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Vol 47, No 3 (2001)

Clinical endocrinology
Stimulation of the growth of "normal" thyrocytes by lymphocytes infiltrating the tissue of diffuse toxic goiter
Krainova S.I., Kryukova I.V., Mkrtumova N.A., Keda Y.M., Kandror V.I.

The capacity of lymphocytes isolated from diffuse toxic goiter (DTG) tissue to stimulate the proliferation of normal thyrocytes isolated from paranodular tissue adjacent to nodular euthyroid goiter was studied. Normal and DTG thyrocytes were incubated for 24 h with fetal calf serum (FCS) in various concentrations, DTG orparanodular lymphocytes, or both FCS and lymphocytes. The proliferation rate of normal thyrocytes in the presence of FCS alone increased with increase of the serum concentration, while the proliferation rate of DTG thyrocytes did not depend on the concentration of FCS. DTG lymphocytes, but not paranodular ones, stimulated the proliferation of normal thyrocytes. The growth-stimulating effect of DTG lymphocytes was paralleled by loss of normal thyrocytes sensitivity to growth factors (FCS). These data indicate a probable role of intrathyroid lymphocytes in increase of thyrocyte count characteristic of DTG and confirm a previous hypothesis on decrease in expression of surface antigens (receptors) on DTG cells under the effect of intrathyroid lymphocytes.

Problems of Endocrinology. 2001;47(3):3-5
Low expression of Met-hepatocytic growth factor receptor as an indicator of poor prognosis in thyroid tumors
Dedov I.I., Troshina Y.A., Mazurina N.V., Belfiore A.

Clinical implication of Met-hepatocytic growth factor receptor (Met/HGF-R) in thyroid adenocarcinoma tissue was studied on 163 operative thyroid samples (129papillary cancers, 21 follicular cancers, and 13 anaplastic cancers). 49 adenomas, 50 nodular goiters and 50 normal thyroids were compared. Expression of Met/HGF-R was estimated using semiquantitative immunohistochemical method including proportion (limits 0-5) and intensity (limits 0-5) of cell staining and calculation of Met/HGF-R total expression (limit 0-10). Met/HGF-R was not found in normal thyroid tissue, was absent or focally expressed in follicular and aplastic tumors, and was present in different amounts in papillary adenocarcinomas. It is suggested that low expression of Met/HGF-R is an indicator of unfavorable prognosis in papillary thyroid cancer.

Problems of Endocrinology. 2001;47(3):6-10
Role of iodine supply in neonatal adaptation of the thyroid system
Kasatkina E.P., Shilin D.Y., Petrova L.M., Khatamova K.A., Lokteva Y.N., Samarcheva T.I., Akinshin V.I.

Population frequency of neonatal hyperthyrotropinemia (NHT) in an iodine deficient region was studied with consideration for published reports about the relationship between prenatal iodine supply and fetal and neonatal thyroid function, and the efficiency of iodine prevention of this condition was evaluated by the results of overall screening of newborns for hypothyrosis. The concentrations of thyrotropic hormone (TTH) in whole blood specimens dried on paper were measured in 29588 newborns in the Belgorod region (Russia) in 1995-1998 using the Neonatal hTSH FEIA (Labsystems OY, Finland). Slight iodine deficiency in this region (median iodine excretion with urine 69 mcg/liter, n = 1313) was associated with an extremely high incidence of NHT: more than 5 iU/liter in 47% and more than 20 iU/liter in 7% newborns. Overall prevention with iodinated table salt during 1 year notably decreased the incidence of NHT (by 1.6 times, p < 0.001) and alleviated its severity from severe to mild degree. Preventive treatment of pregnant women by potassium iodide (200 mcg/day) during the same period more effectively decreased the incidence of the pathological parameter (five fold, p < 0.001). A lower incidence of NHT resultant from prenatal iodine treatment was associated with a lowering of the mean TTH level solely at the expense of the newborns with high levels of the hormone; if TTH levels were normal, they did not change. Therefore, thyroid dysfunction in newborns (NHT) indicates iodine deficiency in a region during intrauterine development; this abnormality can be prevented by iodine treatment in microdoses meeting the physiological requirement in iodine, which is increased during gestation. At the beginning of overall prevention of goiter by iodinated table salt, group prevention with potassium iodide is justified in risk groups, primarily in pregnant women; compensation of prenatal deficiency decreases the cost of screening for congenital hypothyrosis due to a lower requirement in TTH retesting.

