The ultrasonic picture and volume of the thyroid, concentrations of intrathyroid stable iodine, total amount of stable iodine, scintigraphy of the organ, blood concentrations of basal TTH, fгее T4 and T3, antibodies to thyroglobulin, and microsomal fraction were studied in 77 patients (69 women and 8 men) with diffuse nontoxic goiter and 37 controls (18 women and 19 men) aged 18 to 50 without enlargement or signs of impairment of the function of the thyroid. Diffuse nontoxic goiter was found to be associated with increase of the thyroid volume, concentrations of intrathyroid stable iodine and total amount of stable iodine, and TTH, and a decreased concentration of T4. A deficit of intrathyroid stable iodine and of T3 in the blood was revealed in 20% of women with antibodies to thyroglobulin and microsomal fraction in the blood, in comparison with patients who had no antibodies to thyroglobulin and microsomal fraction. A reduced concentration of intrathyroid stable iodine in control women was attended by the presence of antibodies to thyroglobulin and/or microsomal fraction and indirect ultrasonic signs of autoimmune pathology of the thyroid. These results permit a conclusion that iodine measurements directly in the thyroid using noninvasive x-ray fluorescent analysis is a sensitive and informative additional method for the diagnosis of thyroid abnormalities.

Thyroid function was examined in 165 workers of electrolysis shops of aluminum production with more or less expressed signs of chronic fluoride intoxication (fluorosis) by radioimmunoassay of hormones and the test of 13II absorption by the thyroid. The detected thyroid abnormalities were characterized by a moderate reduction of iodine-absorbing function of the thyroid, low T3 with normal T4 level, and a slight increase of TTH concentration. These changes augmented with longer service and fluorosis progress. Hence, the syndrome of low T3 and reduced absorption of 1311 may be considered as diagnostic signs of fluorosis. In case of toxic involvement of the liver in fluorosis patients, low T3 syndrome is observed much more frequently: in 75.6% cases. Liver abnormalities evidently lead to disorders in the peripheral conversion of T4 in T3, occurring primarily in liver parenchyma. Indirect effect of fluorine on the enzymatic system of deiodination cannot be ruled out as well.

A total of 143 children born to mothers who suffered from various forms of endocrine sterility and in whom pregnancy was induced were examined. The levels of somatotropic hormone, prolactin, luteotropic hormone, and follicle-stimulating hormone were measured in the blood on days 1, 3, 6 of life and at the age of 3, 6, and 12 months. The hormones were radioimmunoassayed and measured by imnmnofluorescent methods. The results indicate marked disorders of the adenohypophyseal function in these children, these disorders persisting through the first year of life. The most evident shifts of hormonal parameters are observed in children born to mothers with primary disorders of ovarian hormonal function, particularly so in cases with the polycystic ovaries syndrome, and in children with perinatal involvement of the central nervous system. A high correlation between adenohypophyseal and peripheral gland hormone levels and the concentration of somatotropic hormone was detected.

With obesity-related diabetes, it is possible to use biguanides, which have a slight anorectic effect. The presence of side effects in biguanides often complicates their long-term use, especially in elderly patients who have a history of chronic diseases of the lungs, heart, kidneys, and liver. In such cases, it is advisable to prescribe anorectic drugs that simultaneously affect carbohydrate metabolism. One of these drugs is p-ethyl-a-methyl-3-fluoromethylphenethylamine hydrochloride (minifage, ponderal), which has a stimulating effect on the central nervous system. Fenfluramine reduces the supply and synthesis of monoamines (5-hydroxytryptamine) in the diencephalic regions of the brain, due to which there is a decrease in food requirements and a decrease in body weight. A number of researchers have shown that the hypoglycemic effect of the drug occurs due to peripheral action. Fenfluramine affects the extraneuronal oxidation of monoamins and reduces the level of tryptophan in the blood. T. Pssquire in experiments on rats confirmed that this effect of the drug is achieved by improving the sensitivity of peripheral tissues to insulin, especially muscles. Some researchers observed a decrease in plasma fatty acids and cholesterol levels during treatment with ferfluramine. However, the issue of the effect of the drug on the residual secretion of the C-peptide of b-cells of the pancreas during treatment with fenfluramine is not covered in the literature available to us. In our study, 26 patients with obesity (the control group consisted of 18 healthy subjects who had previously impaired glucose tolerance) showed that fenfluramine restores phase I of insulin secretion on the background of an intravenous load with glucagon or glucose, and compensation for diabetes mellitus during treatment fenfluramine is apparently associated not only with a direct stimulating effect on the β-cells of the islets of Langerhans but also with its peripheral effect.

The effects of T-activin added to basic therapy of children with insulin-dependent diabetes mellitus (IDDM) on the blood serum lipid and phospholipid metabolism were studied in 30 patients aged 6 to 14 with the newly detected condition. Diabetes symptoms manifested 1 week to 3 months before the beginning of insulin therapy. The mean daily insulin dose in the decompensation phase was 0.82 U/kg b. w. The patients were divided into 2 groups: group 1 children were administered basic therapy (diet + insulin), vitamin В15, aevitum, lipamide, cholenzyme. Group 2 patients in addition to basic therapy were subcutaneously injected T-activin in a dose of 1.75 to 2 mg/kg b. w. once a day at 18 o’clock for 5 days. Lipid metabolism was studied by thin-layer chromatography. A combination of basic therapy with T-activin had a more favorable impact on the time course of cholesterolemia than a combination of basic therapy with lipotropic agents. Evidently, T-activin added to insulin therapy exerts hypocholesterolemic effects. Tactivin therapy brought about the normalization of the lipid and phospholipid spectrum of lymphocyte membranes and enriched them with nonesterified fatty acids, the source of synthesis of such bioactive substances as leukotrienes and prostaglandins. After therapy the dose of exogenous insulin was reliably reduced in both groups, this reduction being more expressed in group 2 (with T-activin) than in group 1. We believe that T-activin is conducive to better functioning of the insulin receptor of lymphocytes and consider prescription of T-activin to children with IDDM pathogenetically justified.

The direct causes of death of diabetics in the Archangelsk district in comparison with that in Russia are analyzed. Death certificates of 1991 to 1992 in the town of Archangelsk and statistical reports for the Archangelsk district are reviewed. Mortality caused by diabetes mellitus increased by 1.7 times over the period analyzed, this being paralleled by an increase of the total mortality. The peak of deaths caused by diabetes mellitus is observed in subjects aged 65 and older both in the urban and rural population of the Archangelsk district.

The course of sexual maturation and specific features of the clinical status were retrospectively studied in 65 women aged 17 to 39 with functional variants of androgyny in order to detect the earliest symptoms of nontumorous androgyny which debuts, as a rule, during the pubertal period. The androgynous syndrome was combined with menstrual dysfunction in 56 patients and coursed as idiopathic hirsutism (with regular biphasic cycle) in 9. Twenty-three (41%) patients of those with menstrual dysfunction, but none of those with the normal cycle, had a history of inverted puberty which started by isolated pubarche. In contrast to patients with normal puberty, inverted puberty was associated with earlier pubarche, late thelarche, and similar terms of menarche, the duration of the premenarche androgenization being prolonged almost live-fold (2.8 ± 0.6 years in patients with inverted puberty vs. 0.6 + 0.1 years in the rest, p<0.001). Despite an earlier cessation of growth in inverted puberty, the final height was the same, no matter what the type of puberty. The characteristics of hirsutism were likewise the same, but menstrual dysfunction in patients with inverted puberty was reliably more incident, started earlier, and ran a more grave course (almost always with chronic anovulation). Pubarche was preterm (before the age of 8 years) in 7 patients with inverted puberty and delayed in 16, no differences of any kind being detected between the two groups. A concept on the pathologic type of inverted puberty has been formulated for the first time. Despite the period of its onset, isolated pubarche leads to prolonged androgenization of gonadostat to menarche, this involving a high risk of formation of still more grave nosologic variants of the androgynous syndrome complicated by fertility disorders.

Patients with male and female transsexualism were examined using clinical, cytogenetic, gametological and morphological methods. All patients were shown to possess normal karyotype without disorders in chromosome number or structure. Signs of sclerocystic ovaries were detected in 25% of patients with female transsexualism before treatment; after androgen therapy of 1 to 3 years signs of sclerocystic ovaries and folliculogenesis suppression were observed in 100% cases. All the patients with male transsexualism presented with spermatogenesis in the form of oligoasthenoteratozoospermia and degeneration of immature sex cells before therapy.

