The results of 7-year utilization of a Russian analyzer for noninvasive x-ray fluorescent measurement of intrathyroid stable iodine for diagnosis and monitoring the treatment efficiency in patients with thyroid diseases are analyzed. A total of 400 adults (130 men and 270 women) aged 20-50years and 67children (12 boys and 55 girls) aged 5-16 years with various thyroid diseases were examined. Control group consisted of 60 women and 30 men without thyroid diseases (according to clinical and laboratory studies). Ultrasonography and scintigraphy of the thyroid, measurements of the blood pituitary thyrotropic hormone, thyroid hormones, antibodies to thyroglobulin and thyroid peroxidase, cytological and h istological studies, and a new method for thyroid iodine measurements were used.

The results indicate the need in a new diagnostic method based on analysis of intrathyroid iodine. Such a method is needed for 1) prophylactic screening of population, including children, pregnant and nursing women in order to detect (with an accuracy of 7095%) subjects with suspected autoimmune thyroid diseases; 2) accurate evaluation of the degree of thyroid involvement in autoimmune thyroiditis and identification of the pathogenesis of hypothyrosis or thyrotoxicosis; 3) monitoring the efficiency of treatment with iodides, thyroxin, and their combinations and for thyroid function recovery after mercazolil therapy of diffuse thyroid goiter; and 4) differential diagnosis of benign and malignant thyroid diseases.

The level of leptin production was measured in relation to the concentrations of adrenal androgens, testosterone, and gonadotropins in patients with various disorders of the male reproductive system and obesity. LH, FSH, prolactin, testosterone, estradiol, hydrocortisone, dihydroepiandrosterone (DHEA) and DHEA sulfate were radioimmunoassayed and leptin was measured by enzyme immunoassay. Body weight index (ВИД) in 66 examined patients varied from 20 to 40 kg/m² and leptin content from 0.8 to 106 ng/ml. In general, the level of leptin directly correlated with the levels of BWI, LH, FSH, and DHEA sulfate and inversely with testosterone level. The highest levels of leptin were observed in patients with obesity combined with androgenic insufficiency, while in patients with obesity or androgenic insufficiency alone leptin levels were lower. No significant differences in leptin concentrations in relation to gonadotropin levels were detected. Normal fluctuations in the levels of adrenal androgens did not affect leptin production. These data indicate a possible involvement of testosterone in regulation of leptin production.

The metabolic (MS) or insulin resistance syndrome includes a tetrade of signs: dyslipidemia, carbohydrate metabolism disorders presenting as type 2 diabetes mellitus (DM) or impaired glucose tolerance, arterial hypertension, and abdominal obesity. Arbitrary components are hyperuricaemia and microalbuminuria. The immune status of 24 patients with MS has been examined for the first time. Control groups consisted of 5 patients with type 2 DM without history of MS or chronic infections, 16 patients with chronic infections, and donors. Immunoglobulins A, M. and G were measured by Mancini’s method in gel; CD3, CD4, CD8, CD 16, and CD72 were evaluated using monoclonal antibodies (Sorbent); thyroid hormones were measured by enzyme immunoassay (Biorad). Thyroid diseases (autoimmune thyroiditis with nodular goiter or nodular goiter) were detected in 54%, chronic infectious diseases in 58.3%, and their combinations in 29.2% examined patients. Shifts in immune status were detected in MS patients without concomitant chronic infections and/or thyroid diseases: decreased counts of T lymphocytes and hyperfunction of В lymphocytes and dysimmunoglobulinemia with a significant increase in IgA and IgG levels. Presumably hyperstimulation of humoral immunity is the first stage of immune disorders in patients with MS. Combination of MS with thyroid diseases and/or chronic infections leads to inversion of the immune status with development of T helper, T suppressor, and NK insufficiency, В lymphocyte dysfunction, and low IgG level. Decreased count of NK cells in MS can be associated with increased risk of malignant diseases, including those of the thyroid.

Immunity parameters (Т lymphocytes with CD4\ CDS*, CD95⁺ markers and circulating immune complexes (CIC) with IgM) and the eyeball conjunctival vessels were studied in patients with angiographically documented coronary atherosclerosis with and without metabolic syndrome (MS) with the aim of detecting a relationship between immunological and metabolic parameters. T lymphocyte subpopulations were evaluated by indirect immunoperoxidase test with monoclonal antibodies. High levels of cytotoxic lymphocytes (CDS*) and T cells with Fas molecule were detected in coronary patients with MS, but not in coronary patients without MS. The concentration of CIC with IgM was the highest in patients with MS, which may be conducive to capillary damage. Biomicroscopy of conjunctival vessels detected more pronounced disorders in microcirculation in coronary patients with MS, presenting as a significant increase in the conjunctival indexes in this group in comparison with coronary patients without MS. Statistically significant correlations were detected between CD95* marker and body weight index, atherogenic lipid metabolism parameters, and creatine phosphokinase levels. Abnormal activation of Fas system may be involved in the pathogenesis of ischemic injuries to various organs or in autoimmune processes mediated by cytotoxic lymphocytes.

Pseudoresistance to sulfonylurea drugs is caused by their chronic overdosage and the resultant hypoglycemic reactions leading to decompensation of diabetes. The efficiency of amaril was studied in patients with type 2 diabetes ineffectively treated by traditional sulfonylurea. Amaril therapy in this group of patients resulted in a decrease of glycated hemoglobin fraction A_/c by 2.2% in 3 months. Side effects were rare. Hence, amaril can be regarded as a drug for correcting pseudoresistance to sugar-reducing sulfonylurea drugs in patients with type 2 diabetes, as it notably improves carbohydrate metabolism.