Problems of Endocrinology. 2001;47(3):10-15
Distribution of endothelial NO synthase gene alleles and locus D6S392 near Mn-dependent superox ide dismutase gene in patients with type I diabetes with diabetic nephropathy
Voronko O.Y., Chistyakov D.A., Savostyanov К.V., Chugunova L.A., Shamkhalova M.S., Shestakova M.V., Nosikov V.V., Dedov I.I.

Distribution of alleles and genotypes of microsatellite D6S392 neighboring mitochondrial superoxide dismutase (SOD2) gene and of two polymorphous markers (minisatellite ecNOS4a/4b and mutation in codone 298: replacement of glutamic acid (Glu) with asparaginic (Asp) acid) was studied in patients with insulin dependent diabetes mellitus (IDDM) with and without diabetic nephropathy (DN) (36 and 56 patients, respectively). Distribution of locus D6S392 alleles and polymorphous marker Glu298Asp was virtually the same in both groups. Differences were observed for minisatellite ecNOS4a/4b. In DN patients the content of allele 4a and of genotype 4a/4b is increased in comparison with patients without DN (38.9 vs. 22.3%, p < 0.02, and 61.1 vs. 41.7%, p < 0.05, respectively). Decrease in the percent age of 4b/4b genotype and allele 4b in DN patients are also significant (30.6 vs. 57.1%, p < 0.02, and 61.1 vs. 77.1%, p < 0.02). Hence, polymorphous site ecNOS4b/4a of NOS3 gene is associated with DN development in patients with IDDM living in Moscow.

Problems of Endocrinology. 2001;47(3):15-18
Computer-aided tomography and anthropometry in the diagnosis of visceral obesity in men
Dvoryashina I.V., Ivanova T.N., Rogozina I.A., Korobitsyn A.A.

A total of 153 men with obesity of different degree and 51 men with normal body weight aged 40-60 years were examined in order to detect a relationship between anthropometric parameters and computer tomography data characterizing the accumulation of abdominal fat at different sites. Body weight, height, waist and hips circumferences, and cutaneo-fatty folds were measured. The area of total abdominal fatty tissue, vis- ceral and subcutaneous fat were evaluated by computer tomography; scanning of the abdominal cavity showed images of two sections (at the levels of the 2-3 and 4-5 lumbar verte brae). The results indicate that abdominal obesity in men is characterized by predominant accumulation of fatty tissue in visceral fat depots. The most informative anthropometric markers of the degree of visceral fat accumulation are sagittal diameter and waist circumference. Sagittal diameter 21.1 cm and waist circumference 95.9 cm and more indicate pronounced visceral obesity (93.2 and 88.9% examinees, respectively). These anthropometric parameters are recommended for the diagnosis of visceral obesity in clinical practice.

Problems of Endocrinology. 2001;47(3):18-22
The daily rhythm of secretion of adrenocorticotropic hormone in assessing the adequacy of replacement therapy for primary chronic adrenal insufficiency
Fadeev V.V., Gitel E.P., Melnichenko G.A.

Plasma level о] АС 1Н was radioimmunoassayed every 4 hours for 24 h in three groups of patients in order to evaluate the possibility of using circadian rhythm of ACTH secretion for assessment of the efficacy of substitute glucocorticoid therapy for primary chronic adrenal insufficiency (CAI-1, Addison’s disease). In group 1 (n = 14) patients with CAI-1 were treated with prednisolone (5 mg at 9.00 and 2.5 mg at 14.00), in group 2 dexamethasone (0.5 mg at 23.00) and prednisolone (2.5 mg at 14.00). In addition, all patients with CAI-1 were administered 9a-fluorocortisol in a daily dose of0.005-0.01 mg. Control group consisted of 14 healthy volunteers.

