Discussion
The article is devoted to the molecular genetic aspects of thyroid disease.
The article is devoted to the study of problems of iodine deficiency from physician’s viewpoint.
Clinical endocrinology
The patterns and prevalence of hypothalamo-pituitary abnormalities in children with somatotropic insufficiency were studied using magnetic resonance tomography (MRT). The findings of clinical hormonal analyses and MRT are analyzed in 71 children with various forms of somatotropic insufficiency. High incidence of sellar abnormalities (87.3%) was detected among children with hypopituitarism. Combined triad of abnormalities (neurohypophyseal ectopy, pituitary pedicle aplasia/hypoplasia, and adenohypophysis hypoplasia) ranks first (33.8%) in the structure of detected diseases. This triad was detected in children with isolated somatotropin deficiency and with multiple deficiency of adenohypophyseal hormones. It is associated with de Morsier syndrome (hypopituitarism combined with septooptic dysplasia) and other congenital abnormalities of brain structures).
Antibodies to surface antigens of rat adenohypophysis (ASAG) and human somatotropinoma cells (AHST) were studied in 48 patients with primary "empty"sella turcica syndrome by cellular enzyme immunoassay, antibodies to somatotropic hormone (STH) were radioimmunoassayed, and STH reserves were studied by insulin hypoglycemia test in order to detect a probable relationship between the development of somatotropic insufficiency and autoimmune process in pituitary tissue. The patients were divided into 2 groups by the results of insulin test: with STH insufficiency (54.2%) and normal STH secretion (45.8%). ASAG and AHST were detected in 52 and 27% patients, respectively; the incidence of these antibodies in the patients with STH deficiency and normal secretion of STH was virtually the same. Antibodies to STH were detected in 2 patients with STH insufficiency and in 3 with normal STH secretion, and their presence did not correlate with the presence of antipituitary antibodies. High incidence of ASAG and AHST does not rule out the possibility of lymphocytic hypophysitis in at least some of examined patients.
Sixteen women were treated with estradiol valeriate (progynova) in a daily dose of 2 mg during 30 days for moderate menopausal vasomotor symptoms. The mean age of the patients was 55.3+1.15 years, duration of menopause 5.6 ± 0.8 years, body weight 68.0 + 3.0 kg, and height 161 ± 1.4 cm. Urinary phytoestrogen profiles (8 metabolites) were evaluated by isotope dilution capillary gas chromatography - mass spectrometry. Estrogen-replacing therapy (ERT) of menopausal patients led to redistribution of urinary excretion оf phytoestrogens at the expense of relative predominance of lignanes (enterolactione and enterodiol) over isoflavonoids (daidseine, henisteine). After ERT course the excretion of methoxyestrogens correlated positively with lignane excretion and negatively with isoflavonoid excretion. These changes may be important for secondary modification of clinical and endocrine effects of ERT.
Daily changes in aldosterone secretion and its mean daily blood level were studied in patients with Icenko-Cushing disease with and without arterial hypertension and the relationship between aldosterone secretion, plasma renin activity, and blood hydrocortisone and ACTH level in such patients were studied. Two groups of patients with Icenko-Cushing disease were examined: with and without pronounced hypertension. Serum aldosterone, hydrocortisone, ACTH, and plasma renin activity were radioimmunoassayed simultaneously. Blood samples were collected at 8.00, 16.00, and 23.00, and the mean concentrations of hormones were calculated. Increase of hydrocortisone secretion was paralleled by increased secretion of aldosterone. Daily time course of blood aldosterone concentrations in patients with Icenko-Cushing disease complicated by hypertension was paradoxical: they were maximum in the evening and night hours. Development of hypertension in patients with Icenko-Cushing disease was closely associated with the duration and severity of disease and patient’s age.
The incidence of thyroid cancer has essentially increased at territories contaminated as a result of the Chernobyl accident over the 15 years that passed since the accident, this increase being particularly obvious among children. It is less clear whether low-intensive irradiation affects the formation of another thyroid diseases, including nodular nontoxic goiter. This paper presents the data of many-year ultrasonic screening which was carried out 6-12 years after the accident among children living at radiocesium-contaminated (1-5 Ci/km2) and control territories of European Russia which are considered to be foci of slight natural iodine deficiency. The prevalence of nodular thyroid abnormalities in the cohort of exposed children (n = 955) was 2.3%, which is 5-fold more than intact controls (0.5%), n = 1339; p < 0.01). Echographic characteristics of thyroid nodules in children living at contaminated territories were defined (solitary large nodules with solid or heterogeneous intranodular tissue) which can be classified as formations at a high risk of cancer transformation, requiring active morphological diagnosis by fine needle puncture biopsy. These data and numerous reports about a rise of thyroid cancer incidence in the regions of Chernobyl precipitations necessitate long-term selective screening in the cohort of exposed subjects for timely diagnosis and early therapy of thyroid tumors.
For practitioners
The article is devoted to the study of the peculiarities of diabetic dyslipidemia and approaches to its correction.
Case Reports
The article is devoted to the description of a case with diabetes insipidus with symptoms of epilepsy.
Experimental endocrinology
Effects of ultraviolet radiation and pH of isotonic protein-free solution on erythrocyte capacity to deposit thyroid hormones were studied in specimens of venous blood from men aged 20- 35 years. Ultraviolet irradiation of the blood led to a dose-dependent increase in the plasma triiodothyronin concentration, the concentration of thyroxin remaining unchanged. Incubation of human erythrocytes in phosphate buffers (0.15 M) led to a sharp increase in the concentrations of triiodothyronin and thyroxin in incubation media, the concentration of triiodothyronin depending on the medium pH and the lowest increment in its concentration being observed at pH 6.0. The concentration of thyroxin in buffer solutions surpassed the hormone concentration in the plasma more than 7-fold and did not depend on pH of the medium. Results of ultraviolet exposure of the blood and erythrocyte incubation in buffer solutions suggest that mechanisms of thyroid hormone deposition in erythrocytes are concerned with regulation of mainly triiodothyronin but not thyroxin.
Activities of monoaminoxidase (КР 1.4.3.4), glutaminase (КР 3.5.1.2), adenosine monophosphate deaminase (KP 3.5.4.6), and glutamate dehydrogenase (KP 1.4.1.3) in the brain hemispheres and stem were evaluated in rats in a state of hypoglycemic coma (40 U insulin/kg), 12 and 48 h after a single glucose arrest of coma, and in animals subjected to 5-7 hypoglycemic comas at 2-day intervals and sacrificed after the last coma. The substrate specificity of monoaminoxidase was changed, adenosine monophosphate dehydrogenase activity increased, and glutaminase activity decreased in hypoglycemic coma and in various terms of recovery after coma. The detected changes result from oxidative stress and can be involved in the pathogenesis of posthypoglycemic encephalopathy.
Letters from Our Readers
The article is devoted to the description of the advertised method of combating iodine deficiency, based on the widespread use of food enriched with iodocasein, as well as the intake of biologically active additives (BAA) based on iodocasein.
Peer-REVIEW
The review is devoted to the monograph edited by Prof. E. I. Marova "Neuroendocrinology-clinical essays".
Anniversary
The article is devoted to the anniversary of the prominent Russian pathophysiologist-endocrinologist of Medical Sciences Professor V. I. Kandror.
ISSN 2308-1430 (Online)