H. E. Nielsen

THE SUBCHONDRAL BONE OF THE PROXIMAL TIBIAL EPIPHYSIS IN OSTEOARTHRITIS OF THE KNEE

The trabecular bone of the proximal end of the tibia was assessed as an endoprosthesis-bearing structure. The mass and mineral content as well as the activity of subchondral trabecular bone were determined in osteoarthritis knees with varus or valgus deformity. Bone specimens were taken from the lateral condyle, the medial condyle, and centrally from the intercondylar area of seven varus and four valgus knees. The percentage volume of trabecular bone was determined by histomorphometry. On an additional nine knees, five with varus and four with valgus deformity, as well as ten knees from a normal autopsy material, photon absorptiometric determination of the mineral content of the same areas was performed. On average, the loaded condyle had twice the percentage volume of trabecular bone, and accordingly twice the mineral content, of the unloaded condyle. It was remarkable that the mineral content of the latter was of the same order as the condyles of the normal material.

Osteonecrosis in renal transplant recipients. Early radiological detection and course.

Early radiologic signs and the radiologic course were examined retrospectively in 20 renal transplant patients who developed osteonecrosis after transplantation. Osteonecrosis appeared in 25 hips, 8 knees, 9 shoulders and 1 elbow. In most patients who developed osteonecrosis of the hip the early radiologic signs of osteonecrosis, with areas of lucencies and increased densities, were preceded by a thin fracture line in the immediate subchondral bone, parallel to the articular surface, appearing within a mean of 14 months after renal transplantation. This change seems to be a specific and very early finding in patients who subsequently develop osteonecrosis after renal transplantation. The initiation of collapsing phenomena of the articular surface was preceded by architectural changes near the articular surface wtih areas of lucencies and sclerosis. At the time of this investigation 26 per cent of the bones showed signs of regression of the changes with rebuilding of the former shape; 32 per cent showed progression and in 42 per cent the condition was stationary.

Pentagastrin, calcium and whisky stimulated serum calcitonin in medullary carcinoma of the thyroid.

The efficiency of pentagastrin, calcium and whisky in raising serum immunoreactive calcitonin (S-iCT) concentrations was analysed in 6 patients with medullary carcinoma of the thyroid and in 8 healthy controls. All 6 patients responded to pentagastrin with a significant increase in S-iCT, 5 responded to calcium and only 3 to whisky. In the 8 controls no or only a modest increase in S-iCT occurred following pentagastrin, calcium and whisky with no difference between the three. It is concluded that pentagastrin is the most useful stimulative agent for ICT secretion in patients with C-cell neoplasms. In selected cases the additional use of calcium could be advantageous.

Bone mineral content in osteogenesis imperfecta tarda and in otosclerosis.

In 22 patients with osteogenesis imperfecta and in 63 patients with otosclerosis the bone mineral content in peripheral bones was determined by photon absorptiometry. The bone mineral content proved significantly reduced in patients with osteogenesis imperfecta as compared with normals and with patients with otosclerosis. In the latter patients the bone mineral content was normal. These findings support the assumption that stapedial fixation in otosclerosis and in osteogenesis imperfecta is of different aetiology.

Serum calcitonin and bone mineral content in patients with osteogenesis imperfecta.

Serum calcitonin and bone mineral content in the forearm, measured by photon absorptiometry, were investigated in 21 patients with osteogenesis imperfecta tarda. The bone mineral content was significantly reduced as compared with normal controls, whereas the bone mineral content corrected for bone width was normal in adult patients but subnormal in children and young adults. Serum calcitonin did not differ significantly from that in normal individuals and no relation was found between serum calcitonin and bone mineral content.

Food-Stimulated Serum Calcitonin Concentrations in Patients with Ulcer Negative Dyspepsia, Duodenal Ulcer and in Controls

In 12 normals serum calcitonin (CT) concentration decreased significantly when eating wtih a return to basal value and a significant postprandial fall. No difference was observed in the food-stimulated CT secretion between duodenal ulcer patients and normals. In 25 patients with ulcer negative dyspepsia a significant increase in serum CT concentration occurred during food intake followed by a return to basal level and a secondary significant rise. The pattern in patients with ulcer negative dyspepsia differed significantly from patients with duodenal ulcer and normals.

OSTEONECROSIS AND SPONTANEOUS FRACTURES FOLLOWING RENAL TRANSPLANTATION A Longitudinal Study of Radiological Bone Changes and Metacarpal Bone Mass

Seventy-seven renal transplant (RT) recipients were studied radiologically with regard to bone lesions and metacarpal bone mass, at the time of and after renal transplantation. An increased incidence of rarefaction of the spine, a reduced metacarpal bone mass and an increased frequency of subperiosteal erosions were found at the time of transplantation in RT patients who subsequently developed osteonecrosis or spontaneous fractures as compared with RT patients who did not develop these bone complications. During the years after RT an increase in rarefaction of the spine, in subperiosteal erosions, in soft tissue calcifications and a decrease in metacarpal bone mass were found in all patient groups.

Relation Between Severity of Thyrotoxlcosis and Response to 131I Therapy

The relation between the severity of hyperthyroidism and response to 131I therapy was tested in a group of 45 patients 6 to 12 months after therapy. At following treatment 7 patients were hypothyroid, 13 euthyroid and 25 hyperthyroid. The absolute iodine uptake and gland size was significantly higher in the hyperthyroid group compared with the other groups. The radiation dose was similar in the groups, but the ratio between dose and uptake was significantly lower in the hyperthyroid group.