Defining language lateralisation is important to minimise morbidity in patients treated surgically for temporal lobe epilepsy (TLE). Functional magnetic resonance imaging (fMRI) offers a promising, non-invasive, alternative strategy to the Wada test. Here, fMRI has been used to study healthy controls and patients with TLE in order (i) to define language-related activation patterns and their reproducibility; (ii) to compare lateralisation determined by fMRI with that from the Wada test; and (iii) to explore the usefulness of multiple fMRI language paradigms. 18 healthy controls (12 right-handed and 6 left-handed) and 24 pre-operative TLE patients (19 right-handed: 12 left-TLE, 7 right-TLE; 5 left-handed: 2 right-TLE, 3 left-TLE) were studied using fMRI. Four fMRI language paradigms used: phonetic and semantic fluency, and the naming of living and non-living things. The data for all 4 tasks were acquired during a single scanning session on two occasions. All patients also underwent Wada testing. In patients and controls, phonetic and semantic fluency tasks were robustly activating and strongly lateralising. Quantified language-related lateralisation from fMRI verbal fluency data was highly reproducible and concordant with the lateralisation of the Wada test. Both fluency tasks identified patients with atypical language lateralisation, including 4/12 right-handed patients with left-TLE and 4/5 left-handed TLE patients, regardless of the side of epileptic focus. In comparison, the two confrontational naming tasks were not strongly lateralising and did not reliably agree with Wada lateralisation in either 12 right-handed controls or 19 right-handed patients with TLE. However, there was a difference in the pattern of fMRI activation in right-handed pat ients with left-TLE. Left-TLE patients had a more right lateralised network of activation when naming living things relative to non-living things, suggesting that some patients may be at risk of a category specific naming decline for non-living things after left anterior temporal lobectomy. These results demonstrate that non-invasive fMRI measures of languagerelated lateralisation may provide a practical and reliable alternative to invasive testing for pre-surgical language lateralisation in patients with TLE. The high proportion of TLE patients showing atypical language lateralisation suggests considerable plasticity of language representation in the brains of patients with intractable TLE.

Defining language lateralisation is important to minimise morbidity in patients treated surgically for temporal lobe epilepsy (TLE). Functional magnetic resonance imaging (fMRI) offers a promising, non-invasive, alternative strategy to the Wada test. Here, fMRI has been used to study healthy controls and patients with TLE in order (i) to define language-related activation patterns and their reproducibility; (ii) to compare lateralisation determined by fMRI with that from the Wada test; and (iii) to explore the usefulness of multiple fMRI language paradigms. 18 healthy controls (12 right-handed and 6 left-handed) and 24 pre-operative TLE patients (19 right-handed: 12 left-TLE, 7 right-TLE; 5 left-handed: 2 right-TLE, 3 left-TLE) were studied using fMRI. Four fMRI language paradigms used: phonetic and semantic fluency, and the naming of living and non-living things. The data for all 4 tasks were acquired during a single scanning session on two occasions. All patients also underwent Wada testing. In patients and controls, phonetic and semantic fluency tasks were robustly activating and strongly lateralising. Quantified language-related lateralisation from fMRI verbal fluency data was highly reproducible and concordant with the lateralisation of the Wada test. Both fluency tasks identified patients with atypical language lateralisation, including 4/12 right-handed patients with left-TLE and 4/5 left-handed TLE patients, regardless of the side of epileptic focus. In comparison, the two confrontational naming tasks were not strongly lateralising and did not reliably agree with Wada lateralisation in either 12 right-handed controls or 19 right-handed patients with TLE. However, there was a difference in the pattern of fMRI activation in right-handed pat ients with left-TLE. Left-TLE patients had a more right lateralised network of activation when naming living things relative to non-living things, suggesting that some patients may be at risk of a category specific naming decline for non-living things after left anterior temporal lobectomy. These results demonstrate that non-invasive fMRI measures of languagerelated lateralisation may provide a practical and reliable alternative to invasive testing for pre-surgical language lateralisation in patients with TLE. The high proportion of TLE patients showing atypical language lateralisation suggests considerable plasticity of language representation in the brains of patients with intractable TLE.

