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Biomedical subjects

R K Rude

Publications and source records attributed to R K Rude.

At least 55 records · Page 3Linked to original sources
PubMed1990

Low intracellular magnesium in patients with acute pancreatitis and hypocalcemia.

To determine the role of magnesium deficiency in the pathogenesis of hypocalcemia in acute pancreatitis, we measured magnesium levels in serum and in peripheral blood mononuclear cells in 29 patients with acute pancreatitis, 14 of whom had hypocalcemia and 15 of whom had normal calcium levels. Only six patients had overt hypomagnesemia (serum magnesium less than 0.70 mmol per liter [1.7 mg per dl]). The mean serum magnesium concentration in hypocalcemic patients was not significantly lower than in normocalcemic patients, but the mononuclear cell magnesium content in hypocalcemic patients with pancreatitis was significantly lower than in normocalcemic patients with pancreatitis (P less than .01). The serum magnesium level did not correlate with that of serum calcium or the mononuclear cell magnesium content, but the latter did significantly correlate with the serum calcium concentration (r = .81, P less than .001). Most patients with hypocalcemia had a low intracellular magnesium content. Three normomagnesemic, hypocalcemic patients with alcoholic pancreatitis also underwent low-dose parenteral magnesium tolerance testing and showed increased retention of the magnesium load. We conclude that patients with acute pancreatitis and hypocalcemia commonly have magnesium deficiency despite normal serum magnesium concentrations. Magnesium deficiency may play a significant role in the pathogenesis of hypocalcemia in patients with acute pancreatitis.

Acute Disease↗
PubMed1989

Physiology of magnesium metabolism and the important role of magnesium in potassium deficiency.

Magnesium, the second most abundant intracellular cation, has several critically important roles in the body. In addition to energy production and maintaining electrolyte balance, magnesium is essential for normal neuromuscular function as well as calcium and potassium transport. Evidence suggests that a deficit of magnesium is closely interrelated to potassium deficiency and refractory potassium repletion. Although the consequences of hypokalemia are widely documented and recognized, it is only recently that the importance of magnesium deficiency as a cause of potassium depletion has gained clinical attention. Because of the association between hypokalemia and ventricular ectopy/sudden death, familiarity with the causes of magnesium loss, as well as enhanced identification and treatment, appear to be important.

Hormones↗
PubMed1989

Effect of long-distance running on bone mass in women.

The effect of long-distance running on bone mass was assessed in 10 premenopausal and 9 estrogen-deprived postmenopausal women and compared to that in closely matched sedentary control women. Vertebral trabecular bone density (VBD) was determined by computed tomography and radial cortical bone density (CBD) by single-photon absorptiometry. Physical fitness was assessed by determining maximal oxygen consumption (VO2max) on a treadmill run to exhaustion. VBD was 183 +/- 7 mg/cm3 and VO2max was 48 +/- 1 ml/kg per minute in young women runners and 163 +/- 8 mg/cm3 and 32 +/- 2 ml/kg per minute in sedentary young women. A positive correlation was noted between VBD and VO2max in these groups (r = 0.509, p less than 0.03). Despite a significantly higher VO2max in postmenopausal women runners compared with sedentary controls (37 +/- 2 versus 24 +/- 2 ml/kg per minute), VBD was identical (112 +/- 5 versus 111 +/- 5 mg/cm3) and no correlation was seen between VBD and VO2max (r = 0.187, p = 0.457). Radial cortical bone density was not different between the runners or sedentary groups in young women (0.738 +/- 0.01 versus 0.732 +/- 0.1 g/cm2) or postmenopausal women (0.617 +/- 0.3 versus 0.665 +/- 0.4 g/cm2). These results suggest that although physical fitness enhances vertebral bone density in premenopausal women, it does not appear to prevent age- and/or sex steroid deficiency-induced bone loss in postmenopausal women.

Adult↗
PubMed1989

Determination of intracellular free magnesium by nuclear magnetic resonance in human magnesium deficiency.

