[Evaluation of glucose utilization in patients with insulin-independent diabetes mellitus by using breathing test]. / Kharakteristika utilizatsii gliukozy s pomoshch'iu 13C-neinvazibvnogo dykhatel'nogo testa pri insulinnezavisimom sakharnom diabete.

Commonly used clinical and biochemical parameters, such as the content of glucose, insulin, somatotropic hormone, triglycerides, lactate, pyruvate, and free fatty acids (FFA) in blood of practically healthy subjects and in patients with insulin-independent diabetes mellitus (IIDM), were compared with the parameters obtained by mass-spectrometric analysis of 13CO2 in expired air after 13C-glucose loading. It was shown that, as opposed to healthy subjects, the content of blood glucose and free fatty acids in patients with IIDM increased, the level of glucose dropped in progression upon short-term fasting, and the concentration of lactate changed both upon fasting and after the administration of small test doses of glucose. The use of the 13C-glucose breathing test (13C-GBT), which presupposes the loading of safe small doses of glucose enriched in 13C-isotope permitted one to reveal a number of novel quantitative diagnostic criteria for the evaluation of glucose metabolism in patients with IIDM: a decrease in the rate of 13C withdrawal as a constituent of expired carbon dioxide after the administration of 13C-glucose; a reduction in the amount of exogenous glucose metabolized to carbon dioxide; and increased oxidation of endogenous substrates participating in carbon dioxide formation. Small glucose loads proposed by the authors in 13C-GBT are safe for patients with diabetes mellitus and have no effect on the level of blood glucose in healthy persons. The parameters determined by noninvasive 13C-GBT are more sensitive for diagnosis than commonly used biochemical characteristics of blood in patients with IIDM. The diagnostic criteria obtained allow the prediction of the maximum prohibited glucose loading for every patient.

[Permeability of the erythrocyte membrane for sodium in hypertension and symptomatic hypertension]. / Pronitsaemost' membrany éritrotsitov dlia natriia pri gipertonicheskoi bolezni i simptomaticheskikh gipertenziiakh.

Sodium permeability of erythrocyte membranes was examined, using the recording of maximum rates of sodium-lithium countertransport, in patients with essential hypertension of stages II and III by the WHO classification, renal arterial hypertension, Itsenko-Cushing disease, pheochromocytoma, Conn's syndrome and in subjects with normal arterial pressure who made up a control group. Hypertensive patients demonstrated a more than 60% increase in erythrocyte membrane permeability, as compared to normotensive controls. In patients with pheochromocytoma, the permeability values were almost 40% as low as the control ones. No changes in sodium erythrocyte membrane permeability could be demonstrated in patients with renal hypertension, Itsenko-Cushing disease and Conn's syndrome. It is believed that the erythrocyte membrane permeability parameters can be used for the identification of essential hypertension in the differential diagnosis of hypertensions.

[Nervous system changes in adrenal failure]. / Izmenenie nervnoi sistemy pri nadpochechnikovoi nedostatochnosti.

AIM: To study nervous systems in chronic adrenal failure (CAF). MATERIAL AND METHODS: 262 patients with CAF were studied clinically, biochemically and electrophysiologically before and after treatment. RESULTS: The patients were found to have syndromes of vegetovascular dystonia by hypotonic type, syncopal paroxysms, myastenic, minor strokes, dyscirculatory-dysmetabolic encephalopathy, polyneuropathy. A direct correlation was established between the severity and duration of adrenal failure (AF), lowering of adrenal cortex hormones, coefficient Na/K and clinical manifestations of the neurological syndromes. Adequate hormone replacing and symptomatic therapy promoted a regress of neurological disorders in most of the patients especially in mild and moderate AF. CONCLUSION: Adequate therapy corrects neurological disturbances in patients with chronic NN.

[Sex and pituitary hormone secretion in normal-height and tall adolescents with primary osteogenic sarcoma]. / Sekretsiia polovykh i gipofizarnykh gormonov u normoroslykh i vysokoroslykh podrostkov, bol'nykh pervichnoi osteogennoi sarkomoi.

