Metabolic balance studies in patients with Paget's disease receiving salmon calcitonin over long periods.

Metabolic balance and calcium kinetic studies were performed in four patients with Paget''s disease before treatment with salmon calcitonin and during the early and late stages of the treatment, which lasted 9 to 19 months, A significant decrease in bone turnover and 24-hour urine hydroxyproline and serum alkaline phosphatase values was observed in all patients. In contrast, the calcium, phosphorus and magnesium balances did not change significantly. In agreement with this, the partial body calcium, measured by in vivo neutron activation analysis, did not change. Intestinal calcium absorption increased initially, but returned to baseline levels 9 to 19 months after the study began. During the initial period there was a small, significant, but transient decrease in tubular reabsorption of phosphorus; this was accompanied by a significant decrease in serum phosphorus values--probably a direct effect of calcitonin rather than evidence of secondary hyperparathyroidism. Administration of salmon calcitonin to patients with Paget''s disease decreases bone turnover without affecting calcium and phosphorus balances.     

Treatment of Paget's Disease of Bone with Mithramycin

We report data from three patients with severe Paget''s disease of bone who were treated with mithramycin.Mithramycin infusion resulted in a fall in plasma calcium, phosphate, alkaline phosphatase, and urinary hydroxyproline excretion. There was an improvement in calcium and phosphorus balance in two of the three subjects studied. A pronounced or complete relief of bone pain occurred in all three.We suggest that mithramycin exerts its beneficial effect in Paget''s disease of bone by stimulating parathyroid hormone release. The parathyroid hormone released has a predominantly anabolic action on bone since its catabolic action is blocked by mithramycin, which inhibits bone resorption.     

Renal Effects of Calcitonin

Porcine calcitonin in a slow-release gelatin vehicle was given by intramuscular injection to 10 patients—four with primary hyperparathyroidism, four with Paget''s disease, and two with carcinoma of the breast and hypercalcaemia. All cases showed a fall in serum calcium with an immediate rise in urine calcium. All except three patients with primary hyperparathyroidism showed a fall in serum phosphorus, but an immediate rise in urine phosphorus occurred in all cases. Urine hydroxyproline output fell in three patients with severe Paget''s disease. Urine sodium rose in all cases, but the effects on potassium, magnesium, water, and pH were not appreciably different from results obtained in four control subjects who were given the gelatin vehicle alone.The data suggest that calcitonin caused a decrease in the tubular resorption of calcium and phosphorus. The hypocalcaemic effect appeared to be due to a decrease in bone resorption in the patients with Paget''s disease but in the remaining cases could be accounted for in part or entirely by the rise in urine calcium.     

Effects of calcium deprivation and orchidectomy on bone composition in the rat.

The effects of calcium deprivation and of orchidectomy, separately and combined, on body growth and bone composition have been examined in mature male rats. Calcium deprivation had no significant effect on the rate of body growth but femoral bone weight, bone ash weight and total calcium and phosphorus contents of the femora were reduced while the water content increased. However, there were no significant changes in the ratio of bone weight to body weight, in the amounts of calcium or phosphorus per unit weight of bone, or in the ratio of calcium to phosphorus in the bone. Orchidectomy reduced the rate of body growth, the mean weight of the femora and the ratio of bone weight to body weight. There was a 60% decrease in bone water and a 30--35% reduction in the calcium and phosphorus content of the femora but the amounts of ash, calcium and phosphorus per unit weight of bone fell by only 6--10%. The combination of orchidectomy and calcium deprivation had no greater effect on body weight, bone weight or bone composition than had orchidectomy alone. It is concluded that calcium deprivation and orchidectomy both cause osteoporosis in mature rats but the effects of orchidectomy are more severe than those of calcium deprivation and there appears to be some demineralization of the bone remaining after orchidectomy.     

Early growth and bone mineralization of the iguanid lizard,Sceloporus occidentalis in captivity: Is vitamin D3 supplementation or ultraviolet B irradiation necessary?