Medullary thyroid cancer (MTC) was first described by Hazard et al. in 1959 [27] as a tumor of C cells (parafollicular cells); it amounts to 5-10% [4, 23] among all cases of thyroid cancer (thyroid gland). Parafollicular cells are an integral part of the APU D-system and embryologically migrate from the neural crest to the thyroid tissue [25].

Among the current medical and social problems, one of the most urgent is the pathology of the thyroid gland (thyroid gland). This is due to the fact that the total frequency of various forms of this pathology, even outside areas of goiter endemic, is at least 20% of the total incidence. In goiter endemic regions, where approximately 1/3 of the human population lives, this figure often exceeds 50%.

The condition of the pituitary gland - the central gland of the endocrine system - is influenced by many factors. Despite the fact that the localization of the pituitary gland in the "individual" bone "case" (no anatomical formation in the human body is so mechanically protected) indicates the need to limit external influences on the state of the pituitary gland, the phenomenon of the "empty Turkish saddle" (PTS) is a frequent find in computed tomography and magnetic resonance imaging of endocrinological and neurological patients. The diagnosis of PTS is often discussed in connection with the differential diagnosis of pituitary adenomas. Diagnosis of the pituitary adenoma in elderly patients has its own peculiarities: the symptoms of the pituitary adenoma are manifested against the background of a combination of somatic diseases. Hypertension, coronary heart disease, cardiac and cerebral atherosclerosis complicate the differential diagnosis, complicate therapeutic measures.

Metabolic disorders in the organism associated with diabetes mellitus impair organs and systems, including the respiratory system. However local defense of the lungs in diabetics has been little studied up to the present time. We investigated cellular (total cell counts, counts of alveolar macrophages and segmented neutrophils, phagocytic number, phagocytic index, spontaneous and induced NBT test, and stimulation index) and humoral (lysozyme) factors of local defense of the lungs. Total cell count increased in diabetics, mainly at the expense of increased count of segmented neutrophils; the count of alveolar macrophages decreased, phagocytic number and phagocytic index reduced and spontaneous and induced NBT values and lysozyme level increased. These shifts were more pronounced by day 45 of observation. The above mentioned changes in local defense of the lungs indicate reduced phagocytic and bactericidal activities of alveolar macrophages and a decrease of antibacterial resistance of local lung defense system in diabetes mellitus.

Effective concentrations for D and L thyroxin isomers were determined by the chemiluminescent (CL) method and their effects on free radical oxidation in the mitochondrial and synaptosomal fraction of adult rat cerebral cortex were studied in vitro. A OA DT₄ in a model system with riboflavin was 2.2 times higher than L-T₄. Effective concentrations for both thyroxin forms were 1$q= = 7.43 x 10~⁵+/-0.71 M for D-T₄ and 15q=15.47 x 10~⁵+/1.23 M for L-T₄. Thyroxin effect on membranous fraction of the brain cortex was studied in vitro using luminol-dependent peroxide CL. In normal concentrations (1 x 108 M) both hormone forms exerted equally intensive antioxidant effect which was more pronounced in the mitochondrial fraction, where CL decreased by 69 and 66%, while in the synaptosomal fraction it decreased only by 45 and 46%. Since D form possesses no hormonal activity, this effect may be due to phenol origin of thyroxin.

Most of the most respected researchers in the field of thyroidology agree that the ideal treatment for diffuse toxic goiter (DTZ) should ensure the rapid elimination of the clinical symptoms of thyrotoxicosis and be accompanied by a minimal risk of complications for the patient [1, 2, 7]. Unfortunately, at present, clinical practice does not have a treatment method that fully meets these requirements. The choice of treatment method for DTZ is largely determined by the commitment of specialists and their experience in the application of a particular treatment method, the characteristics of national endocrinological and surgical schools, the capabilities of a particular medical institution, as well as the sex, age of the patient, options for the clinical course of the disease, the patient’s wishes and some others factors. It can be noted that the recommendations given by experts in Europe, the USA and Japan are different. Conservative therapy with antithyroid drugs is quite widespread in European countries, but the low frequency of achieving stable remission of the disease does not satisfy endocrinologists [1,5, 32, 40, 42]. Radioactive iodine therapy, which is widely used in the USA and Western Europe, which is a rather effective method of treating DTZ, over time leads to the development of hypothyroidism in almost all patients [16, 20], it is also necessary to take into account the risk of developing thyroid cancer, breast, infertility and severe osteoporosis in women in the premenopausal period [10, 13, 18, 19]. Surgical treatment occupies a significant place in the treatment of DTZ, providing the patient with the most rapid achievement of the euthyroid state, however, like any surgical intervention, it is accompanied by a number of characteristic complications [2, 46]. Nevertheless, in Japan, thyroidectomy is considered the main treatment for DTZ.

Today the pineal gland is one of the most “titled” endocrine glands, but interest in it has not diminished, but continues to increase. A Melatonin Club has been organized and operates, and Jounal of Pineal Research, Advances in Pineal Research, and European Pineal Society News are published. The rapid development of chronobiology led to the elimination of the leading role of the pineal gland and its hormone melatonin in the implementation of circadian, seasonal and annual rhythms of the most diverse functional systems of the body [1]. Despite this, the amount of modern literature in Russian, devoted not to some particular issues, but to the pineal gland and its pathology as a whole, is very limited.

US 81st Annual Endocrinological Society Conference

Ildar Ganievich Akmaev (on the occasion of his 70th birthday)

Yuri Alexandrovich Pankov (on the occasion of his 70th birthday)