Clinical Endocrinology

I. General Aspects of Endocrinology.- A. Introduction.- B. Biosynthesis of Hormones.- C. Hormone Secretion.- D. Hormone Transport in Blood.- E. Hormone Receptors.- 1. Functional Definition.- 2. Experimental Characterization of Specific Hormone Receptor Binding.- 3. Localization and Chemical Characterization of Receptors.- 4. Modulation of Hormone Receptor Binding: Physiological and Pathophysiological Changes in Receptor Number and Affinity.- F. Consequences of Hormone-Receptor Interaction.- 1. Hormone Effects at the Plasma Membrane.- 2. Mechanism of Action of Peptide Hormones and Amines.- 3. Steroid and Thyroid Hormones.- 4. Specificity of Hormone Action.- G. Hormones as Components of Biological Regulatory Systems.- 1. Endocrine Regulation.- 2. Cellular Regulation.- References.- II. The Hypothalamus.- A. History.- B. Introduction.- C. Definition.- D. Embryology and Anatomy.- 1. Embryology.- 2. Gross Anatomy.- 3. Histology and Immunohistology.- E. Physiology.- F. Pathology and Clinical Features.- G. Diagnosis of Hypothalamic Endocrinopathies.- H. Special Hypothalamic Syndromes.- 1. The Tuberal Form of Dystopia of the Posterior Pituitary Lobe.- 2. The Syndrome of Cerebral Gigantism.- 3. The Laurence-Moon-Biedl Syndrome.- 4. Albright's Syndrome.- 5. Hypogonadotropic Hypogonadism With or Without Anosmia (Kallmann's Syndrome).- References.- III. The Hypothalamo-neurohypophyseal System..- A. Historical Dates.- B. Embryology, Anatomy, Histology, and Ultrastructure.- 1. Neurohypophysis.- 2. Hypothalamo-neurohypophyseal Connections.- C. Pathological Anatomy.- D. Biochemistry, Transport, Inactivation, and Excretion.- E. Physiology.- 1. Place of Formation of Vasopressin and Oxytocin.- 2. Release.- 3. Action of the Neurohypophyseal Hormones.- 4. Interrelations.- F. Hypofunction of the Hypothalamo-neurohypophyseal System: Diabetes Insipidus.- 1. Definition.- 2. Incidence.- 3. Etiology and Pathogenesis of Diabetes Insipidus.- 4. Clinical Features of Idiopathic and Symptomatic Diabetes Insipidus.- 5. Special Forms of Diabetes Insipidus.- 6. Primary Polydipsia.- 7. Adipsia, Usually Associated with (Partial) Diabetes Insipidus.- 8. Differential Diagnosis of Diabetes Insipidus.- 9. Diagnosis of Diabetes Insipidus.- 10. Prognosis and Course.- 11. Therapy.- G. Inappropriate Secretion of Antidiuretic Hormone (Schwartz-Bartter Syndrome, Oversecretion of Vasopressin).- 1. Symptomatology and Pathogenesis.- 2. Differential Diagnosis and Diagnosis.- 3. Course and Therapy.- References.- IV. The Pineal Body and the Circumventricular Organs..- A. Pineal Body.- 1. Phylogenesis, Biochemistry, Physiology, and Clinical Features.- 2. Pinealomas.- B. Subcommissural Organ.- References.- V. The Adenohypophysis..- A. Historical Dates.- B. Embryology and Anatomy. A.M. Landolt.- 1. Embryology.- 2. Gross Anatomy.- 3. Histology, Immunohistology, and Ultrastructure.- 4. Hypothalamo-Adenohypophyseal Connections.- C. Chemistry, Biochemistry and Physiology of Pituitary Hormones.- 1. Prolactin.