[The nonclassical form of congenital adrenal cortical dysfunction in adolescent girls].

The study was undertaken to define the frequency of nonclasslcal 21-hydroxylase deficiency confirmed by CYP21 gene mutations in girls with pubertal hyperandrogenlsm, to estimate the value of clinical and hormonal markers of nonclasslcal 21-hydroxylase deficiency. Eighty-five girls aged 5-17 years who had hyperandrogenlsm (pubertas precox, hirsutism, acne vulgaris). All the examinees underwent adrenocorticotropic hormone (ACTH) (Synacthen-depot) test. After detecting the hormonal markers oj"nonclassical21-hy-droxylase deficiency (the baseline level of 17- О HP being was above 9 nmol/l and/or above 45 nmol/l after A CTH stimulation), the authors analyzed the most common CYP21 gene mutations. The frequency of nonclassical 21-hydroxylase deficiency supported by CYP21 mutations In the girls with hyperadrogenlsm was 8.3%. There were no clinical differences between the nonclassical form of 21-hydroxylase deficiency and other forms of hyperandrogenlsm. The high baseline 17-OHP ( > 20 nmol/l) is the most specific hormonal marker of nonclasslcal 21-hydroxylase deficiency. Glucocorticoid therapy is indicated for patients with substantially accelerated growth and bone maturation and in those with menstrual irregularities as oligomenorrhea or amenorrhea.

[An attempt to use enalapril in arterial hypertension in patients with juvenile obesity]. / Opyt primeneniia énalaprila pri arterial'noi gipertenzii u bol'nykh iunosheskim ozhireniem.

Clinical efficacy of enalapril, a drug belonging to a group of angiotensin-converting enzyme inhibitors, was studied in patients with pubertal juvenile dyspituitarism (juvenile obesity) coursing with arterial hypertension. A reactive increase of plasma renin activity and reduced concentration of plasma aldosterone were revealed. The drug was characterized by a pronounced hypotensive effect. No negative effects on the blood lipid spectrum or carbohydrate metabolism were observed. The study showed that enalapril may be a drug of choice in the treatment of the hypertensive syndrome in patients with juvenile obesity.

[Interrelationships between prolactin and the renin-aldosterone system in patients with various endocrine diseases]. / O vzaimootnosheniiakh mezhdu prolaktinom i sistemoi renin-al'dosteron u bol'nykh s razlichnymi éndokrinnymi zabolevaniiami.

Prolactin and aldosterone secretion and renin activity in the plasma were measured in the course of thyroliberin (TRH) test in women with various endocrine diseases, both connected with the water-salt metabolism disturbances and without these--with the idiopathic edemas (n = 11), hypothyrosis (n = 16), Stein-Leventhal'syndrome (n = 6), and obesity (n = 8). A reciprocal relationship between prolactin concentrations (a drastic elevation) and aldosterone levels (lowered) were revealed, as were universal responses of both the hormones to TRH administration in patients with various conditions. The authors come to a conclusion on the absence of a stimulating effect of prolactin on aldosterone secretion and plasma renin activity. They suggest an indirect contribution of prolactin to the regulation of the renin-aldosterone system, probably via dopaminergic mechanisms.

[Aldosterone content and renin activity in the plasma of hypothyroidism patients before and during treatment with thyroid preparations]. / Soderzhanie al'dosterona i aktivnost' renina v plazme bol'nykh gipotireozom do i v protsesse lecheniia tireoidnymi preparatami.

A study was made of aldosterone (A) level and plasma renin activity (PRA) in 47 patients with hypothyrosis of various degree of severity prior to and during therapy with thyroid drugs. A normal basal A level in the blood plasma was noted, in some patients it was raised or lowered. The following tendency was revealed during therapy with thyroid drugs: in patients with lowered A and PRA levels a rise of these levels was noted during treatment, in raised levels a significant drop was noted. Normal A and PRA basal levels (in most of the patients) showed in the process of treatment diverse tendencies: toward a decrease in the A level and a rise of the PRA level within normal range. The results obtained indicated independent effect of thyroid hormones on A and PRA synthesis. In case of low level of endogenous thyroid hormones as well as exposure to exogenous thyroid hormones changes in the A level were not directly controlled by PRA.

