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Assessing normal growth.

Guidelines are provided to help the physician differentiate growth patterns that are normal from those that are not. Basic tools and clinical findings are described, including proper measurement of height and plotting of data on growth charts.

Adolescent↗

[Androgenic function of the adrenal cortex in girl athletes with retarded sexual development].

Diurnal excretion of 17-ketosteroids and their fractions was studied in 43 girl athletes with retarded sexual development (RSD) and 22 patients who did not go in for sports. Twenty-five healthy girls with a normal menstrual cycle constituted the control group. Athletes with RSD showed relative hyperandrogeny marked by a higher proportion of more active androgenic fractions (dehydroepiandrosterone and androsterone) in total 17-ketosteroids. Excretion of neutral 17-ketosteroids in athletes examined, as compared with non-athletes with RSD, was within age-associated norms or surpassed them. It is suggested that androgens of the adrenal cortex are involved into the pathogenesis of RSD in female athletes.

Adolescent↗

Rathke-cleft cyst.

A patient is reported who presented with signs of hypopituitarism. On surgical exploration, she was found to have an intrasellar cyst containing creamy mucoid substance resembling pus. Microscopic examination revealed the lesion to be a Rathke-cleft cyst. These rare lesions are associated with a better prognosis than the typical craniopharyngioma. The distinguishing features between a Rathke-cleft cyst and a craniopharyngioma are discussed.

Adolescent↗

[Familial hypogonadism with anosmia: Kallmann Syndrome].

The familial occurrence of hypogonadism and anosmia (Kallmann-Syndrome) is reported in a 15 5/12 year old boy and his 20 7/12 year old sister, who in addition has a ventricular septal defect. To establish the diagnosis it is important to examine the patient with hypogonadism for anosmia since voluntary information is rarely obtained. Quite often there are additional, associated anomalies which have to be searched for carefully.

Adolescent↗

[Testicular ectopia in adults].

Testicular ectopia in adults: Postpuberal ectopic testes are seen in about 0.8% of the male population thus being identical in frequency as after the first year of life. Based on our own experience with 32 cases between 1970 and 1979 the significant features of the diagnosis, potential development of malignancy, coincident subfertility and treatment are outlined: 1. In contrast to the situation of early childhood, missing puberal development during early adulthood is always indicative of absent endocrinologically active testis parenchyma. 2. Routine diagnostic work-up includes selective gonadal venography, sonography and CT-scanning may also be of diagnostic help. 3. The risk of tumor development is higher in undescendent as compared to normotopic testes preferably in abdominal ectopia; orchiopexy after the 6th year of life is not preventive in this regard. 4. Unilateral cryptorchism is associated with infertility, the exact cause is obscure, pathological changes are also seen in the contralateral normotopic testis and orchiopexy after the 2nd year of life does not improve spermatogenesis. 5. The therapeutical concept should be oriented on the patient's individual cosmetic and psychological needs and requirements in cases of testicular ablation or orchiopexy and should take, at the same time, the potential risk of malignancy into consideration. Testes prosthesis is an accept able means; in cases in which orchiopexy is easily achieved testis biopsy should be performed to rule out carcinoma in situ. Endocrine work-up is essential to characterize hormone insufficiency and to enable proper substitution.

Adult↗