- 2. Growth Hormone.- 3. Growth Hormone-Dependent and Growth Hormone-Independent Growth Factors.- D. Pituitary Insufficiency, (Hypopituitarism), Panhypopituitarism.- 1. Classification.- 2. Occurence and Incidence.- 3. Etiology, Pathogenesis, and Pathological Anatomy.- 4. Signs, Symptoms, and Clinical Course.- 5. Differential Diagnosis.- 6. Special Forms.- 7. Course and Prognosis.- 8. Therapy.- E. Hyperfunction of the Adenohypophysis.- 1. Classification.- 2. Hyperprolactinemia and Prolactinoma.- 3. Pituitary Gigantism.- 4. Acromegaly.- 5. Gonadotropin-Secreting Tumors.- 6. TSH-Secreting Tumors.- F. Clinically Inactive Pituitary Tumors.- 1. Pathological Anatomy.- 2. Clinical Features.- 3. Therapy for Endocrine Inactive Adenomas and Craniopharyngiomas.- G. Diagnosis of the Anterior Pituitary Function.- 1. Prolactin.- 2. Direct and Indirect Examination of Growth Hormone Activity.- References.- VI. The Thyroid Gland..- A. Historical Dates.- B. Embryology, Gross Anatomy, and Histology.- C. Biochemistry and Physiology.- 1. Chemistry of the Thyroid Hormones.- 2. Hormone Biosynthesis and Release.- 3. State of Thyroid Hormones in Plasma.- 4. Peripheral Hormone Metabolism, Conversion of Thyroxine to Triiodothyronine.- 5. Mode of Action of Thyroid Hormones.- 6. Control of Thyroid Hormone Biosynthesis and Release.- 7. The Thyroid in Relation to Other Endocrine Glands.- 8. Thyroid Function During Pregnancy, Fetal and Neonatal Life, Childhood, and Old Age.- 9. Changes in Circulating Thyroid Hormone Concentrations Associated with Euthyroid States.- 10. Thyroid Function and Drug Pharmacokinetics.- D. Hypothyroidism in the Adult.- 1. Classification and Prevalence.- 2. Primary Hypothyroidism.- 3. Myxedema Coma.- 4. Secondary Hypothyroidism.- 5. Subclinical Hypothyroidism (Diminished Thyroid Reserve).- E. Hypothyroidism in Childhood.- 1. Introduction, Definition, Nomenclature.- 2. Congenital Hypothyroidism.- 3. Hereditary Defects of Thyroid Hormone Biosynthesis or Action.- 4. Secondary (Pituitary) and Tertiary (Hypothalamic) Hypothyroidism.- 5. Acquired and Juvenile Hypothyroidism.- 6. Clinical Features and Particularities.- F. Thyrotoxicosis.- 1. Definition, Classification, and Basic Thyroid Hormone Kinetics.- 2. Toxic Diffuse Goiter (Graves' Disease, Basedow's Disease, Immunogenic Hyperthyroidism).- 3. Miscellaneous Causes of Hyperthyroidism.- G. Simple Goiter and Its Variants: Euthyroid and Hyperthyroid Uni- and Multinodular Goiter.- 1. The Interrelationship Between Simple Nodular Goiter and Other Forms of Goiter.- 2. The Bewildering Nomenclature of Simple Goiter.- 3. Pathophysiology.- 4. Clinical Aspects.- 5. Treatment.- H. Endemic Thyroid Disease (Iodine Deficiency Disorders).- 1. Endemic Euthyroid Goiter.- 2. Endemic Cretinism.- I. Thyroiditis.- 1. Introduction and Classification.- 2. Acute and Subacute Nonsuppurative Thyroiditis (De Quervain's Thyroiditis).- 3. Chronic Lymphocytic Thyroiditis (Hashimoto's Thyroiditis).- 4. Chronic Invasive Fibrous Thyroiditis (Riedel's Struma).- 5. Acute Suppurative Thyroiditis.