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Dual energy X-ray absorptiometry of bone density in the lumbar vertebral column was performed in 32 young women (mean age 24.6 [19-34] years) with hypergonadotropic hypogonadal amenorrhoea. There was a significantly lower bone density (0.74 +/- 0.27 g/cm2) than in a control group of 27 women of similar age (1.17 +/- 0.081 g/cm2; P less than 0.001). Subsequently 21 of the 32 women received cyclical hormone substitution therapy for 24 months (day 1-30: 0.625 mg conjugated oestrogens; additionally, on days 20-30: 5 mg medrogestone; followed by a seven-day pause). After 6 months bone density, compared with that of the 11 untreated women, had increased significantly (P less than 0.001). It is therefore recommended that young hypoestrogenemic women should receive early and continuous hormone substitution treatment.

Bonestability is not only determined by the content but also by the construction of the mineral part and the biochemical structure. In addition the organic parts are important, too. Result of the measurements shows only the bone-quantity. The development of several measurement techniques (highquality quantitative computertomography [QCT]) allow us diagnoses concerning the bone quality. Single photon absorptionsdensitometry (SPA), DPA (dual photon absorptiometry), DEXA (dual energy X-ray absorptiometry) and QCT (quantitative computertomography, peripher and central) are todays measurement techniques. In the meantime SPA looses the importance, also DPA-method is displaced by DEXA.

Bone density was evaluated in 182 healthy climacteric women. Women were recruted from a general prevention program. The results show deviation from 58.2 to 218.6--mean value 128.28, SD 30.91 mg/ccm K2HPO4. 28% of bone density values are under the fracture risk level citated in literature. No statistical relationship was found between bone density and anamnestic data--only the age at hysterectomy shows statistical correlation. The follow up after one year shows no predictive value of anamnestic data to the lost of bone mineral density.

Objective: To assess the bone mineral density in World Health Organization (WHO) III women after hormone replacement therapy., Design: We studied the bone mineral density of 41 women with premature ovarian failure (hypergonadotropic hypogonadic amenorrhea--WHO III) before and during hormone replacement therapy., Setting: All WHO III women were recruited from the Outpatient Department of the First Department of Gynecology and Obstetrics, University of Vienna Medical School, Austria, a public University Hospital., Patients, Participants: Forty-one patients, 30 healthy women., Interventions: Twenty-eight of 41 WHO III women received cyclic hormone replacement therapy consisting of 0.625 mg conjugated estrogen (days 1 to 30) and 5 mg medrogeston (days 20 to 30) in addition, with a 7-day interval., Main Outcome Measure: The bone mineral density was evaluated by single photon absorptiometry and dual energy x ray absorptiometry every 6 months (single photon absorptiometry six times, dual energy x ray absorptiometry four times)., Results: The bone mineral density in young women with hypergonadotropic hypogonadic amenorrhea (WHO III) was lower than in age-matched controls. Hormone replacement therapy produced an increase in bone mineral density in 28 WHO III women, whereas bone mineral density remained quite constant in the women without therapy., Conclusion: Hormone replacement therapy increases the bone mineral density of women with hypergonadotropic hypogonadic amenorrhea. Hormones should be substituted early and consistently in affected patients.

In 21 patients, suffering from amenorrhoeic hypergonadotropic ovarian insufficiency (age 27 +/- 3 years [FSH: 43 +/- 10, LH: 40 +/- 8]), the bone density was measured by single-photon densitometry (SPA), before starting a hormonal replacement therapy with oestrogen/progesterone. Every 5 months, the trend in bone density change was measured in all cases. The bone density before hormonal treatment was lower in the WHO III-group (1.36 +/- 0.21 g/cm; 1.09 +/- 0.26 g/cm2) than in the age-matched group (1.57 +/- 0.21 g/cm; 1.28 +/- 0.31 g/cm2). Bone density increased after hormonal therapy (p less than 0.05). These results point to the necessity of hormonal replacement therapy in cases of WHO III.

Although glucocorticoids have been universally implemented to stimulate fetal lung maturity, their effectiveness and side effects are still widely contested. In search of alternative drugs a double-blind study was conducted between June 1981 and June 1984 comparing betamethasone, a conventional corticoid, and ambroxol, a bromhexine metabolite for efficacy and tolerance in prenatal prevention of the respiratory distress syndrome (RDS) in premature infants and full-term neonates. The therapeutic efficacies of betamethasone and ambroxol for this indication proved to be comparable. Since the possible risks of corticoid therapy in abnormal pregnancies are repeatedly discussed in the literature and in daily clinical practice. 137 patients with EPH gestosis, placental insufficiency, diabetes mellitus, and premature rupture of the membranes were selected from the original group of 308 patients. Only minor side effects (e.g. nausea) were present in a few of the 137 cases undergoing treatment with the 2 test substances. No side effects were observed in the neonates. The incidence of fetal RDS was comparable in both groups (2.9% with ambroxol, 2.2% with betamethasone). Transient and mild RDS cases were slightly more frequent in the ambroxol group than in the betamethasone group. To date, contraindications to ambroxol treatment in abnormal pregnancies are unknown and since generally the rate of potential side effects is considered to be lower in comparison with corticoid treatment, the use of ambroxol especially in abnormal pregnancies corresponding indication can be recommended.