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Vol 39, No 6 (1993)

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Clinical endocrinology
Diabetes mellitus incidence and prevalence in Moscow
Kuraeva T.L., Sergeev A.S., Lebedev N.B., Babadzhanova G.Y., Kerimi N.B.

Epidemiologic survey of two diabetes mellitus types in Moscow has shown that the incidence of type I diabetes markedly increases from birth (0.012-0.013%) to the age of 10-14 (0.04-0.045 %), after which somewhat reduces (0.02-0.03 %) and thus persists up to 40. Type I diabetes prevalence increases from 0.002-0.004 % at the age of 0 to 4 years to 0.14-0.092 % by the age of 35-39 in men and women, respectively. Type II diabetes is diagnosed after the age of 20. At the age of 20 to 24 this diabetes incidence is lower than that of type I condition; at the age of 25-34 the incidence of both is approximately the same, and after 35 the incidence of type II is much higher than that of type I diabetes. Type II diabetes prevalence by the age of 40 is 0.074 and 0.122% in men and women, respectively. Prevalence of diabetes cases treated with diets and oral sugar-reducing drugs at the age 75 and older is 4.3 % in men and 5.5 % in women, of insulin- treated cases 1.2 and 0.5 %, respectively. The true prevalence of type II diabetes is however higher and that of type I condition lower than the resultant values; this is explained by a frequent prescription of insulin to elderly patients with type II diabetes because of complications or concomitant diseases.


Problems of Endocrinology. 1993;39(6):4-7
Myocardial function in diabetics with type 1 condition
Dedov I.I., Makolkin V.I., Syrkin A.L., Mel'nichenko G.A., Alliluev I.G., Vakhlyaev V.D., Petrii V.V., Churganova L.Y., Pecherskaya M.B., Romanovskaya G.A., Chazova T.E., Solov'yan I.K., Slashchuk I.Y.

Myocardial contractility was examined in patients with type I diabetes mellitus without coronary disease by selective tolerance test with transesophageal heart stimulation using dopplercardiography. Nineteen diabetics aged 17 to 36 with the disease duration from 0 to 20 years were examined. Maximal ejection time before and after the test was assessed. The findings indicate impaired myocardial contractility in the examinees, though clinical signs of manifest circulation insufficiency were undetectable in all the patients. The authors come to a conclusion on the significance of diabetes duration and severity in development of myocardial injury.


Problems of Endocrinology. 1993;39(6):7-9
Time course of noninsulindependent diabetes mellitus prevalence: a ten-year prospective analysis
Suntsov Y.I., Kudryakova S.V.

Carbohydrate metabolism was tested in 2468 subjects (male and female) aged 20 to 69 living in one of Moscow districts by means of standard oral glucose tolerance test. Primary screening was carried out in 1979, repeated in 1989. The results indicate an evident increase in the incidence of noninsulin-dependent diabetes mellitus both among men and women. The disease incidence in women was reliably higher than in age-matched men. Prevalence of the condition among women was characterized by a lower, in comparison with that among men, parameters of its time course.

Problems of Endocrinology. 1993;39(6):9-11
Atherogenic potential of the blood serum in patients with type 1 diabetes mellitus
Shagaeva M.M., Sobenin I.A., Slavina L.S., Orekhov A.N.

The task of this research was to study exogenous insulin effect on blood serum atherogenic potential in patients with type I diabetes mellitus. Under study were relationship between blood serum atherogenic potential in diabetics and daily insulin dose and duration of therapy, as well as exogenous insulin effect on the major atherosclerotic manifestations in tissue cultures, such as intracellular cholesterol content in cultured cells and labeled thymidine incorporation in cellular nuclei DNA. Blood serum atherogenicity did not correlate with insulin dose and duration of insulin therapy both in adult patients and children. Insulin prescription to newly detected patients with type I condition did not influence blood serum atherogenic potential. Exogenic insulin did not influence the major atherosclerotic manifestations at the cellular level, namely, on intracellular cholesterol content in cultured cells and these cells proliferative activity; it had no influence on blood serum atherogenic potential of the patients with type I condition.

Problems of Endocrinology. 1993;39(6):11-14
Fetoplacental hormone measurements to predict fetal and newborn viability in insulin-dependent diabetes mellitus
Petrukhin V.A., Fedorova M.V., Knyazev Y.A., Laricheva I.P., Vitushko S.A., Kotov Y.B., Grishin V.L.

A dynamic follow-up of 79 pregnant patients with insulin-dependent diabetes mellitus was carried out. Specific fetoplacental hormonal profiles were detected and analyzed in complex with glycemic levels, this permitting the authors obtain new prognostic criteria of fetal and newborn viability. The results helped optimize the policy of following up such patients and the developed prediction regulations allowed preventive measures aimed at improvement of the future baby health status to be carried out before clinical manifestation of fetal intrauterine suffering.

