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Biomedical subjects

E Kollin

Publications and source records attributed to E Kollin.

At least 19 recordsLinked to original sources

[Treatment of postmenopausal osteoporosis with low doses of calcitonin and a calcitonin-anabolic combination].

Menopausal osteoporotic women (age: 49-69, mean: 59.5 years) with crush fractures of the spine were treated with low doses of calcitonin (Miacalcic, 350 U/month), or with calcitonin + anabolic steroid (Retabolil, 50 mg/month). Efficacy of the therapy was controlled by single foton absorptiometry of midshaft and distal radius, by X-ray morphometry and by registering new crush fractures of the spine. Calcitonin monotherapy stopped further bone loss for two years, but at the end of the third year both absorptiometric values, as well as the radiomorphometrical index of the lumbar spine decreased significantly. In patients on calcitonin+anabolic steroid the decrease was just significant and only at radius midshaft, while at the other measured sites it was not. Two new crush fractures per 1396 patient-months occurred. Intermittent administration of low-dose calcitonin, especially together with an anabolic steroid seems to be a safe and effective therapy in established osteoporosis.

Aged↗

[Spinal and appendicular osteoporosis in streak gonad syndrome. Photon absorptiometric and roentgen-morphometric studies].

Patterns of bone loss in the axial and the appendicular skeleton were studied in 48 women with streak gonad syndrome (age: between 14-38 years, mean: 25.5 years). Bone mineral content was measured in vivo at the lumbar spine and right femoral neck by dual photon absorptiometry and at the midradius and distal radius by single photon absorptiometry. The bone mineral status of 20 patients was evaluated by radiomorphometrical indices of the metacarpals, femorals and lumbar spine, too. Mean bone mineral content and radiomorphometrical indices were significantly lower in patients with streak gonad syndrome than in age-matched normal subjects at all three scanning sites. The patients lost cortical and trabecular bone mineral content at the same rate, suggesting that bone loss in streak gonad syndrome is a generalized phenomenon. In spite of serious bone loss osteoporotic fractures were not observed in the patients, in contrast to patients with pathological post-menopausal osteoporosis having equal degree of bone deficiency. The authors did not find any relationship between the occurrence of osteoporosis and the karyotype of the patients. It is suggested that the osteoporosis in streak gonad syndrome--at least after puberty--is a consequence of gonadal hormone deficiency.

Absorptiometry, Photon↗

Three-year calcitonin combination therapy for postmenopausal osteoporosis with crush fractures of the spine.

Forty-five postmenopausal osteoporotic women with at least one osteoporotic vertebral crush fracture were randomized into three treatment groups. Each patient was on calcitonin, 50 U, on alternate days for 2 weeks monthly (350 U/month), and 500 mg/day oral calcium supplementation. In group II, this therapy was supplemented with phosphate (750 mg/day), and in group III, norandrostenolone decanoate (50 mg/month) was added to the calcitonin+calcium therapy. Bone mineral content, by single photon absorptiometry, of the radius midshaft and distal site (3 cm), as well as the lumbar and metacarpal radiomorphometrical indices were estimated seminannually. The therapeutic trial lasted 36 months except in the phosphate supplementation group, where, due to unfavorable results, treatment was discontinued after 24 months. Calcitonin practically prevented further bone loss for 24 months even in this relatively small and intermittent dosage. Phosphate supplementation was without benefit; however, according to the majority of the examined parameters, combination of calcitonin with the anabolic steroid norandrostenolone decanoate extended efficacy up to 36 months. This latter combination seems to be a promising, relatively inexpensive therapeutic regimen in the treatment of established postmenopausal osteoporosis.

Aged↗

Serum bone Gla protein in streak gonad syndrome.

Osteoporosis is one of the most common complications of streak gonad syndrome (SGS), however its pathogenesis is still unclear. Bone Gla protein (BGP) has been found to be a serum marker of bone turnover in various metabolic disease states. In the present study serum BGP and alkaline phosphatase (AP) were measured in 13 osteoporotic patients with SGS and in 56 healthy women. Mean (+/- SD) serum BGP levels were normal (7.5 +/- 2.0 ng/ml) in seven patients who had been on estrogen-progestin replacement therapy and became significantly elevated (P less than 0.001) 2 and 3 months after discontinuation of the treatment (15.3 +/- 2.3 and 13.2 +/- 1.0 ng/ml, respectively). Mean (+/- SD) serum AP (207 +/- 65 U/l) showed significant increases (P less than 0.05) 2 months after withdrawal of hormonal substitution (287 +/- 74 U/l). Mean (+/- SD) serum BGP (15.4 +/- 3.5) and AP (287 +/- 49) levels were significantly higher (P less than 0.001 and less than 0.05, respectively) in six patients with SGS who had not been on hormonal substitution. These findings are consistent with those obtained in postmenopausal women suffering from "high remodelling osteoporosis" and suggest that bone turnover in osteoporotic patients with SGS is increased and the skeletal loss is a consequence of accelerated bone loss rather than decreased bone formation.

