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  • 1
    ISSN: 1432-1440
    Keywords: Primary hyperparathyroidism ; Histomorphometry ; Trabecular bone structure ; Parathyroid hormone ; Bone biopsy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Iliac crest bone biopsy specimens of 391 patients with surgically proven primary hyperparathyroidism were investigated. In 60 unselected cases quantitative analysis of trabecular bone changes was performed. The age of the patients ranged between 12 and 85 years. The observed morphological findings were divided into four stages. In a few cases no differences from normal bone tissue could be observed. In 46% occurrence of a nonspecific increase of osteoid seams, osteoblasts, and osteoclasts was observed. Of the cases 50% showed a specific, but very often mild endosteal fibrosis. Only in 4% was there a severe fibroosteoclasia with development of so-called brown tumors. The quantitative analysis showed an increase of trabecular bone mass as well as of remodeling surfaces. But there was an overlap of up to 25% with the normal controls. The results demonstrate the influence of parathyroid hormone peptides on bone morphology. However, the investigation of a bone biopsy specimen is not generally very useful for diagnostic purposes.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1440
    Keywords: Bone-marrow blood ; Parathyroid hormone ; Osteoporosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Recently the bone-marrow cavity blood concentration of parathyroid hormone (PTH) has been shown to exceed that of the peripheral blood. As PTH is a primary modulator of bone cell activity, altered levels of the hormone in the bone-marrow blood may play a significant role in the aetiology of bone disease. We therefore measured PTH concentrations in marrow cavity and venous blood of 9 osteoporotic and 14 control subjects using sequence specific radioimmunoassays for intact and mid-carboxyl (Mid-C) regional human PTH (hPTH). Intact and Mid-C PTH levels were identical in the peripheral blood of control and osteoporotic subjects. Furthermore, bone-marrow cavity blood concentrations of Mid-C PTH, whilst universally higher than those found in peripheral blood, were also comparable in the osteoporotic and control subjects. The sole difference in the PTH composition of bone-marrow cavity blood from osteoporotic subjects was an increased concentration of intact PTH. The origins and consequences of elevated levels of intact PTH within the marrow cavity blood of osteoporotic subjects are discussed.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1440
    Keywords: Osteoporosis ; Parathyroid hormone ; Bone metabolism
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In contrast to prevention, the therapy of manifest osteoporosis remains a clinically significant problem. So far all therapeutic attempts have yielded unsatisfying results. For this reason we have tried to achieve a positive bone balance by sequential stimulation and inhibition of the osseous metabolism. The therapy consisted of six 14-day courses with 400 units (1–38)hPTH per day and, in addition, starting with the 2nd week of PTH therapy, EHDP 5 mg per kg body weight per day for a total of 2 weeks. Already the initial therapeutic course resulted in a stimulation of decreased bone metabolism which could be documented by an increase in the calcium-47 accretion rate (six patients). An increase of the alkaline phosphatase could be noted (four patients); this, however, did not correlate with the calcium accretion. A positive calcium balance could, nonetheless, only be attained in four of eight patients within this period, while neither the alkaline phosphatase nor the kinetics would allow a prediction of this effect. Changes of the balance coincided with equal changes in the net calcium absorption. The urinary calcium excretion increased temporarily during the therapeutic phase. We were not able to detect an influence on the vitamin D metabolites. Histomorphometric studies did not demonstrate an increase in bone mass in the iliac creast after six therapeutic courses. Nevertheless, progressive deformations of vertebral bodies did not occur. We conclude that already after 2 weeks this therapeutic concept can lead to a stimulation of bone metabolism.
    Type of Medium: Electronic Resource
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