Problems of Endocrinology. 1993;39(6):14-17
Peripheral circulation regulation in patients with the hypothalamic syndrome neuroendocrine metabolic form
Slavnoe N.V., Markov V.V., Kovpan N.A., Rudichenko V.M., Terekhova G.N.

Peripheral circulation and regulating hormonal (renin- angiotensin-aldosterone system) and electrolytic (plasma sodium and potassium) factors were studied in 102 patients with the hypothalamic syndrome neuroendocrine metabolic form administered pathogenetic therapy with antiserotonin and dopaminergic drugs as well as routine therapy. Blood plasma sodium vasopressin and aldosterone levels were found increased, arterial vessel reactivity in the forearm reduced, and venous circulation disordered in these patients. Routine therapy failed to normalize electrolytes and hormonal parameters and was conducive to a still more marked reduction of arterial vessel reactivity. Peritol therapy resulted in a reduction of vasopressin concentration and normalization of blood plasma sodium and aldosterone, as well as in improvement of the myogenic mechanisms of vascular tone regulation and normalization of venous circulation parameters. A course of parlodel therapy lead to normalization of blood plasma levels of vasopressin, aldosterone, and sodium but no changes in the regional vessels were observed.


Problems of Endocrinology. 1993;39(6):17-20
Urinary catecholamine excretion and blood serotonin content in patients with the juvenile hypothalamic syndrome
Karabakhtsyan R.G., Avakyan Z.A.

Daily urinary adrenalin, noradrenalin, dopamine excretion and blood levels ol serotonin were measured over the course of the cycle in 8 healthy girls and in 52 patients with the juvenile hypothalamic syndrome in the acute and chronic stages. These parameters were found virtually the same in healthy girls and in those suffering from the hypothalamic syndrome in the course of the cycle or in patients during the acute and chronic stages of the condition. Urinary catecholamine excretion and blood serotonin levels were increased by 1.5-2 times in the acute stage of the syndrome and somewhat reduced in the chronic stage; this appears to be due to reduced activity of the sympathoadrenal system in the course of disease progress.


Problems of Endocrinology. 1993;39(6):20-22
Some problems in adrenal surgery of patients with endogenic hypercorticism
Trofimov V.M., Kalinin A.P., Nechai A.I.

For a long time, the method of choice in the treatment of endogenous hypercorticism was surgery on the adrenal glands. The most reliable in terms of eliminating the manifestations of the disease, they remain to this day. However, with the development of other treatments, they have lost their exclusivity.

Problems of Endocrinology. 1993;39(6):22-25
Association of multinodular euthyroid goitre with some genetic markers
Makarov A.D., Bazarova E.N., Kozlov G.I.

Distribution of blood groups ABO, Rh, Pu and MN was studied in 85 patients with multinodular euthyroid colloid goitre. An association has been revealed between the presence of this disease and MN blood group, as well as the absence of Pi antigen. These results permit us considering MN blood group and P| antigen absence as factors of risk for multinodular euthyroid colloid goitre.


Problems of Endocrinology. 1993;39(6):25-26
On the pathogenesis of thyroalgia
Bukhman A.I., Fedoseeva G.I., Puishina T.V.

The authors analyze thyroalgias occurring in various thyroid diseases and diseases of the adjacent organs and tissues. They come to a conclusion that as far as thyroid diseases are concerned, true thyroalgias are the most incident in various thyroiditis forms, thyroid tumors, postoperative cicatrices, and are explained by the pathologic process impact on glandular capsule (stretching, intergrowth, pressure, etc.). Of diseases not directly related to thyroid but causing thyroalgias (pseudothyroalgias) laryngitis, pharyngitis, and osseous conditions are the most incident, which indirectly influence pain development. Pseudothyroalgias should be differentiated from such osseous changes in the neck as deforming spondylosis, spondylarthrosis, extra cervical ribs (a developmental abnormality), and structural specificities of temporal bone styloid processes.


Problems of Endocrinology. 1993;39(6):27-30
Fine needle puncture biopsy and imaging methods of the thyroid gland in the diagnosis of nodular goiter
Vnotchenko S.L., Okeanova T.A., Bronshtein M.E., Nefedov S.B., Fedoseeva G.I.

A retrospective analysis of the results of puncture thyroid biopsy is presented in 256 patients operated on for nodular goiter. Cytological data coincided with histological in 84.8% of cases. Coincidences were most frequent with (multiple) nodular colloid goiter and thyroid cysts (95.7 = 100%) and the least with a single adenoma (65.4%) of predominantly follicular structure. In thyroid cancer, the data correlated in 75% of cases. The presence of cystic changes in the adenoma made the study less informative. The results of an ultrasound examination of the thyroid gland coincided with operational data in 87.5% of patients with (multiple) nodular goiter and in 86.1% of patients with adenomas. Ultrasonography as a method of imaging the thyroid gland is preferable to scintigraphy (scanning) and is the optimal complement to the thyroid puncture biopsy.

