摘要:

Summary:1. Bone is unique in its combination of cells, matrix and mineral.2. It has a dual function in skeletal and mineral homeostasis.3. Cells which are functionally different act as coordinated units depending on a variety of signals which may be hormonal, ionic, mechanical and, possibly, electrical.4. The coordinated activity of the cells is brought about by their having an intimate structural interrelationship, by the probability of their being subject to the influence of factors contained within an extra‐cellular fluid circulating around all the cells underlying the mesenchymal cell envelope, and by the possibility that the osteoclasts and osteoblasts do not represent an end‐stage in differentiation.5. The understanding of the factors which normally control cellular differentiation and function may lead to methods of reversing bone loss, rectifying the effects of metabolic bone disease and promoting the healing of fractu

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1979.tb04105.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1979.tb04106.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Summary:With the advent of serum parathyroid hormone assays the diagnosis of hyperparathyroidism has become relatively straightforward. Current unresolved problems comprise the selection of patients for surgery, the pre‐operative localization of lesions and the medical management of patients who, for one reason or another, are unsuitable for surger

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1979.tb04107.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Summary:About 11% of post‐menopausal women with wrist fractures have spinal osteoporosis with compressed vertebrae, and about 25% of post‐menopausal osteoporosis patients have had a wrist fracture. The estimated prevalence of post‐menopausal spinal osteoporosis is 4% of the female population at age 60 and about 8% at age 80. Osteoporotic patients have lower plasma oestrone and androstenedione levels, lower calcium absorption and higher urinary hydroxyproline than matched controls. Of six treatments tested in three different ways, the least successful were vitamin D2and 1α‐OHD3and the most successful were hormones with or without 1α.‐(OH)2D3and calcium supplements. Calcium and vitamin D given in combination occupied an intermedia

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1979.tb04108.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1979.tb04109.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Summary:Calcitonin has been used in the treatment of Paget's Disease of bone because of its ability to inhibit osteoclastic bone resorption. This results in a return of bone turnover towards normal, as reflected by urinary hydroxyproline and serum alkaline phosphatase. A plateau is reached with these parameters, at about 50% of the pre‐treatment level. The cause of this plateau is unknown, but does not indicate resistance to treatment, since it occurs with all forms of calcitonin. Most treated patients experience pain relief, and there is radiological and histological evidence of arrested progression of Paget's Disease in patients treated with calcitonin. Both primary and secondary resistance to calcitonin occur with all calcitonins, including homologous hormone. Antibodies develop commonly in patients treated with pig or salmon calcitonin, but antibody‐based clinical resistance has been demonstrated only in a few patients. Methods of selection of patients for treatment and of assessment of response are discussed, and treatment schedules summari

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1979.tb04110.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Summary:Of 431 consecutive patients who underwent coronary arteriography during the twelve month period ending December 1976, 23 (5%) had angiographically documented coronary artery ectasia. Of these only five had “pure” or isolated ectasia, whilst 18 had ectatic disease combined with coronary artery stenoses.Clinical findings that are significantly associated with ectasia are male predominance (96%), abnormal lipid patterns (64%), a positive family history of coronary artery disease (57%) and previous hypertension (50%). Anatomically, ectasia most often involved the right coronary artery (96%), then the circumflex artery (75%) and the left anterior descending artery (57%).Only seven (five with severe proximal stenoses) of the 28 patients had coronary artery bypass grafts. Care should be taken not to overdiagnose narrow segments between ectatic, dilated segments as being obstructions. Failure to appreciate this resulted in two patients with isolated coronary artery ectasia having bypass grafts performed with little relief of their sympt

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1979.tb04111.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Summary:Haemoglobin A1in diabetes mellitus. P. C. Bartley and T. E. HamblingHbA1was measured by a rapid method in a routine hospital laboratory. The normal range of 5·0–8·5% compares favourably with other studies. Patients with uncontrolled diabetes had levels of HbA1of up to 20·5% while well controlled patients had levels of HbA1in the normal range. The level of HbA1is relatively stable in normal subjects and does not correlate with age, sex or weight. There was a correlation (p<0·001) with a 1–2 hour postprandial, post‐insulin blood sugar in insulin dependent diabetics. There was a relationship between type of therapy and HbA1level at presentation. From the study of two ketoacidotic patients, it is apparent that the level of HbA1decreases about six weeks after the decrease in blood sugar. It is concluded that the measurement of HbA1is a useful adjunct in the assessment of diabeti

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1979.tb04112.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Summary:Specific serological tests which are now available for the diagnosis of infection with hepatitis A and hepatitis B viruses, were used to distinguish viral hepatitis from other causes of liver disease in pregnancy. Forty‐nine (51·6%) of 95 pregnant patients had viral hepatitis, 24 hepatitis A and 25 hepatitis B. The majority of patients (26 of 28) presenting before 22 weeks gestation had viral hepatitis. By contrast, 23 (34·3%) of the remaining 67 patients presenting with abnormal liver function tests at ≫ 22 weeks gestation, had viral hepatitis; the majority of the remainder had features compatible with intrahepatic cholestasis of pregnancy. Although there were significant clinical and biochemical differences between the two groups, accurate diagnosis was only possible by using specific virological

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1979.tb04113.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Summary:The effects of adverse maternal, fetal, and intrapartum factors on cord serum total cholesterol (TC) and triglyceride (TG) were studied retrospectively on a sample of 428 neonates comprising four subgroups: (1) 54 with isolated cord serum hypercholesterolaemia (HC); (2) eight with cord serum HC and hypertriglyceridaemia (HTg); (3) 70 with isolated cord HTg; and (4) 296 with normal cord serum TC and TG levels.Low birth weight babies (<2500 g) had higher levels of cord TG (P<0·001) and TC (P<0·1) than normal weight babies, as did pre‐term (less than 37 weeks gestation) babies, P<0·05 for TG, P<0·001 for TC, and postmature (over 41 weeks gestation) babies, P<0·01 for TG. The regression coefficient between gestational age and TC was‐0·20 (P<0·001), and for TG‐0·13 (P<0·02).Babies with low one and five‐minute apgar scores had higher means for TG (P<0·001) with the coefficients of regression being 0·34 and 0·30, but no differences were present for TC. Those who had had signs of intrapartum distress, such as tachycardia and bradycardia, also had higher means for TG (P<0·01), but their TC was lower than in the co

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1979.tb04114.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY