Methodological aspects of immunofluorescent detection of autoantibodies to Langerhans' islet /З-cell antigens (ICA), a marker indicating early preclinical insulin-dependent diabetes mellitus (IDDM), have been modified and standardized. The distribution and levels of ICA were evaluated in patients with first diagnosed IDDM and their relatives (risk group) (total 298). In patients with newly diagnosed IDDM, ICA were detected in 83.3% cases. 15.4% clinically healthy siblings of IDDMpatients and 8.3% children one of whose parents was a diabetic were ICA-positive. About 16% children with non-IDDM carbohydrate metabolism disorders were ICA-positive. Hence, immunofluorescent detection of ICA helps detect this IDDM marker; the process is to be monitored in high-risk children and they should be prescribed therapeutic and prophylactic agents preventing the progress of diabetes.

Cellular and humoral immunity parameters were studied in 55 children and adolescents with insulin-dependent diabetes mellitus (IDDM). The patients were divided into 3 groups with different duration of disease: up to I year, 1-5 years, and more than 5 years. Population and subpopulation composition of peripheral blood lymphocytes was studied by indirect immunofluorescence. Serum concentrations of the main immunoglobulin classes were measured by radial immunodiffusion. At the initial stage of diabetes the immunoreactivity status in children and adolescents manifested by depression of T-cellular component of the immune system and activation of humoral immunity, this depression progressing with disease. The concentration of CD16⁺ cells was increased in all patients, irrespective of disease duration. 'The content of HLA-DR⁺ lymphocytes was increased at the stage of initial diabetes and decreased to the norm later. No definite patterns in changes of serum immunoglobulin concentrations could be distinguished during the observed period of disease; however the levels of IgA and IgM were significantly increased during various periods of IDDM.

Effects of metformine and maninil on lipid metabolism and its hormonal regulators were studied in 38 patients with non-insulin-dependent diabetes mellitus (N1DDM) aged 35-55 years. A 3-month metformine course in a daily dose of 0.85 g notably decreased lipid content in the plasma, particularly of triglycerides (TG) and very low density lipoproteins. Monotherapy with metformine decreased basal and stimulated insulin secretion and glycaemia, and normalized GH secretion. Medium-expressed correlation between the extent of TG decrease and GH increase in the plasma was detected. Metformine did not change tissue respiration parameters in patients with initially normal lactate content. Despite diabetes compensation by glycaemia, lipid metabolism did not improve, insulin concentrations did not decrease, and GH did not normalize in NIDDM patients treated with maninil (0.005-0.015 g/day) during the same period.

Although asymptomatic thyroiditis (АГ) is well known by the present time, the prevalence of this disease is still disputed. We evaluated the incidence of A T at Thyroidology Department of Omori Hospital. Asymptomatic thyroiditis was detected in 61 out of 1113 patients (5.5%) during the period of July 1993 to June 1996. On admission, high levels of free thyroxin in the blood (hyperthyroxinemia) were detected in 306 patients. Asymptomatic thyroiditis was the cause of this condition in 38 (12.4%) patients. By the moment of examination of patients with A T, thyrotoxicosis was revealed in 38 patients, euthyroid status in 17, and hypothyrosis in 6 patients. Patients with euor hypothyrosis had complaints and presented with clinical signs of thyrotoxicosis 1-2 months before examination. Antibodies to thyroperoxidase and/or thyroglobulin were detected in 51 out of 61 (84%) patients with A T. Sometimes A T is regarded as diffuse toxic goiter (DTG), but a patient with this condition can develop A T. We should always remember about the possibility of AT but not DTG even in cases with pronounced thyrotoxicosis or with a history of DTG. Regular check-ups of thyroid function will help diagnose the condition without resorting to ¹²²1. If a patient has symptoms of thyrotoxicosis, e. g. palpitation, thyroid function should be examined.

Неге аге 4 typical cases with AT to illustrate this. Patient No. 1 is a classical case of Hashimoto’s thyroiditis. Previously she developed an euthyroid status, and later thyroid destruction and dysfunction (transitory thyrotoxicosis followed by hypothyrosis) developed spontaneously without pregnancies or deliveries. Patient No. 2 had transitory thyrotoxicosis which was not followed by hypothyrosis, but with a transitory slight increase in TTH. She might have had AT3years before. Patient No. 3 aged 63years complained of angina pectoris and arrhythmia; later she was prescribed substitute therapy with L thyroxin for pronounced hypothyrosis (TTH 90.9 microunits/ml). In patient No. 4 DTG was erroneously diagnosed and she was prescribed therapy for this condition. Thyroid dysfunction was transitory in all patients, and the function recovered later.

The efficiency of therapy with a combined thyroxin-iodine drug and monotherapy with thyroxin was compared in patients with diffuse nontoxic goiter (DNG), and the effect of iodine intake was evaluated. The study was carried out in an outpatient setting by the double blind method in 46 women aged 18-50 years with DNG: 22 were treated by the combined drug (TI) containing 100 pg L-thyroxin and 100 pg potassium iodide per tablet (lodthyrox, Merck KGaA) and 24 were treated by thyroxin (T) in a dose of 100 pg (Euthyrox, Merck KGaA). The treatment was administeredfor 1 year. A year after this treatment, 15 women were treated with iodinated oil (IO) (lipidol capsules, Guerbet) containing 380 mg iodine. Thyroid volume, concentrations of intrathyroid stable iodine (ISI), pituitary thyrotropic hormone, free triiodothyronin and thyroxin, and antibodies to thyroglobulin and thyroid peroxidase in the blood were evaluated in all women before and during treatment.

Therapy with T and TI equally decreased the size of the thyroid in DNG. ISI concentration decreased during TI treatment less than during monotherapy. Thyroid volume increased to the pre-treatment size 12 months after therapy with T or TI was discontinued, while ISI concentration remained lowered. Administration of IO led to a decrease in the thyroid size, less pronounced than during T or TI treatment, and to an increase in ISI concentration.

Effects of somatotropic hormone in different concentrations on the phagocytic activity of various populations of human lymphocytes and production of superoxide anion were analyzed in vitro. Blood cells were incubated in medium 199 with various hormone concentrations for 1 h at 37°C. Besides the traditional general parameters of phagocytosis, the counts of eosinophils, neutrophils, monocytes phagocytizing and not phagocytizing sheep red cells (SRC) were evaluated with regard to their activity (number of phagocytosed SRC) in the total pool of phagocytes (sum of all phagocytizing cells of different activity per mm³ blood). The spontaneous and zymosan-stimulated levels of superoxide anion were evaluated in the nitroblue tetrasolium reduction test. Addition of somatotropic hormone stimulated the total phagocytic activity of human leukocytes by activating al! types of phagocytes, but the hormone effect was different for different cells. Growth hormone exerted the greatest stimulating effect on monocytes, increasing 3-5-fold their role in total phagocytosis, in comparison with the control. Addition of growth hormone increased zymosan-stimulated production of superoxide anion but did not change its spontaneous level. The results indicate the probability and demonstrate the direction of the immediate effect of growth hormone on the functions of some populations of human peripheral blood leukocytes.

The relationship between the matrix effect and radioimmunoassayed concentrations of total T₄ in the blood of rats was studied. T4 was measured 4 times in 59 rats: by the initial and modified RIO-T4-PG and RIA-T4-STkits (Minsk). The modification consisted in the following: standard solutions were prepared on rat serum free from T4. The levels of T4 measured by the original and modified kits correlated. For RIO-T4-PG the correlation coefficient p = 0.9809 and regression equation is у = 0.64x+5.087, and for RIA-T4-ST p = 0.9802 and у = 0.875x-l. 712. Hence, for real concentrations, measurements of T₄ by both original kits give underrated values, but the fluctuations of T4 in the control rats appreciably surpassed this underrating. We conclude that the above mentioned commercial kits for measuring T₄ can be usedfor measuring the hormone concentration in the rat blood, provided the appropriate reference groups are available.

Adrenal insufficiency is a clinical syndrome caused by insufficient secretion of hormones by the adrenal cortex, which is the result of a malfunction of one or more parts of the hypothalamic-pituitary-adrenal system [2]. Primary chronic adrenal insufficiency (1-CNI) develops as a result of the destruction of more than 90% of the cortex of both adrenal glands by a pathological process. The main causes of 1-CNN are currently autoimmune (80–85%) and tuberculosis (5–10%) destruction of the adrenal cortex [2, 3]. 1-CNN of the indicated etiology is better known as "Addison's disease." 1-CNN is a relatively rare disease (40-110 new cases per 1 million people per year) [2, 3], but it is of considerable importance in the practice of endocrinology. Without exception, all patients with a diagnosis of 1-chronic heart failure need lifelong replacement therapy with corticosteroids (CS), which will be discussed in this work.

International System of Units SI and conversion factors (main laboratory indicators in endocrinology)