ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1977.tb16772.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

ABSTRACTThirty‐two consecutive, previously untreated patients with plasma cell myeloma were treated with 4‐day courses of melphalan (0.25 mg/kg/day) and prednisolone (2 mg/kg/day) every sixth week. The observation period ranged from 26 to 75 months and the total median survival time was 29 months. 75% of the patients responded to therapy and their median survival time was 42 months. Sex did not influence either the response rate or the survival time. Most patients were treated in an outpatient clinic and required a minimum of check

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1977.tb16773.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

ABSTRACTA number of hematological variables have been investigated and followed during a hospital stay in a group of 34 non‐cirrhotic male alcoholics after acute drinking bouts. The most prominent findings were a rise in reticulocytes, a fall in serum iron and a rise in WBC, especially with respect to the lymphocytes. HB and hematocrit values both fell during hospitalization, while ESR and serum haptoglobin rose. No change was observed in the platelet count. It is concluded that alcohol has marked effects on the hematological system even in subjects without serious liver damage. The results underline the importance of an adequate knowledge of the patient̂s alcohol habits in the investigation of obscure hematologic abnormaliti

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1977.tb16774.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

ABSTRACTSeveral sensitive parameters of cellular immunity were studied in 20 patients with asymptomatic paraproteinaemia as judged after at least 3 years of follow‐up. In vitro lymphocyte transformation by the primary immunogen haemocyanin of Helix pomatia (HPH) following immunization, by PHA, PWM and previously encountered antigens was measured, as was skin sensitization by the primary immunogen dinitrochlorobenzene (DNCB). All 12 patients with low serum paraprotein levels—benign paraproteinaemia according to common criteria— had normal parameters of cellular immunity. However, 5 of 6 patients with high IgG and IgA serum paraprotein levels had a decreased response to HPH; 3 of these 5 also had a decreased PHA response. Two patients with high IgM serum paraprotein levels had normal lymphocyte reactivity. Lymphocyte reactivity by PWM and previously encountered antigens was normal in all patients. Autologous serum culture medium did not influence the results. DNCB skin sensitization was significantly lower in the group with high serum paraprotein levels than in the group with low levels. It is concluded, that in asymptomatic paraproteinaemia, patients with high serum paraprotein levels differ from those with low paraprotein levels in their defective cellular response to primary immunogens. The significance of these findings is disc

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1977.tb16775.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

ABSTRACTIn a previous investigation by our group it was suggested that the stimulating effect of 1‐α‐hydroxycholecalciferol (1‐α‐OH‐D3) on the tubular reabsorption of phosphate is mediated via the parallel suppression of the parathyroid hormone (PTH). A direct effect of 1‐α‐OH‐D3on the renal tubule could however not be completely excluded. Therefore, the effect of 1‐α‐OH‐D3was studied in 5 totally parathyroidectomized patients, in whom concomitant suppression of PTH would not occur. TmP/GFR, i.e. the ratio between the maximal tubular reabsorption of phosphate (TmP) and the glomerular filtration rate (GFR), was used as an indicator of the renal handling of phosphate. Estimation of TmP/GFR was performed 1) when the patients were vitamin D depleted and hypocalcemic, and 2) after 14–27 days of treatment with 1‐α‐OH‐D3to obtain stable normocalcemia. In patients with absent parathyroid function, no effect of 1‐α‐OH‐D3on TmP/GFR could be demonstrated. It is therefore concluded that 1‐α‐OH‐D3exhibits no antiphosphaturic effect in the absence of PTH and that the previously demonstrated antiphosphaturic effect of 1‐α‐OH‐D3

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1977.tb16776.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

