Endocrinologia experimentalis最新文献

Endemic goiter still occurs in several European countries. Alimentary iodine deficiency could be proved as the main cause of endemic prevalence. Extensive epidemiologic surveys showed the great medical and economical impact of this matter for the GDR. Over 200 million Marks might be spent for diagnosis and treatment of thyroid patients per year. Also in the field of veterinary medicine and animal production iodine deficiency plays an important role. Under the conditions of iodine deficiency the fodder containing nitrate and glucosinolates (e.g. bruised rape extraction) results in additional goitrogenic effects (so-called indirect or relative iodine deficiency). Due to iodine deficiency disorders considerable losses of yields in cattle, pigs and sheep occurred. The content of iodine in animal products used for human nutrition was subsequently low. Considering the ecological implication of these problems an Interdisciplinary Iodine Commission within the Society for Endocrinology and Diseases of Metabolism of the GDR was established. Together with the governement authorities it worked out corresponding recommendations for the prophylaxis and control of its efficiency. In 1986 the iodination of most of the packed salt (32 mg KIO3/kg = = 19 mg I/kg) and the administration of iodinated mineral mixtures for the animal production were started for pigs in the whole territory of GDR and for cattle in the southern counties of the GDR only. These activities have been accompanied by information of TV as well as in the newspapers and medical journals. Thus, an improved supply of iodine to the population through iodinated table salt and animal products can be taken into account. The efficiency of these prophylactic measures is controlled interdisciplinarily.(ABSTRACT TRUNCATED AT 250 WORDS)

Ethnic Gypsies represent 9 percent of total population of East Slovakia. However, during first three and half years of compulsory screening of congenital hypothyroidism (CH) there were 15,346 Gypsy newborns which was 16.8 percent of a total number of 90,760 newborns. Out of these Gypsy newborns 7 cases of CH were found (i.e. 1:2192), while 12 cases of CH were observed among 75,414 white newborns (i.e. 1:6284), which was significantly less than that in newborns Gypsies (P less than 0.05). Since the far highest coefficient of inbreeding ever reported for any European population or ethnic groups has been found by others in newborns Gypsies living in Slovakia (Fg = 0.017 obtained by genealogic method and Fi = 0.084 obtained by the method of isonymy), it may be suggested that a high incidence of CH in newborns Gypsies may be due to some genetic and hereditary factors. Though a direct interrelationship cannot be definitely established from the present data and still remains far from to be elucidated, the present observation may be considered as a contribution to the study of this problem.

The data on postmortem thyroid weight and on thyroid volume estimation with the aid of ultrasound are briefly reviewed and correlated with indicated or presumed intake of iodine in the appropriate area. The well known negative correlation between iodine intake and thyroid size may be supported even by this approach which shows that as a normal thyroid volume may be taken that obtained in areas with sufficient iodine intake such as Iceland, Sweden, Netherlands and USA. In these countries the average thyroid volume was found by various authors to be in a range of about 8 to 12 ml (or g) for females and about 11 to 15 ml (or g) in males which is approximately 10 ml (or g) less than the values considered as normal until recently. The comparisons of the data on postmortem weight or sonographically determined volume of the thyroid with palpatory findings showed that the same stage of thyroid size according to various recommended scales as found by palpation or inspection may correspond to a great variety of actual volumes and thus that the palpation may be considered as highly inaccurate method for precise estimation of thyroid size. From this view it may be recommended predominantly for large scale and low cost field epidemiological studies, while a most favourable ultrasonographic volumetry should be used for a majority of basal clinical studies and field surveys.