The insectivorous, heliophilic iguanid lizard, Sceloporus occidentalis, was used in this study. Eight groups of field-collected juveniles were subjected to different doses of ultraviolet-B radiation or were fed crickets maintained on different diets with varying amounts of vitamin D₃ and other nutrients. The crickets fed to all groups were dusted with calcium carbonate powder. Snout-vent lengths and body masses were significantly greater within each group at the end of 10 weeks; however, there were no significant among-group differences in growth. There were no differences among treatment groups regarding plasma calcium concentration or bone calcium, phosphorus or magnesium concentrations. However, compared to length-matched field controls, individuals from treatment groups had significantly greater body masses, greater bone calcium concentrations, and lower bone magnesium concentrations. Lizards exposed to ultraviolet radiation exhibited lower plasma phosphorus concentrations relative to several other treatment groups and field controls. In the field sample, bone calcium concentration was positively correlated with body size while bone magnesium and phosphorus concentrations were negatively correlated with body size.     

The morphology and function of rat C-cells. 4. Determination of calcium, inorganic phosphorus and total nitrogen in the femora of untreated parathyroidectomized or thyreoparathyroidectomized and hormonally substituted female rats]

Female Wistar rats of a live weight of about 160 g and fed with a standard laboratory diet, were parathyroidectomized, or thyroparathyroidectomized and treated with thyroxine, parathyroid hormone, calcitonin. thyroxine and parathyroid hormone, or thyroxine and calcitonin. On the 15th day post operationem, and after twelve days of hormone treatment, the concentrations of calcium, inorganic phosphorus and total nitrogen were determined in the femur bone. Parathyroidectomy resulted in a decrease of phosphorus concentration in bone. After thyroparathyroidectomy (Tx), the concentrations of inorganic phosporus and nitrogen diminished during some days, whereas the calcium content decreased continuously. Thyroxine application normalized the concentration of inorganic phosphorus. The osteolytic and nitrogen-anabolic effect of parathyroid hormone took place only in simultaneous treatment with thyroxine. The injection of calcitonin had a nitrogen-anabolic effect on bone; the simultaneous treatment with thyroxine induced a loss of calcium out of bone, and a deposition of calcium phosphate in renal tissue. Calcitonin did not inhibit a significant decrease of calcium concentration in the femur bone; the hypophosphatemic effect was always present. The metabolism of bone tissue, influenced by hormonal actions, probably determined the localization of the deposition of inorganic phosphorus, deserting the serum under the influence of calcitonin.     

饲料钙磷含量和钙磷比对生长期大鼠体重增长与骨骼发育的影响

目的研究饲料中不同的钙磷含量和钙磷比对生长期实验大鼠体重及骨骼发育的影响。方法采用完全随机化设计方案,取1月龄（100±10）g清洁级Wistar雄性大鼠70只,随机分成7组,每组10只,饲喂7种不同钙磷含量的饲料。自由采食,饮用去离子水,试验期42 d。各组于实验开始和结束时称重。试验结束后,处死动物并分离一侧胫骨和股骨用于实验指标的检测。结果当保持饲料中钙或者磷中的一种含量不变的情况下,调整另一种的含量即改变钙磷比例时,1.2∶1的正常钙磷比例组生长期实验大鼠增重及骨骼发育要明显好于0.4∶1的低钙磷比例组和4∶1的高钙磷比例组（P〈0.05）,并且当保持饲料中钙磷比例不变时,即使在低钙低磷和高钙高磷进食水平下,正常钙磷比例组大鼠增重及骨骼发育都较好,但低钙磷比例组和高钙磷比例组大鼠增重及骨骼发育则由于饲料中钙磷含量的变化波动较大（P〈0.05）。结论饲料中钙和磷需按比例添加,如果两者绝对含量相差过大就会影响到动物的增重及骨骼发育,本实验证明饲料钙磷比为1.2∶1时生长期实验大鼠增重及骨骼发育较好。     

HYPERPARATHYROIDISM

Because of the variable and vague clinical symptoms of the disease, diagnosis of hyperparathyroidism may be missed or delayed.Presenting symptoms and findings may be localized to the urological system or to the skeletal framework, with indications of abnormal blood calcium levels.In any case in which the patient''s only complaints are malaise, lassitude, or progressive weakness, and in which routine laboratory findings are inconclusive, the blood calcium level should be determined.While not in itself diagnostic, a high level of calcium in the blood will lead to further investigation such as skeletal x-ray studies and blood phosphorus and serum alkaline phosphatase determinations.Vigilance postoperatively to forestall tetany is of great importance.     

Model for skeletal resistance to vitamin D in renal failure.

