[Thyroid irradiation doses and organization of endocrinological monitoring of the inhabitants of the Ukrainian S.S.R. after the accident at the Chernobyl AES]. / Pogloshchennye dozy v shchitovidnoi zheleze i organizatsiia éndokrinologicheskogo monitoringa zhitelei USSR posle avarii na Chernobyl'skoi AES.

The paper is devoted to one of the most important aspects of the accident at the Chernobyl Nuclear Power Station: thyroid irradiation in the residents of 8 areas in the Ukrainian SSR and the town of Pripyat, affected with radioactive iodine. Irradiation doses, prognosis of medical effects of the accident, methods and practical measures for the organization of endocrinological monitoring of the affected population were thoroughly considered. The authors proposed a scheme of health care of the population in these areas. They also discussed the structure of data bases for analysis of medico-dosimetric information on "iodine" effects of the accident. The main trends in medico-dosimetric problems of the effects of thyroid irradiation were outlined.

[Clinical-immunological characteristics of the state of the thyroid gland in children exposed to ionizing radiation because of the Chernobyl AES accident]. / Kliniko-immunologicheskaia kharakteristika sostoianiia shchitovidnoi zhelezy u detei, podvergshikhsia deistviiu ioniziruiushchego izlucheniia vsledstvie avarii na Chernobyl'skoi AES.

Overall 806 children evacuated from the city of Pripyat were examined for the thyroid condition. The children who received a dose of more than 30 rad for the thyroid manifested primary response in the form of euthyroid hyperthyroxinemia, a high risk of the development in future of autoimmune diseases in the lack of hypothyrosis.

[Characteristics of the course of pregnancy and labor in women with Cushing's syndrome and the condition of their progeny]. / Osobennosti techeniia beremennosti i rodov u zhenshchin s bolezn'iu Itsenko-Kushinga i sostoianie ikh potomstva.

An analysis of gestational and obstetric histories of 40 women with Cushing's disease has shown that pregnancy is contraindicated during an active phase or partial clinical remission of the disease. Pregnancy is permissible at a prolonged time following the onset of a stable clinical and hormonal remission, bilateral total adrenalectomy and compensation of chronic adrenal insufficiency. No specific therapy is required in the former situation. The adrenalectomized patients need an intensification of replacement therapy and switch to parenteral glucocorticoids ante-, intra- and postpartum. Twenty infants of mothers with Cushing's disease were examined and found to have a normal clinical and endocrine status.

[Dynamics of the corticotropin, cortisol and prolactin content of the blood plasma of women with Itsenko-Cushing disease administered luliberin]. / Dinamika soderzhaniia kortikotropina, kortizola i prolaktina v plazme krovi zhenshchin s bolezn'iu Itsenko-Kushinga pri vvedenii liuliberina.

The paper is concerned with the results of a study of the level of plasma ACTH, cortisol and prolactin before and after i. v. injection of LHRH to 20 patients with Itsenko-Cushing disease and to 5 healthy persons. In healthy persons LHRH injection caused no significant changes in the level of plasma ACTH, cortisol and prolactin. Patients with Itsenko-Cushing disease who had a high basal level of corticotropin on the 30th min after i.v. LHRH injection demonstrated a significant increase in the hormone level. A response to LHRH injection was absent in patients with a normal basal level of corticotropin and in healthy persons. A statistically significant increase in cortisol concentration was noted on the 60th min after LHRH injection in some of the patients responding to LHRH by a high ACTH level. LHRH injection was not accompanied by significant changes in the level of plasma prolactin in either of the subgroups.

[New method of treating Itsenko-Cushing disease by transvenous destruction of the adrenals]. / Novyi metod lecheniia bolezni Itsenko-Kushinga chrezvenoznoi destruktsiei nadpochechnikov.

A new method was developed for therapy of Icenko-Cushing's disease using transcatheter transvenous destruction of the adrenals (TTDA) to replace commonly used adrenalectomy. TTDA was performed by means of venous extravasation of a radiopaque agent (76% verografin solution) and its deposition in the organ parenchyma. TTDA was performed in 57 patients with Icenko-Cushing's disease using 3 tactical approaches including roentgenovascular intervention: bilateral TTDA, unilateral TTDA combined with unilateral adrenalectomy and unilateral TTDA combined with chloditan. TTDA is an effective method of invasive suppression of function of the cortex of the endocrine glands. TTDA superiority over surgical methods of therapy Icenko-Cushing's disease is that an effect of adrenalectomy is achieved without a risk of surgical intervention and narcosis.

[Experimental and clinical basis for using the preparation nacom in the treatment of Itsenko-Cushing disease]. / Eksperimental'no-klinicheskoe obosnovanie primeneniia preparata nakon dlia lecheniia bolezni Itsenko-Kushinga.