- 6. Chronic Nonsuppurative Thyroiditis Due to Specific Infection.- J. Tumors of the Thyroid Gland.- 1. Benign Thyroid Tumors.- 2. Malignant Thyroid Tumors.- 3. Treatment and Follow-up of Thyroid Carcinoma.- K. Thyroid Function Tests.- 1. General Guidelines for Choice of Tests.- 2. Basal Serum TSH and the TRH Test.- 3. Circulating Thyroid Hormones.- 4. Radioiodine Turnover Tests In Vivo.- 5. Imaging Procedures.- 6. Tests for Congenital Defects of Thyroid Hormone Biosynthesis.- References.- VII. Adrenal Cortex..- A. Historical Dates.- B. Embryology, Gross Anatomy, and Histology.- C. Biochemistry.- 1. Steroid Hormones.- 2. Stereoisomerism and Nomenclature.- 3. The Adrenocortical Hormones.- 4. The Biosynthesis of the Adrenocortical Hormones.- 5. Transport of Adrenocortical Hormones.- 6. Metabolic Breakdown and Excretion of Adrenocortical Hormones.- 7. Structure and Biosynthesis of Corticotropin (ACTH).- 8. The Hypothalamic ACTH-Releasing Neurohormone CRH.- 9. Opioid Peptides.- D. Physiology.- 1. Effects of CRH.- 2. Biologic Effects of Corticotropin.- 3. Regulation of Adrenocortical Hormone Secretion.- 4. Biologic Actions of Adrenocortical Hormones.- 5. Stress and the General Adaptation Syndrome.- E. Adrenocortical Insufficiency.- 1. Classification.- 2. Primary Chronic Adrenocortical Insufficiency: Addison's Disease.- 3. Other Forms of Adrenocortical Insufficiency.- 4. Differential Diagnosis of Adrenocortical Insufficiency.- 5. Therapy of Adrenal Insufficiency.- 6. Prognosis of Adrenal Insufficiency.- F. Hyperfunction of the Adrenal Cortex.- 1. Classification.- 2. Mineralocorticoid Excess.- 3. Cushing's Syndrome.- 4. The Adrenogenital Syndrome.- 5. Adrenal Feminization.- G. Hormonally Inactive Adrenal Tumors.- H. Assessment of Adrenocortical Function.- 1. Determination of Plasma ACTH.- 2. Plasma Renin Activity.- 3. Determination of Steroid Hormones.- 4. Stimulation Tests.- 5. ACTH Suppression Tests with Dexamethasone.- 6. Function Tests for Detection of the Source of Androgens in Hirsutism and Virilization.- 7. Indirect Evaluation of Adrenocortical Function.- References.- VIII. The Adrenal Medulla..- A. Historical Dates.- B. Embryology and Histology.- C. Biochemistry.- 1. Chemistry, Site of Formation, Synthesis and Metabolism.- 2. Storage.- 3. Release.- 4. Transport.- 5. Breakdown and Excretion.- D. Pharmacologic Influence on Storage, Release, and Inactivation of Catecholamines.- E. Physiology of the Adrenal Medullary Hormones.- 1. Actions on Organic Systems.- 2. Action on Carbohydrate and Fat Metabolism.- 3. General Action on the Organism.- 4. Regulation of the Secretion of Catecholamines.- 5. Mode of Action and Pharmacologic Influence on the Action.- F. Hypofunction.- 1. Hypoglycemia in Childhood (Adrenal Medullary Hyporesponsiveness Zetterstöm).- 2. Idiopathic Orthostatic Hypotension (Primary Autonomic Insufficiency, Shy-Drager Syndrome).- 3. Familial Dysautonomia (Riley-Day Syndrome).- 4. Lesch-Nyhan Syndrome.- 5. Adrenal Medullary Insufficiency in Severe Stress.