[Estrogen treatment of excessively tall girls (author's transl)]. / Beeinflussung des Grössenwachstums grosswüchsiger Mädchen durch Ostrogentherapie.

20 girls, their age being between 8 to 13 years, with an actual height above the 97th percentile received 10,0 mg conjugated estrogens per day cyclicly or 0,3 mg ethinylestradiol continuously over a period of 0,3 to 3,8 years, in order to inhibit excessive growth. The duration of therapy ranged from 0,6 to 3,8 years regularly. Before and during treatment the patients were examined, and each time the expected final height was calculated based on the actual height and the bone age. The stage of puberty was defined according to Blizzard, and the determination of the bone age was performed as described by Tanner and Whitehouse. The extragenital side effects were also recorded. The effectiveness of the estrogen treatment, i. e. the reduction of the expected final height, depends on the chronological age, the skeletal age and the stage of puberty before therapy. It ranged between 0,5 and 5,1 cm. The earlier treatment was started the better were the results. The effectiveness was more obvious in cases with continuous estrogen treatment. No serious side effects could be observed.

[Excessive peripheral conversion of thyroxine (T4) to triiodothyronine (T3) in the pathogenesis of T3-hyperthyroidism (author's transl)]. / Exzessive periphere Konversion von Thyroxin (T4) zu Trijodthyronin (T3) in der Pathogenese der T3-Hyperthyreose

In a 41-year-old woman and a 3-year-old girl, both of them with T3-thyrotoxicosis, serum levels of total and free T4 and T3 were measured serially during anti-thyroid drug treatment. Attempts to substitute thyroxine during the antithyroid treatment had to be interrupted because the patients became hyperthyroid again with excessive increases in total and free serum T3, even when concentrations of total and free T4 were brought to subnormal levels. The increased conversion of administered thyroxine ceased later on and higher amounts of oral T4 were tolerated after one year of treatment. In both patients there was an extremely low serum T4/T3 ratio, differing in this respect significantly from six other patients with T3-thyrotoxicosis and 41 patients with "conventional" T3/T4-hyperthyroidism. It is concluded that, in patients with T3-thyrotoxicosis due to excessive peripheral T4 to T3 conversion, substitution during antithyroid drug treatment should be either with very low doses of thyroxine or with triiodothyronine in divided daily doses. In such cases the level of serum T3 represents the most reliable biochemical measurement for the control of treatment, serum T4 levels being irrelevant.

[The pycnodysostosis (author's transl)]. / Die Pyknodysostose

Two own observations of pycnodysostosis initiated our description of this disease. Inherited as an autosomal recessive trait the syndrome is characterized by a medium degree generalized osteosclerosis, open craniial sutures and fontanels until adult lige, hypoplastic mandibles with deficiency of the angle, prominence of the forehead and occiput, hypoplasia of the paranasal sinuses, commonly observed dysproportionate dwarfism, acro-osteolysis and increased bone fragility. Contrary to osteopetrosis the prognosis is good.