Vol 39, No 2 (1993)

Clinical endocrinology
Indirect calorimetry in the differential diagnosis of the metabolic status of obese patients with non-insulin dependent diabetes mellitus
Dreval A.V., Vysotsky V.G., Yatsyshina T.A., Plotnikova O.A., Tishin D.P., V. Anykina N.V., Chernyak О.I.
Abstract

Twenty-one obese patients with non-insulin dependent diabetes mellitus, 16 female and 5 male ones, were led similar isocaloric rations, differing only by the share of substitution of the traditional protein products (0 %, 60 %, 30 %, 45 %) in the Danpro-S, Danpro-Fibre soybean protein concentrate. The parameters tested were daily glycemia, C-peptides, blood hydrocortisone, and urinary excretion of nitrous metabolites. Indirect calorimetry was used to assess the protein, fat, and carbohydrate oxidation rates at rest. Addition of proteins of a plant origin to the diets of such patients was associated with significant changes of the energy metabolism at rest at the expense of increased oxidation of carbohydrates and reduced protein catabolism, that may be regarded as a favorable effect. In this patient population a 30 % soybean diet brings about an almost maximal positive effect in patients with the first degree of obesity, whereas in those with the second degree of obesity such effect is attained by the 45 % soybean diet.

Problems of Endocrinology. 1993;39(2):4-7
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Comparative assessment of the effects of glurenorm and some sulfonylurea preparations on microcirculation in type II diabetes mellitus
Kakhnovsky I.M., Koroleva T.V., Zakharchenko V.N., Larionov S.N.
Abstract

Analysis of the effects of glurenorm and some sulfonylurea drugs, such as maninil, minidiab, chlorpropamid, on some parameters of intravascular microcirculation has demonstrated the specific features of this drug. Though all these hypoglycemic agents favorably influence the microcirculation when carbohydrate metabolism compensation is attained, glurenorm improved the status of formed elements of the blood (red cell and platelet aggregation) more noticeably than the rest drugs, which fact recommends it as a drug of choice for patients with type II medium-severe diabetes with the predominant involvement of the cellular component of the microcirculation.

Problems of Endocrinology. 1993;39(2):7-9
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Antioxidants (alpha-tocoferol acetate) in therapy of diabetes mellitus
Kuznetsov N.S., Abulela A.M., Neskoromny V.N.
Abstract

The authors have examined the time course of lipid peroxidation processes and the levels of total lipids in red cell membranes and blood plasma of diabetics administered alpha-tocoferol acetate. Patients with medium-severe diabetes of the first and second types were divided into 2 groups. Group 1 patients were administered only traditional sugar-reducing treatment, in Group 2 alpha-tocoferol acetate in a daily dose 300 mg was added to such therapy. Similar examinations were carried out in both the groups before and after the treatment. Lipid peroxidation levels and the content of total lipids were found significantly increased in the cellular membranes and blood plasma of Group 2 patients, whereas in Group 1 no changes of this kind were detected. Therapy with alpha-tocoferol acetate normalized lipid peroxidation processes in the red cell membranes and the total lipid content in the blood plasma reduced the blood plasma level of lipid peroxidation products and the content of total lipids in red cell membranes. These results permit a conclusion on the favorable effect of alpha-tocoferol acetate on blood plasma lipid peroxidation and total lipid levels in diabetics.

Problems of Endocrinology. 1993;39(2):9-11
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Effect of hyperbaric oxygenation on microcirculation, oxygen budget, and acid base balance of patients with diabetic angiopathies of the lower limbs
Gonchar М.G., Vavrik Z.М., Deltsova Y.I., Zelenetsky R.G.
Abstract

These effects were studied in 52 patients with degrees III-IV diabetic angiopathies of the lower limbs. Microcirculation parameters were found changed in this patient population, this leading to disorders of the oxygen budget and development of metabolic acidosis. Development of destructive changes in the limb evidences failure of the compensatory adaptive mechanisms of microcirculation. Addition of hyperbaric oxygenation to multiple-modality treatment of patients with diabetic angiopathies was conducive to improvement of the blood rheology, of tissue saturation with oxygen, and to essential reduction of metabolic acidosis. The detected microcirculation disorders necessitate addition to the therapeutic complex of the drugs improving the biophysical characteristics of the blood.

