Screening of 430 children and adolescents with insulin-dependent diabetes mellitus in 54 regions of the Moscow district showed a trend to further increase of the disease prevalence in the district and an unsatisfactory level of carbohydrate metabolism compensation in the majority of patients. The authors necessitate the development of a "School for Diabetics" for training children and their parents.

The reaction of beta-cells and hydrocortisone levels after standard glucose test were compared in the indigenous population of the Extreme North and newcomers in two Northern regions — the Arctic and continental. Residents of Central Siberia were controls. In Northern residents the concentrations of insulin and C-peptide and their increase after glucose loading were reliably lower than in the residents of Siberia, being the lowest in the indigenous population of and newcomers to the Arctic region. Basal level of hydrocortisone in the blood of residents of the Extreme North was higher than in residents of Central Siberia, but glucose intake led to a decrease of the hormone content and leveled the differences in its concentrations in all examinees. Glucose tolerance in the presence of low insulinemia was normal in residents of the Extreme North.

Certain alleles of genes HLA-DQA1 and DQB1 may be regarded as reliable genetic markers of risk of insulin-dependent diabetes mellitus (IDDM) in the Russian population and in Caucasian populations. The presence of predisposing alleles Arg 52⁺ for DQA1 and Asp 57“ for DQB1 predicts a high risk of IDDM. The carriers of DQAl*0301, DQBl*0302, and DQBl*0201 are at the highest risk of the disease.

Comprehensive analysis of the qualitative and quantitative composition of mono- and disaccharides and their metabolites in the blood serum, urine, and food ingredients in diabetes mellitus showed that the composition of saccharides and their metabolites in diabetics differ appreciably from metabolism in health. The parameters differed in the patients with insulin-dependent and noninsulin-dependent condition and clearly depended on the disease compensation.

Psychological personality features were analyzed in 83 patients with diffuse toxic goiter. Modern methods for assessing thyroid function and a complex of psychological tests permitting the assessment of various personality characteristics were used. The contribution of psychological factors to predisposition to diffuse toxic goiter was revealed using Leonhard’s questionnaire. The emotive exaltation type of personality accentuation was reveled in 65.2% of examinees. The Follow-Up method and the method for assessing the level of neurotization and psychopathization indicated an increased level of neurotization, which reliably decreased when thyrotoxicosis was eliminated (47.0 ± 8.7 scores in toxicosis and 25.8 ± 4.5 scores in euthyrosis, p<0.01). Patients with ophthalmopathy were an exclusion: psychological changes were more manifest and stable in them. If ophthalmopathy persisted, elimination of thyrotoxicosis did not reliably decrease the level of neurotization. In complicated forms of diffuse toxic goiter a dissociation between the severity of patient’s status and his or her self appraisal was observed

A total of 25130 newborns were examined, which was 91% of all babies born alive in the Krasnoyarsk region. For detecting hypothyrosis, TTH levels were measured in dry blood stains on special paper filters using Delfia diagnostic kit in accordance with the manufacturer’s instructions. Hyperthyrotropinemia was detected in 3.76% of all samples examined (primary positive results of screening), but subsequent examinations of newborns with suspected thyroid insufficiency confirmed congenital hypothyrosis in only 6 patients, or 0.99% of all infants examined repeatedly. In 99.01% of cases the detected hyperthyrotropinemia was transitory. According to the findings of neonatal screening, the incidence of congenital hypothyrosis was 1 per 4134 newborns. Congenital hypothyrosis is most often confirmed in cases with the primary positive value of TTH higher than 100 pU/ml. At lower TTH levels the probability of the diagnosis validation was lower, although not ruled out

Iodination of foodstuffs is one basic trend in prevention of iodine deficit and diseases caused by it. The production of iodine salt is rather expensive, and hence, another highly prevalent foodstuff was chosen as "iodine carrier": bread. Bread is traditional food in Russia and its consumption is stable throughout the year. Bread baking is centralized in the majority of regions of our country. It is manufactured at rather large bakeries and delivered even to the most faraway regions. In order to solve the practical problems of baking iodinated bread, a pilot experiment was carried out in 1993-1995 in the Pavlovsky Posad district near Moscow (a region with moderate and slight iodine deficiency). The experiment was sponsored by the UNICEF (UN Childhood Foundation) and included development of the formula of bread iodination and assessment of this method of iodine prophylaxis. According to the proposed formula, 60 mg of potassium iodide is to be added per 100 g of flour; such a dose covers the daily requirement of an organism in iodine, provided 500 g of bread is consumed daily. The efficacy of iodinated bread was assessed from the time course of renal excretion of iodine and incidence of thyroid enlargement in 162 schoolchildren aged 7 to 14 at a boarding school in the town of Pavlovsky Posad, who were given 300 g of bread daily, and in 178 schoolchildren aged 9 to 11 living in the rural regions, eating about 100 g daily. After 3 months the median level of urinary iodine increased from 4.8 to 12.6 pg% in town and from 3.0 to 6.2 pg% in the country. After 9 months the levels of urinary excretion of iodine were the same, moreover, the incidence of thyroid enlargement decreased in both groups. Hence, the tasks of pilot experiment were fulfilled: a method for bread iodination has been developed and introduced at bakeries and its efficacy in normalization of iodine supply validated.

The authors analyze the results of many-year application of magnetic imaging to the diagnosis of volume diseases of the adrenals. The method may be effectively used for topical diagnosis of such conditions. Due to some of its characteristics, such as clear differentiation of soft tissues, possibility of examination in 3 and more projections, safety, etc., magnetic imaging may be considered a method of choice in the diagnosis of adrenal tumors. It provides valuable information on the size, shape, localization, and dissemination of adrenal tumors and in some cases differentiates the variants of anatomical norm of the adjacent organs simulating adrenal tumors shown by other topographic methods. Features of magnetic image of tumors different by their hormonal activity: aldosteroma, pheochromocytoma, corticosteroma, "incidentaloma", and malignant tumors are described. Use of paramagnetic contrast agents appreciably improves the quality of magnetic resonance tomographic diagnosis of adrenal tumors, for it permits a more reliable conclusion on the tumor structure and its position amidst the adjacent vascular structures (abdominal aorta and inferior vena cava) and the parenchymatous organs (liver and kidneys), which is particularly valuable for planning surgery.

A retrospective analysis of the efficacy of surgical intervention (demedullation of both ovaries) for the polycystic ovaries syndrome (POS) in 245 women aged 28 to 40 was carried out. Primary POS was diagnosed in 138 women (the ovarian form) and the endocrine metabolic form of the hypothalamic syndrome with secondary POS in 107. The findings showed anovulation to be responsible for infertility in 34.5% of cases, postoperative adhesions in the pelvic organs and obstruction of the uterine tubes in 34.2%, hyperprolactinemia in 11%, endometriosis in 18.3%, and ovarian cysts in 1% of cases. Treatment strategy in patients ineffectively operated on for POS cannot be standard and depends on the diseases which is diagnosed after surgery.  

In the previous issue of the magazine, we talked about how the lack of pituitary hormones manifests itself and what modern methods of diagnosis and treatment of these conditions exist. Today we continue the story about the disease of the hypothalamic-pituitary system and dwell on the symptoms of excessive secretion of pituitary hormones.

The autonomous nervous system consists of individual reflex arcs, each of which includes a receptor, afferent unit, central nervous system, efferent unit and effector organ. Autonomous control of each organ system is divided between oppositely acting sympathetic and parasympathetic innervations. Moreover, the fibers of the autonomic nervous system are distributed in the form of a web and are not widely available for the study of nerve conduction. Although double innervation, compound reflex arcs, and the anatomical abundance of nerve fibers made research difficult, the autonomic nervous system has been well studied in the last 10 years. Based on these studies, a classification of diabetic autonomic neuropathy has been developed.

The effects of propranolol (obsidan) and pyrogen- al on the course of experimental diabetes mellitus were studied. Both drugs are known as potent correctors of insulin resistance in psychiatry. Nonselective p-adrenoblocker propranolol attenuated the symptoms of alloxan diabetes in rats, which manifested in a decrease of hyperglycemia, concentrations of free fatty acids and creatinine in the blood, and in correction of secondary insulin resistance. Side effects of propranolol were as follows: increase of blood lactate level and injury to the skeletal muscles associated with a decrease of total protein content in muscle tissue paralleled by increase in the activity of blood serum creatine phosphokinase. Repeated injections of pyrogenal to rats with alloxan diabetes brought about a trend to an increase of glucose level in the blood and led to hyperlactatemia.

The biological activities of LHRF superactive agonists surfagon (Russia), a promising agent for correcting many disorders of the reproductive function, and busereline (Hoechst A. G., Germany) were assessed by their capacity to stimulate gonadotropin and sex steroids secretion in experiments on adult Papio hamadryas. A single intravenous injection of surfagon and busereline to male monkeys in doses of 50, 500, and 5000 ng/kg similarly stimulated the secretion of luteinizing hormone and testosterone for at least 8 h. Injection of surfagon to females during the early follicular phase induced a prolonged activation of estradiol secretion, more expressed after a dose of 5000 ng/kg. The activating effect of LHRF agonist on follicular steroidogenesis may be associated with subsequent disorders in the pattern and duration of the ovarian menstrual cycle. Injection of surfagon in the middle of the luteal phase had both a luteotropic effect and sharply activated the secretion of estrogens, particularly expressed after a dose of 5000 ng/kg.

Extensive experimental and clinical material cited in the modern scientific literature indicates the effect of sex hormones on the cardiovascular system and the need to take into account changes in its activity during therapy with drugs containing these biologically active substances [3, 5, 7, 71]. Along with the numerous compounds mediated through the structures of the central nervous system and circulating in the circulatory system, the genomic vasoactive effects of all steroid compounds, including sex hormones, can be realized due to the direct effect on the vascular wall [55, 66, 71, 75].