- G. Hyperfunction: Pheochromocytoma.- 1. Incidence.- 2. Localization.- 3. Pathologic Anatomy.- 4. Clinical Picture and Symptoms.- 5. Diagnosis of Pheochromocytoma.- 6. Differential Diagnosis.- 7. Management.- References.- IX. The Testis..- A. Historical Dates.- B. Embryology, Gross Anatomy and Histology.- C. Biochemistry.- 1. Androgens.- 2. Estrogens.- 3. Gonadotropins.- 4. Gonadotropin-Releasing Hormone (GnRH).- D. Physiology.- 1. Site of Production of Testicular Hormones.- 2. Pituitary and Hypothalamic Control of Testicular Hormone Secretion.- 3. Action of Testosterone.- 4. Semen.- E. Hypogonadism in the Male.- 1. Definition.- 2. General Symptoms of Androgenic Failure.- 3. Investigation and Classification.- 4. Different Forms of Male Hypogonadism.- 5. Anti-Androgens ("Chemical Castration").- 6. Differential Diagnosis of Male Hypogonadism.- 7. Therapy.- F. Cryptorchidism (Undescended Testes).- 1. Definition and Incidence.- 2. Etiology.- 3. Consequences of Cryptorchidism.- 4. Histopathology.- 5. Incretory and Secretory Function of Undescended Testes.- 6. Examination Technique and Classification.- 7. Treatment.- G. Male Infertility.- 1. Etiology and Pathogenesis.- 2. Diagnosis.- 3. Therapy.- 4. Induced Reversible Sterility (Male Contraception).- H. Impotence, Problems of Sexual Behavior.- I. Gynecomastia.- 1. Physiologic Gynecomastia.- 2. Gynecomastia in Endocrinopathies.- 3. Gynecomastia in Nonendocrine Diseases.- 4. Drug-Induced Gynecomastia.- 5. Familial Gynecomastia.- 6. Therapy.- K. Testicular Hyperplasia or Hypertrophy.- 1. Compensatory Unilateral Hyperplasia.- 2. Bilateral Hypertrophy.- L. Testicular Tumors.- 1. Germ Cell Tumors.- 2. Sex Cord Gonadal Stromal Tumors.- 3. Other Testicular Tumors with Endocrine Activity.- 4. Treatment.- M. Methods of Investigation.- 1. Clinical Signs.- 2. Examination of the Semen.- 3. Testicular Biopsy.- 4. Determinations of Steroids, Gonadotropins, and GnRH Test.- References.- X. The Ovary.- A. Historical Dates.- B. Anatomy.- 1. Macroscopic Anatomy.- 2. Embryology and Microscopic Anatomy.- C. Biochemistry and Physiology of Ovarian Hormones.- 1. Chemistry.- 2. Biosynthesis.- 3. Production and Secretion.- 4. Metabolism and Excretion.- 5. Biological Action.- 6. Synthetic Hormones.- 7. Methods of Quantitation.- D. Regulation of the Female Reproductive System.- 1. The Menstrual Cycle.- 2. Hypothalamic-Pituitary System.- E. Ovulation.- 1. Detection.- 2. Induction.- 3. Inhibition.- F. Transition Periods.- 1. Puberty.- 2. Climacteric and the Menopause.- G. Pathology of Hypothalamic-Pituitary-Ovarian Function.- 1. Definitions.- 2. True Precocious Puberty.- 3. Pseudoprecocious Puberty.- 4. Primary Amenorrhea.- 5. Secondary Amenorrhea.- 6. Corpus Luteum Insufficiency and Luteinized Unruptured Follicle Syndrome.- 7. Dysfunctional Uterine Bleeding.- 8. Polycystic Ovary Syndrome.- 9. Premature Ovarian Failure and Autoimmune Disease or Exogenous Factors.- 10. Premature Ovarian Failure and Gonadotropin-Resistant Ovary Syndrome.- 11. Premenstrual Syndrome and Dysmenorrhea.