Problems of Endocrinology. 1993;39(2):11-13
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Study of absorption of subcutaneously injected short-acting insulin in diabeties
Nakamura T., Sekino K., Kasai F., Ishii M., Kudoo K., Imamura K., Kikuchi H., Takebe K.
Abstract

In patients with diabetes mellitus (DM), it is necessary to constantly monitor the level of glucose in the blood to prevent the onset and development of complications of the disease. When conducting insulin therapy in patients with diabetes, despite the introduction of the same amount of insulin, changes in blood glucose in many patients have significant differences. An abnormality in the absorption of insulin from subcutaneous adipose tissue is indicated as one of the reasons. So far, basic research on insulin absorption has been mostly done in healthy people. In this work, we studied the absorption of human short-acting insulin (simple, short insulin), administered subcutaneously, in patients with diabetes, measuring the insulin content in serum.

Problems of Endocrinology. 1993;39(2):14-16
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Contribution of anaerobic microorganisms to the genesis of thyroiditis and thyroid cysts
Krystev I., Alexiyev C., Katranushkova N., Marina M., Kantardzhiyev T., Topov Y.
Abstract

Until now, with diseases of the thyroid gland, bacterial infections have not been given much importance. The role of bacterial infection is firmly proven only in acute and subacute thyroiditis. However, in the literature available to us, we did not find a description of cases of subacute thyroiditis caused by anaerobic microorganisms. Only in some cases of acute thyroiditis, non-spore-forming anaerobes were isolated. The presence of a chronic inflammatory process in many patients with thyroid pathology (13-15%) in the absence of immune disorders from other organs and systems, common lymphatic circulation for the oral cavity and thyroid gland, frequent microabsorption in patients with subacute thyroiditis and the presence of segmented white blood cells in some patients with thyroiditis and thyroid cysts led us to the idea of conducting a microbiological study of aspirated material.

Problems of Endocrinology. 1993;39(2):16-18
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Effects of drugs on growth hormone secretion regulation
Berstein L.M., Gamayunova V.В., Poroshina T.Y., Simonov N.N., Gulyayev A.V., Leonchuk A.D., Dilman V.M.
Abstract

The authors have assessed the effects of 7 metabolic and 5 neutral drugs and their combinations on the basal blood concentration of the growth hormone (GH) and on the sensitivity of GH-regulating centers to homeostatic glucose inhibition. No significant changes in GH basal level were revealed. Nacom and a combination of vitamins E and C reduced the threshold sensitivity to glucose inhibition of the GH, whereas miscleron and trental elevated this threshold sensitivity. A combination of butamid and nacom had the highest stimulatory effect on the cellular immunity and macrophagal function, that may be mediated by enhanced GH secretion. In subjects with the ‘superior’ (android) type of obesity GH basal concentration and its sensitivity to glucose inhibition were lower than in those with the ‘inferior’ (gynoid) type, this being true after the drug discontinuation.

Problems of Endocrinology. 1993;39(2):18-22
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Age-specific features of dopaminergic regulation of prolatin secretion in men
Gubernatorov Y.Y., Gherasimov G.A., Vershinsky V.P., Pivovarov S.A., Orlov К.V.
Abstract

Age-specific time course of prolactin secretion and features of dopaminergic regulation of this hormone secretion were studied in boys aged 3 to 15 and in adult men aged 20 to 25. Blood plasma prolactin concentration was found reduced in boys, and this hormone level, characteristic for adults, sets up at the age of 9-11. Dopaminergic regulation of prolactin secretion undergoes, three stages in boys: Stage 1 — hyperreaction to introduction of a receptor antagonist at the age of 3 to 8, Stage 2 — at the age of 9 to 11 — reduced reaction to D2 receptor blocking, though this reaction being much higher than in adults, and Stage 3 (at the age of 12-15) — development of a normal reaction characteristic of adults.

Problems of Endocrinology. 1993;39(2):22-24
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The hypothalamic monoaminergic regulation of adrenocortical function in patients with hyperandrogenemia
Komarov Y.K.
Abstract

Since the majority of monoamines cannot penetrate through the hematoencephalic barrier, it is difficult to study their central metabolic disturbances. The ethymisole test was used to study the adrenocortical function in patients with hyperandrogenemia; ethymisole can penetrate through this barrier, it stimulates the brain structures that regulate adrenocortical function via endogenic monoamines activation. In 10 patients with the common form of ovarian polycystosis the ACTH and hydrocortisone response to ethymisole administration was virtually the same as in the reference group. This response was enhanced in 13 patients with ovarian polycystosis and adrenal hyperandrogenemia, and it could be arrested by ciproheptadin. This fact evidences, that the adrenal component of hyperandrogenemia is explained by hyperactivity of the hypothalamic serotoninergic systems, that regulate the secretion of corticotropin releasing factor. In 8 patients with ovarian polycystosis and functional hyperprolactinemia ACTH and hydrocortisone reaction to ethymisole administration was reduced; such type of response is observed in metoclopramide blocking of dopaminergic receptors. This fact points to the presence of hypothalamic dopaminergic insufficiency in the patients with ovarian polycystosis and hyperprolactinemia, this insufficiency involving not only the adrenocortical function regulating centers, but, possibly, the tuberoinfundibular system structures as well.

