[Vitamin A poisoning with hypercalcemia].
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Child↗
Biomedical subjects
L Mosekilde
Publications and source records attributed to L Mosekilde.
Effects of thyroid hormone(s) on mean wall thickness of trabecular bone packets.
The mean wall thickness of iliac trabecular bone packets was determined in undecalcified iliac crest bone specimens from 14 hypothyroid patients, 14 hyperthyroid patients and 28 age- and sex-matched normal controls. Calcification rate and fractional resorption, formation and labeled surfaces in trabecular bone from the patients were measured by conventional histomorphometric methods after double-labeling with tetracycline. The mean wall thickness was increased in the hypothyroid patients (58,9 microns), while no change was demonstrated in the hyperthyroid group (52,5 microns) as compared to the controls (54,0 microns). Calculated estimates of trabecular bone remodeling at the "Basic Multicellular Unit" level showed longer periods of resorption, formation and total remodeling in the hypothyroid than in the hyperthyroid patients.
Adult↗
Reduced 2,25-dihydroxyvitamin D and 24,25-dihydroxyvitamin D in epileptic patients receiving chronic combined anticonvulsant therapy.
Thirty-one adult epileptic outpatients on chronic combined anticonvulsant therapy were investigated. Eleven patients took vitamin D2 supplementation 400-1200 IU/day as multivitamin tablets. Mean serum calcium and renal calcium excretion were reduced. Serum alkaline phosphatase and urinary hydroxyproline excretion were increased. Forearm bone mineral content was reduced. Serum concentrations of 25-hydroxyvitamin D (25-OHD), 24-25-dihydroxyvitamin D (24,25-(OH)2D) and 1,25-dihydroxyvitamin D (1,25-(OH)2D) were reduced (p less than 0.001). A positive correlation was found between the serum 25-OHD and 24,25-(OH)2D concentrations (p less than 0.05) with the highest levels in those receiving vitamin D2 supplementation (p less than 0.01). Serum 1,25-(OH)2D correlated positively with renal calcium excretion (r = 0.65, p less than 0.001) suggesting that the intestinal calcium absorption in epileptic patients depends on 1,25-(OH)2D levels.
24,25-Dihydroxyvitamin D 3↗
Bromocriptine reduces diarrhoea in medullary thyroid carcinoma.
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Adult↗
Iliac crest bone mass and remodelling in acromegaly.
Iliac crest bone biopsies from 18 patients with active acromegaly, of whom 11 had received tetracycline double-labelling, were evaluated by quantitative histomorphometry and compared with age- and sex-matched normal controls. A significant increase (P less than 0.01) was found in both cortical (175%) and trabecular (130%) bone mass. In trabecular bone, resorption surfaces and active (tetracycline-labelled) and total formation surfaces were increased (P less than 0.05 and P less than 0.01, respectively) causing an enhanced bone turn-over at tissue level (P less than 0.01). The increased trabecular bone mass indicates a positive net balance per remodelling cycle and, therefore, larger than normal bone remodelling units, which in part may explain the increased bone turn-over at tissue level. The activity of the osteoblasts active in mineralization (the appositional rate) was increased (P less than 0.01) and positively related to the fasting serum growth hormone levels (Rs = 0.69, P less than 0.05). The average activity of active and inactive osteoblasts (bone formation rate at basic metabolic unit (BMU) level) was insignificantly increased. The proportion of active (tetracycline labelled) to nonactive formation surfaces was normal. The bone changes were unrelated to serum levels and urinary excretions of calcium and phosphorus or to renal excretion of total and non-dialyzable hydroxyproline or cAMP.
Acromegaly↗
The role of bone biopsy in the diagnosis of metabolic bone disease.
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Adolescent↗
Antibodies to Escherichia coli and serum immunoglobulin levels in epileptics on long-term anticonvulsant therapy.
Antibodies to 11 different Escherichia coli (E. coli) serotypes were determined by indirect haemagglutination in 53 epileptics treated with diphenylhydantoin (DPH) and in 53 matched controls. Agglutinins were found more often and at higher titres in epileptics (83 . 4%) than in controls (51 . 7%) (P less than 0 . 05). No correlation between the occurrence of E. coli agglutinins and the serum concentration or clearance of DPH, or abnormal biochemical liver tests could be established. E. coli antibodies were predominantly of the IgM classes, and the percentage of positive reactions was slightly, but not significantly, higher in epileptics with elevated serum IgM (88 . 2%) than in those with normal IgM (83 . 1%) (0 . 20 greater than P greater than 0 . 10). The increased incidence of E. coli agglutinins could not be explained by a low serum IgA concentration which may suggest an impaired secretory immune function. The incidences of positive reactions in epileptics with subnormal (less than 37 mg/100 ml), normal (37-285 mg/100 ml) and elevated (greater than 285 mg/100 ml) serum IgA values were 73 . 7, 84 . 7 and 93 . 7% respectively (0 . 01 greater than P greater than 0 . 001). It is suggested that DPH can both suppress and stimulate the humoral immune response in humans, and that genetic or acquired factors may be of importance for the development of modified immune responses.