Problems of Endocrinology. 1993;39(6):30-33
Case Reports
A case of thyroid cancer dystopian to the root of the tongue
Choinzonov E.L., Dubskii S.V.

The extreme variability of the shape and position of the thyroid gland is due to deviations in its embryonic development. Special studies have shown that in about half of cases, the remains of thyroid tissue are found in the region of the hyoid bone, the root of the tongue.

Problems of Endocrinology. 1993;39(6):33-35
For practitioners
The use of glycemic indices in the diet therapy of diabetes mellitus (lecture)
Kasatkina E.P., Odud E.A.

Diabetes mellitus (DM) is one of the endocrine-metabolic diseases in which diet therapy is one of the main methods of treatment. At present, around the world, the most appropriate in the complex therapy of this disease is recognized as a physiological diet, which contains the number of calories necessary for a full life of the patient with a balanced ratio of proteins, fats and carbohydrates.

Problems of Endocrinology. 1993;39(6):35-38
Drug correction of hypotonic gallbladder dyskinesia in patients with diabetes mellitus
Geller L.I., Rybalka E.D., Gryaznova M.V.

A decrease in contractile activity of the gallbladder is characteristic of many cases of diabetes mellitus [3]. Hypotonic dyskinesia of the gallbladder negatively affects digestion processes, and also favors the development or aggravation of liver disorders [4, 6, 9]. This necessitates the search for therapies for gallbladder hypotension in diabetes mellitus. In connection with the wide clinical use in case of hypomotor disorders of the upper digestive tract of various genesis (including diabetic) metoclopramide (cerucal, raglan), we considered it appropriate to analyze its effect on the contractile activity of the gallbladder in patients with diabetes mellitus. In addition, we investigated their effect on the motility of the gallbladder of sorbitol as a stimulator of cholecystokinin incretion, the main physiological regulator of contractile function of the gallbladder

Problems of Endocrinology. 1993;39(6):38-39
Clinical guidelines
Glycemic indices of foods and dishes in the nutrition planning of a patient with insulin-dependent diabetes mellitus
Kasatkina E.P., Odud E.A., Stepanov V.E.

The glycemic index (GI) was proposed in the 80s to assess the effect of various products on blood sugar, provided that they contain the same carbohydrate content.

Problems of Endocrinology. 1993;39(6):39-41
Experimental endocrinology
The effect of chorionic gonadotropin on the formation of a secondary immune response
Ширшев S.V.

Chorionic gonadotropin (CG), synthesized by human placenta, controls the hormonal mechanisms of growth and development of the fetoplacental complex from the moment of implantation of the egg to the birth. A semi-allogenic fetus and placenta are recognized by the mother’s lymphocytes as foreign antigenic material, but for a number of reasons they are not rejected by them.

Problems of Endocrinology. 1993;39(6):41-43
Kinetic parameters of GABA receptor binding by rat adenohypophysis membranes under conditions of modeling various levels of corticosteroids and ACGT in the body
Mishunina T.M., Kononenko V.Y.

Kinetic parameters of l4C-GABA specific binding by rat adenohypophyseal plasma membranes were studied in experiments on modelling various corticosteroid and ACTH levels in animal body. A single hydrocortisone injection did not change Ka for high- and low-affinity GABA receptors, the number of the former (Bmax) increasing in this case. Repeated hydrocortisone injections were associated with Ko reduction for high-affinity GABA receptors and a noticeable increase of Kn for low-affinity receptors, with their number reducing. ACTH injection did not change the kinetic parameters of GABA binding with receptors. The number of high-affinity GABA receptors and their affinity reduced after removal of adrenals whereas the number of low-affinity receptors in this case was increasing. A single hydrocortisone injection to adrenalectomized rats had a normalizing effect on adenohypophyseal GABA receptors. Analysis of the results and changes in blood hormonal levels indicated that affinity changes in high-affinity receptors and changed number of low-affinity adenohypophyseal GABA receptors correlated with changes in ACTH and hydrocortisone changes.


Problems of Endocrinology. 1993;39(6):43-46
Interaction of antibodies from the sera of autoimmune patients thyroidopathies with isolated diffuse cells toxic euthyroid nodular goiter.
Krainova S.I., Kandror V.I.