Dissertation submitted in fulfilment of the requirements for the degree Master of Technology: Radiography (Nuclear Medicine) In the Faculty of Health and Wellness Sciences At the CAPE PENINSULA UNIVERSITY OF TECHNOLOGY, 2012 / Thyroid physiology and structure can be evaluated by scintigraphic imaging. Iodine-131, discovered in the late thirties was the first radioisotope to be used for thyroid uptake assessment, since then thyroid uptake and imaging continues to play a vital role in different thyroid related clinical situations. Because Iodine-131 has serious disadvantages related to high radiation dose, it has been limited to staging and follow up of patients with thyroid carcinomas. Its substitute Iodine -123 has proved to be suitable in terms of shorter half-life and better imaging energy. Technetium-99m pertechnetate, because of its availability is also used for thyroid imaging and uptake assessment. The similarity of the Technetium-99m pertechnetate ions and iodide is the explanation for the thyroid glands ability to absorb it. Historically, chronological changes in the normal values of thyroid uptake normal values have been reported in different geographical areas. These changes have been linked to geographical and chronological fluctuations in dietary iodine intake in different populations. Technetium-99m pertechnetate, Iodine-131 and Iodine-123, all reflect thyroid iodide accumulation. In areas where there is iodine deprivation there will be elevated radioisotope uptake in euthyroid persons, and radiotracer uptake is even higher in areas of Iodine deficiency. Conversely in areas where a population is exposed to stable iodine and abundant amount of iodine intake from other sources, radiotracer uptake will be decreased. Namibia is a country with mixed ethnicity consisting mainly of Africans (Hereros, Ovahimba, Kavangos, Caprivians, Ovambo, Damaras, Namas, Bushmen, Coloureds and Caucasians). The population has access to dietary iodine and all ethnic groups consume reasonable amounts of food containing iodine such as bread, dairy products, table salt and sea food. Similar to other Nuclear Medicine departments worldwide, Namibia makes use of Technetium-99m pertechnetate for thyroid uptake and imaging. However thyroid uptake quantification needs to be related to normal values as a point of reference. Despite reports of thyroid uptake fluctuations of normal values and reports emphasising the importance of periodic checks on the thyroid uptake normal values, Namibia has never determined these reference values. This study examines the fundamental statement posed in the hypothesis that the thyroid uptake reference values for Technetium-99m pertechnetate in a Namibian population deviate from available International normal reference values. Eighty three participants considered to be euthyroid from Windhoek, Namibia received Technetium-99 m pertechnetate as part of their evaluation. The euthyroid state was based on a combined evaluation of clinical history, palpation of the thyroid gland and assessment of thyroid hormones (TSH, T3 and T4). The objectives of the study were:  To establish normal reference values of Technetium-99m pertechnetate uptake in euthyroid persons in Namibia.  To compare the outcome reference values to current available existing International normal reference values.  To determine possible factors contributing to the deviation of thyroid uptake reference values in the Namibian population.  To recommend reference values for Namibia. This was achieved by studying the unmedicated 83 participants with their iodine diet, rather than patients with thyroid or other diseases. The participants reported to the Nuclear Medicine department. The participants completed a questionnaire designed to reveal the presence of thyroid pathologies or any other pathology. The completed questionnaire was reviewed and if the participant fulfilled the requirements for the study, blood was drawn for thyroid hormone assessment. The participants were then given 100MBq Technetium-99m pertechnetate intravenously. Using a low energy high resolution dual head gamma camera, the thyroid uptake was recorded at 20 minutes. There was a marked difference between the International normal values (0.75% to 4%) used in the Nuclear Medicine department and those found in this study. The results of seven subjects were excluded due to abnormal blood results, and technical errors, bringing the actual sample size to 76 euthyroid participants. The age range was 39 to 81 years, and there were 58 females and 18 males. The mean uptake for the euthyroid group was found to be 0.78%± 0.45%. The Kolmogorov-SmirnovaLilliefors Significance parametric test presented us with results that state that our population has a non-normal distribution, and therefore the standard deviation should not be applied to determine the normal values. The statistical test for skewness and kurtosis was adopted in this study to correct for skewness and the normal values determined were 0.35% to 1.22% (95.5% CI) of Technetium-99m pertechnetate at 20 minutes. An alternative method used to determine the normal reference range for Technetium-99m pertechnetate in a study sample obtained from a non- normal distribution was determined using the 5th and the 95th percentiles .The normal reference range using the 5th and the 95th percentile was 0.17% - 1.7%. This study provides new evidence supporting the importance of periodic checks on normal reference values. The evidence is provided by the analysis of the empirical data obtained in this study of a population that has sufficient daily intake of stable iodine. The results obtained from this study and other studies proving the difference in thyroid uptake between different populations and geographical regions makes it incumbent upon laboratories to establish a normal reference range for a particular geographical location. Furthermore the study attests to the importance of re-evaluating normal values for thyroid uptake as part of a quality assurance programme.