Adolescent↗
Screening for familial medullary thyroid carcinoma.
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Calcitonin↗
No effect of cimetidine on calcitonin secretion from medullary thyroid carcinoma.
The effect of cimetidine on basal and pentagastrin-stimulated serum immunoreactive calcitonin (S-iCT) concentrations was studied in six patients with medullary carcinoma of the thyroid (MCT). Basal S-iCT was elevated in all patients and showed a marked increase after i.v. injection of pentagastrin, 0.5 micrograms/kg b.wt. Cimetidine, 200 mg i.v., 30 min before administration of pentagastrin had no effect on either basal or pentagastrin-stimulated S-iCT. Thus, the mechanisms of basal and pentagastrin-stimulated calcitonin secretion from MCT do not seem to involve agonism with histamine H2-receptors.
Adult↗
Histomorphometrical determination of bone marrow cellularity in iliac crest biopsies.
The point-count principle is an exact method of bone marrow quantitation but fairly good correlation was found between quantitated and estimated values of the cellularity in iliac crest biopsies, although the latter values were significantly lower. No intraspecimen variation was found, but the cellularity in the individual biopsies varied considerably from field to field, indicating that quantitation and estimation on small samples obtained by aspiration may be misleading. The correlation between the values from undecalcified and decalcified sections was high, but decalcification of the biopsies resulted in an underestimation of the amount of haemopoietic tissue.
Adolescent↗
Trabecular bone mineralization lag time determined by tetracycline double-labeling in normal and certain pathological conditions.
Quantitative histomorphometric analyses of iliac crest biopsy specimens were performed after tetracycline double-labeling in 41 normal individuals, 20 hyper- and 10 hypothyroid patients, 18 patients with primary hyperparathyroidism, 20 epileptic patients receiving long-term anticonvulsant therapy, and 17 patients after jejunoileal bypass for morbid obesity. The mineralization lag time in trabecular bone or the period of time between apposition and subsequent mineralization of osteoid was calculated from the bone formation rate at BMU level (Basic Multicellular Unit) and the mean width of osteoid seams. The mineralization lag time was 8-52 days (median 21 days) in normal individuals and showed no variation with sex or age. The mineralization lag time was shortened in hyperthyroidism, normal in anticonvulsant bone disease and in primary hyperparathyroidism, and markedly prolonged in hypothyroidism and following jejunoileal bypass. Among all individuals an inverse hyperbolic relation (r = 0.94, p less than 0.001) was found between the mineralization lag time and the average cellular activity of the osteoblasts.
Adult↗
Low serum levels of 1.25-dihydroxyvitamin D and histomorphometric evidence of osteomalacia after jejunoileal bypass for obesity.
Twenty-seven unselected patients were investigated three to eight years after jejunoileal bypass for morbid obesity. The serum levels of calcium, magnesium, and phosphorus, and the renal excretions of calcium and magnesium were reduced. The serum alkaline phosphatase levels were increased. The serum levels of the two vitamin D metabolites 25-hydroxyvitamin D (25-OHD) and 1.25-dihydroxyvitamin D (1.25-(OHD)2D) were reduced and inversely related to the increased serum levels of immunoreactive parathyroid hormones (iPTH). Serum 1.25-(OH)2D correlated positively and serum iPTH inversely with serum concentrations and renal excretion rates of calcium. Iliac crest bone biopsies after in vivo tetracycline double-labelling showed a reduced bone turnover with an increased amount of osteoid due to an increase in both surface extent and mean width of osteoid seams. The increased volume of osteoid was caused by a decreased osteoblastic function with a longer life-span of bone-forming sites and a prolongation of the mineralisation lag time. The amount of trabecular bone was normal. The results indicate an impaired vitamin D metabolism with osteomalacia and secondary hyperparathyroidism.
Adult↗
Pentagastrin, calcium and whisky stimulated serum calcitonin in medullary carcinoma of the thyroid.
The efficiency of pentagastrin, calcium and whisky in raising serum immunoreactive calcitonin (S-iCT) concentrations was analysed in 6 patients with medullary carcinoma of the thyroid and in 8 healthy controls. All 6 patients responded to pentagastrin with a significant increase in S-iCT, 5 responded to calcium and only 3 to whisky. In the 8 controls no or only a modest increase in S-iCT occurred following pentagastrin, calcium and whisky with no difference between the three. It is concluded that pentagastrin is the most useful stimulative agent for ICT secretion in patients with C-cell neoplasms. In selected cases the additional use of calcium could be advantageous.