Magnesium (Mg) deficiency is a common clinical problem. As Mg is predominantly an intracellular cation and Mg deficiency may exist despite normal serum Mg (sMg) concentrations, we have utilized nuclear magnetic resonance (NMR) techniques in an attempt to measure intracellular free Mg (Mg2+) in red blood cells (RBC). Twenty normal subjects, 22 hypomagnesemic patients, and 17 normomagnesemic alcoholic patients were studied. Mean RBC Mg2+ in normal subjects (178 +/- 6.3 microM) was significantly greater than in hypomagnesemic patients (146 +/- 7.1 microM, p less than 0.002). RBC Mg2+ correlated with sMg concentration (r = 0.54, p less than 0.001). In addition, four normal subjects were given a low Mg diet for 3 weeks. There was a progressive fall in both the sMg concentration and RBC Mg2+ during Mg depletion, with a concomitant rise in retention of a parenterally administered Mg load. These data suggest that the determination of intracellular Mg2+ by NMR may be a useful research tool in assessing the effect of changes in Mg2+ on intracellular processes. Its utility in the clinical evaluation of disorders of Mg deficiency remains to be determined.

Erythrocytes↗
PubMed1988

Electrophysiologic effects of intravenous magnesium in patients with normal conduction systems and no clinical evidence of significant cardiac disease.

Parenteral magnesium has been used for several decades in the empiric treatment of various arrhythmias, but the data on its electrophysiologic effects in man are limited. We evaluated the electrophysiologic effects of magnesium sulfate (MgSO4) administration in eight normomagnesemic patients with normal mononuclear cell magnesium content, who had no clinically significant heart disease and had normal baseline electrophysiologic properties. After administration of intravenous MgSO4, serum magnesium rose significantly from 1.9 +/- 0.1 to 4.4 +/- 1.7 mg/dl (p less than 0.02). During a maintenance magnesium infusion, we observed significant prolongation of the ECG PR interval (145 +/- 18 to 155 +/- 26 msec, p less than 0.05), AH interval (77 +/- 27 to 83 +/- 26 msec, p less than 0.002), antegrade atrioventricular (AV) nodal effective refractory period (278 +/- 67 to 293 +/- 67 msec, p less than 0.05), and sinoatrial conduction time (60 +/- 34 to 76 +/- 32 msec, p less than 0.02). No significant effect was observed on sinus cycle length, sinus node recovery time, intra-atrial or intraventricular conduction times, QRS duration (during both sinus rhythm and ventricular pacing), QT interval, HV interval, paced cycle length resulting in AV nodal Wenckebach block, AV nodal functional refractory period, retrograde ventriculoatrial (VA) effective refractory period, or atrial and ventricular refractory periods. These findings, in conjunction with the demonstrated ability of magnesium to block slow channels for sodium movement, may provide an explanation of the mechanism by which magnesium exerts its effect in the treatment of atrial and junctional arrhythmias.

Adult↗
PubMed1987

Blood mononuclear cell magnesium in normal pregnancy and preeclampsia.

Magnesium (Mg) is effective in the treatment of pregnancy-induced hypertension (PIH). In order to determine if patients with PIH are Mg deficient, we assessed mononuclear cell magnesium content (mMg) and serum Mg concentrations (sMg) in 23 normal pregnant women and in 12 women with PIH admitted in active labor. The sMg concentration in women with PIH was 1.74 +/- 0.1 mg/dl (mean +/- SD) and was not significantly different from normal pregnant women at 1.69 +/- 0.2 mg/dl. Both groups had sMg concentrations lower than in normal, non-pregnant controls (sMg = 1.96 +/- 0.1 mg/dl, p less than 0.001). The mMg content in normal pregnant women did not differ significantly from that in women with PIH (1.54 +/- 0.26 micrograms Mg/mg protein and 1.50 +/- 0.26 micrograms Mg/mg protein respectively). The normal control mean mMg was 1.36 +/- 0.17 micrograms Mg/mg protein, slightly lower than in normal pregnancy (p less than 0.005) and PIH (p less than 0.02). Mononuclear Mg content did not correlate with sMg concentration. These data suggest that PIH is not associated with an intracellular Mg deficit. Further studies utilizing other measures of intracellular Mg are indicated to assess the presence or absence of Mg deficiency in patients with both normal pregnancy and pregnancy complicated by PIH.

Adult↗
PubMed1987

Evidence that prostacyclin mediates the vascular action of magnesium in humans.

