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Vol 48, No 1 (2002)

Structural changes of the thyroid gland. Causes of occurrence, diagnosis, treatment methods
Starkova N.T.

The article is devoted to structural changes of the thyroid gland, causes of occurrence, diagnosis, treatment methods.

Problems of Endocrinology. 2002;48(1):3-6
Clinical endocrinology
A fragment of apolipoprotein B with insulin-like immunoreactivity
Panin L.Y., Poteryaeva O.N., Voronova O.S., Shevkoplyas O.P., Polyakov L.M.

The purpose of this study was immunochemical analysis of a fragment of apolipoprotein В with insulin-like immunoreactivity. We denoted it as peptide B. The peptide isolated by electrophoretic elution was used to obtain specific antibodies. Antibodies to peptide В reacted with apolipoprotein B-100, whole serum, serum after precipitation of β-lipoproteins, and with supernatant after removal of all lipoproteins by ultracentrifugation. Enzyme immunoassay was optimized for evaluation of serum peptide В after precipitation of β-lipoproteins. Serum concentrations of peptide В were increased in patients with type 2 diabetes mellitus in comparison with donors. The content of peptide В increased with increase of body weight index and disease duration.

Problems of Endocrinology. 2002;48(1):6-9
Social and psychological aspects of life quality of diabetics
Sidorov P.I., Solovyov A.G., Novikova I.A.

In order to evaluate the inner picture of the disease and the changes in socio-psychological sphere under the effect of endocrinological disease, 120 diabetics were interviewed using a special questionnaire including 85 questions on different aspects of patient’s life. The results showed pronounced emotional and personal problems in all socially significant spheres, which deteriorated the quality of life. A distorted picture of the disease with fixation on "escape into disease" was characteristic of the majority of respondents. The detection of patient’s emotions concerning their suffering and revelation of the inner picture of disease in diabetics are aimed at evaluation of the adaptive potential, value motivation system, and defense mechanisms for development of more adequate psychotherapeutic approaches.

Problems of Endocrinology. 2002;48(1):9-13
Laser therapy of diabetics with dyslipemia
Kovaleva T.V.

This paper sums up the results of 3-year observation of 59 patients with diabetes mellitus in an outpatient setting. 37 of these patients received combined laser therapy and 22 were controls. A significant prolonged clinical effect was observed in the patients treated by combined laser therapy. These results can be useful in follow-up of diabetics in an outpatient setting.

Problems of Endocrinology. 2002;48(1):13-17
Tromethamol salt of thioctic (alpha-lipoic) acid in the treatment of diabetic neuropathy
Severina T.I., Tarasov A.V., Trelskaya N.Y., Shilova O.L., Drometr D.A.

Thioctic acid tromethamol salt (thioctacide 600, ASTA Medica, Germany) was used in the treatment of 20 diabetics with type 1 disease with pronounced diabetic neuropathy (DN). The drug was injected intravenously by drip infusion in 200 ml 0.9% sodium chloride for 3 weeks (5 times a week with 2-day intervals), after which it was given orally, I tablet 30 min before breakfast for 4-8 weeks. After the course essential improvement was observed in all the patients. According to the questionnaires, pain decreased by 64%, and according to DN score 2.3 times. Elec-troneuromyographic parameters improved significantly, cardiac rhythm variability increased in 67% patients with stable heartbeat. In the placebo group 50% patients noted improvement, but it was far less expressed. Hence, the study demonstrated a high efficiency of thioctacide in the treatment of patients with DN.

Problems of Endocrinology. 2002;48(1):18-21
Development of relapsing toxic goiter
Bubnov A.N., Kuzmichev A.S., Trunin E.M.

The causes of postoperative relapses of thyrotoxicosis are analyzed in 102 patients with various forms of toxic goiter (diffuse toxic goiter - DTG, poly nodular toxic goiter - PTC, and diffuse toxic goiter with adenomatous transformation - DTNG). AH these patients were reoperated for relapses of toxic goiter. The incidence of postoperative relapses of thyrotoxicosis and the development of relapses after surgical treatment of toxic goiter were studied. 7.1% patients previously operated for various forms of toxic goiter developed relapses of thyrotoxicosis. The causes of relapses were different, but technological errors during the first intervention were the most frequent among patients with diffuse forms (45%). Adenomatous transformation of the remaining thyroid with increase of the mass of functioning tissue was the cause of thyrotoxicosis relapse in 32.5% patients, being most frequent in patients with PTC. The intensity of autoimmune process can be responsible for thyrotoxicosis relapses in the rest 22.5% patients. High titers of antibodies to thyrotropin receptors in the presence of genetic liability to DTG essentially increase the risk of postoperative relapse of the disease, particularly in young patients.

