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Biomedical subjects

G Offermann

Publications and source records attributed to G Offermann.

At least 109 records · Page 6Linked to original sources
PubMed1981

The influence of the calcium/phosphorus ratio in the diet on human bone disease, the role of nutritive secondary hyperparathyroidism.

60 out of 100 patients suffering from severe periodontal disease received a daily calcium supplementation of 1,000 or 2,000 mg during a period of 9 or 12 months. Different investigations such as PTH and serum parameters were not influenced by this treatment. However, animal experiments, as well as acute studies in men involving an oral phosphorus load, suggest that parathyroid secretion might be increased by a lowered calcium/phosphorus ratio. Therefore it is possible that a diet too low in calcium could contribute to the pathogenesis of periodontal disease. The lacking effect of calcium therapy implies very strongly that other factors are more important for the development of this disorder.

Calcium↗
PubMed1980

[Influence of vitamin D therapy on renal osteodystrophy in children (author's transl)].

Growth arrest and renal osteodystrophy is a major problem in renal insufficiency of children. The present report describes our experiences in managing renal osteodystrophy by using vitamin D3 for 24 months. Values in plasma of Ca, Mg, alkaline phosphatase, iPTH, 25-OH-D were determined regularly. Skeletal X-rays and analysis of iliac crest bone biopsies were obtained in each child. In treatment with vitamin D3 no hypercalcemia was seen despite high serum levels of 25-OH-D. Plasma-Ca, alkaline phosphatase, and iPTH normalized nearly. Radiographic abnormalities improved. Bone biopsies showed improvement in signs of secondary hyperparathyroidism and ostitis fibrosa, whereas osteomalacia remained unchanged. Osteoblast population showed a small reduction. No real increment in body growth was seen.

Alkaline Phosphatase↗
PubMed1980

Failure to show a correlation between serum parathyroid hormone, nerve conduction velocity and serum lipids in hemodialysis patients.

The proposed role of parathyroid hormone as an important agent for the development of certain uremic complications could not be confirmed in studies correlating, in dialysis patients, the nerve conduction velocity and the serum lipids with four different immunochemically defined forms of circulating parathyroid hormone. To a certain extent the data invalidate suggestions which favor parathyroid hormone as a leading uremic toxin.

Alkaline Phosphatase↗
PubMed1979

[Treatment of renal osteopathy with 5,6-trans-25-hydroxycholecalciferol (author's transl)].

The influence of 5,6-trans-25-hydroxycholecalciferol on renal osteopathy was investigated in a total of 132 patients in 26 dialysis centres. Various doses were used, the average being 4000-6000 IU/day. In 32 patients a daily dose of 6000-9000 IU was used. The average individual duration of treatment was 276 days with a maximum of 910 days. Histologically there was an improvement in the renal osteopathy in 55.9% of evaluable cases (n = 34) and in 25.3% there was no deterioration. Radiographically these results were found in 21% and in 70.5% of evaluable cases (n = 105). Serum calcium increased in 46.6% of cases (n = 131), remained the same in 32.8% and decreased in 20.6%. The changes in alkaline phosphatase were similar : it dropped in 42.1% of patients, remained the same in 28.1% and rose in 29.8%. Immunoreactive parathormone which was invariably raised at the beginning of treatment (n = 36), fell in 25.0%, remained the same in 44.4% and rose further in 30.6%. The clinical symptoms of renal osteopathy which had been present in 57 patients improved in 51.0%, remained the same in 46.0% and deteriorated in 3.0%. Signs of intolerance and side effects were rare. Severe hypercalcaemia did not occur.

Adolescent↗
PubMed1979

Antiepileptic drugs and vitamin D supplementation.

The incidence of biochemical signs of vitamin D deficiency and the effects of vitamin D supplementation were investigated in 83 children and 95 adults on chronic antiepileptic therapy and 40 mentally retarded controls living under comparable conditions. Low 25-hydroxyvitamin D and serum calcium, and elevated immunoreactive parathyroid hormone and alkaline phosphatase was a common finding in all groups, but in patients on antiepileptic drugs, signs of vitamin D deficiency were recorded more frequently. Supplementation of 125 microgram or 250 microgram vitamin D3 per week for 9 months normalized the laboratory findings in most patients; the effect of 37.5 microgram/week only slightly exceeded the influences of season observed in the controls and in epileptic patients without vitamin D. It is suggested that a dose between 37.5 and 125 microgram vitamin D3/week might be most suitable to avoid biochemical signs of vitamin D deficiency in children and adults on antiepileptic drugs.

Adolescent↗
PubMed1979

Renal bone disorders in children: therapy with vitamin D3 or 1,25-dihydroxycholecalciferol.