- 12. Sport and Ovarian Function.- 13. Smoking and Ovarian Function.- 14. Benign and Malignant Breast Disease and Ovarian Function.- 15. Body Weight and Ovarian Function.- 16. Effect of Drugs and Other Agents on Ovarian Function.- H. Sterility.- 1. Causes.- 2. Diagnostic Procedures.- 3. Treatment of Ovarian Cycle Dysfunction.- 4. Ovulation Induction for In Vitro Fertilization.- I. Endocrine Active Ovarian Tumors.- J. Methods for Evaluation of Ovarian Function.- 1. Basal Body Temperature.- 2. Cervical Mucus.- 3. Vaginal Cytology.- 4. Endometrial Biopsy.- 5. Ultrasound.- 6. Laparoscopy/Pelviscopy.- 7. Estrogen Measurements.- 8. Progesterone Measurements.- 9. Gonadotropin Measurements.- 10. Prolactin Measurements.- 11. Progestagen Test.- 12. Estrogen Test.- 13. Clomiphene Test.- 14. GnRH Test.- References.- XI. Pregnancy.- A. Historical Dates.- B. Anatomy.- 1. Development and Structure of the Placenta.- 2. Specific Changes of the Maternal Endocrine Glands.- 3. Specific Changes of the Fetal Endocrine Glands.- C. Biochemistry, Biologic Activity, and Metabolism of Proteohormones, Steroids, and Proteins.- 1. Placental Proteohormones.- 2. Placental Steroid Hormones.- 3. Proteins.- 4. Hormones of the Decidua.- D. The Fetoplacental Unit.- E. Normal Pregnancy.- 1. Human Chorionic Gonadotropin.- 2. Human Placental Lactogen.- 3. Prolactin.- 4. Relaxin.- 5. Oxytocin.- 6. Progesterone and 17?-Hydroxyprogesterone.- 7. Corticosteroids.- 8. Androgens.- 9. Estrogens.- F. Hormones in Pathology of Pregnancy.- 1. Abortion.- 2. Ectopic Pregnancy.- 3. Hydatidiform Mole and Chorioepithelioma.- 4. Intrauterine Growth Retardation Without Hypertension.- 5. Pregnancy-Induced Hypertension.- 6. Rh Isoimmunization.- 7. Diabetes Mellitus.- 8. Postterm Pregnancies.- 9. Fetal Malformations.- 10. Intrauterine Fetal Death.- 11. Sulfatase Deficiency.- 12. Smoking.- 13. Treatment with Antibiotics.- 14. Treatment with Corticosteroids.- G. Hormones in Amniotic Fluid.- H. Adrenocortical Function in Pregnancy.- 1. Zona Glomerulosa (Mineralocorticoids).- 2. Zona Fasciculata (Glucocorticoids).- 3. Zona Reticularis (Androgens).- 4. Interrelationship Between Maternal and Fetal Hypothalamus-Pituitary-Adrenal Cortex System.- I. Thyroid and Parathyroid Function in Pregnancy.- 1. Thyroid.- 2. Parathyroid.- 3. Interrelationship Between Maternal and Fetal Hypothalamus-Pituitary-Thyroid System.- 4. Interrelationship Between Maternal and Fetal Hypothalamus-Pituitary-Parathyroid System.- K. Carbohydrate Metabolism in Pregnancy.- L. Renin-Angiotensin-Aldosterone System in Pregnancy.- M. Hormonal Effects on the Maternal Organism.- 1. Uterus.- 2. Cervix and Isthmus.- 3. Vagina.- 4. Tubes.- 5. Ovaries.- 6. Skin.- 7. Breasts.- 8. Skeleton, Joints, and Ligaments.- 9. Gastrointestinal and Urinary Tract.- N. Endocrinology of Fetal Lung Maturation.- O. Endocrinology of Parturition.- 1. Estrogens.- 2. Progesterone.- 3. Cortisol.- 4. Oxytocin.- 5. Prostaglandins.- 6. Prostacyclin.- 7. Concepts and Hypotheses About the Initiation of Labor.