Adult↗

Endoscopy in the diagnosis and treatment of benign stenosis of the papilla of Vater.

Of 921 endoscopic sphincterotomies (EST) performed by the authors, 110 (12%) were done for benign stenosis of papilla of Vater. Based on these data, they consider the possibilities of endoscopic diagnosis and treatment in the stenosis of papilla. One of the conditions for the diagnosis of papilla stenosis is the detectability of dilated biliary tract by endoscopic retrograde cholangiography. But this cannot be taken as a specific sign because, e.g., the biliary tract may become dilated in spite of normal sphincter tone after gall-bladder removal. At the same time, biliary tract dilation is a diagnostic criterion for papilla stenosis, and abnormal findings in biliary scintigraphy and the laboratory syndrome consistent with cholestasis cannot be avoided. EST is the method of first choice in the treatment of papilla stenosis in comparison to surgery. The complications of EST, however, occur in papilla stenosis more frequently than in choledocholithiasis (8.8%). Bleeding and cholangitis are responsible for the excess incidence.

Ampulla of Vater↗

Growth hormone reserve in diabetes mellitus.

The magnitude of hGH reserve was investigated in young (16-40 years old) diabetic patients. Forty patients were examined with the arginine infusion test, twenty three with a sensitized version of the L-Dopa test. The patients were divided into four groups based on the type of their illness (IDDM or NIDDY) and the clinical stage of IDDM. It was concluded that the hGH reserve of the various diabetic groups differs from the hGH reserve of healthy persons as well as from one another. Taking into consideration the possible causes of these differences, it is suggested that the hGH reserve depends primarily on the metabolic condition of the patients, while the type of diabetes (IDDM or NIDDY) and the insulin therapy used may also be important contributing factors. Achievement of a good metabolic control within the same type of diabetes leads to the normalization of the previously pathologic hGH reserve.

Adolescent↗

Calcitonin secretion in streak gonad syndrome (Turner's syndrome).

Osteoporosis in one of the most common complications of streak gonad syndrome (SGS), however, its pathogenesis is still unclear. To test whether SGS is associated with calcitonin (CT) deficiency, 11 affected individuals and 8 age-matched healthy women were studied. Calcium, 3.6 mg/kg b.w. as a 10% solution of calcium chloride, was given intravenously for 3 minutes. Serum levels of CT and calcium were measured before and at 5, 30, 60, and 120 minutes after the injection. There was a statistically significant rise in serum calcium levels both in the control subjects and patients with SGS, with significantly lower levels prior to and at 30, 60, and 120 minutes following calcium load in the control group. The CT rise following calcium load was also significant at 5, 30, and 60 minutes in the controls and at 5 and 30 minutes in patients with SGS, with a significantly lower baseline and 30, 60, and 120 minutes levels in the latter group. Maximum levels of calcium and CT occurred 5 minutes after the calcium load and were statistically indistinguishable. There were no significant differences in either the calcium or the CT incremental changes between the two groups. These findings are consistent with decreased basal (and 30-120 minute) CT levels in SGS and suggest that CT deficiency may be involved in the development of osteoporosis in patients with SGS. The possible causal relationship of estrogen deficiency to the reduced CT levels in SGS is discussed.

Adolescent↗

Androgens, bone mineral content and hyperostosis frontalis interna in pre-menopausal women.

Greater than normal bone mineral content, bone width of the radius measured by photon absorptiometry and bone mineral content to bone width ratio found in women with hyperostosis frontalis interna pointed on a generalized alteration of the skeletal system. An increase in serum dehydroepiandosterone, its sulphate and testosterone levels and a significant correlation between serum free dehydroepiandosterone and bone mineral content in subjects without any sign of hirsutism or obesity suggested an involvement of androgens in pathogenesis of this metabolic bone disorder.

17-alpha-Hydroxyprogesterone↗

[Endoscopic occlusion treatment in patients with chronic pancreatitis].

Between 1980 and 1983 an endoscopic occlusion of pancreatic duct was performed in 12 patients with chronic pancreatitis. In 4 patients it could be achieved a complete, in 8 patients only a partial occlusion. Four patients became free of pain whereas 5 patients have been operated on following an aggrevation of disease. After one year diabetes mellitus developed in 2 patients. We conclude that the endoscopic occlusion of the pancreatic duct may be recommended in some patients with defined diagnosis and special duct constellation.

Adult↗