[Various hormonal interrelations in idiopathic edema]. / Nekotorye gormonal'nye vzaimootnosheniia pri sindrome idiopaticheskikh otekov.

The content of aldosterone and renin activity were examined together with the determination of progesterone, estradiol, gonadotropins and prolactin in the blood of 39 women with idiopathic edemas and in 15 normal women in different phases of menstrual cycle. Women with idiopathic edemas showed a number of hormonal deviations: absolute and relative hyperaldosteronism, particularly demonstrable in the ortho-position, impairment of physiological stability between aldosterone levels in the luteic and folliculin phases; a decrease in progesterone level in the luteic phase; a decrease in the absolute amount of estrogens in the folliculin phase and relative hyperestrogeny in the luteic one; an increase in prolactin content in the early folliculin phase in a considerable number of patients (50%). It is assumed that deviations described might be involved in the formation of edemas.

[Neurogenic mechanisms of the idiopathic edema syndrome]. / Neirogennye mekhanizmy sindroma idiopaticheskikh otekov.

Clinical and experimental studies on cerebral components, emotional-motivation--personality sphere, vegetative nervous system and their relationships were carried out in 31 women suffering from idiopathic edema. Three neurogenic factors (psychological, hypothalamus dysfunction and brain homeostasis disorder) influence the disease pathogenesis. It has been demonstrated that these factors correlate well with endocrine and vegetative disorders being the pathological basis of the disease. It is concluded that the neurogenic factors play a different role in the disease pathogenesis. Severe forms of the disease are characterized by cerebro-endocrine mechanisms of the fluid retention, and mild cases by psychovegetative ones.

[Aldosterone and progesterone content and blood renin activity in women with idiopathic edema syndrome in various phases of menstrual cycle]. / Soderzhanie al'dosterone, progesterona i aktivnost' renina v krovi u zhenshchin s sindromom idiopaticheskikh otekov v razlichnye fazy menstrual'nogo tsikla.

Aldosterone and progesterone content and renin activity were studied by the radioimmunological method in women with the idiopathic edema syndrome and in healthy women in various phases of the menstrual cycle. The most significant differences were revealed in the luteinic phase of the cycle. A parallel elevation of the renin activity and of the aldosterone level against the background of a high progesterone level occurred in healthy women at this phase. Patients showed greater increase in the aldosterone level with the reduction of renin activity and a low progesteron level. Hyperaldosteronism was observed in patients with the idiopathic edema syndrome in all the phases of the cycle. It is suggested that an excessive elevation of the aldosterone level and a decrease in the progesterone level in the luteinic phase of the cycle could served as one of the pathogenetic mechanisms of the edema syndrome formation.

[A fluorescent method of determining aldosterone in urine]. / Fliuorestsentnyi metod opredeleniia al'dosterona v moche

The authors suggest a method of aldosterone determination in the urine. Aldosterone is extracted from the sample and purified with the aid of columnar and thin-layer chromatography on silicagel. Aldosterone is distinctly identified in ultraviolet light on the chromatogram by its green fluorescence developing after sprinkling the plate with phosphoric acid and its subsequent heating. Quantitative determination is carried out by the measurement of the intensity of aldosterone fluorescence in sulfuric acid.

[Excretion of aldosterone in the urine, renin activity in the plasma and some indices of the metabolism of potassium and sodium in patients with the iodiopathic edema syndrome]. / Ekskretsiia al'dosterona s mochoi, aktivnost' renina v plazme i nekotorye pokazateli obmena kaliia i natriia u bol'nykh s sindromom idiopaticheskikh otekov

It appeared that urinary aldosterone excretion was increased in 23 of 35 patients with a syndrome of idiopathic edema. The plasma renin activity failed to differ from the norm; consequently it can be supposed that the renin-angiotensin system played no significant role in the mechanism of hyperaldosteronism development in this form of pathology. A negative sodium balance was revealed in some of the patients with an edema syndrome and hyperaldosteronism.