- P. Endocrinology of the Postpartum Period.- 1. Hormones.- Q. Hormone Assays in Pregnancy.- References.- XII. Disorders of Sexual Differentiation (Intersexuality)..- A. Definition and Terminology.- B. Embryology.- C. Methods of Investigation.- D. Review and Classification.- E. Abnormal Gonadal Development.- 1. Turner's Syndrome (Gonadal Dysgenesis).- 2. Male Turner's Syndrome and Noonan's Syndrome.- 3. Pure Gonadal Dysgenesis.- 4. Asymmetrical Mixed Gonadal Dysgenesis.- 5. Testicular Dysgenesis.- 6. XX Males.- 7. True Hermaphroditism.- 8. Gonadal Agenesis.- F. Abnormal Genital Development in the Presence of Normal Testes (Male Pseudohermaphroditism).- 1. Presistent Oviducts.- 2. Defects of Testosterone Synthesis.- 3. Defect of Testosterone Metabolism.- 4. Leydig Cell Hypoplasia with an LH Receptor Defect.- 5. Androgen Insensitivity.- 6. Partial Androgen Insensitivity.- 7. Hereditary Perineal Hypospadias.- G. Abnormal Genital Development in the Presence of Normal Ovaries (Female Pseudohermaphroditism).- Transplacental Virilization.- H. Diagnosis and Differential Diagnosis.- 1. Intersexual Genital Appearance.- 2. Female Genital Appearance.- 3. Male Genital Appearance.- I. Psychosexuality.- K. Therapy and Choice of Sex.- References.- XIII. The Pancreas..- A. Historical Dates.- B. Embryology and Anatomy.- C. Pathology of the Endocrine Pancreas.- 1. Diabetes Mellitus.- 2. Syndromes of Hormonal Overactivity of the Pancreas.- D. Diabetes Mellitus: Physiology and Pathophysiology of Glucose, Fat, and Ketone Metabolism.- 1. Energy Disposal and Intermediary Metabolism.- 2. Glucose Metabolism of the Liver.- 3. Chemistry, Synthesis, Biosynthesis, Secretion, and Effects of Insulin.- 4. Pathogenesis, Etiology, and Epidemiology of Diabetes Mellitus.- 5. Diagnosis of Diabetes Mellitus.- 6. Classification of Diabetes Mellitus.- 7. Treatment of Diabetes Mellitus.- 8. Absolute Insulin Deficiency and Diabetic Ketoacidosis.- 9. Diagnosis, Differential Diagnosis, and Prognosis of Diabetic Coma.- 10. Treatment of Diabetic Coma.- 11. Long-Term Complications of Diabetes Mellitus.- 12. Contraception and Pregnancy.- 13. The Infant of the Diabetic Mother.- 14. The Child with Diabetes.- 15. Psychological Aspects of Diabetes Mellitus.- E. Pathophysiological and Clinical Aspects of Hypoglycemia.- 1. Definition.- 2. Symptoms.- 3. Treatment of Hypoglycemic Coma.- 4. General Pathophysiology.- 5. Reactive Hypoglycemia.- 6. Fasting Hypoglycemia.- 7. Extrapancreatic Tumoral Hypoglycemia.- 8. B Islet Cell Adenomas and Hyperinsulinism.- F. Glucagon and the Glucagonoma Syndrome.- 1. Physiology of Glucagon.- 2. Glucagon Levels in Diabetes Mellitus.- 3. The Glucagonoma Syndrome.- References.- XIV. The Parathyroids: Parathyroid Hormone, Calcitonin, D-Vitamins, and Metabolic Bone Disease..- A. History.- B. Physiology and Biochemistry of Calcium and Phosphate Metabolism.- 1. Calcium Metabolism.- 2. Phosphate Metabolism.- 3. Bone Metabolism.- 4. Metabolic Bone Disease.- 5. Regulation of Calcium and Phosphate Metabolism.