Problems of Endocrinology. 1993;39(2):24-28
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The reproductive system involvement and sex-transforming surgery
Okulov A.B., Negmadjanov В.В.
Abstract

The authors analyze the experience gained in the surgical treatment of more than 5300 patients aged 2 days to 42 years, suffering from various abnormalities of the reproductive organs. They describe the surgical policy in sex-transforming surgery (masculinizing or feminizing plasty of the genitals) and give recommendations on rehabilitation of the patients with involvement of the reproductive system organs in the postoperative period.

Problems of Endocrinology. 1993;39(2):28-32
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Case Reports
An insulinoma case
Osokina Y.A., Voznyuk N.Y.
Abstract

Hormone-active beta-cell adenoma of the pancreatic Langerhans Islands, or insulinoma — is a relatively rare disease (1:10,000). In the domestic literature, 282 cases were reported, of which in 19 cases the tumor had a malignant character. The complexity of disease recognition is confirmed by the fact that 1/3 of all publications are sectional findings. The tumor produces insulin in large quantities, which causes hypoglycemic attacks. These hormonal and metabolic disorders are the basis of the clinical picture of the disease, which is often dominated by disorders of a neuropsychiatric nature, due to the special sensitivity of nerve cells of the brain to a lack of glucose. Diagnosis of the disease is very difficult. The period from the appearance of the first clinical symptoms to the establishment of a correct diagnosis ranges from 2 to 20 years. For a long time, due to the General nature of symptoms, patients are observed in therapists, neuropathologists, psychiatrists with diagnoses of epilepsy, neuroses, psychoses, organic brain lesions, etc.there Are the most characteristic signs, United by the Whipple triad: a) the development of neuropsychic disorders with loss of consciousness on an empty stomach or after exercise; b) hypoglycemia below (40 mg%, 2.22 mmol/l) during the attack; C) rapid relief of the attack by intravenous glucose or taking sugar. Due to the diversity of the clinic, the rarity of the described disease, the difficulty of diagnosis, the description of each clinical observation is of interest.

Problems of Endocrinology. 1993;39(2):32-33
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Short Messages
Role of the family in the prevention and treatment of cryptorchidism aftereffects
Matkovskaya A.N.
Abstract

Prevention and therapy of infertility are an urgent social task. According to statistics, men are responsible for 50 % of all sterile marriages. One of the reasons for male sterility is cryptorchidism, since untimely or improper treatment leads to impaired spermatogenic function. Success in dealing with the consequences of cryptorchidism largely depends on the parents familiarizing themselves with the main issues of the clinic, the diagnosis and treatment of cryptorchidism. Early detection of the disease, timely access to a specialist doctor, beginning treatment as early as possible, careful adherence to medical prescriptions at the stage before cryptorchidism is cured in children are the key to preventing hypogonadism and infertility in adults who have had cryptorchidism in childhood. The solution to these problems is impossible without the activity of parents interested in having happy children and healthy grandchildren.

Problems of Endocrinology. 1993;39(2):33-36
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Experimental endocrinology
Rat uterus hormonal sensitivity after chemical desympathization
Sekretareva Y.V., Proimina F.I., Flerova N.I.
Abstract

Currently, there is no convincing evidence of a significant role of female sex steroids in the genesis of node growth in uterine fibroids in women, since in many cases with this disease the hormonal status remains unchanged. It is not possible to explain this phenomenon with an increase in the concentration of estradiol receptors (E2) in fibromatous nodes, which could provide an increase in sensitivity to this hormone, which stimulates growth processes in the uterus. Previously, we found an increased content of receptors only in those nodes that consist mainly of myocytes (fibroids). In nodes, consisting mainly of connective tissue elements (fibromas), the concentration of E2 receptors was, on the contrary, reduced. It may be thought that an increase in the sensitivity of fibromyoma cells to estrogens is associated with the progressive denervation of the growing node. The present study was undertaken to test this hypothesis, given the fact that the question of the interaction of catecholamines (CA) and sex steroids at the level of target organs has been relatively little studied to date.

