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Altogether 144 patients with various forms of retardation of growth aged 1 to 24 were investigated. Somatotropic function of the pituitary body was assessed by the results of a stimulation test with clopheline. A STH level was determined by a radioimmunoassay. Somatotropic function was undisturbed in an overwhelming majority of cases of genetically determined retardation of growth. Hormone therapy was not indicated in these cases as it could lead to unfavorable results: decreased indices of definitive growth resulting from the formation of antibodies to the growth hormone.

Over 100 transplantations were performed in 86 children and adolescents with a severe course of insulin dependent diabetes mellitus. A good effect was achieved in 81 +/- 6%, in other cases the effect was uncertain. Therapy resulted in a significantly higher rate of cases of stable compensation with a lesser number of injections and a stable dose of insulin, in stabilization and regression of some complications. Transplantation was followed by an increase in the level of C-peptide 3-4 times as compared to the basal one for a period of 6 mos. A better effect was noted in a group of patients with a high residual secretion of C-peptide. An assumption was made of simultaneous secretory activity of a graft and residual beta-cell-stimulated endogenous production of insulin.

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.

As many as 117 patients with inpalpable testis redux were examined. They had undergone selective testicular venography with measurements of testosterone content in random blood samples after stimulation with human chorionic gonadotropin. The data obtained during all-round investigation make it possible to estimate the morphological status of the testes and their functional reserves. This forms the basis for recommending an optimal treatment method in each specific case of inpalpable testis redux.

Radioimmunoassay was used to study the blood content of LH and FSH in 116 patients aged 1 to 36 years with abnormalities of sexual development (false male hermafroditism, false female hermafroditism, true hermafroditism and gonadal dysgenesis). With a view of control the content of gonadotropins was measured in 92 subjects (33 females and 59 males) of the same age. The data were evaluated in accordance with the age and genetic sex of patients. It was shown that in health, the concentration of LH and FSH reflected the process of puberty, permanently growing until 18 years, whereas in patients, the age-related time course was less consistent. Unidirectional changes in the hormonal level (towards its rise) were common to all the forms of abnormal sexual development. In all the examinees, the pattern of changes in gonadotropic activity reflected the features of the formation of the neuroendocrine mechanisms by which the sexual system is controlled in ontogenesis.

The paper is concerned with the study of the results of allo- and xenotransplantation of pancreatic islet cell culture to 44 children aged 1.5 to 15 suffering from a severe form of insulin dependent diabetes mellitus. An impossibility to achieve stable compensation of disease with routine therapy and complications of diabetes mellitus were the main indications for transplantation. Transplantation of beta-cell culture can be recommended as one of the methods of adjuvant therapy of juvenile diabetes.

Genitography was performed in 60 patients with different sexual abnormalities. The main types of the structure of external and internal genitals were revealed. Genitography can be used in any age, including the 1st year of life. It allows one to take timely measures in determining the civil sex of the infant and early planning the correcting surgery. The data obtained indicate this method to be of interest in the examination of patients suffering from intersexuality.

A study was made of the level of prolactin in the blood plasma of 55 patients aged 16 to 23 with different types of gonad dysgenesia. It was shown for the first time that in most of the patients with gonad dysgenesia disregarding pathology type the level of prolactin did not differ from that in the follicular phase of the menstrual cycle of healthy girls, and was significantly decreased as compared to the level of this hormone in the luteal phase. Estrogen therapy caused a considerable rise of the prolactin level in all the examines. The detection of hyperprolactinemia in patients with gonad dysgenesia can indicate a possibility of the development of microadenomas of the hyperstimulated hypophysis in them.

A study was made of a possibility to use a test with the administration of the nonsteroid antiandrogen flutamide to male patients with testicular hypogonadism to evaluate the gonadotropic reserves in this pathology and differential diagnosis of the pathogenetically different forms of this diseases in male patients aged 12 to 33. Flutamide was prescribed for internal use, 10 mg/kg a day for 5 days. Functional reserves of the hypothalamo-hypophyseal-gonadal system were estimated by the change of LH secretion with morning and daily urine after 3 and 5 days as well as by the LH, FSH and T content in the blood plasma. A significant rise of LH excretion with morning and daily urine was noted in patients with primary hypogonadism receiving flutamide. On the contrary, no significant changes in LH secretion under the influence of flutamide were detected in secondary hypogonadism. It is suggestive of the preservation of the gonadotropic reserves in primary hypogonadism and their absence in secondary hypogonadism. The test is proposed for differential diagnosis in diagnostic difficulties. The most accurate results are obtained by using LH in the urine collected for 3 days of flutamide intake.

On the basis of analysis (with the aid of the "Minsk-22" computer) of the data on the information character of 485 signs in hypophyseal, hypothalamic, thyrogenic, somatogenic nanism spondylo-epyphyseal dysplasia ans Shereshevsky-Turner's syndrome the authors selected 50 signs with the greatest diagnostic value. These signs were assessed and graded by marks; a diagnostic table was elaborated with the aid of which a correct diagnosis with the probability of over 0.90 was established in 72 per cent of cases.

The content of total testosterone (T), dehydrotestosterone (DHT), androstenedione (A), estradiol (E2), luteotropin (LH) and follicle-stimulating hormone (FSH) was studied in patients with ovarian and idiopathic hirsutism by a radioimmunoassay. The level of T-E-binding globulin (TEBG) was determined by 3H-DHT binding. Concentrations of free and TEBG-unbound T, DHT and E2 were calculated on the basis of the mass action law. The level of free and TEBG-unbound T and DHT was found to be the most reliable marker of the excessive production of androgens in hirsutism. The level of total T and DHT was raised in 50-60% of patients with hirsutism. Patients with hirsutism of ovarian genesis were characterized by considerable blood elevation of LH and FSH with still greater values in patients with menstrual disturbance, and by a rise of an A level. Difference found in hormonal indices can be used in differential diagnosis of ovarian and idiopathic hirsutism.