The paper deals with a comparison of basal levels of secretion of total testosterone (T) and estradiol-17 beta (E2), their free and albumin and sex-steroid-binding globulin fractions as well as LH, FSH, prolactin and STH in blood serum of 60 normal height and 60 tall healthy adolescents and those with primary osteogenic sarcoma of bones at different stages of puberty. The study established a significantly higher level of testosterone and free androgen index and a lowered concentration of sex-steroid-binding globulin in blood serum of both normal and tall adolescent patients with osteogenic sarcoma at different stages of puberty. No significant differences were found in said indexes of estrogens between sarcoma patients and a specific group chosen for comparison, as far as physical status is concerned. The role of sex steroid hormones and, particularly, that of androgens in the pathogenetical mechanisms of osteogenic sarcoma growth is discussed.

[Hyperinsulinemia and severity of cardiovascular disorders in generalized lipodystrophy syndrome]. / Giperinsulinemiia i vyrazhennost' serdechno-sosudistykh narushenii pri sindrome generalizovannoi lipodistrofii.

The examination of 40 patients with generalized lipodystrophy elucidated the dependence of the severity of cardiovascular disorders in these patients on the immunoreactive insulin/C-peptide index. In high values of the latter cardiovascular disorders occur more frequently. The role of insulin in pathogenesis of essential hypertension, chronic IHD is assessed.

[Impaired fat tolerance as a risk factor of insulin resistance in young patients with obesity]. / Narushenie tolerantnosti k zhiru kak faktor razvitiia insulinrezistentnosti pri ozhirenii u lits molodogo vozrasta.

The study was undertaken to examine the nature and degree of postprandial lipemia during routine food fat loading (FFL) in young obese patients and the possible ways of correcting excessive body mass (BM) and hormonally metabolic disturbances. Fifty obese patients aged 18 to 25 years were examined. Group 1 comprised 20 patients with the BM index (BMI) of 33.4 +/- 0.8 kg/m2; Group 2 included 30 patients with the BMI of 33.05 +/- 5.22 kg/m2. The conventional glucose tolerance test was performed in all the examinees, by determining the degree of glycemia, the levels of immunoreactive insulin, and the insulin-resistance index (IRI). With FFL, lipid profile trends were studied in Group 1 patients. Before and 6 months after xenical therapy, anthropometric, lipid and carbohydrate metabolic parameters were determined and BMI was calculated in Group 2 patients. Group 1 patients were found to have impaired tolerance to FFL as compared with the control group. Postalimentary lipemia was accompanied by atherogenic changes in hormonally metabolic parameters. During xenical therapy, Group 2 patients were found to have positive changes in all anthropometric parameters, including those characterizing abdominal obesity, as well as normalized basal hyperinsulinemia, diminished stimulated insulinemia, increased insulin sensitivity, improved blood lipid profile with decreased atherogenic changes. Thus, the study has revealed that young obese patients show impaired fat tolerance with normal glucose tolerance. For therapy of obesity in young individuals, xenical may be recommended as an agent that not only decreases BM, but also improves hormonally metabolic parameters.

[Characteristics of the course of hypothyroidism in the galactorrhea syndrome]. / Osobennosti techeniia gipotireoza pri sindrome galaktorei.

The results of investigation and treatment of 8 patients with initial hypothyrosis, galactorrhea and disturbed menstrual function are presented. The initial hypothyrosis in patients with galactorrhea may have a latent form and/or be combined with intracellular hypophyseal tumor. Sometimes the first sign of the syndrome mentioned is abnormal lactation. The prolactin level is elevated in these patients and its depot increased. In latent hypothyrosis the thyrotropin content is within normal, its response to thyroliberin stimulation being enhanced and prolonged. Thyroid hormone therapy is effective in these patients. It was concluded that thyroid hormone substituting therapy is an adequate method for the treatment of initial hypothyrosis, galactorrhea and disordered menstrual function.