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In a previous study the optimal TRH test dose of 1 microgram/kg (i v.) was determined in 67 infants between the ages of 2 weeks and 2 years old. At that time the following doses were tested: 0.5 microgram, 1 microgram, 1 microgram/kg, 2 micrograms/kg and 200 micrograms. In the present study the clinical application of this low dose TRH administered to children between the ages of 25 months and 16 years will be reported. There was a significant increase in TSH in all of the 70 euthyroidic children. The 30 minute values after intravenous injection of 1 microgram TRH/kg were 11.7 +/- 4.5 microU/ml (400% increase, upper threshold value 20 microU/ml). The dose of 200 micrograms TRH resulted in a 30 min value of 13.0 +/- 6.6 microU/ml in 30 of the children (430% increase, upper threshold value 20 microU/ml). In children two years old and younger these values were significantly higher. After administering 1 micrograms TRH/kg, the value 17.0 +/- 8.5 microU TRH/ml was measured in 20 children (735--400% increase) and after 200 micrograms TRH, the value 21.0 +/- 7.5 microU/ml (690--200%). The upper threshold value is 36 microU TSH/ml. The TSH basal secretion did not depend on the age of the child. The upper threshold value of 7.5 microU TSH/ml applies to children two weeks of age and older. 1 microgram TRH/kg (i. v.) is the optimal test dose for children. The higher doses do not provide any additional clinical information.

Report on a boy aged 6-1/2 years with pseudohypoparathyroidism. This is due to a genetic lack of PTH inducible adenocyclase. Even during vitamin D treatment renal camp formation by giving PTH extract cannot be stimulated, while in this situation. PTH shows a clearly phosphaturic effect. Whether this is due to a PTH potentiated vitamin D effect is discussed. The assay of camp in urine before and after stimulation with PTH extract has proved the most certain diagnostic criterion.

This is a report on two 10-year-old girls with a decompensated autonomous adenoma of the thyroid gland. Both girls were clinically euthyroid. In one girl there was no response of the thyrotropic cells of the anterior pituitary lobe to TRH stimulation for a short time during the first postoperative weeks. The diagnostic and therapeutic procedure in the case of nodular transformations in the thyroid area is discussed.

New aspects in the hormonal treatment of undescended testes have been introduced with the LH-RH nasal spray. There are 188 references on boys with 232 retained testes. A four-weeks' course with LH-RH nasal spray (1.2 mg in 24 hours) resulted in complete descension in 52% of the cases (32%-87%). In 21% of the cases, the position of the testes was improved. No success was recorded in 27% of the cases only. The author's own patients material included 40 boys with 50 maldescended testes, success being recorded in 78% of the cases. Administration of LH-RH nasal spray did not produce any side effects. Today, this method can be considered as the method of first choice in the hormonal treatment of undescended testes.