Vol 8, No 1 (2008)

This work was devoted to analysis for the effects of serotonergic drugs of positive and negative type action on parametrs of cognitive and affective status in rats under the condition of hormonal imbalanceof hypophysis-ovary and hypophysis-thy­roid systems.

The research of the hormonal regulation during the adaptation of healthy men to extreme conditions of high mountains, physical loadings, the longtime hypodinamia, the position of orthostasis, stay in high breadthes (wintering in Antarctica) is lead. The increase of activity of hypophysis-adrenal and renin-aldosterone systems, and also a level of insulin, was observed almost at all kinds of stress influences. The exception was made with the antiorthostatic test during which the levels of cortisole, aldosterone and insulin were reduced at the majority of examinees. The production of somatotropic hormone (STH) was increased under influence of the hyperdinamia and conditions of high mountains at the examinees, the decrease in level of STH was observed in polar explorers and at the longtime hypodinamia.

The initial stages of human adaptation to extreme influences of the environment is provided with the hormones of adrenal glands, and also insulin and STH. The hypophysis-gonad system replies to a stress with the deferred reaction. Interrelations between hormonal and hemodynamic parameters are revealed. The increase of the hormonal production (cortisol, aldosterone, STH and insulin) was accompanied by the increase in the intimate emission and the general peripheral resistance. The normalization of the hormonal regulation and hemodynamics was observed at the majority of men during the rehabilitation after the stay on high mountains and the orthostatic test. The long and numerous stay in conditions of a climate of Antarctica was accompanied with the early development of an arterial hypertensia and ischemic illness of heart in polar explorers.

The nervous, endocrine and immune systems are anatomically and functionally interconnected. These organ systems both express and respond to a large number of common regulatory molecules including steroids, neuropeptides, cytokines, which provide the molecular basis for integrated, bidirectionally coordinated neuroendocrine-immune responses to homeostasis disturbances induced by stress, inflammation, autoimmune and infection diseases. HPA axsis activation, which under primary hypotalamic control by corticotropin releasing hormone (CRH) is critical for maintaining physiological homeostasis under this circumstances. More recent findings indicate quite subtile but sustained changes in glucocorticoid secretion activity are potentially hazardous and may contribute to the pathogenesis of a number of common diseases, including cardiovascular disease, insulin resistance, autoimmune diseases.

An article dedicated to neuroendocrine tumors of pancreas - the group of malignant and benign formations, least explored in oncoendocrinology, extremely laborious for diagnostics and treatment. Contemporary points of view on questions of topical diagnostics, estimation of tumor morphological characteristics, their differentiation and malignancy, determine effectiveness of treatment of that sort f patients and disease prognosis. Considering of genetic and morphological properties of neuroendocrine tumors of pancreas, the principal method ot treatment is surgical. Contemporary scientific elaborations, dedicated to different aspects of neuroendocrine neoplasms, produce conditions for combination surgical operation with antisecretory, radionuclide and chemotherapy. The combined therapeutic management provide for considerable improvement quality and duration of life patients with such tumors.

In present work, we have analyzed clinical and prognostic significance of autoantibodies repertoire in patients with autoim­mune endocrine diseases, summarizing our five-year work experience in diagnostics of polyendocrinopathies. We have shown that serological markers of additional autoimmune diseases constituting the polyendocrinopathies are revealed in upto 11-15% of the patients with autoimmune endocrinopathies, such as diabetes mellitustype 1, thyroid diseases, polyendocrinopathies type 3a. These serological markers are associated with appropriate clinical presentations at a time-point of their detection, e.g. parietal-cell autoantibodies are associated with symptoms of gastrointestinal tract affections and with anemia.The observations of seropositive patients showed high manifestation risk for additional autoimmune diseases. Anti-thyroid peroxidase autoan­tibodies are associated with high risk of autoimmune thyroiditis development, whereas parietal-cell autoantibodies were con­nected with subsequent development of chronic autoimmune gastritis, gastroduodenitis and anaemia. We have determined high prognostic value of autoantibodies to islet cells in the children with disorders of carbohydrate metabolism and without clinical presentation of diabetes mellitus type 1 We have demonstrated that the incidence of islet-cell autoantibodies and adrenal-cortex autoantibodies preceded clinical manifestation of diabetes mellitus type 1 and Addison's disease for a period of up to one year. We have developed an algorithm for immunological screening of the patients with diabetes mellitus type 1, autoimmune thyroiditis, polyendocrinopathies of 3a type.

On the basis of the analysis of results of complex investigation of patients with neoplasmas of adrenal glands the radiological semiotics of tumours with various histologic structure and character of hormonal activity is specified. The special attention is given incidentaloms. Opportunities of radiological technologies in definition of a morphological accessory of a tumour are shown. The estimation of efficiency of ultrasonic, CT, MRI in diagnostics of neoplasmas of adrenal glands is made. The algorithm of inspection this group of patients is developed.

A review of literature covering the Molecular and biological basis of humoral regulation disturbances in type 1 and type 2 diabetes mellitus. The role of genetic factors, cellular and humoral immunopathologic mechanisms of pancreatic cells damage, state of other parts of endocrine system, neuroendocrine changes and metabolic disturbances are discussed.

