The primary requirement for the attachment of embryo to the uterine epithelium is the critical synchrony between the maternal tissue and the freely floating blastocryst. This in turn prepares the endometrium to become receptive and the blastocysts to attain eexpanded statei. The driving force of this phenomenon is the titre of the endogenous hormones, mainly the estrogen and progesterone. In principle the process of implantation begins in two phases, the apposition and the adhesion. While the former reflects on progressive intimacy between trophoblasts and luminal epithelial cells around the entire blastocyst, the latter begins on the antimesometrial side of the uterus in most of the rodent species. The exact biochemical or molecular basis of peri and immediate post-implantation changes that occur in embryonic cells, mainly the trophoblasts and the uterine endometrial cells are not know, and since to study such changes at cellular level is not possible in situ the in vitro studies offer the only alternative. To concentrate on this new methods have been adopted for detailed studies of the participating embryonic and maternal cells ex vivo with a view to identify the cells types isolated from the respective tissues following implantation. These cells maintained in complimented culture medium have been studied for morphological changes through optical transmission and scanning electron microscopes. In addition the macromolecules synthesized or secreted by these cells, while in incubation have been analysed in order to pinpoint the cell and stage specific markers.

We present the clinical and possible etiological factors in twelve children who presented with precocious sexual development over an eight year period at out Center. There were nine girls and three boys. Eight had true isosexual precocious puberty. Two had primary hypothyroidism; of the other six (four girls and two boys), one boy had suprasellar mass. The mean age of six children with true isosexual precocious puberty was six years. Two girls had congenital adrenal hyperplasia. Two other girls had premature thelarche.

Trunkal obesity, measured by waist-hip ratio (WHR) is correlated with increased risk of diabetes mellitus in susceptible individuals. The risk increases with a WHR greater than 1.0 in men and 0.8 in women. The adverse metaolic effects of visceral fat occur independent of subcutaneous or total body fat. Therapy is directed towards behavior modification (eating physical exercise), psychotherapy which lowers sympathetic overactivity, correction of hormonal imbalances (if present, eg testosterone) and other pharmacological agents.

Diagnosis of thyroid dysfunction is confirmed by abnormalities in thyroid hormone levels in plasma. With the availability of ultrasensitive assay of TSH, it can be used to identify both primary hypothyroidism and hyperthyroidism (with TSH levels being high and low respectively). Overdose of thyorxine replacement can also be identified, along with diagnosis of subclinical hypothroidism, and evaluation of thyroid function in hospitalized patients, and in pregnancy. Subclinical hypothyroidism was diagnosed by an exaggerated TSH response to intravenous TRH bolus. Prenatal diagnosis and treatment of hypothyroidism is also possible.