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Abstract. In a total of 195 children and adolescents of both sex (mean age 12.9, range 5–17 years) with endemic non-toxic goitre the thyroidal iodine concentration (IC) was determined using X-ray fluorescent scanning on admission and during iodine (100 μg daily) and l-thyroxine (3 μg/kg body weight daily) treatment respectively. Additionally the thyroid volume was measured sonographically in a longitudinal study including 46 patients before and after 4–8 months of iodine supplementation (100 μg daily).

The IC was 305 ± 144 μg/g. It compared well with that of adult goitre patients (288 ± 109 μg/g) and was significantly inferior to the value of normal controls (389 ± 170 μg/g). Under l-thyroxine therapy the IC further decreased (243 ± 144 μg/g), whereas patients receiving iodide showed an increase of the IC (570 ± 197 μg/g). The mean TSH level fell from 2.3 ± 0.9 μU/ml to 1.4 ± 0.6 μU/ml. The average T₄/TBG (thyroxine binding globulin) ratio showed a slight increase which, however, was not significant.

The mean goitre volume decreased by 40%.

It was evidenced that iodide is useful not only in the prophylaxis of non-toxic goitre but also as a more physiologic treatment than thyroid hormones, at least for young subjects with simple diffuse goitres.

Abstract. The steroid binding capacity and concentration of plasma sex hormone binding globulin have been compared in 116 children aged between 2 and 14 years. Concentration was measured by electroimmunodiffusion standardised with reference to the mass of the pure protein and binding capacity by quantitating the binding of radiolabelled 5α-dihydrotestosterone. Binding capacity correlated highly with concentration in all subjects and neither differed significantly between the sexes before or during puberty. However, both were significantly lower in pubertal than in pre-pubertal children. These findings suggest the metabolism of the protein is similar in boys and girls and that the fall in its steroid binding capacity at puberty in fact is due to a fall in its concentration rather than to changes in its physicochemical properties.

Abstract.

The effect of iv calcium on the urinary excretion of total adenosine-3',5',-monophosphate (cAMP) and total hydroxyproline (OH-P) was investigated in 5 children with parathyroid hormone (PTH)-deficient and PTH-resistant hypoparathyroidism, two of them being normocalcaemic during the study, in comparison to 4 healthy and 8 epileptic children and adolescents. Eighteen mg/kg body weight calcium, infused over 3 h, induced a decrease of cAMP to (mean ± sd) 82.1 ± 2.5% of the baseline value in controls and to 69.8 ± 9.7% in epileptic patients with an inverse correlation to the relative increase of serum calcium after the infusion in both groups (r = −0.75, P < 0.01). In contrast, the cAMP excretion increased after calcium load in the 5 hypoparathyroid children to 118.7 ± 14.9% of baseline despite a comparable serum calcium increase. OH-P decreased to (mean ± SD) 48.0 ± 6.8% of baseline in controls, 48.2 ± 12.7% in the epileptic patients and 39.4 ± 9.8% in the children with hypoparathyroidism, the differences between the three groups being statistically not significant.

It is concluded that the simple measurement of urinary cAMP before and after calcium infusion may provide a diagnostic tool to identify hypoparathyroid patients even in the normocalcaemic state. In contrast, the measurement of the calcium-induced suppressibility of OH-P does not discriminate these patients from subjects with normal parathyroid function.

Abstract.

In 4 girls and 1 boy with pseudo-hypoparathyroidism growth and physical maturation were followed longitudinally for 7 – 13 years until adult height had been reached. As a result of early puberty and cessation of growth all patients were relatively shorter as adults than in their childhood years. The difference between average height at the age of 8.0 years and average adult height was 2.25 sd. This observation offers an explanation for the finding in the literature that short stature is more common in adults with this disease than in children. Skeletal age was advanced in all cases and the development of the tubular bones of the hand was more advanced than the development of the round bones. It is possible that this difference resulted from inappropriately early closure of the epiphyseal discs of disproportionally short metacarpals and phalanges. On the other hand it may be an aspecific phenomenon of advanced skeletal maturation.

Abstract.

Serum somatomedin B levels were determined by radioimmunoassay in 209 healthy boys and girls from one month to 16 years of age.

Low values were found up to the second year life. In the first year the mean level was 13.8 mg/l in girls and 11.5 mg/l in boys. In older children the values increased to levels between 13 and 22 mg/l in boys and between 13 and 18.5 mg/l in girls. They were independent of the stage of pubertal development.

Somatomedin B levels were normal in 71 children with constitutional growth delay, primordial dwarfism, familial dwarfism and other forms of growth disturbance. The mean levels were between 12.1 and 14.4 mg/l.

Values below 6 mg/l were present only in children with hGH deficiency. In these patients we could find an increase of the mean level from 4.3 mg/l without therapy to 9.4 mg/l under treatment.

Thus the determination of somatomedin B seems to be useful for the diagnosis of hGH deficiency.

Abstract. Luteinizing hormone (LH) bioactivity was determined by an in vitro microbioassay in 65 plasma samples from 26 infants and young children between 10 days and 6.5 years of age. In addition LH was measured by radioimmunoassay. For both, LH preparation LER-907 was used as standard.