The incidence of relapses after surgical treatment of toxic goiter can be decreased by better training of surgeons and more profound examination of the patient’s immune status.

Problems of Endocrinology. 2002;48(1):21-24
Evaluation of iodine supply at territories contaminated as a result of the Chernobyl accident
Shakhtarin V.V., Tsyb A.F., Proshin A.D., Doroshchenko V.N., Kvitko B.I., Petrakova O.I.

The level of iodine consumption of the population living at a territory contaminated by the Chernobyl accident is evaluated for the Bryansk region (more than 30,000 km2). Analysis of iodine concentrations in the urine, carried out in 6750 children and adolescents from 125 settlements indicates that the level of iodine supply at the studied territory varies from normal to medium low iodine insufficiency. Age and sex did not affect renal excretion of iodine. An algorithm is suggested for detailed assessment of iodine consumption at large territories.

Problems of Endocrinology. 2002;48(1):25-31
Incidence of diffuse toxic goiter in children irradiated as a result of the Chernobyl accident
Shilin D.E.

Time course of incidence of diffuse toxic goiter (DTG) was studied in 1986-1999 in the cohort of subjects who were aged under 15 years in the year of the Chernobyl accident and lived at radionuclide contaminated iodine deficient territories of Central Russia (Belgorod, Voronezh, and Orel regions, a total of 34 territories, n = 215,294). Control cohort (3-fold more numerous) consisted of age-matched residents of the same region, but from non-contaminated territories (45 territories, n = 665,987). During 5 years after the accident the morbidity was the same in both groups and lower than in children of Europe, Americas, Asia living in regions with normal and excess iodine consumption (0.279 per 100,000 annually in the main cohort and 0.390 in the control vs. 3-4 in foreign countries). The values remained low during subsequent 4 years (0.697 and 0.526 - the increases are insignificant). During recent 5 years the incidence of DTG sharply increased at all territories, most drastically in the cohort of irradiated subjects (1.579 and 0.841). The morbidity increased 2- fold in the control vs. the initial level (the relative risk being 2.1 (1.1-4. l,p < 0.03) and almost 6-fold in the main cohort (relative risk = 5.7 (1.7-19.3, p < 0.004). On the whole, 10-15 years after the accident, the risk of DTG for children exposed to low-intensive radiation surpassed the estimated level 1.9 times ([1.1-3.4], p < 0.04).

Problems of Endocrinology. 2002;48(1):31-37
Internet for endocrinologists and patients with endocrine diseases
Buziashvili I.I., Fadeev V.V., Melnichenko G.A.

Recently, in connection with the rapid development of information technologies, the World Wide Web (WWW) - the computer network Internet - has become quite widespread throughout the world. This is due primarily to the universal computerization of any kind of activity, convenience and relative ease of use, the availability of a huge amount of information "without leaving home." WWW capabilities are now superior to those using all other means of information exchange [2].

Problems of Endocrinology. 2002;48(1):37-40
Experimental endocrinology
Role of the endothelium in regulation of contractile and dilatatory reactions of the aorta in rats with experimental hypothyrosis
Lobanok L.M., Luksha L.S., Solovyova N.G., Krylova I.I.

The role of endothelium in regulation of the functional activity of vessels in experimental hypothyrosis was studied during different periods of ontogenesis. The study was carried out on isolated segments of the aorta from young (1 month) and adult (4-5 months) female rats. Hypothyrosis was induced by addition of thyrostatic mercasolil to the ration. Vascular stenosis was induced by norepinephrine, dilatation by carbacholine. The specific features in the mechanisms regulating arterial tone of euthyroid rats in the early ontogenesis are explained by a lower basal level of NO and specificity and/or density of adrenergic and cholinergic receptors, characteristic of this age. Reactions of arteries to norepinephrine and carbacholine in hypothyrosis are largely determined by age, modification of adrenergic receptor system of smooth-muscle cells, and endothelial function. A lower level of basal NO synthesis, characteristic of young hypothyroid animals, can be regarded as one of the main determinants of vasoconstrictive effect stimulation in hypothyrosis.

Problems of Endocrinology. 2002;48(1):41-44
Autoimmune diseases of the thyroid and apoptosis
Kandror V.I.

The article is devoted to autoimmune diseases of the thyroid and apoptosis.

Problems of Endocrinology. 2002;48(1):45-48

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