[Somatotropic function of the pituitary gland in patients with genetically determined forms of growth retardation]. / Somatotropnaia funktsiia gipofiza u bol'nykh s geneticheski determinirovannymi formami zaderzhki rosta.

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.

[The transplantation of beta-cell cultures in the treatment of insulin-dependent diabetes mellitus in children]. / Transplantatsiia kul'tur beta-kletok v lechenii insulinzavisimogo sakharnogo diabeta u detei.

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.

[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.

[Tactics of examining patients with unpalpable testis redux]. / Taktika obsledovaniia bol'nykh s nepal'piruemymi neopushchennymi iaichkami.

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.

[The use of klofelin for studying somatotropin secretion in children]. / Primenenie klofelina dlia izucheniia sekretsii somatotropina u detei.

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.

[Contents of gonadotropic and sex hormones in the blood of healthy children]. / Soderzhanie gonadotropnykh i polovykh gormonov v krovi zdorovykh detei.

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.

[Problems of pathogenesis of ovarian and idiopathic hirsutism]. / Voprosy patogeneza ovarial'nogo i idiopaticheskogo girsutizma.

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.

[Characteristics of prolactin secretion in patients with different types of gonadal dysgenesis]. / Osobennosti sekretsii prolaktina u bol'nykh s razlichnymi vidami disgenezii gonad.

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.

[Experience with the treatment of children with diabetes mellitus using allo- and xenografts of cultures of pancreatic islet cells]. / Opyt lecheniia detei, stradaiushchikh sakharnym diabetom, pri pomoshchi allo- i ksenotransplantatsii kul'tury ostrovkovykh kletok podzheludochnoi zhelezy.

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.

[Use of the antiandrogen niftolide for studying reserves of the hypothalamo-hypophyseal system in patients with male hypogonadism]. / Primenenie antiandrogena niftolida dlia issledovaniia rezervov gipotalamo-gipofizarnoi sistemy u bol'nykh muzhskim gipogonadizmom.

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.

[New functional test using the antiandrogen niftolid for studying the gonadotropic reserves of the hypothalamo-hypophyseal system]. / Novaia funktsional'naia proba s primeneniem antiandrogena niftolida dlia issledovaniia gonadotropnykh rezervov gipotalamo-gipofizarnoi sistemy.

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.

[Gonadotropic function of the pituitary gland in patients with intersexualism and gonadal dysgenesis]. / Gonadotropnaia funktsiia gipofiza u bol'nykh s interseksualizmom i gonadal'nym disgenezom.

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.

[Detection of the heterozygote carrier state for the gene of congenital virilizing adrenal cortical hyperplasia by the blood testosterone level]. / Vyiavlenie geterozigotnogo nositel'stva gena vrozhdennoi viriliziruiushchei giperplazii kory nadpochechnikov po urovniu testosterona krovi.

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.