The present article briefly describes the historical development of endocrinology in Russia with special reference to the most noticeable achievements obtained by the researchers and clinicians of this country.

This article briefly presents the history of medical care provided for the children with endocrine disorders in this country.

The present paper briefly outlines the main lines of experimental endocrinological research carried out at Endocrinological Research Centre started in the first experimental laboratories and continued up to the present time.

110 acromegalic patients were examined: 62 patients with newly diagnosed acromegaly (de novo), 25 patients were receiving somatostatin analogues treatment (SSA) and 23 patients underwent transsphenoidal sugery (TSS). The prevalence of carbohydrate metabolism disturbances (CMDs) in groups de novo, the SSA and the TSS was 53.3, 88.0 and 43.4%, respectively. Levels of fasting plasma insulin (FPI), index of insulin resistance (HOMA-IR index) did not differ in groups SSA and TSS and were more than 1.5 times lower than in the de novo group (p<0.05). Аrea under insulin curve in the first 30 minutes (AUC ins.30) of oral glucose tolerance test in the SSA group was 5.3 times lower than in the TSS, and 6.7 times lower than in the de novo group (p<0.05). Among the 23 de novo patients controlled acromegaly in 6 months was at 46% in group SSA and 50% of patients TSS. In the SSA group there were found increase of fasting plasma glucose levels (FPG), HbA1c (p=0.05), in the TSS group - decrease of FPG (p<0.05). There were the tendency to decrease of HOMA-IR (p=0.06), decrease of FPI and AUCins. (p<0.05) in SSA and TSS groups. Extent of decrease in AUCins.30 on SSA therapy exceeded the extent of decrease in UC ins.30-120 (in 11.0 and 2.3 times, respectively, p<0.05), but after TSS - these changes were comparable (2.4 and 3.2 times, respectively, p<0.05). Despite comparable reduction in insulin resistance on SSA therapy and after TSS decrease of the first phase of insulin secretion on SSA therapy leads to the development of CMD.

The objective of the present study was differential diagnostics between ovotestis and gonadal dysgenesis, the choice of the gender and the surgical strategy for the treatment of abnormal sexual glands. Diagnostics of the disturbances of gonadal differentiation (DGD) requires morphological verification. The ovotesticular gonad is characterized by the presence of a mature ovarian tissue and a dysgenetic testicular component. The authors describe the surgical separation of the ovotestis with preservation of the segments represented by the mature ovarian tissue. The presence of immature ovarian elements in the testicular gonad is one of the signs of its dysgenesis. Such cases need to be treated by the surgical removal of dysgenetic gonads.

Micro- and macroangiopathies are the main causes of disability and mortality among the patients suffering from diabetes mellitus. Endothelial dysfunction is the early and important condition preceding the development of diabetic angiopathies. The serum fibronectin content may be one of the markers of endothelial dysfunction. We have documented the enhanced serum fibronectin content in the patients suffering from type 1 diabetes mellitus with concomitant microangiopathies and in the subjects presenting with obesity. The rise in the serum fibronectin level correlated with the body mass index, parameters of carbohydrate and lipid metabolism. Alteration of these parameters discovered in the present study may be used as the markers of endothelial dysfunction associated with the above pathological conditions.

The present work was designed to elucidate the frequency and the structure of polymorbidity and analyze the discrepancies between diagnoses in the patient presenting with type 2 diabetes mellitus based on the results of comparison of clinical and morphological features. The study has demonstrated the high prevalence of polypathies; their contribution to the impaired accuracy of life-time diagnostics was estimated. It was shown that in the majority of the cases except for acute pyelonephritis the diagnostic errors had no significant influence of on the final outcome of the disease.

A population of ethnic Kyrgyz was examined with a view to elucidating the relationship between the adiponectin G276T gene polymorphic locus and the development of abdominal obesity (AO). The study included 288 subjects at the age between 40 and 70 years. 139 of them (81 women and 58 men) presented with AO while 149 without obesity (62 women and 87 men) constituted the control group. The measured anthropometric parameters included arterial pressure, blood glucose, insulin, and leptin levels, blood lipid composition. Genotypes of adiponectin (AN) G276T gene polymorphism were identified by means of PCR-RFLP analysis. The relationship between the presence of the adiponectin G276T gene polymorphic and the development of abdominal obesity in the women was demonstrated. Specifically, 31% of the women with AO were carriers of T allele compared with 17% in the control group (χ2=7.89; p =0.005). The GT + TT genotype and carriage of T allele were associated with an increased risk of development of abdominal obesity (OR=2.5; 95% CI = 1.25-4.97 for the genotype and OR = 2.2; 95% CI = 1.26-4.000 for the allele). No such relationship was documented among men. The women with AO and GT+TT genotype more frequently than homozygotes presented with type 2 diabetes mellitus (64 and 37% respectively; p=0.017), hypertriglyceridemia (41 and 16.2% respectively; p=0.016), and enhanced blood glucose level (7.74±3.3 and 6.52±1.17; p=0.033). Moreover, their HOMA index was higher than in the homozygotes (3.5±1.7 and 2.63±1.24 respectively; p=0.02). It is concluded that the adiponectin G276T gene polymorphic variant in the women of Kyrgyz ethnicity is associated with abdominal obesity, type 2 diabetes mellitus, hyperglycemia, and hypertriglyceridemia.

Platelet aggregation was assessed by the method of G. Born modified as described by Z.A. Gabbasov. Blood viscosity was measured using an AKR-2 rotating-type viscometer - rheological blood analyzer at six shear rates (10 s-1, 20 s-1, 50 s-1, 100 s-1, 200 s-1, and 300 s-1) simulating different intensities of the blood flow through the vessels. The model of arterial thrombosis induced by electrical current was constructed based on the method of G. Guglielmi et al (1991). Gliclazide was used in the studies of Limiglidol antiaggregant and antithrombotic properties and pentoxifylline in the studies of the influence of Limiglidol on rheological blood properties. It was shown that Limiglidol inhibited platelet aggregation and prolonged the time of thrombus formation. It proved to be superior to gliclazide in terms of these activities and reduced blood viscosity to a higher degree than pentoxifylline.

A case of isolated sarcoidosis of cervical lymph nodes is reported that was first erroneously interpreted as parathyroid adenoma. The patient was a 70 year-old woman presenting with hypercalcemia and elevated blood parathormone level. The ultrasound study showed the presence of a tissue mass measuring 1.5 cm in the projection of the inferior right parathyroid gland. The scintigraphic study with 99mTc MIBI demonstrated the accumulation of the radiopharmacological agent in the tissue mass that was identified as an adenoma of the parathyroid gland. The surgical removal of this neoplasm together with the adjacent lymph nodes resulted in the normalization of the blood calcium and parathormone levels. The histological study revealed sarcoidosis of lymph nodes in the absence of lesions in other organs. A literature review of the problem pertaining to hypercalcemia associated with sarcoidosis of cervical lymph nodes is presented with special reference to the difficulties encountered in differential diagnostics of this condition.

Endocrine ophthalmopathy (EOP) is a multidisciplinary problem at the intersection of endocrinology and ophthalmology. The patients presenting with this condition experience deficit of adequate medical aid due to the poor cooperation between ophthalmologists and endocrinologists. There are practically no specialized centres in this country where the patients with EOP could receive the combined treatment of this pathology including the surgical intervention. Taken together, late diagnostics and delayed seeking the efficacious medical assistance, the absence of stable compensation of the functional disorders of the thyroid gland, erroneous identification of the phase of the disease, and incorrect choice of the methods for its treatment, the lack of coordination and consistency in the actions of ophthalmologists and endocrinologists are responsible for the low effectiveness of EOP treatment. On the other hand, the absence of the unified approach to diagnostics and treatment of endocrine ophthalmopathy, the necessity of introducing the international experience gained in this field into the routine clinical practice and pooling efforts of representatives of different medical disciplines (endocrinologists, ophthalmologists, radiologists, endocrine surgeons, and neurosurgeons) created the prerequisites for the solution of the EOP problems and gave impetus to the development of the recommendations being proposed.