Investigations of a patient with the benign adult form of osteopetrosis (Albers-Schönberg) revealed that the clinical symptoms correlated with a high bone metabolism, high calcium incorporation in bone, increased osteoclast activity and probably reactive increase of calcitonin in the blood.

Investigations of a patient with the benign adult form of osteopetrosis (Albers-Schönberg) revealed that the clinical symptoms correlated with a high bone metabolism, high calcium incorporation in bone, increased osteoclast activity and probably reactive increase of calcitonin in the blood.

A 36 year old patient received an implantable central venous catheter system for a bone marrow transplantation. One year after the successful transplantation, embolization of the catheter was discovered by a routine x-ray three weeks after beginning of an exercise program with a spring expander including arm exercises. The catheter was removed without further complication via the vena femoralis. We assume that the cause for this incident was material fatigue due to pressure between clavicula and first rib possibly caused by strength training. We suggest as a consequence that patients with an implanted catheter system should before starting exercise consult a sports medicine specialist who would in turn cooperate with the specialist responsible for the catheter, so that an adequate and safe training program can be selected.

The clinical course of a patient presenting with thrombocytopenia (86 X 10(3)/L) and signs of intravascular coagulation (prothrombin time, 45%; partial thromboplastin time, 49 s; fibrinogen, 40 mg/dl; antithrombin III, 85%; factor X, 73%; plasminogen, 42%) due to a giant hemangioma of the liver (Kasabach-Merritt syndrome) is reported. Treatment with i.v. heparin, fibrinogen, and fresh-frozen plasma led to significant elevation of fibrinogen (156 mg/dl) and antithrombin III (102%) without changing the decreased activities of the procoagulant factors. Similarly, the signs of hyperfibrinolysis persisted (fibrinogen degradation products, 50 micrograms/dl; plasminogen, 43%; alpha-2 antiplasmin, 74%). The hemangioma was completely removed by excision of the left lobe of the liver. Subsequently, all coagulation parameters returned to normal, indicating a complete reversibility of the coagulation disorder.

Abstract Several side‐effects of asparaginase therapy have been said to be a consequence of the glutaminase activity of Escherichia coli asparaginase, especially the deleterious influence on the liver function. We report here the drug‐induced impairments of asparagine and glutamine metabolism in correlation to concentrations changes of plasma proteins, synthesized in the liver, in patients with acute lymphatic leukaemia. One hour after asparaginase application, plasma glutamine decreased to 5% (0–39%: median, range) of the initial values, with a subsequent rise to concentrations slightly lower than those prior to therapy. During the 14 days of drug application the fasting plasma concentrations of glutamine fell to a median of 63% of the pre‐therapeutic levels, indicating a depletion of the glutamine pools. Two days after the end of asparaginase application, in one patient the glutamine concentrations increased to the pre‐therapeutic range. Plasma concentrations of fibrinogen and antithrombin III decreased to 46% and 56%, respectively, of the initial values, with a slight increase 2 days after the end of therapy. The changes of plasma protein concentrations followed the course of plasma glutamine and asparagine. From that we deduce that the hepatic synthesis of the plasma proteins might be influenced by asparagine and glutamine depletion as a consequence of the therapy with E. coli asparaginase.

In 51 unselected mothers, we studied, before and after delivery: serum ferritin, serum iron, serum transferrin, the eryhtrocyte count, the hemoglobin concentration, the hematocrit, and the derived red cell indices. Eighteen percent of women showed a hemoglobin value below 120 g/l. The mean transferrin saturation (22 ±7.6% (SD) and the mean serum ferritin (34 ± 18 μg/l (SD) indicated a probable decrease of iron stores at term. Only three patients seemed to show hematological evidence of latent iron deficiency, and none had manifest iron deficiency. A decrease of iron stores is considered to be physiological. There was no apparent relation between iron store values and infant birth weight centiles. After delivery the changes in red blood indices showed a close correlation with the amount of blood lost during delivery. At 5 or 6 days post partum the serum ferritin level increased and values showed a wide scatter. As with other acute phase proteins, ferritin synthesis might be stimulated by the non-specific mechanisms during the perinatal period. Hence, after normal delivery serum ferritin levels do not necessarily indicate normal iron stores.

For the diagnosis of primary osteoporosis, various semiquantitative radiologic methods were compared in 149 unselected patients, aged over 50 years. Crush fracture syndrome (CFS), lumbar spine index (LSI), and Singh Index (SI) were assessed by three radiologists and after reevaluation, the intra-and interobserver errors were calculated. The reliability of the subjective grading was improved by joint and repeated reading of the radiographs. Additionally, the peripheral trabecular bone content was measured by photonabsorptiondensitometry (PAD). To test the value of the various semiquantitative methods, LSI, SI, and PAD have been compared with sex-matching before and after separation into age in decades in CFS-positive and CFS-negative patients. In an attempt to differentiate osteoporotics nonosteoporotics by CFS, our results indicate that CFS-positive and CFS-negative males cannot be separated by LSI, SI, and PAD, whereas in females these methods can discriminate irrespective of the age in decades. However, in age related groups, only SI can discriminate significantly between CFS-positive and CFS-negative females. Correlation of the semiquantitative methods, regardless of the diagnosis of a CFS, revealed a significant correlation-between SI and PAD, but no correlation between LSI and SI, and LSI and PAD, respectively.

Investigations of a patient with the benign adult form of osteopetrosis (Albers-Schönberg) revealed that the clinical symptoms correlated with a high bone metabolism, high calcium incorporation in bone, increased osteoclast activity and probably reactive increase of calcitonin in the blood.

Serum ferritin, -iron, and -transferrin, and red cell blood count in 53 non-selected pregnant women at term, and from the respective cord blood samples were determined. In addition, serum ferritin was measured in 20 infants longitudinally on the first and sixth day of life. The mean cord blood concentrations of fetal serum ferritin were 135 micrograms/l, (maternal: 30,5 micrograms/l), and of fetal serum iron 27,7 mumol/l (maternal: 17,3 mumol/l), and of fetal transferrin 1,6 g/l (maternal: 4,43 g/l). A correlation between maternal and fetal serum ferritin levels could not be demonstrated. There was also no relationship between maternal serum ferritin concentrations and fetal serum iron, transferrin, and red blood count. Within the first week of life serum ferritin levels of the newborn showed a tendency to increase. From these results and from experimental data in the literature, we conclude that the feto-placental unit covers its demand on iron at the mother's expense, and independent from maternal iron stores. It is probably only an additional insufficient nutritional supply of iron, combined with depleted iron stores which might have unfavourable effects to the fetal and neonatal iron metabolism.

Die Anämie bei Patienten mit chronischer Polyarthritis (cP) gilt als häufige extraartikuläre Manifestation dieser Krankheit. Indirekte Parameter des Eisenstatus wie Serumeisen, Transferrin, Transferrinsättigung, Hämoglobin, Erythrozyten oder Erythrozyten-Indizes geben aber bei der chronischen Polyarthritis keinen exakten Hinweis für den Füllungszustand der Eisenspeicher [1]. Ein Eisenmangel, z.B. bedingt durch subklinisch verlaufende, chronische, gastrointestinale Blutverluste nach Langzeittherapie mit verschiedenen Antirheumatika, kann die bestehende Anämie zusätzlich komplizieren. Serumferritin zeigt eine gute Korrelation mit dem zytologisch nachweisbaren Speichereisen [2, 3]. Aus diesem Grund scheint dieser Parameter als Screening-Test für die Indiaktionsstellung einer Eisentherapie bei der cP geeignet zu sein. Diesbezügliche Studien liegen bisher nicht vor.