No description available.

Increasing evidence has shown that abnormal metabolic phenotypes in body fluids reflect the pathogenesis and pathophysiology of Parkinson's disease (PD). However, the relationship between metabolic phenotypes and PD is not fully understood. Mass spectrometry (MS) based metabolomics is a powerful technique, which was frequently used for the sensitive and reproducible detection of hundreds to thousands of metabolites in biofluid samples.. Here we developed and performed MS-based metabolomics studies involving hundreds of human urine samples with data acquired from multiple analytical batches for surveying potential biomarkers of PD. A new software statTarget was developed and introduced. Protocols for liquid chromatography-mass spectrometry (LC-MS) and gas chromatography-mass spectrometry (GC-MS) were developed, including sample preparation, data acquisition, quality controls, quality assurance and data analysis. Urinary metabolites from a total of 401 clinical urine samples collected from 106 idiopathic PD patients and 104 normal control subjects were profiled by using LC-MS. Quality control (QC) strategy has been performed in MS-based metabolomics for high reproducibility and accuracy of MS data. GC-MS with methyl chloroformate (MCF) derivatization was used for profiling highly polar metabolites in patients with early-, middle- and advanced-stage PD. Our study revealed the significant correlation between clinical phenotypes and urinary metabolite profiles. Comprehensive metabolomics was successfully developed with the goal of identifying urinary metabolite markers that can be used for evaluating the development of PD. A group of 18 metabolites have shown not only a high discriminating ability for the early-stage PD patients but also accurately distinguished the middle- and advanced- stages patients from control subjects. For the evaluation of PD, 18 metabolites showed good potential as metabolite markers with related metabolic pathway variations observed in branched chain amino acid metabolism, glycine derivation, steroid hormone biosynthesis, tryptophan metabolism, and phenylalanine metabolism.. We have further performed targeted analysis of potential biomarkers by using ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) and GC-MS. The UPLC-MS/MS method was developed and optimized for detecting the concentration variation of metabolites in tryptophan metabolism for alpha-synuclein over-expressed flies (Parkinson's disease model). The altered tryptophan metabolism was proved as one of the common metabolite signatures between PD patients and alpha-synuclein over-expressed fly model of PD, and thus may be used for developing potential markers of the disease and evaluating the efficacy of novel therapeutic agents. An asymmetric labeling strategy and positive chemical ionization gas chromatography-tandem mass spectrometry (PCI-GC-MS-MS) approach was developed for the determination of non-amino organic acids and amino acids, as well as short chain fatty acids. Carboxylic and amino groups could be selectively labelled by propyl and ethyl groups, respectively. The specific neutral losses of C3H8O (60 Da), C3H5O2 (74 Da) and C4H8O2 (88 Da) were useful in the selective identification for qualitative analysis of organic acids and amino acid derivatives. The developed PCI-GC-MS/MS method showed good reproducibility and linear range.. In summary, metabolomics study has its inherent advantage in the characterization of biomarkers for the development of PD and may bring new scientific knowledge as well as impact on the progression of PD and other related neurodegenerative diseases.