Biologically measured LH values (bio-LH) were always higher than radioimmunologically determined LH values (RIA-LH) as reflected by bio/RIA ratios greater then 1.0.

In male infants bio-LH was elevated up to 7 months of age. Thereafter, it decreased and remained low over the age range of our study. In female infants bio-LH was also elevated, but decreased after 1 month and showed a slight tendency to rise in the age group 3–6.5 years.

The results of RIA-LH showed approximately the same pattern, but at a lower level. In boys RIA-LH levels were highest around 1 month of age, decreased steadily between 2 and 7 months and remained constant thereafter. Girls had rather constant RIA-LH values between 2 months and 3 years of age. In contrast to bio-LH, there is a clear-cut drop of RIA-LH in the age group 3–6.5 years, resulting in a statistically significant increase of the bio/RIA ratio.

In boys the time course of the bio-LH changes coincides with the known elevation of testosterone during the first months of life.

In girls the elevated bio-LH levels observed during the first month are not so far associated with a known steroid correlate.

Our study shows an increased biological activity of circulating LH and a marked dissociation of biologically and radioimmunologically active LH during early infancy, analogous to observations during puberty.

Abstract. The effect of more frequent (daily) injections of human growth hormone (hGH) on growth rate was studied in 16 growth hormone deficient children (12 boys, 4 girls) during 2 years. All had previously been treated with im injection of hGH 2–3 times weekly and in the majority of the patients a waning growth response was observed.

For a total weekly dose of 12 IU hGH a daily dose of 2 IU was injected sc at night before sleep. This dosage has been shown by us to imitate the average nocturnal hGH profile in plasma.

Growth response on the im treatment was 5.2 ± 1.2 cm/year (sd) in boys and 5.4 ± 0.9 cm/year in girls. A significant increase was seen during the first year of sc treatment to 7.9 ± 2.7 cm in boys and 6.3 ± 2cm in girls. During the second year the growth response was still significantly increased in boys (7.2 ± 1.9 cm). Bone age was more advanced and the period of previous im treatment was longer in girls (6.7 vs 3.6 years) which may be the main cause of the waning second year response (4.7 ±1.3 cm/year). Pubertal development occurred in 9 children during treatment. However, the highest growth rates were not found in these children.

Absence of antibodies against hGH and local reactions at the injection site is evidence of the safety of the treatment, which was very well accepted by the children.

Daily sc injections thus represent an effective alternative to conventional im injections ensuring high acceptance in children with growth hormone deficiency.

The aim of the present work was to obtain bone mass estimates of healthy Greek children aged 6–18 years. This work was considered worthwhile since similar data are very few in the world litterature (Bonnard 1968, Gryfe et al. 1971), while those for Greece (Livadas et al. 1975) refer to 902 children only (462 boys and 440 girls) aged 5–13 years.

The material of the present study consists of 2.406 schoolboys and 2.451 schoolgirls aged 6–18 years, of whom 864 boys and 1.189 girls were living in Attica, while the remaining 1.542 boys and 1.262 girls were living in communities outside Attica (i.e. Atalanti, Arnea, Elatia and Karpenisi). Standing body height and body weight was measured in all subjects. Furthermore, a plain x–ray of the left hand was taken in all children, using a focal distance of 80 cm.

By means of a micrometer apparatus (Taschenmessloupe TM4, C. Zeiss) the

This is a report of a case of precocious sexual development in a boy 3 years of age, due to an interstitial cell tumor of the testis. Of the eight cases of this type reported in the literature (table 2) this is the youngest and the only case in which the 17-ketosteroids have been studied.

CASE REPORT

In May 1946 a boy aged 2 11/12 years was admitted to the pediatric department of the Crownprincess Louise's Children's Hospital (K. L. V. 528/46). He was the only child of healthy parents. The boy had developed normally until the fall of 1945. Then, at the age of 2 3/12 years he began to increase abnormally in weight and height. In 5 months he gained 4 kg. and in the following 3 months he gained another 4 kg. His facial expression became coarse and his skin became seborrhoic. Coincident with this his voice

Abstract. The low molecular weight form of insulin-like growth factor binding protein (35 kD IGFBP), determined in serum by radioimmunoassay during non-fasting conditions, was high at birth and declined with increasing age during childhood and adolescence (N = 149). Inverse correlation was found between chronological age and 35 kD IGFBP values (r = −0.61, P < 0.001) during childhood and adolescence, but no age dependency was found in adult subjects aged 20–66 years (N = 73). The mean and 95% confidence limits of immunoreactive 35 kD IGFBP were 34 μg/l and 15–79 μg/l, respectively, in healthy adults (N = 73) in whom the blood samples were drawn after a one-night fast. The mean level of the 35 kD IGFBP in patients with acromegaly (19 μg/l, N = 23) was decreased by 50% in comparison with healthy adults, whereas a 2-fold elevation of the mean levels was found in both anorexia nervosa patients (70 μg/l, N = 13) and adult patients with GH deficiency (69 μg/l, N = 22). In patients with anorexia nervosa, the 35 kD IGFBP levels were inversely related to the body mass index (r = −0.65, P < 0.02).