Evidence in vitro and in humans suggest that Mg2+ can alter systemic and renal vascular tone. However, the mechanism of these effects is not known. The role of vasodilator prostaglandin release and Ca2+ flux in Mg2+-induced changes in blood pressure and renal blood flow was studied in 10 normal subjects maintained on a fixed 80-mEq Na+ and K+ diet. Magnesium sulfate infused at 200 mg/hr for 3 hours reduced systolic and diastolic blood pressure within 1 hour (from 119 +/- 2 [SEM] to 109 +/- 4 mm Hg systolic; from 74 +/- 3 to 64 +/- 4 mm Hg diastolic; p less than 0.02). This hypotensive response was seen in all subjects and persisted for 3 hours. The pulse rate did not change, but renal blood flow (p-aminohippurate clearance) increased (from 902 +/- 78 to 1108 +/- 130 ml/min/1.73 m2; p less than 0.05). The Mg2+ infusion produced a significant increase in the excretion of the stable prostaglandin I2 (PGI2) metabolite 6-keto-PGF1 alpha (from 96 +/- 12 to 154 +/- 16 ng/g creatinine; p less than 0.01). In contrast, urinary PGE2 was not altered (328 +/- 75 vs 399 +/- 145 ng/g creatinine; p greater than 0.6). To evaluate the functional role of PGI2 release, the cyclooxygenase inhibitors indomethacin (75 mg) or ibuprofen (600 mg) were given before the Mg2+ infusion. Both cyclooxygenase blockers, given in doses that inhibited immunoreactive 6-keto-PGF1 alpha release, completely prevented the Mg2+-induced decline in blood pressure and increased renal blood flow.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Low blood mononuclear cell magnesium content and hypocalcemia in normomagnesemic patients.

Hypomagnesemia can cause hypocalcemia. Because less than 1% of the total body magnesium (Mg) is in extracellular fluids, however, patients may be Mg-deficient despite normal serum Mg concentrations. To determine if hypocalcemia can be seen in patients who have normal serum Mg concentrations but low intracellular Mg, we studied the serum and mononuclear cell Mg contents in 82 alcoholic subjects, 30 of whom had hypocalcemia that could not be explained by other known causes of hypocalcemia. The mononuclear cell Mg content in both hypomagnesemic and normomagnesemic patients with and without hypocalcemia was significantly lower than in normal controls. The serum Mg level did not correlate with the mononuclear cell Mg or serum calcium level, but hypocalcemic patients had a significantly lower mononuclear cell content than normocalcemic patients. Six patients underwent parenteral Mg tolerance testing as an additional measure of Mg deficiency and had increased Mg retention. The serum calcium concentration returned to normal in hypocalcemic patients who were given magnesium intravenously.

Alcoholism↗
PubMed1986

Low blood mononuclear cell magnesium in intensive cardiac care unit patients.

Magnesium deficiency may play a role in the pathogenesis of atherosclerosis, cardiac arrhythmias, and coronary spasm. Because less than 1% of magnesium (Mg) is extracellular, the serum magnesium (sMg) does not always accurately reflect intracellular Mg stores. To determine the frequency of Mg deficiency in patients with cardiovascular disease, we measured blood mononuclear cell Mg content (mMg) and sMg concentrations in 104 unselected patients admitted to our intensive cardiac care unit (CCU). Twenty-seven normal healthy controls and 33 hypomagnesemic patients with chronic alcoholism and/or malabsorption syndrome served as reference groups. The sMg concentration in the CCU patients was 2.05 +/- 0.03 mg/dl (mean +/- SEM), and did not differ from normal controls (mean 2.01 +/- 0.03 mg/dl). Only 8 of 104 CCU patients were hypomagnesemic (7.7%). mMg in the CCU patients, however, was significantly lower than in the normal controls (1.15 +/- 0.02 micrograms/mg protein and 1.34 +/- 0.02 micrograms/mg protein respectively, p less than 0.001). Fifty-three percent (55 of 104) of CCU patients had mMg contents less than 1.119 micrograms/mg protein, i.e., below that of the lowest normal control. mMg was significantly lower in those patients with congestive heart failure (mMg = 1.08 +/- 0.03 micrograms/mg protein) when compared to those patients without congestive heart failure (1.23 +/- 0.02 micrograms/mg protein, p less than 0.001). We conclude that the incidence of intracellular Mg deficiency in patients with cardiovascular disease is much higher than the sMg would lead one to suspect, and may contribute to clinical cardiovascular morbidity.

Adult↗
PubMed1986

TmMg and renal Mg threshold in normal man and in certain pathophysiologic conditions.