Coronary artery disease has become a world wide medical problem. There is an overwhelming association between coronary atherosclerosis, angina pectoris, acute myocardial infarction and sudden death. The narrowing of coronary arteries is thought to damage the heart by limiting appropriate changes in coronary blood flow and by causing myocardial ischemia. This thesis attempts to examine the coronary circulation in patients who present with chest pain with and without coronary artery disease. One of the aims of this thesis is to validate the use of a short-lived radionuclide to study changes in regional myocardial perfusion. This technique has been applied in clinical medicine in an attempt to describe the disturbances of regional myocardial perfusion that occur in patients with coronary artery disease. These disturbances of perfusion have been related to the patients' symptoms, the electrocardiogram and the stenosed arteries seen in the arteriogram. Krypton-81m in solution is an inert freely diffusible gas (half-life 13 seconds) which emits a single 190 kev gamma ray. This tracer, a special catheter and a gamma camera have been developed in experiments to measure changes in regional myocardial perfusion. The systematic and rand-Om errors of the method have been defined in experiments. The results show that the mixing and delivered arterial concentration of krypton-81m are stable within a useful physiological range of changes in heart rate, blood pressure and coronary blood flow. Correlations with a reference technique have shown that the method can measure changes in regional myocardial perfusion between O and 3 ml/ml/min. The invasive method, the planar imaging and the need for calibration with washout at high levels of perfusion are investigated and described as limitations that must be considered. Eighty patients presenting with chest pain have been investigated by routine clinical methods, precordial mapping of the electrocardiogram during exercise and coronary arteriography. Changes in regional myocardial perfusion at rest and during atrial pacing has been measured using krypton-81m. The results have shown that stable mixing and delivered arterial concentration of krypton-81m can be achieved in the patients. Fifteen patients with negative exercise tests all demonstrated uniform increases in regional myocardial perfusion with pacing. The remaining 65 patients with positive exercise tests and significant coronary artery disease all showed both regional increases and decreases in myocardial perfusion during atrial pacing. In 16 of the 65 patients the jeopardized segment of ventricular myocardium showed significant increases in perfusion during the first 4 to 7 minutes of pacing. Th e increase stopped and regional perfusion in the affected segment then decreased progressively until the pacing was stopped. In 23 of the 65 patients the affected segment showed no changes in perfusion for 5 to 7 minutes of atrial pacing and then showed progressive decreases in regional myocardial perfusion until the pacing was stopped. Finally, in 26 of the 65 patients the affected segment showed immediate and progressive decreases of regional myocardial perfusion starting with the commencement of atrial pacing. In all the patients with disturbed perfusion ST segment depression in the electrocardiogram appeared after (140 ± 14 sec) the regional decrease of myocardial perfusion in the affected segment. Chest pain always appeared later at 220 ± 19 sec after the appearance of disturbed myocardial perfusion. Regional myocardial perfusion returned to normal in all the patients after the atrial pacing was stopped. There was a spatial relationship between the region of the ventricles affected by disturbed perfusion and the region of the precordium showing abnormal electrocardiographic signs during the exercise test. In conclusion, this clinical study has shown that patients with chest pain who have coronary artery disease suffer decreases of regional myocardial perfusion in affected segments of the ventricles during episodes of angina pectoris induced by atrial pacing. Regional perfusion may increase, remain stable or decrease in the affected segment following the onset of a stress test such as atrial pacing. This probably represents the amount of reserve function and adaptation left in the diseased coronary circulation and may be a useful physiological indicator of the severity of coronary disease and of patients at high risk. ST segment depression and pain have a close temporal relationship to the decreases of regional myocardial perfusion that occur in these patients. These studies suggest that there is a close relationship between myocardial perfusion and metabolism in health and disease. Both myocardial perfusion and metabolism will have to be affected by any rational therapy for angina pectoris and ischemic heart disease.

No description available.

Increased blood plasma concentrations of the aminothiol homocysteine (Hcy) are associated with a variety of disease states including those which cause impaired renal function, many forms of cardiovascular disease, and neurodegenerative diseases such as Alzheimer's. Therefore, Hcy has the potential to be a significant diagnostic biomarker. Routine monitoring of Hcy plasma concentration is encumbered by the time and resources required to quantify Hcy using currently accepted instrumental analysis methods. As part of the continuing effort to develop a quick, reliable, inexpensive, and user-friendly test to quantify Hcy at the point of care, we have designed a series of novel colorimetric and fluorescent chemical probes based on bridged viologen structures. The absorbance at 540 nm for the para-bridged bis-nitrile viologen probe (pCN) was found to be proportional to the concentration of Hcy analyte, with LOD = 2.17 μM and LOQ = 6.10 μM where unhealthy Hcy plasma concentrations are > 15 μM. The mechanism of reactivity between pCN and Hcy encompasses a dynamic set of reactions which involve pimerization of radical probe species and thioether adduct formation of pCN with Hcy. Preliminary results with fluorometric analogs of the bridged viologen probes are also presented.

