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Biomedical subjects

L David

Publications and source records attributed to L David.

At least 253 records · Page 14Linked to original sources

Serum calcitonin-lowering effect of magnesium in patients with medullary carcinoma of the thyroid.

The effect of magnesium chloride or magnesium sulfate infusion on circulating levels of immunoreactive calcitonin (iCT) was evaluated on nine occasions in three patients with metastatic medullary carcinoma of the thyroid. One patient was normocalcemic and had normal circulating levels of immunoreactive parathyroid hormone (iPTH), one patient was hypocalcemic and had surgical hypoparathyroidism, and one patient had mild to moderate hypercalcemia associated with bone metastases. The basal serum iPTH levels were undetectable in the latter two patients. In every instance magnesium administration produced a rapid and striking fall in circulating iCT and usually a detectable fall in serum calcium. During the hypermagnesemic state, serum iPTH fell from normal to undetectable in the patient with normal parathyroid function, while serum iPTH levels remained undetectable in the hypoparathyroid patient and in the patient with hypercalcemia associated with bone metastases. The results of these studies indicate that: (a) contrary to what has been reported in normal experimental animals, magnesium administration lowers circulating iCT in human subjects with thyroid medullary carcinoma and (b) the calcium-lowering effect produced by magnesium in patients with medullary carcinoma may, in part at least, be due to a redistribution of body calcium that is not mediated by the actions of either parathyroid hormone or clacitonin.

Aged↗

[Study of the pathogenic mechanism of hypocalcemia in primary hypomagnesemia. Demonstration of a blockage of the mechanism of release of parathyroid hormone].

Parathyroid function and peripheral responsiveness to parathyroid hormone were studied during magnesium dependent hypocalcemia in a 5 years old boy with primary hypomagnesemia. The bone system and the kidneys were responsive to exogenous bovine parathyroid extracts as demonstrated by the normalisation of the calcemia and the increase of urinary cyclic AMP, phosphorus and hydroxyproline. Low levels of serum immunoreactive parathyroid hormone gave also clear indication of impaired parathyroid function. By contrast intravenous injection of magnesium sulfate induced an instantaneous and very sharp increase of serum immunoreactive parathyroid hormone as shown by levels well above the normal range one minute after the injection ; this was followed by a regular decrease of hormonal levels reaching the normal range one hour later. This finding clearly demonstrates that severe magnesium depletion induces impaired parathyroid hormone release in man.

Child, Preschool↗

[Short-term biological effects of synthetic salmon calcitonin in Paget's disease. Influence of posology].

In ten patients with Paget's disease of bone (Group I) intramuscular injection of 50 MRC units of synthetic Salmon calcitonin (SCT) induced a marked decrease of serum calcium (-1,444 mg%), serum phosphorus (-1,06 mg%), urinary total hydroxyproline (-71%), and a marked increase of urinary cyclic AMP (+ 114%). These changes occur at maximum 6 hours after the injection with a return to the initial values after 24 hours. In six other patients with Paget's disease (Group II) the acute biological effects were of the same nature and magnitude after the injection of 100 MRC units of SCT. In this group a significant but temporary increase of the plasma parathyroid hormone level was demonstrated. The magnitude of the hypocalcemia seems proportional to the initial serum alkaline phosphatase and urinary hydroxyproline levels. After one month of treatment, the alkaline phosphatase and urinary hydroxyproline have more marked and more regular decrease in group II who received 100 MRC units of SCT daily than in group I who received 50 MRC units three times a week. The cellular mechanisms of these biological changes are discussed. A posology of two daily injections of 50 MRC units of SCT is suggested when a quick and maximum stoppage of pagetic remodeling is required.

Adult↗

Calcium metabolism in newborn infants. The interrelationship of parathyroid function and calcium, magnesium, and phosphorus metabolism in normal, "sick," and hypocalcemic newborns.

Serum immunoreactive parathyroid hormone (iPTH) and plasma total calcium, ionized calcium, magnesium, and phosphorus levels were determined during the first 9 days of life in 137 normal term infants, 55 "sick" infants, and 43 hypocalcemic (Ca <7.5 mg/100 ml; Ca(++)<4.0 mg/100 ml) infants. In the cord blood, elevated levels of plasma Ca(++) and Ca were observed, while levels of serum iPTH were either undetectable or low. In normal newborns during the first 48 h of life there was a decrease in plasma Ca and Ca(++), while the serum iPTH level in most samples remained undetectable or low; after 48 h there were parallel increases in plasma Ca and Ca(++) and serum iPTH levels. Plasma Mg and P levels increased progressively after birth in normal infants. In the sick infants, plasma Ca, Ca(++) and P levels were significantly lower than in the normal newborns, while no significant differences were found in the plasma Mg levels. The general pattern of serum iPTH levels in the sick infants was similar to that observed in the normal group, though there was a tendency for the increase in serum iPTH to occur earlier and for the iPTH levels to be higher in the sick infants. In the hypocalcemic infants, plasma Mg levels were consistently lower than in the normal infants after 24 h of age, while no significant differences were found in the plasma P levels. Hyperphosphatemia was uncommon and did not appear to be a contributing factor in the pathogenesis of hypocalcemia in most infants. Most of the hypocalcemic infants, including those older than 48 h, had inappropriately low serum iPTH levels. Evidence obtained from these studies indicates that parathyroid secretion is normally low in the early new born period and impaired parathyroid function, characterized by undetectable or low serum iPTH, is present in most infants with neonatal hypocalcemia. Additional unknown factors appear to contribute to the lowering of plasma Ca in the neonatal period. The net effect of unknown plasma hypocalcemic factor(s) on the one hand and parathyroid activity on the other may account for differences in plasma Ca levels observed between normal, sick, and hypocalcemic infants. Depressed plasma Mg is frequently present in hypocalcemic infants. To what degree the hypomagnesemia reflects parathyroid insufficiency or the converse, to what degree parathyroid insufficiency and hypocalcemia are secondary to hypomagnesemia, is uncertain.

Antigens↗