Chronic renal disease in man and animals is associated with disturbances in calcium homeostasis which are resistant to vitamin D-therapy. Partially nephrectomized and intact rats were used to evaluate the effect of uremia on the response of bone to vitamin D. Serum calcium, serum phosphorus and blood urea nitrogen levels were higher in uremic rats than in intact rats, both given vitamin D. Metaphyseal bone in uremic rats was resistant to vitamin D-induced bone resorption; osteoblasts and osteocytes appeared less active ultrastructurally and osteoclass were infrequent. Calcitonin synthesis and release evaluated electron microscopically was greater in uremic rats. It is suggested that the altered response of bone to vitamin D in uremic rats was due in part to elevated serum phosphorus and increased calcitonin release. The present model does not refute experimental and clinical data that metabolism of vitamin D is altered in renal disease. It does, however, emphasize that in chronic renal failure other parameters (phosphorus levels, calcitonin release, uremia) are operating which may influence end organ response to pharmacologic doses of vitamin D. The partially nephrectomized rat may be a useful model for evaluating end-organ resistance to vitamin D in uremia.     

The Effect of Bovine Parathyroid Hormone Withdrawal on MC3T3-E1 Cell Proliferation and Phosphorus Metabolism

Hypocalcemia and hypophosphatemia are common complications after parathyroidectomy (PTX). Sudden removal of high circulating levels of parathyroid hormone (PTH) causes decreased osteoclastic resorption resulting in a decreased bone remodeling space. These phenomena are likely due to an increased influx of calcium and phosphorus into bone. However, there are currently no data to support this hypothesis. In this study, we found that PTX significantly reduced levels of PTH, calcium and phosphate. Compared with preoperative levels, after 1 year, postoperative PTH, calcium and phosphate levels were 295.6 ± 173.7 pg/mL (P < 0.05), 86.62 ± 15.98 mg/dL (P < 0.05) and 5.56 ± 2.03 mg/dL (P < 0.05), respectively. We investigated continuous bovine PTH administration as well as withdrawal of bovine PTH stimulation in the mouse osteoblast precursor cell line MC3T3-E1. MC3T3-E1 cells were cultured with continuous bovine PTH treatment for 20 days or with transient bovine PTH treatment for 10 days. High doses of continuous bovine PTH exposure strongly reduced cell proliferation, alkaline phosphatase activity and the number of mineralized calcium nodules. However, withdrawal of bovine PTH (100 ng/mL) significantly increased the number of mineralized calcium nodules and caused a rapid decline in calcium and phosphorus content of culture medium. In conclusion, continuous exposure to bovine PTH inhibited osteoblast differentiation and reduced the formation of mineralized nodules. However, this inhibition was removed and mineralized nodule formation resumed with withdrawal of bovine PTH. According to the results of our clinical examinations and in vitro experiments, we hypothesize that the sudden removal of high levels of PTH may cause an increased influx of calcium and phosphorus into bone after PTX.     

Bone and serum calcium in normothermic,cold-acclimated and hibernating hamsters

• 1.1. An examination of calcium homeostasis in a facultative hibernator, the golden hamster (Mesocricetus auratus) was made.
• 2.2. Fresh bone length and weight, and ash bone calcium and phosphorus were examined in normo-thermic, cold-acclimated and hibernating hamsters.
• 3.3. Although fresh bone weight changes were noted, when corrected for body weight, no change was seen in either hibernating or cold-acclimated animals. Bone calcium and phosphorus were similarly unaffected by these forcings.
• 4.4. The data are supported by histologie studies of bone and constant plasma calcium values, and are discussed in terms of mechanisms underlying alterations in mineral balance.

     

Calcium metabolism in adult outpatients with epilepsy receiving long-term anticonvulsant therapy

Long-term anticonvulsant drug therapy may lead to abnormalities of calcium metabolism resulting in osteomalacia. The prevalence and severity of altered calcium metabolism was studied in an adult outpatient population of persons with epilepsy receiving anticonvulsant therapy for a minimum of 2 years. Assessment of calcium metabolism was based on serum concentrations of calcium, phosphorus, alkaline phosphatase and 25-hydroxycholecalciferol and of plasma parathyroid hormone, intestinal absorption of isotopic calcium and skeletal bone mineral mass as determined by in vivo neutron activation or x-ray photodensitometry.Thirty-nine patients who had been receiving anticonvulsant therapy for an average of 20 years were studied; none had clinical evidence of metabolic bone disease. Decreased serum calcium concentration was noted in 10%, decreased serum phosphorus concentration in 10% and elevated serum alkaline phosphatase concentration in 44%. The mean serum 25-hydroxycholecalciferol concentration was significantly lower (P < 0.001) than in a control group (11.6 v. 19.6 mg/mL). None of 18 patients studied had an increased plasma concentration of parathyroid hormone, and only 1 of 17 patients had decreased intestinal absorption of isotopic calcium. Bone mineral mass was decreased in 44% of 32 patients studied.It was concluded that long-term treatment with anticonvulsant drugs leads to mild abnormalities of calcium metabolism and decreased bone mineral mass in a substantial percentage of adult outpatients with epilepsy. These abnormalities probably predispose the patients to the development of clinically significant metabolic bone disease.     

