidence of diabetes is steadily increasing. Every 10-15 years in all countries of the world, the number of patients doubles. Among the causes of death, diabetes mellitus takes third place after cardiovascular and oncological diseases. All these facts make us persistently look for new methods of treatment and new medicines.

Problems of Endocrinology. 1998;44(4):43-45
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Reviews
Etiological aspects of primary chronic adrenal insufficiency
Melnichenko G.A., Fadeev V.V., Buziashvili I.I.
Abstract

Adrenal insufficiency (adrenal cortex insufficiency, hypocorticism, NN) is a clinical syndrome caused by insufficient secretion of hormones of the adrenal cortex as a result of impaired functioning of one or more parts of the hypothalamic-pituitary-adrenal system. According to the initial localization of the pathological process, NN is divided into primary (lesion of the adrenal cortex itself, 1-NN) and central forms that are the result of impaired secretion of adrenocorticotropic hormone - ACTH (secondary NN) or KRG (tertiary NN). Due to the fact that in clinical practice 1-NN is most common (more than 95%), a leading place in the world literature is given to the consideration of various aspects of this type of hypocorticism.

Problems of Endocrinology. 1998;44(4):46-51
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