Bartter syndrome is characterized by hyperreninemia against the background of hyperplasia of juxtaglomerular cells, hyperaldosteronuria, potassium deficiency, metabolic alkalosis, and vascular resistance to angiotensin. A study of the pathogenetic aspects of this disease allowed a number of authors suppose that this syndrome is associated with autosomal recessive inheritance, in which there may be no sensitivity of vessels to the pressor effect of angiotensin II, impaired renal reabsorption of sodium and chlorine, increased renal production of prostaglandin E. Primary renal defect, leading to the loss of potassium also is not excluded, because bilateral adrenalectomy does not completely reduce hypokalemia. However, it is not always possible to establish a primary genetic defect. The clinical symptoms of this disease are characterized by adynamia, polyuria, polydipsia, headache, and sometimes vomiting. Blood pressure is normal or even low. Children have a lag in mental and physical development. The pathophysiology of clinical symptoms is caused either by a hereditary disorder of tubular reabsorption of potassium and secondary sodium due to an enzymatic defect in the tubule wall, or by resistance of target cells to the stimulation by renin, angiotensin, and aldosterone, the production of which increases due to a disturbed feedback mechanism. In foreign literature, a description of this syndrome is quite rare. This fact was the basis for the publication of a similar clinical syndrome in homozygous twins - brothers A. and D. born in 1967, who were followed up for 3 years.

Thyroxine is one of the 13 most commonly prescribed drugs in the United States. Thyroxine is even more frequently prescribed to patients in several countries of Western Europe, where, due to iodine deficiency, there is a high prevalence of thyroid diseases. Indication for the use of thyroxine is either conventional replacement therapy in patients with hypothyroidism, or blocking the secretion of thyroid stimulating hormone (TSH) in patients with nodular goiter or after surgery for thyroid cancer. Hypothyroidism is a common disease: according to foreign authors, from 1.5 to 2% of women and about 0.2% of men suffer from it. Among people over 60, the prevalence of hypothyroidism is even higher: up to 6% of women and 2.5% of men have a TSH level that is 2 times higher than the upper limit of normal. According to foreign studies conducted in areas without iodine deficiency (UK), thyroid nodules are found in 0.8% of men and 5% of women, and the frequency of nodes increases after 45 years. In areas with iodine deficiency in the biosphere, which includes the vast majority of the territory of Russia, the frequency of nodular goiter in women of reproductive age reaches 10% or more. Thyroid cancer is the most common endocrine localization of malignant tumors. In 1984, 10,000 new cases of thyroid cancer were reported in the United States. For a long time, the selection of thyroxine doses for substitution and suppressive therapy was purely empirical and was based mainly on clinical signs: dynamics of mass, pulse, disappearance of myxedema, etc. At present, there are objective methods for controlling the thyroxine dose.

The status of the hypothalamo-pituitary-adrenal system (HPAS) and the group of regulatory neuropeptides synthesized in the zone of the medial small-cell hypothalamic subnucleus, the principal site of production of corticotropin-releasing factor, were studied in Wistar rats. HPAS was studied by radioimmunological and morpholiistochemical methods, the neuropeptidergic system by indirect immunofluorescence which helps measure the levels of neurotensin, bombesin, vasoactive intestinal peptide, leu- and met-enkeplialines, calcitonin-gene-related peptide, and cholecystokinin in the neurones and medial eminence of the hypothalamus. Development of diabetes mellitus in rats was found to be associated with an increase of HPAS activity and alteration of the peptidergic system presenting as an increase of the number of identified immunoreactive neurones and changed content of neuropeptides in neurones and of their concentration in the medial eminence.

Tlie efficacy of levonorgestrel butanate in doses 1, 2, 4, and 8 mg/kg in spermatogenesis suppression was studied in adult male Papio hamadrias. The drug was injected intramuscularly twice with 3 month interval. All gestagen doses had an inhibitory effect of spermatogenesis, this effect increasing with the dosage build-up. None of the animals developed azoospermia, which was due to incomplete suppression of the pituitary gonadotropic function and of testosterone secretion. Hormonal concentration in the peripheral blood was 55-60% reduced in response to the minimal dose and 60-80% reduced in response to the maximal dose. Injection of long-acting gestagen did not influence the secretion of adrenocortical hormones hydrocortisone, dehydroepiandrosterone, and pregnenolone.