钙、磷摄入对骨代谢及骨组织形态影响的研究进展

骨代谢始终贯穿于动物的生命过程之中,而机体摄入的钙、磷水平和钙、磷比例又是骨代谢的重要影响因素。钙、磷摄入水平和比例的改变会使甲状旁腺激素（PTH）、降钙素（CT）和1α,25-双羟维生素D3[1,25-（OH）2D3]的水平产生变化,影响RANK／RANKL／OPG系统对骨细胞功能的调控,进而对骨代谢及骨组织形态产生影响。骨唾液酸蛋白（Bone Sialoprotein,BSP）是目前评价成骨细胞分化和骨骼矿化情况的新指标,研究BSP表达水平的变化规律,可以从分子水平解释钙、磷摄入水平和比例对骨组织形态影响的机理。而骨组织形态计量学（Bone Histomorphometry）则是研究钙、磷摄入水平和比例对骨组织形态影响的重要方法。     

A mild magnesium deprivation affects calcium excretion but not bone strength and shape, including changes induced by nickel deprivation, in the rat

An experiment was performed to determine the effect of a mild magnesium deprivation on calcium metabolism and bone composition, shape, and strength in rats, and whether nickel deprivation exacerbated or alleviated any changes caused by the magnesium deprivation. Weanling male rats were assigned to groups of 10 in a factorial arrangement, with variables being supplemental nickel at 0 and 1 mg/kg and magnesium at 250 and 500 mg/kg of diet. The basal diet contained about 30 ng Ni/g. Urine was collected for 24 h during wk 8 and 12, and rats were euthanized 13 wk after dietary treatments began. Mild magnesium deprivation decreased the urinary excretion of calcium and increased the tibia concentration of calcium but did not affect femur shape or strength (measured by a three-point bending test). Dietary nickel did not alter these effects of magnesium deficiency. Nickel deprivation increased the urinary excretion of phosphorus and the femur strength variables maximum force and moment of inertia. Strength differences might have been the result of changes in bone shape. Magnesium deprivation did not alter the effects of nickel deprivation on bone. The findings indicate that a mild magnesium deficiency affects calcium metabolism but that this does not markedly affect bone strength or shape, and these effects are not modified by dietary nickel. Also, nickel deprivation affects phosphorus metabolism and bone strength and shape; these effects apparently are not caused by changes in magnesium metabolism or utilization.     

Relationship of serum and saliva calcium, phosphorus and alkaline phosphatase with dry mouth feeling in menopause

doi: 10.1111/j.1741‐2358.2012.00619.x Relationship of serum and saliva calcium, phosphorus and alkaline phosphatase with dry mouth feeling in menopause Objectives: The aim of this study was to compare serum and saliva calcium, phosphorus and alkaline phosphatase of menopausal women with/without dry mouth (DM) feeling. Background: The composition of saliva in menopause women with/without DM feeling is different. Some of these differences are in hormones that are related to bone turnover. Methods: A case–control study was carried out on 60 selected menopausal women aged 45–79 years with or without DM feeling (30 as case, 30 as control), conducted at the Clinic of Oral Medicine, Tehran University of Medical Sciences. The phosphorus concentration was measured by photometrical measurement of the blue colour formed after the addition of ammonium molybdate and stannous chloride; calcium was measured by Arsenazo reaction; and alkaline phosphatase by the pNPP‐AMP method. Statistical analysis of Student’s t‐test was used. Results: The mean serum phosphorus and alkaline phosphatase, stimulated and unstimulated saliva calcium and alkaline phosphatase levels were significantly higher in the menopausal women suffering from DM. There were no significant differences between groups regarding saliva phosphorus and serum calcium concentration. Conclusion: Calcium, phosphorus and alkaline phosphatase appear associated with DM feeling in menopause.     