The level of A CTH varied within a wide range in both variants of substitute therapy in comparison with the norm. The areas under the curve reflecting ACTH concentrations within 24h differed negligibly in groups 1 and 2 and in group 2 and control. The area under ACTH curve in group 1 was significantly larger than in the control. The mean concentrations of ACTH in group I at 7.00 and 11.00 were significantly higher than in the two other groups. In general, circadian rhythms of ACTH secretion were closer to the norm in the patients treated with dexamethasone. According to our clinical experience, dexamethasone had to be discontinued because of the overdosage syndrome (body weight excess, high appetite and insomnia) in at least 2/3 of patients initially prescribed this agent, and therefore we conclude that the clinical picture and data on the 24-h rhythm of A CTH secretion disagree. Evaluating the results of substitute therapy for CAI-1, one should remember that normal rhythm of ACTH secretion during 24 h does not rule out overdosage of glucocorticoids, and therefore the results of laboratory tests should be interpreted with due consideration for the clinical picture.

Problems of Endocrinology. 2001;47(3):20-24
For practitioners
Total iodination of table salt for prevention of iodine deficiency diseases: The advantages essentially surpass the risk
Gerasimov G.A.

The article is devoted to the total iodination of table salt for prevention of iodine deficiency diseases.

Problems of Endocrinology. 2001;47(3):22-26
Case Reports
A rare case with Icenko-Cushing syndrome caused by multiple bilateral benign and malignant adrenocortical tumors
Molitvoslovova N.N., Belova Y.Y., Yushkov P.V., Kuznetsov N.S., Marova Y.I., Vanushko V.E.

The article is devoted to the descripition of the rare case with Icenko-Cushing syndrome caused by multiple bilateral benign and malignant adrenocortical tumors.

Problems of Endocrinology. 2001;47(3):26-29
Familial adrenoleukodystrophy
Chumak S.A., Pesochina E.A., Ozerova L.S., Pechersky В.V.

The article is devoted to the description of adrenoleukodystrophy - a hereditary disease with X - linked recessive type of inheritance, belonging to the group of peroxisomal diseases and manifested mainly by the defeat of the white matter of the nervous system and the adrenal cortex.

Problems of Endocrinology. 2001;47(3):29-33
Glymepiride (amaril): Clinical pharmacology and compliance in diabetes mellitus
Karpov О.I.

The article reviews an action of glimepiride (amaryl), its clinical pharmacology and compliance in diabetes mellitus.

Problems of Endocrinology. 2001;47(3):41-44
Obesity and somatotropic hormone: cause and effect relationships
Verbovaya N.I., Bulgakova S.V.

The article reviews the obesity and somatotropic hormone, its cause and their effect relationships.

Problems of Endocrinology. 2001;47(3):44-47
Experimental endocrinology
Specific GABA binding in the adrenals and blood corticosteroid level in stress in intact rats and rats with changed functional activity of the hypothalamo-pituitary-adrenal system
Mishunina T.M., Kononenko V.Y.

Thirty-minutes swimming of rats led to a decrease of specific GABA binding by adrenal plasmatic membranes in intact rats but not in rats with increased level of amino acid reception repeatedly injected with hydrocortisone for inhibition of basal hypothalamic-pituitary-adrenal activity. In jections of baclophene and gamma-L-aminobutyril-taurine before stress did not modify the specific GABA binding, although the drugs changed the corticosteroid concentrations in the blood.

Problems of Endocrinology. 2001;47(3):33-36
NPY-Synthesizing cells of Langerhans’ islets in normal and diabetic rats after injection of synthetic neuropeptide Y
Trailin A.V., Kolesnik Y.M., Orlovsky M.A.

The purpose of this study was identification and evaluation of NPY-synthesizing cells of Langerhans ’ islets in Wistar rats in health, streptosotocin diabetes of different duration, and during chronic treatment of diabetic animals by synthetic NPY. NPY- and insulin-producing cells in the islets were identified by indirect immunofluorescence using Peninsula Laboratories Inc. kits (USA) and their status was analyzed by VIDAS-386 image processing (Kontron Elektronic, Germany). NPY-immunoreactive cells of different shape and size were detected in the islets of normal animals. Three-week development of diabetes led to more than twofold increase in their count in comparison with the control, indicating activation of the peptide synthesis, which normalized by day 35 of disease. Injection of synthetic peptide from day 26 to day 35 of diabetes largely restored the count and function of p-cells, prevented the inhibition of NPYsynthesis in the islets, and stimulated its secretion.

Problems of Endocrinology. 2001;47(3):36-41

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