- 6. Bones, Calcium, and Phosphate.- C. Hypoparathyroidism and Pseudohypoparathyroidism.- 1. Definition.- 2. Heredity.- 3. Pathogenesis.- 4. Symptoms and Signs.- 5. Diagnosis and Differential Diagnosis.- 6. Treatment.- D. Primary Hyperparathyroidism.- 1. Definition.- 2. Etiology.- 3. Incidence.- 4. Pathology.- 5. Clinical Features and Symptoms.- 6. Diagnosis.- 7. Differential Diagnosis.- 8. Natural History of Primary Hyperparathyroidism.- 9. Therapy.- E. Secondary Hyperparathyroidism.- 1. Definition.- 2. Pathology.- 3. Etiology.- 4. Pathophysiology.- 5. Clinical Picture and Radiographic Signs.- 6. Differential Diagnosis.- 7. Therapy.- 8. Tertiary Hyperparathyroidism.- References.- XV. Tissue Hormones..- A. Definition.- B. Polypeptides.- 1. Gastrointestinal Hormones.- 2. Kinins.- 3. Renin-Angiotensin.- 4. Atrial Natriuretic Peptides.- C. Glycoprotein: Erythropoietin.- D. Amines.- 1. Serotonin.- E. The Metabolites of Arachidonic Acid (Prostaglandins, Thromboxanes, and Leukotrienes).- 1. Introduction.- 2. Biosynthesis.- 3. Metabolism and Inactivation.- 4. Pharmacological and Dietary Modulation of Arachidonic Acid Metabolism.- 5. Pharmacological and Biological Properties.- 6. Arachidonic Acid Metabolites and Circulatory Disorders.- 7. Disorders of Platelet Activity.- 8. Clinical Disorders of Renal Function.- 9. Gastrointestinal Diseases.- 10. Diabetes Mellitus.- 11. Hypercalcemic States.- 12. Overproduction of Arachidonic Acid Metabolites in Various Neoplastic Diseases.- 13. Reproductive Processes.- 14. Pulmonary Disease.- 15. Inflammatory and Hypersensitivity Diseases.- 16. Therapeutic Applications of Arachidonic Acid Metabolites.- References.- XVI. Endocrine Hyperfunctional Syndromes Caused by Ectopic Hormone Formation (Paraneoplastic Syndromes)..- A. Definition.- B. Pathogenesis.- C. Clinical Features, Diagnosis, and Therapy.- References.- XVII. Thymus..- 1. Embryology.- 2. Structure: Cell Traffic.- 3. Thymus and Immune Function.- a) In Situ Role of the Thymus.- b) Thymic Hormones: Extrathymic Action.- 4. Thymus in Disease.- a) Congenital Thymic Aplasia and Hypoplasia.- b) Thymic Involution.- c) Thymitis and Myasthenia Gravis.- d) Thymic Tumors.- References.- XVIII. The Pluriglandular Syndromes..- A. Multiple Endocrine Adenomatoses (MEA I, II, IIb; Multiple Endocrine Neoplasia).- 1. Multiple Endocrine Adenomatosis [Endocrine Polyadenomatosis, Familial Multiple Endocrine Adenoma (MEA I), Wermer's Syndrome, "Job's Syndrome," Steiner's Multiple Neoplasia, Type I].- 2. Medullary Thyroid Carcinoma - Bilateral Pheochromocytoma (Sipple's Syndrome, Steiner's Multiple Endocrine Neoplasia, Type II, MEA IIa and MEN II.- 3. MEA IIb Syndrome.- B. Autoimmune Polyendocrinopathy (Pluriglandular Insufficiency; Polyglandular Failure; Multiple Endocrine Sclerosis; Schmidt's Syndrome).- 1. Definition.- 2. Pathogenesis.- 3. Clinical Features.- C. Syndrome of Diabetes Mellitus, Diabetes Insipidus, Optic Atrophy, Deafness, and Other Abnormalities (DIDMOAD Syndrome).- References.- XIX. Growth and Development..