Introdução: O hermafroditismo verdadeiro, caracterizado pela demonstração histológica de tecido ovariano e testicular no mesmo indivíduo, responde por cerca de 5% dos casos de anomalia da diferenciação sexual. Como a variabilidade fenotípica é muito grande, desde mulheres com genitália externa normal até homens com genitália externa normal, passando por toda uma gama de apresentações intermediárias, torna-se impossível o diagnóstico baseado apenas em dados clínicos. A avaliação da presença de tecido testicular é bem estabelecida, mas não há teste para a demontração de tecido ovariano. A inibina A é produzida exclusivamente no ovário e é estimulada pelas gonadotrofinas. Objetivos: 1. Avaliar a efetividade do método de estimulação gonadal com a associação LH/FSH na demonstração de tecido ovariano; 2. Avaliar a eventual presença de tecido ovariano em pacientes com anomalias da diferenciação sexual através da dosagem sérica de Inibina A e de estradiol após estímulo gonadotrófico e; 3. Facilitar o diagnóstico de hermafroditismo verdadeiro antes da fase de exploração cirúrgica das gônadas. Métodos: Foram incluídos no estudo, dez pacientes com hiperplasia congênita de supra-renal, dez pacientes com criptorquidia unilateral isolada, treze pacientes com anomalia da diferenciação sexual sem etiologia definida e sete pacientes com hermafroditismo verdadeiro com diagnóstico histológico. Todos os pacientes foram submetidos a um teste de estímulo gonadotrófico, representado pela administração de gonadotrofina humana da menopausa (menotropina), que tem em sua composição LH e FSH, na dose de 150 UI de cada gonadotrofina, por via intramuscular, durante três dias subseqüentes. Dosagens de LH, FSH, estradiol, testosterora e inibina A foram realizadas antes (B), 24h após a primeira dose (A1) e 24 horas após a terceira dose (A2). Resultados: O LH não apresentou elevação significativa nos quatro grupos. O FSH elevou-se nos quatro grupos de forma progressiva e semelhante. O estradiol elevou-se significativamente nos grupos de pacientes com hiperplasia congênita das supra-renais (p=0,005) e de pacientes com hermafroditismo verdadeiro (p=0,031), enquanto a testosterona elevou-se nos grupos com criptorquidia isolada (p=0,027) e de pacientes com ambigüidade genital sem etiologia definida (p=0,028). A inibina A elevou-se significativamente nos grupos de pacientes com hiperplasia congênita das supra-renais (p=0,005) e com hermafroditismo verdadeiro (p=0,043). Conclusão: O teste de estímulo com LH e FSH mostrou-se útil para o diagnóstico da presença de tecido ovariano tanto em pacientes com hiperplasia congênita das supra-renais, como naqueles com hermafroditismo verdadeiro. / Introduction: True hermaphrodism (TH) is characterized by the presence of ovarian and testicular tissue in the same patient comprises 5% of the intersex cases. A large spectrum of phenotypical variation is observed, ranging from normal female genitalia to normal male genitalia, covering a wide range of intermediary presentations, it becomes very difficult to make the diagnosis of TH on clinical basis. The detection of testicular tissue is well stablished but there is no available test to demonstrate the presence of ovarian tissue. Objectives: 1. To evaluate the effectiveness of the LH/FSH gonadal stimulation in demonstrating ovarian functiom 2. To evaluate the presence of ovarian tissue in intersex patients under gonadotropic stimulation and 3. To make the TH diagnosis before the surgical procedure. Patients and Methods: Ten patients with congenital adrenal hyperplasia (CAH), 10 with unilateral cryptorchidism, 13 intersex patients with no defined etiology, and seven TH patients have been included in the study. All the patients had a gonadotropic stimulation test with human menopausal gonadotropin (menotropin-hMG),150 IU, intramuscular, for three consecutive days. LH, FSH, estradiol, testosterone, and Inhibin A were measured before (0 time), 24h after the first gonadotropin dose, and 24h after the third gonadotropin dose. Results: LH did not show any significant increase in the four groups studied. FSH increased in the four groups in a similar way. Estradiol increased in CAH pacients (p=0.005) and in TH patients (p=0,031), while testosterone increased in patients whit unilateral cryptorchidism (p=0.027) as well as in the intersex patients without defined etiology. Inhibin A levels increased in CAH patients (p=0.005) and in the TH patients (p=0.043). Conclusion: The LH/FSH stimulation test demonstrated to be a useful method to diagnose the presence of ovarian tissue in CAH patients as well as in TH patients, becoming an important tool to diagnose TH even before the surgical procedure and histologic studies of the gonads.