Problems of Endocrinology. 1993;39(2):37-39
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Specific features of the progeny of unilaterally ovariectomized rats
Ryzhavsky В.Y., Yeryomenko I.R., Vasilyeva Y.V., Nagorskaya N.V.
Abstract

Five-day progeny of 12 hemiovariectomized rats (111 ratlings) and of 9 intact females (81 ratlings) were examined. Hemiovariectomy was carried out 1.5-2 months before pairing with intact males. Body, testicle, ovary, adrenal, and brain mass was measured. The number of follicles in the ovaries, the section size of the tortuous seminal canaliculi in the testes, 3beta-ol-steroid dehydrogenase activity in the adrenocorticocytes of the adrenocortical bundle zone were under study. The findings evidence a higher body mass, brain, testicular, and adrenal mass of the 5-day progeny of ovariectomized rats. Signs of advanced formation of the follicles and great numbers thereof were found in the ovaries. Another finding was a significant elevation of 3beta-ol-steroid dehydrogenase activity in the cells of the adrenocortical bundle zone. Therefore, 5-day ratlings of the test group presented with signs of advanced physical dedelopment of the examined endocrine glands

Problems of Endocrinology. 1993;39(2):39-41
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Effects of somatotropin and peptide mitogenic factor on thymocyte proliferative activity
Bezvershenko I.A., Goidash M.M.
Abstract

Hydrocortisone-resistant thymocyte proliferation is stimulated by the nonpeptide mitogenic factor. In vivo incubation of hydrocortisone-resistant thymocytes in the presence of the nonpeptide mitogenic factor results in accumulation of extra- and intracellular hypoxanthine, originating from 8-14C-adenylic acid. Stimulation of in vitro incorporation of 2-14C-thymidine in the thymocyte DNA may be effected via the somatotropic hormone in case nonseparated thymocytes (but not hydrocortisone-resistant ones) are used. No hypoxanthine accumulation in somatotropin-stimulated nonseparated rat thymocytes was observed. 2- 14C-thymidine incorporation in the hydrocortisone-resistant thymocyte DNA was enhanced by incubation of the cells in the presence of hypoxanthine in concentrations observed after thymocyte stimulation with nonpeptide mitogenic factor. The authors come to a conclusion that somatotropin and nonpeptide mitogenic factor stimulate the proliferation of two different thymocyte populations, that may be involved in the process of proliferation and regeneration of the thymus exposed to steroids

Problems of Endocrinology. 1993;39(2):41-43
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Intestinal iransport of vitamin D3 and its metabolism in the liver of rats with alloxan-induced diabetes
Apukhovskaya L.I., Stefanov M.V., Antonenko L.V., Omelchenko L.I.
Abstract

Vitamin D3 intestinal transport and liver metabolism were studied in rats with alloxan-induced diabetes. The condition was induced by alloxan injection in a dose of 40 mg/kg b. m. Diabetes development was monitored by blood serum glucose measurements, carried out for 30 days. [3H]-cholecalciferol absorption in the rat intestine was found inhibited in the diabetic animals as against the reference animals, which fact results in disordered entry of vitamin D3 to the body. [3H]-cholecalciferol absorption by the liver is reduced in the examined condition, and the time of its metabolism is increased more than threefold as against the reference animals. The share of vitamin D3 hydroxylation by the liver of diabetic rats is also significantly reduced. The described disorders are responsible, among other things, for the reduction of the levels of vitamin D3 active metabolites in the blood serum of rats with experimental diabetes

Problems of Endocrinology. 1993;39(2):43-46
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Morphofunctional analysis of the status of some endocrine glands in candidiasis
Bykov V.L.
Abstract

Morphometric analysis of the thyroid, parathyroid glands and adrenal cortex was carried out in mice with candidiasis. A grave systemic form of candidiasis, that eventuated in the death of the animals, was associated with a reduction of the functional activities of the thyroid and parathyroid glands and a drastic activation of the adrenal cortex. A benign course of the infection was parallelled by a moderate inhibition of the thyroid activity, followed by its activation and normalization. Changes of the parathyroid activity were negligible in such a case, and the adrenocortical activity is moderately growing at the peak of the infection and normalizes later.

