Calcium isotope composition in serum and urine for the assessment of bone mineral balance (BMB) - The Osteolabs post-market follow-up study.

To further explore the clinical applicability of the calcium (Ca) isotope marker (CIM), we determined the 44Ca/42Ca isotope ratio in blood serum and urine. This ratio is expressed in the conventional δ-notation (as defined in the text below) specifically as CIM-serum for serum and as CIM-urine for urine. Our study tested the hypothesis that CIM values can differentiate between positive and negative bone mineral balance (BMB) across a diverse clinical population considering variables such as age, gender, and diet. The threshold values (CIM-serum: -0.85 ± 0.06 ‰ and CIM-urine: 0.23 ± 0.06 ‰) established in the OsteoGeo study (NCT02967978, Eisenhauer et al., 2019) were evaluated in 2320 participants as part of a surveillance study referred to as Osteolabs study. The earlier study revealed women with osteoporosis had an average CIM-serum value of -0.91 ± 0.21 ‰ (N = 24) and a CIM-urine value of 0.18 ± 0.33 ‰ (N = 71) that are significantly below the threshold values (p = 0.02 for urine, one-sided Wilcoxon rank test, p < 0.001 for serum, one-sided Student's t-test). Diseases affecting BMB such as osteoporosis, acute and chronic kidney disease (CKD), hyperthyroidism, breast cancer, prostate cancer, and myeloma were associated with significantly lower average CIM values, falling below the equilibrium thresholds and indicating negative BMB. In contrast, patients receiving osteoprotective treatments such as denosumab, Romosozumab, bisphosphonates, or hormone replacement therapy for certain diseases, had CIM values above the equilibrium thresholds indicating a positive BMB. Additionally, Ca supplements taken by some of the patients ((N = 22 (serum), N = 49 (urine), median dose: 500 mg) showed a Ca isotope composition approximately 1 ‰ higher than that from a normal diet. Consequently, their CIM values need to be adjusted to account for the amount and duration of supplementation to be comparable to those with a normal diet. Participants taking vitamin D (237 women; 58 men) showed no significant difference from the average values of the study group. Counterintuitively, the possible impact of malnutrition on individual BMB was most pronounced in vegans, who exhibited the highest average CIM-urine values compared to patients on a normal diet (p < 0.001, N = 17). The results of this study were consistent with the registered OsteoGeo study (NCT02967978) and other earlier published Ca isotope-based studies on BMB. We confirm that the CIM threshold values determined in the OsteoGeo study are generally valid for this much larger and diverse surveillance study group covering a diverse population encompassing various medical conditions and therapies.

[Therapy concept in phyllodes tumors of the breast]. / Therapiekonzept bei Phylloides-Tumoren der Brustdrüse.

The data of 22 women with a phyllode tumor of breast operated in our department from 1980 to 1997 were analysed. 11 benign, 7 borderline and 7 malign phyllode tumors were found in accordance to WHO-classification. In conclusion diameter of tumor is a relevant prognostic factor beside histologic classification. Therefore local excision is recommended for benign and borderline phyllode tumors smaller than 5 cm. A safety distance of 1 cm is claimed. Benign or borderline lesions greater than 5 cm and all malign require a simple mastectomy. Only recurrence smaller than 5 cm after excision of benign and borderline phyllode tumor should excised once more. Metastasis have to be cured by surgical therapy.

[90th birthday of the Monatsschrift Kinderheilkunde]. / Zum 90. Geburtstag der Monatsschrift Kinderheilkunde.

The first issue of the Monatsschrift für Kinderheilkunde (Monthly Journal of Pediatrics) appeared in October 1903 with contributions by leading European pediatricians. The editor was Arthur Keller, who remained responsible until 1934. As a novelty, the journal contained detailed reviews of world-wide pediatric literature. After Keller's death in 1934, Georg Bessau became editor-in-chief for the next 10 years. The first issue after the second world war appeared in 1948/49 and was edited by Hans Kleinschmidt, Göttingen. In 1962 the editorial responsibility was transferred to Karl Heinz Schäfer, whom joined Hans Ewerbeck in 1970. The monthly journal written in German deals with informations for pediatricians in children's hospitals and in practices and with scientific contributions in all fields of pediatrics and related areas. The present editors are Flix Bläker and Werner Schröter. In 1949 it became the official organ of the Deutsche Gesellschaft für Kinderheilkunde (German Society of Pediatrics), endorsed by the impressum since 1956. In 1993 the subscription of the journal became part of the membership fee of the Deutsche Gesellschaft für Kinderheilkunde.

[The 150th birthday of Otto Heubner 21 January 1993]. / Zum 150. Geburtstag von Otto Heubner am 21. Januar 1993.

Otto Heubner can be counted among the fathers of pediatry. Beginning as an autodidact, he became pediatrist by chance, holding the first university chair in Germany (1884) exclusively devoted to pediatry; he needed no Dr. med. habil. thesis. Observing the little patients was his primary interest; for the infants treated in the hospital he introduced "aseptic environments". Heubners main scientific achievements were the treatment of infectious and stomach-intestinal diseases. He described "Endarteritis syphilitica" and found Meningococci in the cerebrospinal fluid. "Serious deficiency of digestion" (Coeliac disease) became known through his work. Together with his friend M. Rubner he created the notion of EQ (Nutrition Quotient). Also, he realized the functional effects of orthotic albuminuria. Heubners centers of activity were Leipzig and Berlin, where he had a large community of followers; his successor, recommended by him, was A. Czerny.