The TmMg and renal Mg threshold were assessed in normal subjects and in a number of pathological conditions. The TmMg in normal subjects was 1.4 mg/100 ml glomerular filtrate (GF) 1.73 m2 and numerically equalled the renal Mg threshold of 1.4 mg/100 ml. No significant difference was seen in patients with primary hyperparathyroidism or hypoparathyroidism. Patients with familial hypocalciuric hypercalcemia, however, tended to have an elevated renal Mg threshold. Investigation of 3 patients with idiopathic renal Mg wasting demonstrated a normal TmMg but reduced renal Mg threshold. Urinary Mg excretion was also assessed in normomagnesemic alcoholic patients. Retention of a parenterally administered Mg load and renal Mg retention were significantly greater than normal despite normal serum Mg concentrations. These data suggest that determination of TmMg and renal Mg threshold may provide useful information in understanding Mg homeostasis in normal subjects and in disorders which may result in abnormal Mg metabolism.

Calcium↗
PubMed1985

Skeletal adenylate cyclase: effect of Mg2+, Ca2+, and PTH.

Plasma membranes were prepared from mineralized guinea pig bone in order to study Mg2+ and Ca2+ modulation of skeletal adenylate cyclase. Plasma membrane preparation was accomplished by crushing the bone in liquid N2 and subsequent multiple washings in buffer containing EGTA to remove all Ca2+ prior to adenylate cyclase assay. Skeletal adenylate cyclase was found to be dependent on GTP and Mg2+ and responsive to bovine 1-34 PTH. Ca2+ caused a competitive inhibition of Mg2+ -activated skeletal adenylate cyclase. The apparent KaMg was 1.9 +/- 0.3 in the presence of 0.2 microM Ca2+ but increased to a mean of 7.2 +/- 1.3 in the presence of 5.0 microM Ca2+. Analysis of the Ca2+ inhibition curves at concentrations from .05 microM-1.0 mM were consistent with the presence of two Ca2+ inhibition sites, one with an apparent Ki of 1-2 microM and the other with an apparent Ki of approximately 500 microM. Lowering the Mg2+ concentration increased the contribution of the high affinity Ca2+ binding site to the overall Ca2+ inhibition, and raising the Mg2+ concentration had the opposite effect. While bPTH 1-34 enhanced adenylate cyclase activity, it did not increase the affinity of Mg2+ for skeletal adenylate cyclase nor did it alter the KiCa or the pattern of Ca2+ inhibition. These data may explain the skeletal resistance to PTH during Mg deficiency.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenylyl Cyclase Inhibitors↗
PubMed1985

A viral antigen-bearing cell line derived from culture of Paget's bone cells.

This study documents the characteristics of a viral antigen-bearing cell line derived from co-culture of the bone from a 71-year-old woman with Paget's disease of bone and HEp-2 cells. The cell line has survived in continuous culture for 3 1/2 years and 185 subcultures. The cells are epithelioid in appearance, produce alkaline and acid phosphatase, increase alkaline phosphatase activity in response to 1,25-(OH)2-D3 and contain receptors for 1,25-(OH)2-D3. Immunofluorescent studies utilizing antisera to respiratory syncytial virus and measles virus reveal antigens of both viruses in the cells. These cells do not produce bone in culture and the adenylate cyclase activity found in their plasma membrane does not increase significantly in response to parathyroid hormone or calcitonin. The cells are not contact inhibited and form spherical colonies in agarose. They are aneuploid and have a modal number of 62-74 as well as HeLa markers. When injected into athymic mice, osteosarcomas are produced. These tumors continue to bear viral antigens. The availability of this cell line should aid in further studies of the viral antigens associated with Paget's disease of bone.

Aged↗
PubMed1985

Estrogen and progestin effects on urinary calcium and calciotropic hormones in surgically-induced postmenopausal women.

Seventeen surgically-induced postmenopausal (PM) women were randomized to receive either 0.625 mg of conjugated estrogens (CE) daily or 150 mg of intramuscular depomedroxyprogesterone acetate (DMPA) every 3 months. Urinary calcium/creatinine ratios were significantly higher than ratios of premenopausal controls before treatment, but were lower in all patients 2 months after both types of treatment. Compared to controls, all PM patients had similar levels of serum PTH and 25 hydroxy vitamin D before and after treatment. As a group, PM patients had lower levels of 1.25-dihydroxyvitamin D. In 5 patients who had levels which were below the normal range, 3 were treated with CE and 2 received DMPA. These patients all had significant increases in 1,25-dihydroxyvitamin D after treatment. Serum calcitonin did not change with either CE or DMPA treatment. These data suggest that, while both CE and DMPA lower calcium excretion in PM women, the mechanism(s) for the effects of hormonal treatment on bone resorption remain unsettled.