Adult↗
Myopathy in bone loss of ageing: improvement by treatment with 1 alpha-hydroxycholecalciferol and calcium.
1. Eleven patients with the bone loss of ageing were treated with the vitamin D analogue 1 alpha-hydroxycholecalciferol and calcium for 3--6 months. 2. Muscle biopsies were taken from the vastus lateralis before and after the treatment and the activity of several enzymes was measured. Succinate dehydrogenase and total phosphorylase activities, which are a measure of the oxidative capacity, were low and increased significantly with the treatment. The lactate dehydrogenase activity, which can be taken as a measure of the anaerobic metabolism, was normal and did not change with treatment. The phosphagen stores, ATP and creatine phosphate were low and increased to normal with treatment. 3. Histochemical classification of the fibre composition revealed that the treatment induced an increase in the relative number of fast-twitch a (FTa or type II A) fibres accompanied by a reduction of the fast-twitch b (FTb or type II B) fibres. The cross-sectional area of the FTa fibres also increased with the treatment. 4. The present findings indicate that treatment with the active vitamin D analogue, 1 alpha-hydroxycholecalciferol, and calcium improves the myopathy associated with the bone loss of ageing.
Aged↗
Fractional intestinal calcium absorption in epileptics on anticonvulsant therapy. Short-term effect of 1,25-dihydroxycholecalciferol and 25-hydroxycholecalciferol.
Fractional intestinal 47Ca calcium absorption (alpha) in 12 epileptic outpatients receiving chronic high-dose anticonvulsant therapy was reduced (p less than 0.05) compared to 12 matched normal controls. Six of the epileptics were treated orally with 0.5 microgram of 1,25-dihydroxycholecalciferol (1,25-DHCC) per day and six with 10 microgram of 25-hydroxycholecalciferol (25-HCC) per day for 10 days. The alpha was determined before and after treatment and compared with the effect of 0.5 microgram of 1,25-DHCC per day given for 10 days to 6 controls. An increase of the same order in alpha was found in all groups (p less than 0.05). No changes were observed in the serum levels of calcium, phosphorus, alkaline phosphatase or iPTH during treatment. Urinary calcium excretion was low in the epileptic patients and rose during treatment. The investigation demonstrates that the sensitivity of the intestine to 1,25-DHCC is normal in epileptic patients on anticonvulsant therapy and that 1,25-DHCC and 25-HCC in the given doses had an equal effect on the reduced intestinal calcium absorption.
Administration, Oral↗
Bone mineral content in hyperthyroid patients after combined medical and surgical treatment.
Bone mineral content (BMC) and bone mineral concentration (BMC') of the forearm were determined by photon absorptiometry in 20 untreated hyperthyroid patients and in 33 patients previously treated for hyperthyroidism. In untreated hyperthyroidism a significant decrease was found in both BMC and BMC'. In treated hyperthyroidism BMC and BMC' were normalized. The findings suggest that a previous hyperthyroid state is not a risk factor for development of spontaneous fractures providing the hyperthyroid state is effectively treated.
Adult↗
Tetracycline double-labeling of iliac trabecular bone in 41 normal adults.
A histomorphometric evaluation of the iliac crest trabecular bone remodeling was performed after tetracycline double-labeling in 41 normal Danes (12 males and 29 females) aged 19 to 56 years. The fraction of formative (osteoid covered) and resorptive surfaces was unrelated to age but higher in males than in females (P less than 0.02 and P less than 0.05, respectively). The appositional rate (0.65 +/- 0.12 micrometer/day) was unrelated to age and sex, whereas the fractional labeled surfaces were higher (P less than 0.01) in the males (0.18 +/- 0.08 micrometer2/micrometer2) than in the females (0.12 +/- 0.05 micrometer2/micrometer2), and among the females inversely related to age (R = -0.38, P less than 0.05). The bone formation rate at BMU level (0.50 +/- 0.20 micrometer3/micrometer2/day) was unrelated to sex, but among the females inversely related to age R = -0.49, P less than 0.01). The bone formation rate at tissue level was higher (P less than 0.02) in the males (0.13 +/- 0.07 micrometer3/micrometer2/day) than in the females (0.07 +/- 0.03 micrometer3/micrometer2/day) and among the females inversely correlated to age (R = -0.43, P less than 0.05). the age- and sex-dependent variations in the dynamic parameters underline the importance of a more elaborated normal material.
Adult↗
Effects of a single dose of fluoride on calcium metabolism.
Fluoride 27 mg was given perorally to 14 subjects. It was found that the serum fluoride concentration increased followed by a decrease to normal levels during 24 h. Serum concentrations of calcium and phosphate decreased initially whereas those of serum immunoreactive parathyroid hormone increased. After 24 h the measured quantities were within normal limits. The results are discussed with reference to mineralization of hard tissues and to fluoride treatment of osteoporotic patients.
Adult↗