Problems of Endocrinology. 1993;39(2):46-48
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Activities of the anterior hypothalamus neurosecretory nuclear enzymes in exposure to organophosphorus compounds
Shamsiyeva N.К., Khusinov A.A.
Abstract

Under study were activities of glycolysis enzymes: LDH, Crebs’ cycle — SDH, those of electron transport system — NAD and NADP-diaphorase, and of the hydrolytic enzymes, acid and alkaline phosphatases in the hypothalamus, as were morphofunctional shifts in these enzymes’ activities in poisoning with organophosphorus compounds. The experiments were carried out in 72 white male outbread rats weighing 180-200 g, that were administered PHOS antio (an organophosphorus compound) in a daily dose of 0.1 LD50 for 30 days. Early dates of poisoning were associated with an essential rise of the redox enzymes and a lowering of the hydrolytic enzymes levels, this being parallelled by morphologic signs of activation of the neurosecretory cells. Later high levels of neurosecretory material in the neurosecretory nuclei and reduced counts of neurosecretory cells were coupled with almost all the enzymes’ activities lowering. This permits a conclusion that changed activities of the enzymic systems may be one of the pathogenetic mechanisms and possible causes of neurosecretory cell dysfunction in pesticide poisonings

Problems of Endocrinology. 1993;39(2):49-51
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Reviews
Vitamins and their role in the reproductive system functioning
Babichev V.N., Yeltseva T.V.
Abstract

The need to analyze literature data on the role of vitamins in the normal functioning of the reproductive system logically follows from the general formulation of the question of the mechanisms of its central regulation. Vitamins, like hormones, are highly active compounds involved in the work of all the links in the regulation of the gonadotropic function of the pituitary gland at the level of both the hypothalamus and the pituitary gland. A vitamin such as D3 with its generalized effect can be considered as an analogue of hormones involved in the implementation of hormonal effects at all levels. Clinical endocrinologists are also very interested in other fat-soluble vitamins, such as vitamins A and E. Based on the foregoing, the authors attempted to describe existing concepts regarding the role of vitamins in the normal functioning of the reproductive system, their mechanisms of action, and the importance of using them for therapeutic purposes.

Problems of Endocrinology. 1993;39(2):51-55
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Spironolactone therapeutic effect in the hyperandrogenism syndrome
Shilin D.Y., Dedov I.I., Grigoryeva Y.A.
Abstract

Hyperandrogenism syndrome, the main manifestations of which are pathological hirsutism, acne, oily seborrhea, androgenic alopecia, accompanies a wide range of diseases of the female reproductive system, manifested by various disorders of menstrual function and infertility. Isolated hirsutism is also a serious psychological and cosmetic problem, especially since almost one in ten women of reproductive age have excessive hair growth. To get rid of "excess" hair, women use various methods. However, in severe manifestations of hyperandrogenism or in the case of severe and moderate hirsutism, it is advisable to use systemic antiandrogenic therapy.

Problems of Endocrinology. 1993;39(2):55-60
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Glucose metabolism and conception
Makhmudov E.S., Khodzhimatov V.A.
Abstract

The birth of a full-fledged viable offspring is directly dependent on the state of the mother's body. Since the earliest periods of pregnancy, many factors of the external and internal environment have an effect on the intrauterine development of the fetus. Successful completion of pregnancy and the birth of healthy offspring are possible with a balanced metabolism and the satisfaction of all the needs of the mother's body. In this process, a large role is played by carbohydrates, and in particular glucose, which is intensively used by the intrauterine developing embryo. Glucose deficiency in the mother's body can inhibit the development and even cause early death of the offspring. Therefore, given the importance of glucose for a developing organism, this review discusses issues related to its metabolism and regulation during pregnancy.

Problems of Endocrinology. 1993;39(2):60-62
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Obituary
In memory of K. N. Kazeyev
 
Abstract

On October 5, 1992, at the age of 62, a major surgeon-endocrinologist, doctor of medical Sciences, Professor Konstantin Nikolayevich Kazeev died. The whole working life of Konstantin Nikolaevich was connected with the Institute of endocrinology. He joined it in 1957 as a graduate student and worked until the very last day, going from Junior researcher to head of the Department, which he led for 17 years. Konstantin Nikolayevich Kazeev was considered to be one of the leading Russian endocrine surgeons. He performed more than 3 thousand operations on endocrine glands, had the largest experience in Europe in the surgical treatment of pheochromocytoma. K. N. Kazeev generously shared his experience, vast knowledge, paid much attention to pedagogical activity. Endocrine surgeons trained by him successfully work in different regions of the country. He was respected by colleagues and loved by patients. He always worked hard. Many thousands of patients owe their health to him.

Problems of Endocrinology. 1993;39(2):63-63
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