Introdução: O hermafroditismo verdadeiro, caracterizado pela demonstração histológica de tecido ovariano e testicular no mesmo indivíduo, responde por cerca de 5% dos casos de anomalia da diferenciação sexual. Como a variabilidade fenotípica é muito grande, desde mulheres com genitália externa normal até homens com genitália externa normal, passando por toda uma gama de apresentações intermediárias, torna-se impossível o diagnóstico baseado apenas em dados clínicos. A avaliação da presença de tecido testicular é bem estabelecida, mas não há teste para a demontração de tecido ovariano. A inibina A é produzida exclusivamente no ovário e é estimulada pelas gonadotrofinas. Objetivos: 1. Avaliar a efetividade do método de estimulação gonadal com a associação LH/FSH na demonstração de tecido ovariano; 2. Avaliar a eventual presença de tecido ovariano em pacientes com anomalias da diferenciação sexual através da dosagem sérica de Inibina A e de estradiol após estímulo gonadotrófico e; 3. Facilitar o diagnóstico de hermafroditismo verdadeiro antes da fase de exploração cirúrgica das gônadas. Métodos: Foram incluídos no estudo, dez pacientes com hiperplasia congênita de supra-renal, dez pacientes com criptorquidia unilateral isolada, treze pacientes com anomalia da diferenciação sexual sem etiologia definida e sete pacientes com hermafroditismo verdadeiro com diagnóstico histológico. Todos os pacientes foram submetidos a um teste de estímulo gonadotrófico, representado pela administração de gonadotrofina humana da menopausa (menotropina), que tem em sua composição LH e FSH, na dose de 150 UI de cada gonadotrofina, por via intramuscular, durante três dias subseqüentes. Dosagens de LH, FSH, estradiol, testosterora e inibina A foram realizadas antes (B), 24h após a primeira dose (A1) e 24 horas após a terceira dose (A2). Resultados: O LH não apresentou elevação significativa nos quatro grupos. O FSH elevou-se nos quatro grupos de forma progressiva e semelhante. O estradiol elevou-se significativamente nos grupos de pacientes com hiperplasia congênita das supra-renais (p=0,005) e de pacientes com hermafroditismo verdadeiro (p=0,031), enquanto a testosterona elevou-se nos grupos com criptorquidia isolada (p=0,027) e de pacientes com ambigüidade genital sem etiologia definida (p=0,028). A inibina A elevou-se significativamente nos grupos de pacientes com hiperplasia congênita das supra-renais (p=0,005) e com hermafroditismo verdadeiro (p=0,043). Conclusão: O teste de estímulo com LH e FSH mostrou-se útil para o diagnóstico da presença de tecido ovariano tanto em pacientes com hiperplasia congênita das supra-renais, como naqueles com hermafroditismo verdadeiro. / Introduction: True hermaphrodism (TH) is characterized by the presence of ovarian and testicular tissue in the same patient comprises 5% of the intersex cases. A large spectrum of phenotypical variation is observed, ranging from normal female genitalia to normal male genitalia, covering a wide range of intermediary presentations, it becomes very difficult to make the diagnosis of TH on clinical basis. The detection of testicular tissue is well stablished but there is no available test to demonstrate the presence of ovarian tissue. Objectives: 1. To evaluate the effectiveness of the LH/FSH gonadal stimulation in demonstrating ovarian functiom 2. To evaluate the presence of ovarian tissue in intersex patients under gonadotropic stimulation and 3. To make the TH diagnosis before the surgical procedure. Patients and Methods: Ten patients with congenital adrenal hyperplasia (CAH), 10 with unilateral cryptorchidism, 13 intersex patients with no defined etiology, and seven TH patients have been included in the study. All the patients had a gonadotropic stimulation test with human menopausal gonadotropin (menotropin-hMG),150 IU, intramuscular, for three consecutive days. LH, FSH, estradiol, testosterone, and Inhibin A were measured before (0 time), 24h after the first gonadotropin dose, and 24h after the third gonadotropin dose. Results: LH did not show any significant increase in the four groups studied. FSH increased in the four groups in a similar way. Estradiol increased in CAH pacients (p=0.005) and in TH patients (p=0,031), while testosterone increased in patients whit unilateral cryptorchidism (p=0.027) as well as in the intersex patients without defined etiology. Inhibin A levels increased in CAH patients (p=0.005) and in the TH patients (p=0.043). Conclusion: The LH/FSH stimulation test demonstrated to be a useful method to diagnose the presence of ovarian tissue in CAH patients as well as in TH patients, becoming an important tool to diagnose TH even before the surgical procedure and histologic studies of the gonads.