In recent years, the attention of researchers of various specialties is increasingly attracted by diseases and syndromes associated with impaired secretion of prolactin (PRL). The isolation of PRL as an independent hormone from the human pituitary gland occurred relatively recently - in 1970. This event in subsequent years significantly changed the idea of ​​the regulation of reproductive function and the origin of infertility in women and men. It turned out that excessive secretion of PRL, which previously had a modest role as a lactation regulator in the postpartum period, is responsible for more than 25% of cases of menstrual irregularities, hypogonadism, and infertility. The accumulated clinical and experimental data showed that an impared secretion of PRL and the symptoms associated with this pathology occurs both in the primary lesion of prolactin-secreting structures, and in various other endocrine and non-endocrine diseases, as well as when taking some pharmacological drugs. These data formed the basis of the modern concept of primary hyperprolactinemia as an independent nosological unit and its secondary forms observed in other diseases. One of these diseases is primary hypothyroidism (PG). For the first time, the relationship of lactorrhea and hypothyroidism was noted by W. Jackson, who described the case of the development of persistent lactorrhea in a patient after thyroidectomy. He also suggested that thyroidectomy stimulates the secretion of lactotrophic hormone. The combination of PG with lactorrhea-amenorrhea is known in the literature as Van Wyk-Ross-Hennes syndrome. The isolation of this clinical variant was based on the general idea of ​​the relationship between hyperprolactinemia induced by PG and sexual disorders dominating this syndrome.

On May 11–13, 1995, the 3rd Plenum of the Russian Association of Endocrinologists on the organization of care for patients with diabetes was held in Moscow (Center for Rehabilitation of the Sanatorium named after A. I. Herzen). The agenda included two issues: monitoring late complications of diabetes mellitus and discussing the federal diabetes mellitus program. In his opening remarks, the chairman of the Russian Association of Endocrinologists acad. RAMS I. I. Dedov highlighted the state of medical care in Russia. In recent years, there has been a steady decline in specialized care for patients with diabetes, in particular insulin supply. According to the reports of the chief endocrinologists of the regions and territories, over the past 3 years there have been situations when out of all insulin preparations only insulin or short-acting, or medium-acting, were available. This situation was observed not only in remote areas, but even in Moscow and the Moscow region. The acceleration of the convocation of the plenum of the Russian Association of Endocrinologists was due to a serious situation that arose in connection with the entry into medical practice of insulin of Russian-Polish production in violation of the order established by the Pharmacological Committee of the Russian Ministry of Health.

70 years have passed since the birth of the famous scientist endocrinologist - consultant of the Endocrinological Research Center of the Russian Academy of Medical Sciences, corresponding member of the Russian Academy of Medical Sciences, Lenin Prize laureate, Honored Scientist of the Republic of Uzbekistan, Doctor of Medical Sciences, Professor Rajab Kaplanovich Islamambekov. R.K. Islambekov in 1947 graduated from the Tashkent Medical Institute, and in 1950 - graduate school. R.K. Islambekov was one of the organizers of the Institute of Regional Medicine (now the Institute of Endocrinology) in Tashkent, where he worked for 18 years - first the head of the laboratory, then the head of the endocrinology department and the director of the institute. In 1961 he defended his doctoral dissertation "Clinical and morphological study of endemic goiter." R.K. Islambekov is a talented scientist whose scientific interests are concentrated in the field of physiology and pathology of the thyroid gland, problems of endemic goiter. He is one of the pioneers of introducing in the USSR methods of diagnosing and treating thyroid diseases with radioactive iodine. R. K. Islambekov proposed and substantiated the concept of the role of iodine and other trace elements in the multifactorial etiology of endemic goiter, on the basis of which a drug was created for the prevention and treatment of endemic goiter. R.K.Islambekov is the organizer of many expeditions to study the etiology, pathogenesis, and prevalence of endemic goiter in Uzbekistan, to conduct mass iodine prophylaxis, as a result of which the incidence of endemic goiter in this region has sharply decreased.