The paper is concerned with the results of an experimental study of the nacom (NC) effect on the activity of the hypothalamohypophysioadrenal system and the results of its application to 29 patients with Icenko-Cushing's disease with curative purposes. In rats the concentration of corticotropin and aldosterone was determined with a radioimmunoassay, that of corticosterone with a competitive protein binding method. The dopamine content in the hypothalamus and cerebral cortex was studied by fluorimetry. To define the hypothalamohyphysioadrenal system in the patients a study was made of blood corticotropin, cortisol and aldosterone basal levels as well as response of the system to insulin hypoglycemia induced stress. Dopaminergic NC was shown to be dose-related with the activity of the hypothalamohypophysioadrenal system. The NC effect was associated with an increase in the dopamine level in the hypothalamus and cerebral cortex. Clinical investigations proved NC efficacy for therapy of Icenko-Cushing's disease permitting one to recommend it as a pathogenetic agent for therapy of this disease.

[Testosterone content of the blood in women with Itsenko-Cushing disease]. / Soderzhanie testosterona v krovi zhenshchin s bolezn'iu Itsenko-Kushinga.

The paper is concerned with the results of a study of the testosterone content in the blood of 68 women with the Itsenko-Cushing disease at different stages of therapy. The testosterone level was elevated in the blood of untreated patients at the stage of exacerbation and remission following various therapeutic modalities including khloditan and returned to normal after bilateral total adrenalectomy. It is assumed that the source of testosterone hyperproduction in the Itsenko-Cushing disease is the adrenals.

[Criteria for the selection of drugs for the pathogenetic treatment of Itsenko-Cushing disease]. / Kriterii vybora preparata dlia patogeneticheskogo lecheniia bolezni Itsenko-Kushinga.

The authors presented the results of a study of the level of corticotropin and cortisol in the blood at different time after a single intake of peritol or parlodel in 48 patients with Icenko-Cushing disease at the active stage. Corticotropin and cortisol concentrations were determined by radioimmunoassay with the help of standard kits. The study showed a different sensitivity of patients with Icenko-Cushing disease to peritol and parlodel. According to the expression of the reaction of the hypophyseal-adrenal system all the patients were divided into the following groups: with a noticeable reaction to one or both drugs, with a slightly noticeable decrease in the level of hormones or a paradoxical reaction to the drugs. A single test with inhibitors of hypophyseal corticotropic function provided an opportunity for an individual choice of an effective drug for pathogenetic treatment of patients with Icenko-Cushing disease. The optimum time for blood examination to determine the concentration of corticotropin was 1 and 2 hrs, the level of cortisol 2-4 hrs after the intake of peritol and parlodel.

[Interrelation of disorders in gonadotropin and prolactin secretion and the activity of the hypothalamo-hypophyseal-adrenal system in Itsenko-Cushing disease]. / Vzaimosviaz' narushenii sekretsii gonadotropinov i prolaktina i aktivnosti gipotalamo-gipofizarno-nadpochechnikovoi sistemy pri bolezni Itsenko-Kushinga.

An obvious relationship between changes in ACTH, gonadotrophin, prolactin and cortisol secretion was discovered on the basis of studying the basal ACTH, cortisol, LH, FSH and prolactin levels, as well as from correlative examination of the data obtained in 30 females with Icenko-Cushing's diseases. It is suggested that combined ACTH, gonadotrophin and prolactin secretion occurs in the active stage of the disease, whereas cortisol inhibits gonadotrophin production. A degree of gonadotrophic insufficiency is dependent on the ratio of excessive ACTH-cortisol secretion.

[Diagnosis of adrenal cortex diseases using radioimmunoassay of hormone levels in blood samples from the inferior vena cava and its tributaries]. / Diagnostika zabolevanii kory nadpochechnykh zhelez s pomoshch'iu radioimmunologicheskogo analiza soderzhaniia gormonov v probakh krovi iz nizhnei poloi veny i ee pritokov.

To diagnose the Icenko-Cushing syndrome and disease, samples of the venous blood were taken from the inferior vena cava, the renal and adrenal veins of 51 patients to determine hydrocortisone and ACTH. Thirty-nine patients showed a tendency to an increase in the basal level of hydrocortisone in the blood from the inferior vena cava and the renal veins and a significant elevation of its concentration by approximately an equal value in the blood from both adrenal veins. The ACTH content in their blood was elevated, all these indicating the presence of primary disorders in the hypothalamus-hypophysis system and the secondary involvement of the adrenal cortex in the pathological process, i.e. the Icenko-Cushing disease. Different changes of the hydrocortisone content in some places of the venous blood sampling were observed in 12 patients. A significant difference in the hydrocortisone concentration from the left and right adrenal veins and a decrease in the ACTH level in the blood were observed. Such a combination of the signs points to the presence of an autonomous hormone producing adrenal tumor (the Icenko-Cushing syndrome). The results of measurement of the hydrocortisone concentration in the blood within a group of patients with suspicion of corticosteroma recurrence were taken into account to select an appropriate therapeutic method.