- A. General Concepts of Growth and Development.- 1. General Factors of Growth.- 2. Body Growth and Growth of the Endocrine Glands.- B. Hormonal Influence on Growth and Bone Maturation.- 1. Survey.- 2. Hypophyseal Growth Hormone (STH, GH).- 3. Thyroid Hormones.- 4. Insulin and Glucagon.- 5. Adrenocortical Hormones.- 6. Gonadal Hormones.- C. Normal Values for Body Measurements and Development of Bones and Teeth.- 1. Height and Weight.- 2. Body Surface and Dosages for Tolerance Tests.- 3. Body Proportions.- 4. Bone Maturation.- 5. Prediction of the Timing of Puberty and of Adult Height from Present Height and Bone Age.- 6. Dental Development.- 7. Graphic Representation of Growth and Development.- D. Disorders of Growth.- 1. Definition of Short Stature, Dwarfism, Tall Stature and Gigantism.- 2. Etiological Classification of Short Stature and Dwarfism.- 3. Dyscerebral and Microcephalic Dwarfism.- 4. Hypocaloric and Psychosocial Dwarfism.- 5. Constitutional Delay of Growth and Development.- 6. Primordial Dwarfism.- 7. Progeria.- 8. Dysmorphic Syndromes with Short Stature.- 9. Clinical Investigation of Dwarfism.- 10. Prognosis and Treatment of Dwarfism.- 11. Tall Stature and Gigantism.- E. Puberty.- 1. Survey.- 2. External Characteristics and Course.- 3. Hormonal Findings.- 4. Hormonal Dependence of Secondary Sexual Characteristics.- 5. Hypothalamus, Gonadarche, Adrenarche and Puberty.- F. Special Variations of Normal Puberal Development.- 1. Survey.- 2. Isolated Premature Pubarche.- 3. Isolated Premature Thelarche.- 4. Puberal Gynecomastia.- 5. Somatic, Psychological and Psychosexual Variations of "Masculinity" and "Femininity".- 6. Prepuberal and Puberal Obesity.- 7. Anorexia Nervosa.- G. Precocious Puberty.- 1. Survey.- 2. Idiopathic Precocious Puberty.- 3. Precocious Puberty and Organic Brain Disorders.- 4. Precocious Puberty and "Hormonal Overlap".- 5. Precocious Puberty and HCG-Producing Tumors.- 6. Precocious Pseudopuberty and Disorders of Adrenal Cortex.- 7. Familial Testicular Hyperplasia.- 8. Precocious Puberty and Fibrous Dysplasia of the Bones (McCune-Albright-Syndrome).- 9. Precocious Pseudopuberty and Testicular Tumors.- 10. Precocious Pseudopuberty and Ovarian Tumors and Cysts.- 11. Precocious Pseudopuberty and Exogenous Hormones.- 12. Differential Diagnosis.- 13. Treatment.- H. Delayed Puberty.- References.- XX. Fundamentals of Hormone Treatment of Nonendocrine Disorders..- A. Endocrine Therapy for Carcinomas of the Breast, Prostate, and Corpus Uteri and for Prostatic Hyperplasia.- 1. Introduction.- 2. Endocrine Therapy for Carcinoma of the Breast.- 3. Endocrine Therapy for Carcinoma of the Prostate.- 4. Endocrine Therapy for Carcinoma of the Corpus Uteri.- 5. Endocrine Therapy for Prostatic Hypertrophy.- B. Pharmacological Use of Hormones.- 1. Cortisol and Its Derivatives.- 2. Anabolic Therapy.- 3. 9 ?-Fluorohydocortisone and Other Mineralocorticoids.- 4. Progesterone in Respiratory Dysfunction.- 5. Vasopressin Derivatives in Coagulopathies.- References.