Adult↗
PubMed1985

Magnesium deficiency in a medical ICU population.

The serum magnesium level was measured in 94 consecutive patients admitted to the medical ICU of Los Angeles County/University of Southern California Medical Center over a 2-month period. Sixty-five percent of patients with serum creatinine concentrations of 1.1 mg/dl or less were hypomagnesemic. Of these, one third had hypocalcemia that was corrected with magnesium supplementation. Physicians should be alert to the high incidence of magnesium deficiency in critically ill patients.

California↗
PubMed1985

Diminished internalization and action of 1,25-dihydroxyvitamin D3 in dermal fibroblasts cultured from New World primates.

We investigated the occurrence of 1,25-dihydroxyvitamin D3 [1,25-(OH)2D3]-resistant osteomalacia in the New World primate colony of Saguinus imperator at the Los Angeles Zoo. The mean serum concentration of 1,25-(OH)2D3 was elevated 5-fold in the New World primates compared to that in their Old World counterparts. The specific internalization of 0.6 nM [3H]1,25-(OH)2D3 by cultured dermal fibroblasts from New World primates was reduced 75% compared to that by cells from Old World primates or man. The decrease in hormone uptake resulted from a decrease in the number of high affinity intracellular binding sites for 1,25-(OH)2D3 and apparently caused a 90-95% reduction in 1,25-(OH)2D3-induced 25-hydroxyvitamin-D3-24-hydroxylase activity. There was no alteration in the capacity or avidity of New World primate serum for 1,25-(OH)2D3 compared to that of serum from Old World primates. These data suggest that the occurrence of vitamin D-resistant osteomalacia in New World primates is the result of decreased high affinity, receptor-mediated uptake of 1,25-(OH)2D3 by the target cell.

Animals↗
PubMed1985

Low serum concentrations of 1,25-dihydroxyvitamin D in human magnesium deficiency.

The effect of magnesium deficiency on vitamin D metabolism was assessed in 23 hypocalcemic magnesium-deficient patients by measuring the serum concentrations of 25-hydroxyvitamin D (25OHD) and 1,25-dihydroxyvitamin D [1,25-(OH)2D] before, during, and after 5-13 days of parenteral magnesium therapy. Magnesium therapy raised mean basal serum magnesium [1.0 +/- 0.1 (mean +/- SEM) mg/dl] and calcium levels (7.2 +/- 0.2 mg/dl) into the normal range (2.2 +/- 0.1 and 9.3 +/- 0.1 mg/dl, respectively; P less than 0.001). The mean serum 25OHD concentration was in the low normal range (13.2 +/- 1.5 ng/ml) before magnesium administration and did not significantly change after this therapy (14.8 +/- 1.5 ng/ml). Sixteen of the 23 patients had low serum 1,25-(OH)2D levels (less than 30 pg/ml). After magnesium therapy, only 5 of the patients had a rise in the serum 1,25-(OH)2D concentration into or above the normal range despite elevated levels of serum immunoreactive PTH. An additional normocalcemic hypomagnesemic patient had low 1,25-(OH)2D levels which did not rise after 5 days of magnesium therapy. The serum vitamin D-binding protein concentration, assessed in 11 patients, was low (273 +/- 86 micrograms/ml) before magnesium therapy, but normalized (346 +/- 86 micrograms/ml) after magnesium repletion. No correlation with serum 1,25-(OH)2D levels was found. The functional capacity of vitamin D-binding protein to bind hormone, assessed by the internalization of [3H]1,25-(OH)2D3 by intestinal epithelial cells in the presence of serum was not significantly different from normal (11.42 +/- 1.45 vs. 10.27 +/- 1.27 fmol/2 X 10(6) cells, respectively). These data show that serum 1,25-(OH)2D concentrations are frequently low in patients with magnesium deficiency and may remain low even after 5-13 days of parenteral magnesium administration. The data also suggest that a normal 1,25-(OH)2D level is not required for the PTH-mediated calcemic response to magnesium administration. We conclude that magnesium depletion may impair vitamin D metabolism.

Calcifediol↗