Callitrichids as phyletic dwarfs,and the place of the callitrichidae in platyrrhini

Cebuella, Callithrix, Leontopithecus, andSaguinus share five distinguishing features. All of these features are best interpreted as derived character states within Platyrrhini, and these animals are phyletic dwarfs. These derived traits may form a single complex that evolved as a result of dwarfing. Two changes in the dentition are shown to be correlated with dwarfing in mammals. These four platyrrhine genera may or may not form a monophyletic group. It is suggested thatCallimico is an “incipient dwarf platyrrhine.” Causes of dwarfing in mammals are discussed.     

A Magnesium Based Phosphate Binder Reduces Vascular Calcification without Affecting Bone in Chronic Renal Failure Rats

The alternative phosphate binder calcium acetate/magnesium carbonate (CaMg) effectively reduces hyperphosphatemia, the most important inducer of vascular calcification, in chronic renal failure (CRF). In this study, the effect of low dose CaMg on vascular calcification and possible effects of CaMg on bone turnover, a persistent clinical controversy, were evaluated in chronic renal failure rats. Adenine-induced CRF rats were treated daily with 185 mg/kg CaMg or vehicle for 5 weeks. The aortic calcium content and area% calcification were measured to evaluate the effect of CaMg. To study the effect of CaMg on bone remodeling, rats underwent 5/6th nephrectomy combined with either a normal phosphorus diet or a high phosphorus diet to differentiate between possible bone effects resulting from either CaMg-induced phosphate deficiency or a direct effect of Mg. Vehicle or CaMg was administered at doses of 185 and 375 mg/kg/day for 8 weeks. Bone histomorphometry was performed. Aortic calcium content was significantly reduced by 185 mg/kg/day CaMg. CaMg ameliorated features of hyperparathyroid bone disease. In CRF rats on a normal phosphorus diet, the highest CaMg dose caused an increase in osteoid area due to phosphate depletion. The high phosphorus diet combined with the highest CaMg dose prevented the phosphate depletion and thus the rise in osteoid area. CaMg had no effect on osteoblast/osteoclast or dynamic bone parameters, and did not alter bone Mg levels. CaMg at doses that reduce vascular calcification did not show any harmful effect on bone turnover.     

Handling of induced hypercalcaemia in hyperthyroidism

The mean serum calcium of 13 hyperthyroid patients was found to be significantly higher than that of controls matched for sex and age, though none of the patients'' values were outside the normal range. Nevertheless, these patients responded very promptly to hypercalcaemia (induced by an intravenous calcium load), and their serum calcium returned to normal much more rapidly compared with the matched controls. There was also increased retention of intravenous calcium load, possibly owing to increased calcitonin production. Calcium infusion may be useful in treating bone diseases in which increased bone resorption exceeds bone accretion.     

Effects of fixation and decalcification on the immunohistochemical localization of bone matrix proteins in fresh-frozen bone sections

To examine the stability of bone matrix proteins for crystal dislocation, the immunolocalization of type I collagen, bone sialoprotein, and osteopontin was investigated during different stages of fixation and decalcification. Four-week-old rat femurs were rapidly frozen, and were sectioned without fixation or decalcification. Thereafter, following or bypassing fixation in 4% paraformaldehyde, these sections were decalcified in 5% EDTA for 0-5 min. Before decalcification, marked radiopacity of bone matrix was observed in contact microradiography (CMR) images, and electron probe microanalysis (EPMA) demonstrated intense localization for phosphorus and calcium. In fixed and unfixed sections without decalcification, immunolocalization of bone matrix proteins were almost restricted to osteoid. After 1 min of decalcification, reduced radiopacity was apparent in the CMR images, and less phosphorus and calcium was observed by EPMA, which completely disappeared by 5 min decalcification. After 3-5 min of decalcification, unfixed sections showed that these proteins were immunolocalized in bone matrix, but were not detectable in osteoid. However, fixed sections demonstrated that these were found in both bone matrix and osteoid. The present findings suggest that bone matrix proteins are embedded in calcified matrix which is separated from the aqueous environment and that they hardly move, probably due to firm bonding with each other. In contrast, matrix proteins in osteoid are subject to loss after decalcification because they may be bound to scattered apatite crystals, not to each other.