A study was made of a possibility to use a nonsteroidal antiandrogen flutamide to investigate the gonadotropic reserves of the hypothalamo-hypophysial system. In healthy males aged 12 to 36, the intake of flutamide tablets at a dose of 10 mg/kg bw for 3 or 5 days was accompanied by an increase in the LH excretion and general gonadotropic activity in the daily urine by 1.5-2 times and more. An elevation of the gonadotrophin level in morning urine portions was less noticeable. The LH level in the blood plasma did not change, that of FSH and testosterone increased but in certain age groups. For purposes of functional diagnosis it was suggested that the gonadotrophin level in the daily urine should be studied prior to and after 3- or 5-day of flutamide intake.

The blood content of follicle-stimulating, luteinizing hormones, prolactin, testosterone and estradiol was measured in 343 normal children (181 boys and 162 girls) aged 1 month to 16 years by radioimmunoassay with the aid of standard commercial kits. Standardized age- and sex-associated indicators have been elaborated. The time-course of changes in the hormonal content during puberty has been characterized.

The study of genealogy of the families with cases of congenital adrenocortical virilizing hyperplasia allowed one to suggest a possibility of the heterozygous bearing of a pathological gene. The investigation of the plasma testosterone level in the parents of children with the adrenogenital syndrome has shown that an increase in the blood circulating testosterone level 1.6 to 4 times compared with normal may serve as a marker of heterozygosis for this disease.

The authors studied the state of the nervous system in 29 patients with hypophyseal and 25 patients with cerebral nanism. In was demonstrated that in cerebral nanism, unlike hypophyseal, there are signs of the nervous system lesions on different levels. A REG study of the state of cerebral vessels in 14 patients with hypophyseal and 17 patients with cerebral nanism demonstrated that in patients with hypophyseal nanism the vascular condition practically did not differ from normal children of the same age, while in cerebral nanism there was an irregularity of the rheographic waves, an increased cerebral-vascular tone and a significant intrahemispheric asymmetry of the pulse blood flow. These data may be used for differential diagnosis of hypophyseal and cerebral nanism.

The authors present the results of study of the somatotropic function of the hypophysis in 18 healthy children and in 70 patients suffering from various forms of growth retardation. The blood serum level of the STH of the hypophysis was studied by the authors by standard sets for radioimmunological determination on fasting stomach and in dynamics during the standard glucose-tolerance test. The data of basal, maximal and mean STH levels were taken into consideration. Investigations revealed a reduction of the somatotropic function of the hypophysis in the patients with hypophysial, cerebral and somatotropic nanism. With the first tow forms of growth retardation the disturbances were associated with the organic affections of the hypophysis or of the hypothalamus, and in the somatogenic one- they were functional. Somatotropic function was retained in spondylo-epiphysial dysplasia and in the patients with thyrogenic nanism given displacement therapy. In the patients with the Shereshevsky-Turner syndrome the STH secretion remained unchanged, but the reaction of the hypothalamo-hypophysial system to the functional distrubances was disturbed. An increase of the mean STH level followed complex therapy.

The blood plasma testosterone content was determined by radioimmunological method in patients with hirsutism, premature sexual maturation, false male hermaphroditism, true hermaphroditism, mixed gonad dysgenesis, adrenogenital syndrome, and also in some mothers of patients suffering from intersexualism and in healthy persons. The testosterone concentration proved to depend on clinical manifestations in boys with hyper- and hypogonadism and in girls with adrenogenital syndrome. In intersexual conditions in the presence of mixed gonad dysgenesis the testosterone level was found to be intermediate between the normal values in men and women of the same age. By the testosterone level patients with false male hermaphroditism were divided into two groups: with absolute androgen insufficiency and with disturbed receptor testosterone sensitivity.

Function of the insular apparatus of the pancreas was studied in 12 healthy children and in 86 patients with growth retardation. The content of immunoreactive insulin (IRI) in the blood serum was examined with the aid of sets for radioimmunological determination on fasting stomach and in dynamics during the standard glucose-tolerance test. Investigations carried out showed the changes in insulin secretion in the patients with growth retardation to be in different direction; these changes were independent of the form of nanism. Normal IRI curves were revealed in 36.1%, and pathological ones--in 63.9% of the patients with growth retardation. Four types were distinguished among the pathological curves; they were hyposecretory (10.5%), torpid (15.1%), hypersecretory (30.2%), paradoxic (8.1%). The established disturbances in the function of the insular apparatus of the pancreas could serve as one of the pathogenetic moments causing or aggravating the growth retardation.

A stimulation clonidine test was performed in children for a study of STH secretion. The drug was injected at a dose of 0.15 m per 1 m2 of body surface. A total of 47 children were investigated. Of them 21 were healthy, with normal growth and 26 with constitutional retardation of growth (CRG). Maximum values of STH secretion were observed 60-90 min. after clonidine administration. Mean values of a STH secretion peak exceeded the initial ones greater than 8-fold in both groups without significant differences between them. Side-effects were insignificant and of transient nature. Thus clonidine is a sensitive, easy to use and safe stimulator of STH secretion. We revealed no difference in STH secretion between children with normal growth and those with CRG.