ABSTRACTAseptic necrosis of bone has developed 5–48 months (mean 23) after renal transplantation in 22 (11%) of 195 patients with graft function for more than 6 months. The bone lesions were mainly localized to weight‐bearing cancellous bone areas, most often the femoral heads. The mean duration of hemodialysis was significantly longer in recipients with aseptic necrosis than in those without. The serum concentration of phosphate was reduced and the serum concentration of parathyroid hormone increased in both groups of recipients. Quantitative histological examination of iliac crest biopsies showed a pronounced reduction of spongy bone (osteopenia) in recipients with aseptic necrosis compared with both normals and recipients without aseptic necrosis. Both patient groups showed similar changes in bone remodelling, indicating decreased bone formation. These findings suggest that osteopenia is an important contributory factor in the development of aseptic necrosis of bone after transplantation. The osteopenia may be a consequence of both the uremic bone disease before transplantation and the immunosuppressive treatment after transplantat

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1977.tb16777.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

ABSTRACTThe development of bone abnormalities has been studied in 24 patients with severe chronic renal failure. The glomerular filtration rate (GFR) was between 5 and 25 ml/min. The mean values of plasma calcium, degree of bone mineralization (P/Hypro) and bone mineral content (BMC) were subnormal, whereas the mean values of plasma phosphorus and serum parathyroid hormone (PTH) were elevated. Analysis of the data revealed that the various parameters became increasingly pathological with decreasing renal function. Serum PTH correlated inversely with both GFR and plasma calcium. The decrease in bone P/Hypro with decreasing renal function could be explained by an inverse correlation to serum PTH. Plasma alkaline phosphatase correlated inversely to both bone P/Hypro and BMC. The present study on individual patients with varying degrees of renal insufficiency shows that the development of secondary hyperparathyroidism correlates with a reduction in the degree of bone P/Hypro and suggests that significant bone changes appear when the GFR falls below 15 ml/min.

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1977.tb16778.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

ABSTRACTSeveral laboratory parameters have been followed before and after surgery in a 69‐year‐old woman with parathyroid adenoma and severe skeletal involvement. High preoperative levels of immunoreactive parathyroid hormone rapidly decreased postoperatively, accompanied by a similar fall in the peptide‐bound hydroxyproline (HP) excretion in the urine. Renal clearance of free HP was high both pre‐ and postoperatively, probably because of renal damage associated with the disease. The high serum alkaline phosphatase levels increased slightly after the operation. The patient developed severe postoperative hypocalcaemia, and prolonged calcium supplement therapy was necessary. The results imply a clear correlation between the changes in Ca homeostasis and the breakdown rate of bone collagenous matrix. Postoperative hypocalcaemia was mainly due to the rapid change in the rates of bone formation and dest

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1977.tb16779.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

ABSTRACTUrinary adenosine 3′, 5′‐monophosphate (cyclic AMP, cAMP) has been determined in 84 males. Two protein‐binding assays were used: the method of Gilman and the Amersham assay kit. The results were in close agreement. The excretion of cAMP was not correlated to urinary calcium or to estimated calcium

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1977.tb16780.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

ABSTRACTWith the aim of evaluating bone phosphorus/hydroxyproline ratio (P/Hypro) as an index of osteomalacia, this bone index and the bone mineral content (BMC) have been investigated together with other indices of calcium metabolism in 27 gastrectomized patients. None of the patients had clinically manifest bone symptoms. The mean values of bone P/Hypro, BMC, plasma calcium and plasma magnesium were subnormal; the mean values of serum parathyroid hormone (iPTH) and plasma alkaline phosphatase were elevated. Mean serum 25‐hydroxycholecalciferol (25‐OH‐D) did not differ from normal. A significant positive correlation was found between bone P/Hypro and serum 25‐OH‐D, but no significant correlation between bone P/Hypro and BMC. Serum 25‐OH‐D and bone P/Hypro were significantly lower and serum iPTH was significantly higher in a subgroup of 12 patients with no regular supplementary intake of vitamin D. In conclusion, the gastrectomized patients had blood biochemical evidence of a mild vitamin D insufficiency and the low bone P/Hypro values can be explained by mild osteomalacic ch

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1977.tb16781.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY