Studies of membranoreceptor system in patients with insulin-dependent diabetes mellitus revealed that insulin resistance in pregnant patients with type I diabetes is caused by disordered cellular sensitivity to threshold physiological and submaximal insulin doses, whereas the maximal doses of the hormone normalize glucose consumption by the cells. High insulin doses intensify lipid peroxidation, normalize the status of membranous proteins, reduce the number of thiol groups, reduce AOA level in membranes, and, hence, reduce membranous capacity to bind active peroxide radicals. Structural and functional changes in red cell membranes are associated with reduced affinity of insulin receptors, reduction in the number of insulin-binding sites in membranes, this disordering intracellular effects of insulin.

Immune status of 48 patients with noninsulindependent diabetes mellitus (NIDDM) was studied by the cytotoxic test with monoclonal antibodies. The majority of NIDDM patients were found to develop secondary immunodeficiency of the relative hyposuppressor type, the degree of immune shifts augmenting with the disease duration and as they acquire insulin dependence.

The shortcomings of current approaches to therapy of patients with noninsulin-dependent diabetes mellitus are discussed. A tendency to early prescription of oral sugar-reducing drugs which are prescribed to 71 % of patients during the first year of the disease was noted, as well as underevaluation of nondrug therapy. Poor efficacy of therapeutic and prophylactic care of patients with this condition is demonstrated as exemplified by quite a number of district health centers of Moscow, resulting in inadequate level of compensation, a high incidence of diabetes complications, and increase in the number of patients administered insulin therapy. The authors emphasize the importance of introducing practical training of patients as a means to improve the quality of specialized diabetological care.

Goiter prevalence and iodine excretion levels were assessed in schoolchildren aged 9 and 13 in the city of Moscow (n=91) and the Moscow region, 60 km East of Moscow (n=92). Goiter prevalence was evaluated by ultrasonography. In Moscow it was found to be 31.1 % among children aged 9 and 17.5 % among those aged 13. The respective values in the Moscow region were 47.2 and 39.3 %. Medium urinary iodine levels were 6.9 to 7.5 pg/dl in Moscow and 4.1 to 5.4 pg/dl in the region. According to modern criteria, iodine deficiency in Moscow may be regarded as mild and in the region as moderate. Control programs are urgently needed tc prevent development of iodine deficiency disorders.

In many regions of the world, regardless of the presence of iodine endemic, a steady increase in thyroid pathology has been recorded over the past three decades. Given the unfavorable environmental situation that is typical for most countries today, one can think that this trend will continue and problems of the state of the thyroid gland will take place among the most relevant and significant in modern clinical medicine.

A natural consequence of this is the growing interest of scientists and practitioners of endocrinologists in the issues of early diagnosis and monitoring, the etiology and epidemiology of thyroid diseases.

In this study, we assessed the state of the thyroid gland with the aim of epidemiological analysis of the frequency of various forms of goiter in 5423 people living in 18 districts of Kherson region.

A total of 1649 children aged 0 to 16 years were examined in the Khvalynsk district of the Saratov region endemic for goiter. Age-specific features of prevalence of goiter and chronic somatic diseases were studied. Goiter was found to form starting from the first years of life, with its morbidity peaks observed at the age of 3, 5, 7, and 12. Disease incidence in children with endemic goiter was found to be higher than in those without thyroid abnomalities.

Screening of 1520 children living in the Khvalynsk district of the Saratov region, including assessment of urinary excretion of iodine and ultrasonic examinations of the thyroid in children and adults, revealed endemic goiter in the region. Special attention was paid to echographic examination of the thyroid; this method was used in examinations of 161 children aged 2 to 14 with thyroid enlargement of the I—III degree. 103 (64.0 %) of there children had enlarged thyroid, in some children with diffusely enlarged thyroid of the I — II dergee ultrasonic examination showed no enlargement, and in some children the gland was found even reduced in size. The greatest discrepancy between the data of palpation and ultrasonography was observed in first-degree thyroid enlargement, the least so in second-degree enlargement; in third-degree enlargement there was no such a discrepancy. Assessment of thyroid structure revealed various disorders of the organ in 29 of the 161 examined children, these disorders present both in enlarged glands and in those of normal or reduced size. Nodes that could not be palpated were detected in 2 children. Ultrasonic examinations of 56 adults aged 20 to 60 revealed changed structure of the thyroid in 35, with nodes of various sizes and localization detected in 15 of these.

The incidence of postoperative hypothyrosis after subtotal resection of the thyroid for diffuse toxic goiter is rather high, 40-50 % according to many authors. A method is suggested permitting assessment of the share of “active zones” during surgery. A certain amount of thyroid tissue is left with due consideration for this share, this amount being sufficient to attain an euthyroid state in the postoperative period.

T-cellular immunity was studied in 104 patients with autoimmune thyroiditis to assess the function of the thyroid and treatment method. A reliable reduction of the activity of T-lymphocyte receptor system, lymphopoiesis activation, and their relationship with the thyroid status were revealed. Plasmapheresis as monotherapy was used in 22 patients. It brought about a short-term positive effect, this necessitating search for other methods of' immunorehabilitation. In 82 patients it was supplemented with immunocorrecting therapy (thymalin) and in 49 with hypothyrosis with substitution therapy (L-thyroxine, thyroidin). Combined therapy helped attain a stable clinical and immunological effect. Subpopulation composition of T-lymphocytes recovered, their functional activity normalized (follow-up period 1 year).

Bone system was examined in 112 liquidators; in 71 of these osseous tissue density was studied by osseous densitometer using bienergetic x-ray absorptiometry and in 45 x-ray examinations, analyses of biochemical and hormonal parameters were carried out. Spinal painful syndrome was detected in 61 to 82 % of the examinees. For analysis of densitometric and x-ray parameters the liquidators were divided into 2 groups: group I included those who worked at the power plant in 1986 (55 %) and group 2 were those who worked there in 1987-1989. Radiation doses in group 1 reliably surpassed those in group 2 (p<0.001). Bone mineral density in the lumbar vertebrae was significantly lower in group 1 as against group 2 and lower in both groups us. controls. More than 5 % osseous mineral loss was revealed in 73 % of group 1 liquidators and in 43 % of group 2 ones. Analysis of spinal roentgenograms in 45 liquidators showed a high incidence of negligible and moderately expressed osteoporosis without compression fractures of vertebral bodies: osteopenia signs were found in 87 % of group 1 examinees complaining of pain in the spine and in 73 % of group 2 examinees; signs of osteochondrosis and spondylosis were detected in 40 % of group 1 and in 47 % of group 2 subjects. Hence, a higher incidence of osteopenia in liquidators, more manifest condition and its higher detection rate in subjects exposed to higher radiation doses indicate a certain contribution of radiation factor to the development of the osteopenia syndrome in liquidators.

Basal secretion of immunoreactive and bioactive LH was measured in 24 patients with polycystic ovaries, secretion during LH-RF test in 18 patients. Basal LH level was assessed from in vitro testosterone secretion by murine Leydig’s cells. The content of basal LH and basal LH to FSH ratio in patients with the polycystic ovaries syndrome was markedly increased vs. the norm. Three types of gonadotroph responses were observed in the patients in response to LH-RF, these responses differing by increment rate, time course of secretion, and ratio of secreted basal and immunoreactive LH. Gonadotroph response was found related to ovarian morphology and clinical manifestations of the disease. Administration of LH-RF to patients with polycystic ovaries and tecomatosis changed the ratio of secreted basal and immunoreactive LH by reducing basal LH level. In young girls and women aged under 20 the increment of basal and immunoreactive LH noticeably surpassed its values in older patients with longer disease duration.

Examinations of 33 patients with the polycystic ovaries syndrome with measurements of monoamines, ovarian and honadotropic hormones, and prolactin revealed disordered monoaminergic regulation in all the patients, manifesting by reduced dopamine level in normoprolactinemia and its reduction parallelled by increase of serotonin level in hyperprolactinemia. Disturbances in monoaminergic regulation result in increased level of LH and reduction of FSH levels in all the patients, as well as different prolactin levels. Hyperandrogenism in patients with the polycystic ovaries syndrome and normoprolactinemia is determined by a unidirectional increase of testosterone and androstendione, whereas in hyperprolactinemia a sharp increase of testosterone content occurrs in parallel with decrease of androstendione level. Normal total estradiol level was associated in all the examinees with manifest relative hypoestrogenism. The detected disorders in hormonal-mediator relationships in patients with the polycystic ovaries syndrome give us new information on the pathogenesis of this condition, which may be important for its diagnosis and treatment.

One of the main manifestations of juvenile hypothyroidism is usually a delay in both somatic and sexual development. However, in some cases, primary hypothyroidism is accompanied by premature sexual development (PSD).

This was first reported by F. Kendle in 1905. The author observed a girl with cretinism, whose diagnosis was made in the 1st year of life, however, thyroid replacement therapy was not always carried out regularly. At the age of 5, against the background of clinically pronounced signs of hypothyroidism, an increase in the mammary glands, menstrual-like spotting appeared. With the resumption of adequate replacement therapy with thyroid drugs, a cessation of menstruation was observed, a decrease in the size of the mammary glands.

In 1955, S. Bergstrand also drew attention to an unusual combination of untreated primary hypothyroidism and PSD in a 9-year-old girl. Along with the aforementioned manifestations of PSD, the author first noted the expansion of the Turkish saddle in his patient. When prescribing replacement therapy, mensis stopped, a decrease in the size of the mammary glands was observed, and from 15 years (after 6 years of regular administration of thyroid drugs), the patient had a spontaneous puberty having a physiological course.

The first publications were descriptive, and only in 1960 was an attempt to explain the pathogenetic mechanisms of this syndrome for the first time. In their report, J. Van Wyk and M. Grumbach hypothesize a partial hormonal “overlap” at the pituitary level (the possibility of a hypothalamic or tissue, molecular “overlap” was not ruled out), as a result of which, under the influence of hypersecretion of tyroliberin, only thyroid-stimulating hormone (TSH), but also prolactin, gonadotropins. In addition, the authors suggested the possibility of increasing the half-life of estrogens from the body during hypothyroidism, due to which an increase in their effect is observed.

In their article, J. Van Wyk and M. Grumbach describe three girls (7 years old, 8 years old 8 months old, 12 years old 9 months old), who, along with an increase in the size of the mammary glands, had galactorrhea, early onset of menarche, adult sizes of the uterus, cystic -changed ovaries (in a patient of 8 years 8 months). All patients had a delay in the differentiation of the skeleton, an increase in the size of the Turkish saddle. After the appearance of this fundamental article, the syndrome, which includes PSD against the background of a long-running untreated primary hypothyroidism, was called Van Wyk-Grumbach syndrome.

The combination of pathology of the adrenal glands and thyroid gland is very rare and, as a rule, is characterized by adrenal insufficiency and hypothyroidism / Schmidt syndrome), which develop in type II autoimmune polyglandular syndrome. There is a single description of low-krenin aldosteronism due to thyroid cancer. In the available literature, we have not found information about the combination of primary hyperaldosteronism and diffuse toxic goiter.

Somatotropic hormone (STH) biosynthesis and secretion were studied in primary adenohypophyseal cultures of neonatal, prepubertal, and adult rats. It was shown by disc PAAG electrophorqsiS of products synthesized in incubation of neonatal rat hypophyseal cells that L-'⁴C leucin incorporates predominantly in the STH containing fraction. The share of prelabeled STH secreted into the culture virtually did not depend on the age of animals, this indicating the maturity of mechanisms of basal somatotroph secretion as early as in the neonatal period of development. Ca-regulating agents (ionophore A23187, EGTA) caused quantitatively similar changes of somatotroph secretory activity in cultures of hypophyseal cells from rats of different ages. At the same time, clear-cut age-specific features of stimulating effect of dibutyryl derivatives of cAMP and cGMP on secretion of immunoreactive STH were detected. The results indicate that somatotropic function in neonatal hypophysis is a dominant one and demonstrates increased reactivity to secretogenic action of cyclic nucleotide analogs.

The authors present data- on the protective effect of newborn rabbits pancreatic islet cell culture xenotransplantation of Langerhans’ islets P-cells of rats with alloxan diabetes. This effect was the most marked in rats fed diets with normal or increased protein content. The authors discuss a possible stimulating effect of rabbit islet cell culture xenooransplantation on regeneration processes in recipient rat pancreatic islets. This effect was better pronounced in rats kept on rations with increased protein content. Further experiments will help more accuretaly define the indications for therapy of insulindependent diabetes mellitus by xenokansplantations of islet cell cultures.

A quick reliable homogenous polarization fluoroimmunoassay (PFIA) of progesterone was developed. The assay is carried out with Abbott TDx (USA) polarization fluorometer and it takes 5-7 min to analyze 10 samples by this method. The range of progesterone concentrations determined is 1 to 1000 ng/ml. Fluorescein labeled progesterone-3-carbo- xymethyloxime which was used as tracer (labeled antigen) during analysis has been synthesized and purified. Two types of PFIA were developed: one making use of rabbit antiserum to progesterone-3-carboxymethyloxime conjugated with bovine serum albumin (BSA) or keyhole limpet hemocianin (KLH), in the other antiserum to progesterone-11-hemisuccinate-BSA (or KLH) is used. Different combinations of the tracer and antibodies were used. The sensitivity of heterologous PFIA (with antibodies to immunogen heteroioguos to tracer by structure) was higher than that of homologous PFIA. The test is sufficienctly sensitive and specific. The method is particularly valuable for determination of progesterone in model solutions (using buffer standards).

At present, puberty is considered as a formation period during which sexual sensitivity is formed, secondary sexual characteristics develop, and menstruation first appears in females. The future will show how this combination of features is complete and can be widely used by both professionals and non-specialists. However, it is clear that the process of puberty is a temporary phenomenon and includes both growth and differentiation. In humans and primates, the normal process of puberty occurs during the growth period and ends after complete differentiation. A feature of sexual development in primates is the presence of a significant interval between the time of birth and the onset of the puberty process, the onset of spermatogenesis or the ovarian cycle in them occurs in the second decade of life.

The process of puberty in primates estimated to last for several years and is characterized by a cascade of morphological, physiological and behavioral processes, and an increase in ovarian and testicular activity. Some biological changes occur discretely and can be quantified in this phase of development, others are less obvious and their assessment is more complicated. However, most researchers agree that it is not possible to fix the beginning and end of the puberty process with a certain degree of certainty, let alone show the chronology of events, because they are considered as a process of individual development during puberty.

The first descriptions of the pathological desire to change your gender date back to the middle of the last century. This pathology was designated by N. Ellis as a perverse sensation of one’s sex, a sexual-aesthetic inversion.

The term "transsexualism" was proposed by N. Benjamin, who was the first to describe this phenomenon from a scientific point of view.

Transsexualism - TS (eonism, sexual-aesthetic inversion, mental hermaphroditism) is a pathological state of a person, consisting in a polar divergence of the biological and civil sex, on the one hand, with the mental sex, on the other. In other words, Tc is a violation of sexual self-identification, which consists in the mismatch of the feeling of one's gender identity with the nature of the external genital organs. TS - persistent awareness of belonging to the opposite sex. The diagnosis of TS is made by adults and adolescents who have reached puberty, who wish to change their genitals and live as a representative of the other sex, after the exclusion of mental disorders. A person with TS feels like a man enclosed in a woman’s body, and vice versa. In a harmoniously organized body of a certain gender (the chromosomal, gonadal and morphological sex correspond to each other, providing the possibility of fertilization, and in women and childbearing) there lives an “another gender” soul. And this soul not only lives, it feels, thinks, suffers, experiences desires and drives that it cannot realize. In fact, we are talking about chronic stress, therefore, in most patients with TS, suicidal behavior can be detected.

TS is a rather rare pathology. There is no data on vehicle prevalence in our country. When studying the prevalence of TS in other countries, it was noted that TS is found in many, if not all, ethnic groups, despite significant cultural differences, which can serve as indirect evidence of the biological basis of this pathology. The average age of patients with TS who go to the doctor about sex change is 20-24 years (51% of patients). This is typical for both female and male vehicles. At the age of 15-19 years, this percentage is 12, at the age of 25-29 years - 25, at the age of 30-34 years - 11, over 35 years old - no more than 1. According to the majority of authors, male TS significantly prevails over female - the ratio 3: 1.

Insulin-dependent diabetes mellitus (T1DM) is one of the most important problems of our time. This disease plays a significant role in the structure of chronic childhood pathology, leads to severe complications that invalidate a person, and significantly increases mortality at a young age. The study of the incidence of T1DM (the number of new cases of T1DM in a certain population within 1 year) allows you to get answers to a number of questions on its etiology and pathogenesis, to solve the problems of the need to allocate material resources for the organization of preventive and therapeutic measures.

Information on the incidence of T1DM in the world applies in most cases to people under the age of 15 years, data for the age group up to 18–20 years of age are less common. Epidemiological studies in various countries show an increase in the incidence of T1DM in children. This is shown by the example of Norway, the USA, Finland, Denmark from the 20s of our century, England - from the 50s and other countries over the past 20 years. It is possible to reliably distinguish a true increase in the incidence from an improvement in the detection of diabetes only on the basis of standardized epidemiological studies for certain periods of time. Many countries have compiled national childhood diabetes registries. Thus, in a number of countries standardized information on sex and age was obtained on the incidence of children with T1DM for at least 10 years, divided into 5-year periods. According to these data, the incidence rate has increased in the vast majority of countries over the past 10-20 years. It is noteworthy that the change, namely, an increase in the incidence of type 1 diabetes mellitus in children, is uneven. In some regions of the world, this indicator remained virtually unchanged over fairly long periods of time.

Growth hormone deficiency (GH) for a long time was recognized only in childhood. Compelling evidence has been obtained showing that HR replacement therapy effectively stimulates growth and, in many cases, achieves normal end-points of physical development. More recently, it was shown that the most effective in this regard was the appointment of regular evening injections of the drug, which mimic the physiological secretion of GH during sleep. Despite the fact that the acceleration of linear growth is the most objective criterion for the effectiveness of therapy for GH, it is known that GH has a significant effect on body structure, causing a decrease in fat mass and an increase in muscle mass.

Until recently, GH was not considered an important hormonal regulator in adults, and therefore, there was no study of GH deficiency and treatment of children with GH deficiency when they reached adulthood, as well as patients with hypopituitarism who became ill in adulthood. However, in 1989, as a result of two double-blind trials using placebo in the control group, the effectiveness of GH replacement therapy in adults with an abnormally low level of GH, up to a severe degree of GH deficiency, was revealed. Further studies showed the presence of violations of both physical and mental status in adults in whom GH deficiency develops as a result of the tumor process in the pituitary gland or its therapy. Most of these disorders, but not all, can be corrected as a result of GH replacement therapy, which confirms the significant effect of GH throughout life.

The completion of growth, which is determined in this study by slowing down the growth rate below 1 cm per year, was observed only in 15 of 640 treated with growth hormone (GH) girls with Turner syndrome (ST), information about which is included in the KIGS database. GH was administered to patients at a dose that ranged within the group within 0.3–1.0 IU / kg per week, with a multiplicity of 3 to 7 injections per week. The results of the study were presented graphically for each patient. At the beginning of GR therapy, the standard deviation index (SDS) of growth ranged from -2.4 to 1.5 compared with the standards for CT patients developed by M. Ranke. At the beginning of the study, the group indices of median, maximum and minimum SDS growth were 0.3, -2.4 and 1.5, respectively, and by the time the final growth was achieved, their increase was noted to 1.1, -1.8 and 2.7 respectively. The final growth in girls with ST ranged from 132.7 to 161.1 cm. Compared with the predicted growth calculated for each patient, changes in the final growth in the treatment of GH in combination with oxandrolone and ethinyl estradiol ranged from -0.9 to 11.9 cm (median - 5.4 cm), while in the treatment of GH in combination with ethinyl estradiol, the median indicator was 1.6 cm. For the whole group as a whole, the median of final growth was 150.4 cm, in the subgroup of patients treated with GH in combination with oxandrolone and ethinyl estradiol, 152.1 cm and in girls, receiving GH and ethinyl estradiol, 149.3 cm.

Among 8457 children undergoing treatment with genotropin included in the database of international growth monitoring of the Kabi Pharmacia firm (KIGS) until June 1992, 818 patients were with Turner syndrome (TS). Side effects, classified as “serious” and “not serious”, were registered in 62. Based on the data regarding side effects, it can be assumed that the clinical tolerance of growth hormone (GH) in TS is comparable to that observed in the treatment of GR in patients with GH deficiency.