The analysis of amino acid sequences of insulinotropic polypeptides has revealed a common short segment, consisting of four amino acid residues. Tetrapeptide KEDWa, analogous to this segment and protected from the effects of amino acid proteinases, has been synthesized. Intramuscular administration of this tetrapeptide for 11 days to rats with alloxan diabetes partially restored the insulin synthesis. The degree of inclination of the sugar curve in this case was similar to that of healthy animals. Oral or intramuscular administration of the tetrapeptide for 10 days to rats with experimental streptosotocin diabetes showed, that orally administered tetrapeptide exerted a pronounced hypoglycaemic effect during its administration. Intramuscular administration normalized the adhesive ability of mesentery microvesseis endothelium, at the same time not affecting their permeability These results point out a hypoglycaemic and endothelioprotective effect of the tetrapeptide in case of experimental diabetes mellitus. It was suggested, that the tetrapeptide is an activator of promoter segment of preproinsulin gene, and that it complementarily interacts with nucleotide sequences ggcagg and cctgcc ofthe leading strand of the DNA double helix.

Diabetes mellitus is one of main risk factor of atherosclerosis. Development of dislipoproteinemia is one of the important atherogenic effect of diabetes. Diabetes is accompanied by nonenzymatic glycation of plasma proteins including low density lipoproteins (LDL). Antibody production against modified (glycated) LDL lead to formation of cytotoxic immune complexes. These events may aggravate atherosclerosis. It was supposed that in patients with diabetes there are formation of two times lesions in arteries: atherosclerotic plaques and arteriosclerotic fibrotic plaques complicated with calcium deposition and thrombosis.

Patients with diseases of peripheral nervous system (PNS) make up the basic mass of patients in neurological hospitals. The most severe form of PNS affection is polyneuropathy. Dismetabolic polyneuropathies are remarkable for the variety of clinical variants and commonality of regularity of development of neural conductivity block, which is determined by peculiarities of denervative - regenerative changes in nervous system that are caused by different pathogenetic factors. Revelation of causes that form denervation and deafferentation syndromes is a hard clinical task, which often demands thorough clinical- neurological, laboratory and instrumental investigations. However even after the most careful investigation, there still remains some patients with no established cause of disease. Comparative analysis of clinical manifestations of neural conductivity block caused by different reasons allowed to enlarge the concept of pathogenesis of diseases of peripheral nervous system, to create prerequisites for improving the strategy and the tactics of treatment of aforesaid pathology.

The paper is reviewed the pathogenesis, classification and treatment of complications of diabetes mellitus, namely diabetic rethinopathy and maculopathy. The hyperglycemia, glucose toxicity and disturbances of the eye microcirculation were observed as the main pathogenetic chain of vision disorders in diabetes mellitus. Among of the treatment methods of diabetic rethinopathy the author specified stabilization of diabetes mellitus stage and modern lazer, surgical and drug therapy.

The events of emergent hospitalization of patients with acute pancreatitis suffering with diabetes mellitus was reviewed in the article. The classification of acute pancreatitis, its clinical picture, diagnostic methods depended on the stage of the disease and the principles of conservative drug treatment were described.

The paper analyzes surgical treatment of pulmonary tuberculosis, combined with diabetes based on the experience of treating 184 patients. During hospitalization there were 19% of bacilli-producers, including 52 % of heavy bacilli-producers. D rug resistance of mycobacteria to tuberculostats developed almost in 90% of patients. It was determined the high frequency of complications both in tuberculosis and in diabetes, diagnosed more than half of patients. These factors have led to low efficiency of intensive preoperative preparation (26%) and disease progression against the backdrop of therapy in 9% of patients. The data of plating of lung tissue and pathologic examinations of resected lungs found out considerably higher extent and activity of tuberculosis in its combination with diabetes in comparison with tuberculosis patients without concomitant diseases. These factors contributed to the increased frequency of postoperative complications and mortality, which are 2-4 times higher than those obtained in surgical tuberculosis patients without diabetes. The results of long-term follow-up of patients undergone lung surgery and patients refused it make clear conclusion on the need for surgical treatment of this heavy contingent, which gives a clinical cure of tuberculosis of two-thirds patients.

Randomized study of the patients of both sexes and various age has been performed. The results of the study have demonstrated that indices of abdominal obesity incidence, combination of abdominal obesity and arterial hypertension (AH), hyperglycemia and AH, hypercholesterolemia and AH, obesity and hyperglycemia are more characteristic of the females in perimenopausal period then in males of the similar age and females of the child-bearing age. Abdominal type of obesity in hypertensive patients results in well-marked structural and functional cardiac alteration refractive to the drug hypotensive therapy.

Analyzing aproximetely (100) hundred thousand «histories» (patients cards), was shown that 23,6% of all patients of den­tal clinics suffer from different somatic diseases, including 1,7% - who suffer from diabetitis. In 18,2% of all cases, treatment of periodontitis has led to teeth extraction, according to progressing of acute odontogenic infection (AOI). That is why the treat­ment have to be provided in the conditions of specialized hospital.

4139 patients with AOI were hospitalized during 5 years. 73 of them (1,72%) had diabetitis, 21 among them (28,7%) have discovered it for the first time.

Among 61 patients of this group acute odontogenic osteomielitis completed with development of paramandibular phlegmonas of different localisation (44-60,2%), sepsis (13-17,8%), mediastinitis (3-4,1%), meningoencephalitis (1-1,3%), which led to the risk of their life.