The experience obtained in one of two Hungarian screening centers for congenital hypothyroidism (CH) is reported which is based on the examinations of dried blood samples tested with the aid of TSH-RIA developed in this laboratory. During the past six years (1982-88) and CH was diagnosed in 54 cases out of a total of 306,265 newborns (prevalence: 1:5470). The recall rate because of increased TSH values was 0.28-0.29% within the last two years. The triple of this had to repeat for technical reasons (imperfect samples, borderline results). Within the last year the treatment of diagnosed infants with L-thyroxine was started at the average age of 13 days. The history of three missed cases is briefly reported. Four out of 54 patients (7.4%) died in infancy. Since the pituitary sensitivity for TSH suppression by replacement doses of L-thyroxine appeared to be decreased in several cases, the control of free thyroxine levels is preferred to avoid the clinical hypo- or hyperthyroidism. The shortening of the present three days TSH RIA method, the extension of systematic examination of TSH binding antibodies and psychological studies are in progress.

Regular examinations of thyroid function in newborn infants were started in the district of Praha 10 in 1975. Later the incidence of congenital hypothyroidism in Czechoslovakia was assessed in a pilot study including several centers in 1981. As a screening method we used the estimation of total thyroxine (T4) in a dried spot of blood obtained from a heel prick on the fifth day after birth. A total of 45,535 newborns was screened by such method and the incidence was 1:5059 of live born infants. Since 1985 the screening of congenital hypothyroidism has been extended to cover the whole territory of Czechoslovakia. Three screening centers (in Praha, Brno and Banská Bystrica) are responsible for carrying out this screening program. The first screening method employed was the determination of total thyroxine in a dried spot of blood on filter paper as mentioned above. By the end of December 1987, 313,618 samples from newborns have been assayed in Bohemia and Moravia. The incidence of congenital hypothyroidism was found to be 1:5700 of live newborn infants. The treatment of detected cases was started before the end of the first month after birth which ensured normal development of children thus afflicted. When T4 was the first method employed, a relatively high incidence of altered TBG (thyroxine binding globulin) production (1:6400) was encountered, especially in boys.

In the introduction the results of previous retrospective study (1975-79) including 312,259 newborns and of preliminary screening program including 31,780 newborns are briefly summarized. After January 1st, 1985 a compulsory screening of congenital hypothyroidism (CH) was started in the whole territory of Slovakia using the estimation of thyroxine in dry blood spot obtained from a heel prick on 5th day after birth. In suspected cases a complete clinical and laboratory examination was made including TSH estimation by RIA and after January 1st, 1988 by IRMA. The organization of screening program is described in detail. During three and half year period 286,469 newborns were examined which represented almost 100 percent of all newborns. A total of 44 cases of CH was found out of them 13 cases of athyreosis, 3 cases of ectopic thyroid and 28 cases of dyshormonogenesis (among them 5 cases with goiter and 23 cases without goiter). The average incidence of CH was 1:6874. Until January 1st, 1988 (when only T4 estimation was used as a first step) the recall rate was 2.32% and the treatment was started before 25th day after birth, while after the use of TSH by IRMA from dry blood spot in suspected cases (i.e. after January 1st, 1988) the recall rate decreased to 0.82% and the treatment was started before 14th day of life. In addition, the data on 39 cases of TBG deficiency and on regional differences in their incidence are reported. Some remarkable differences in the incidence of total CH and of its individual variants between West, Central and East Slovakia with different historical, cultural, economical and genetical background as well as in some ethnic groups (Gypsies) are also presented.

Two preliminary pilot studies of prevalence of thyroid disorders in Central Bohemia (with mild endemy before the onset of iodine prophylaxis in 1948) were made: 1. Questionary survey of adult persons in Praha (1559 persons); 2. Clinical and laboratory investigation of 2015 employees of SKODA automobile works in Mladá Boleslav. Prevalence of thyroid disorders in Praha was 11.99%. In randomly selected subjects from Mladá Boleslav (evaluated in two periods after 10 years) the prevalence of clinically manifested thyroid disorders was 0.35% in men and 2.32% in women, respectively, the presence of positive titres of antithyroglobulin antibodies, varied from 2.43-6.11% of high titres and from 2.35 to 17.33% of low titres. However, the prevalence of goiter was markedly higher than expected, since diffuse goitre was found in 8.36% of men and in 11.34% of women. Even more striking was the prevalence of nodular goitre which was 5.59% in men and 22.96% in women thus making the total goitre prevalence of 13.95% in men and 34.30% in women. In addition, an unfavourable increase of prevalence of nodular goitre was found in younger women in comparison with older group. These results, although preliminary, pointed out the necessity of further more extensive and intensive studies of prevalence of thyroid disorders and of methodology of iodine prophylaxis.