Blood sera of 46 patients with diffuse toxic goiter (DTG) and of 48 ones with Hashimoto’s thyroiditis (HT) were tested for antibodies—complement-mediated cytotoxicity carriers (ACMMC). ACMCC targets were isolated DTG cells and cells of euthyroid nodular goiter (ENG) perinodular tissue. Antimicrosomal antibodies were assayed in the sera by indirect immunofluorescence and antibodies to all thyrocyte surface antigens isolated from both tissue samples were determined by solid-phase enzyme immunoassay. When DTG cells were targets, DTG patients' sera detected ACMCC in 36 % of cases and HT patients’ sera in 73% of cases (p<0.001).

In ENG cells the sera of patients of both groups detected ACMCC equally frequently (in more than 70% of cases). Of the 27 DTG patients’ sera tested with both tissues app. roximately a half detected ACMCC in only ENG tissue. There was no difference in HT patients’ sera effects on ACMCC detection in both tissue samples. This has brought the authors to a conclusion about DTG cells deficiency for ACMCC mediating antigens. Moreover, DTG cells bound much less antibodies from sera of patients with autoimmune thyropathies, than ENG cells (p<0.001), this confirming a deficiency of surface antigen on DTG cells. No correlation between the presence in the sera of antimicrosomal cells and of ACMCC was detected. A conclusion has been made about heterogeneity of antimicrosomal antibody population and about the presence of ACMCC in blood sera of patients with autoimmune thyropathies, these antibodies not belonging to antimicrosomal ones. ACMCC also may be heterogenous and differ in DTG and HT patients.

Problems of Endocrinology. 1993;39(6):46-50
Activation of the sympathetic-adrenal system by the administration of corticoliberin in the caudate nucleus of dogs
Rakitskaya V.V., Shalyapina V.G., Voilokova N.L., Suvorov N.F., Turkina E.V.

Corticotrophin releasing factor injection into the head of the caudate nucleus of dogs was followed by a more than threefold increase of blood plasma adrenaline and noradrenaline levels as soon as in 30 min and . by their reduction by the 60th min after the injection though not to the initial values. These changes are compatible to stressor reaction and are associated with an increased orientation research reaction in animals. Injections of 6-hydroxydopamine into caudate nucleus drastically exhausted dopamine content in this structure. Subsequent injections of corticotrophin releasing factor into caudate nucleus virtually did not change blood plasma catecholamine content, this indicating the participation of the strionigral complex dopaminergic structures in realization of corticotrophin releasing factor effect on the sympathoadrenal system.


Problems of Endocrinology. 1993;39(6):50-52
Pituitary-adrenocortical system with experimental hereditary hypertension
Naumenko E.V.

An experimental study of hypertension is the main way to discover the mechanisms of formation, flow patterns and the search for ways to prevent one of the most common human diseases. The most interesting in this aspect are genetic models [19], since heredity plays a significant role in the pathogenesis of hypertension. In most of these models created on rats by their long-term selection for high blood pressure (BP), its increase occurs spontaneously, that is, almost independently of environmental influences, and is determined mainly by the animal’s genotype (lines GH, LH, MSN and SHR ) In such rats, hypertension is irreversible; its formation is inevitable for all individuals without exception.

Problems of Endocrinology. 1993;39(6):52-55
Theories of the pathogenesis of cryptorchidism
Yunusov M.Y., Muminov A.A.

The criteria for choosing the optimal period and method of treating cryptorchidism are directly dependent on the causes and mechanisms that caused testicular retention (6, 8). The polyetiological nature of this condition defines cryptorchidism as one of the manifestations of a systemic disease that covers almost all organs and tissues [4, 5].

Problems of Endocrinology. 1993;39(6):55-57
The use of magnetic resonance imaging in the diagnosis of diseases of the hypothalamic-pituitary system
Zenkova T.S., Fedin I.A.

In recent years, it has become apparent that the incidence of diseases of the hypothalamic-pituitary system is extremely high. The clinical manifestations of diseases such as acromegaly, Itsenko – Cushing's disease, primary hyperprolactinemic hypogonadism are considered to be well known [8, 9, 32, 45]. However, to select the optimal method of treatment in each specific clinical situation, it is imperative for the clinician to obtain information about the state of the main structural link of the pathological process - the pituitary gland

Problems of Endocrinology. 1993;39(6):57-62
Nikolai Alekseevich Yudaev (1913-1993, on the occasion of his 80th birthday)

14/ХП 1993 г. исполняется 80 лет со дня рождения крупного ученого, организатора науки и общественного деятеля Николая Алексеевича Юдаева. С его именем связаны фундаментальные исследования в области биохимии гормонов и нейрогормональной регуляции, и он по праву считается одним из основоположников отечественной эндокринологии.

Problems of Endocrinology. 1993;39(6):62-63
In memory of Grigory Semenovich Stepanov

29 июня 1993 г. скоропостижно скончался один из самых 4 ярких представителей Ленинградской (Санкт-Петербургской) школы эндокринологов проф. Григорий Семенович Степанов.

Problems of Endocrinology. 1993;39(6):63-64

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