Formation of aminoacyl-tRNA-guanulul-5'-methylene diphosphonate-elongation factor complex.
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Six patients with Paget disease of bone were treated with a 6-mo course of disodium-ethane-1-hydroxy-1, 1-diphosphate (EHDP) at a dosage of 5 mg/kg/day (one patient) or 20 mg/kg/day (five patients). In addition to symptomatic and biochemical improvement which persisted 3 mo after discontinuance of therapy, EHDP resulted in a significant increase in intestinal calcium absorption that was not correlated with a change in serum 1 alpha, 25-(OH)2-vitamin D concentration. EHDP appears to stimulate intestinal calcium transport by either a vitamin D independent process or by an increased intestinal mucosal cell sensitivity to vitamin D.
A case of mandibular bone graft with metallic mesh implant following a segmental resection for ameloblastoma was evaluated by means of 99m technetium disphosphonate bone scanning of the mandible. The bone scan showed good evidence of bone graft regeneration when conventional radiography could not read any bone tissue regeneration within the metallic mesh. The scan was extremely helpful in eliminating the need for surgical intervention and exploration.
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Bone scintigraphic results for 28 patients with Paget's disease treated with a combination of EHDP and calcitonin are reported. The uptake of the bone scintigraphic agent decreased considerably during the first year of treatment. There was good correlation between scintigraphic and biochemical changes, but most of the 22 patients who attained normal biochemical values still had one or more active lesions scintigraphically. Remission of disease does not therefore mean normalization of the bone scintigram. All affected bones showed a distinct drop in activity, but lesions with a higher initial activity remained more active than lesions with a lower initial activity. One third of the affected bones normalized completely, although radiographic anomalies persisted. There were slight differences in scintigraphic activity depending on the anatomical site. The success of treatment, however, could not be predicted from the pretreatment scintigram. A recurrence of disease was often visible on the scintigram, in certain cases 6 months prior to the biochemical decline. This could be of importance in the therapeutic management of the recurrence.
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