Thyroid volume by ultrasonographic volumetry was estimated in a total of 427 boys and 425 girls aged 7 to 16 years from East Slovakia. It was found that the volume is increasing by age and body weight, being in average about 2.5 ml in 7-8 years old, 3.5 to 4.5 ml in 9-12 years old, 5.2-6.0 ml in 13-14 years old and, as reported previously, 11-12 ml in 15-16 years old. Comparing these results to the findings reported from other countries, it may be concluded that in 13-14 years old schoolchildren the thyroid volume was about twice as high as reported for the same age group from Sweden (with presumably sufficient iodine intake) and by about 20 percent less than found in 13 years old schoolchildren in Federal Republic of Germany (with insufficient iodine intake). The average thyroid volume found in pubertal adolescents aged 15-16 years closely resembled that found in Federal Republic of Germany and was even higher than that found in adults from Sweden and Netherlands where the iodine intake is considered to be sufficient. Palpatory findings according to WHO scale showed 21 percent of goiter stage 1a in boys aged 7-14 years and 24 percent in girls of the same age group, while such values were 23 and 27 percent for boys and girls aged 15 and 16 years, respectively. In addition, in those aged 15-16 years about 3 percent of goiter stage 1b were found, while in those aged 7-14 only 3 cases of goiter stage 1b out of 425 examined were observed. It may be concluded that the present status of thyroid size in examined group closely resembles the first grade endemy of goiter as defined recently by Hetzel and, moreover, it may be suggested that the intake of iodine about 100 micrograms daily (which was recently reported by other authors from Czechoslovakia as based on urinary excretion of iodine) apparently does not fully prevent the development of goiter stage 1 in a considerable amount of children and adolescents.

The effect of estradiol on phosphorylation with gamma-32P-ATP of ribosome proteins from polyribosome fraction, isolated from female rat liver is found out. Rats (180 g) used were: sham-operated, ovariectomized and treated after ovariectomy for 11 days with 20 micrograms 17 beta-estradiol-dipropionate per 100 g body weight. The estradiol deficiency after ovariectomy decreased phosphorylation, but the estrogenization of ovariectomized rats increases it twice. In vitro the hormone (1-2 mumol/l) [corrected] also stimulated ribosome protein phosphorylation. It is supposed that the hormone may take part in the regulation of protein synthesis in the translational region of the process.

The effect of estradiol valerate and progesterone on mammary growth of prepubertal (20, 25 and 30 days of age) female and prepubertal (15, 20 and 30 days of age) and adult male C3H/Di mice were studied. Estradiol treatment had no effect on mammary growth in 30 day old females, but mammary growth of 20 and 25 day old females showed clear inhibition. In contrast, treatment with progesterone alone stimulated both the growth of ducts and formation of alveolar buds. In males, the injection of estradiol valerate resulted in a stimulation of the growth of mammary rudiment. The treatment with progesterone alone stimulated the growth of mammary ducts and the formation of alveolar buds in males treated from day 15 and 20 of age, while mammary growth of those treated from day 30 of age was low and the growth of mammary rudiment of adult males was not stimulated at all. The mammogenic effect of progesterone was not affected by time of weaning of males but it was inhibited by simultaneous application of testosterone. An age dependent decrease of the mammogenic effect of progesterone in males is related to an increase in plasma concentration of testosterone.