Twelve children with chronic renal failure (CRF) and sixteen children receiving regular dialysis therapy (RDT) were treated with between 10,000 and 50,000 IU of vitamin D daily. This was associated with an increase in serum calcium levels and reduction in PTH levels. In the children with CRF, secondary hyperparathyroidism was improved with treatment but its development was not completely prevented nor was healing complete. In the patients receiving RDT, treatment with vitamin D improved the changes associated with secondary hyperparathyroidism in 50% of cases but these features sometimes reappeared despite continuing treatment. Hypercalcaemia or metastatic calcification was not seen. Subsequently, 1,25(OH)2D3 was administered to 14 children receiving RDT. This was associated with the return of serum calcium levels to normal, inhibition of PTH synthesis and an improvement in intestinal calcium absorption. Fibro-osteoclasia was cured and there was improvement in actual bone resorption. There was also improvement in osteoidosis in those children who showed disturbances of mineralisation. Calcification in the limbus area of the eyes may occur and hypercalcaemia was seen commonly. Treatment with 1,25(OH)2D3 should only be offered to children with severe renal bone disease. Neither vitamin D3 nor 1,25(OH)2D3 can guarantee complete recovery of osteodystrophy and of growth arrest in uraemic children.

Adolescent↗
PubMed1979

Effect of 1,25(OH)2D3 and 24,25(OH)2D3 on experimental rickets.

The vitamin D3 metabolite 1,25(OH)2D3 alone may not be able to reverse defective bone mineralization, while a combination with another metabolite, 24,25(OH)2D3 might be necessary to display the known effect of vitamin D on bone. Growing rachitic rats were treated with 25 ng vitamin D3/d, 10 ng 1,25(OH)2D3/d, 10 ng 24,25(OH)2D3/d, 5 ng 1,25(OH)2D3/d and 5 ng 24,25(OH)2D3/d in combination and 10 ng 1,25(OH)2D3/d and 10 ng 24,25(OH)2D3/d in combination. After 10 days of treatment the epiphyseal plate width of femura and the distance of tetracycline fluorescence bands were measured microscopically on undecalcified sections of the bone. The calcium content of femur epiphysis was measured by neutron activation analysis. Neither parameter showed on greater effect of the combination of 1,25(OH)2D3 and 24,25(OH)2D3 than of 1,25(OH)2D3 alone.

Animals↗
PubMed1978

[Immunoreactive parathyroid hormone in samples from thyroid veins (author's transl)].

Blood samples were obtained from 16 patients with primary or secondary hyperparathyroidism by selectively catheterising cervical and thyroid veins. Immunoreactive parathyroid hormone was measured with two aminoterminal (anti-N)- and three carboxyl-terminal (anti-C)-specific antisera. Two anti-C sera and one anti-N serum were useful in localising the parathyroid tumors. In addition, the parathyroid hormone fragments were separated by gelfiltration and the immunoreactivity in the effluent was estimated with anti-N and anti-C sera. The results suggest that the usefulness of antisera for parathyroid tissue localisation is determined by their affinity for the intact hormone, regardless of their anti-N or anti-C qualities.

Chromatography, Gel↗
PubMed1978

[Vitamin D deficiency and osteomalacia in old people (author's transl)].

The frequency and causes of vitamin D deficiency in old age were investigated in 53 hospital patients, 88 persons from old people's homes, 21 tenants of a hostel, and 29 members of a seniors meeting group, aged between 65 and 93 years. In all persons 25-hydroxyvitamin D, calcium, phosphate, alkaline phosphatase, leucine arylamidase and creatinine were determined. In 27 cases immunoreactive parathormone was measured. In hospital patients there was evidence of vitamin D deficiency significantly more frequently as compared with the other groups. The 25-hydroxyvitamin D concentration was on average lower in the cases from old people's homes and hostels than in the members of the seniors group. The results in the groups investigated showed a relation to the average exposure to the sun. The results in 10 further patients in this age group with florid osteomalacia indicate a multifactorial aetiology of vitamin D deficiency disease due to reduced exposure to sun, inadequate nutrition and reduced absorption of vitamin D.

Age Factors↗
PubMed1978

1,25-dihydroxycholecalciferol in hypophosphataemic osteomalacia presenting in adults.

The effects of exogenous 1,25-dihydroxycholecalciferol (1,25(OH)2D3) in two adults with late-onset hypophosphataemic osteomalacia were studied. In the presence of elevated 25-hydroxyvitamin D levels 1,25OH)2D3 improved intestinal 47Ca absorption and increased urinary calcium, phosphate and hydroxyproline excretion. Hypophosphataemia, parathyroid hormone and bone mineralization were not significantly affected. The rise of the 1,25-dihyroxyvitamin D concentrations was dose dependent. The results indicate htat the impared renal phosphate conservation--the primary defect in this disorder--is not corrected by exogneous 1,25-dihydroxycholecalciferol.

Adult↗
PubMed1978

Chronic hemofiltration. A critical evaluation of a new method for the treatment of blood.

The experiences which have been compiled in more than 2400 hemofiltrations confirm that this method represents an alternative way of treating uremic patients. The main advantages of chronic hemofiltration are the comfort of the patient and the ease in handling excess overhydration without extending treatment time, which is less than 3 X 3 hours/week if adequate hemofilters are used. With regard to the improvement of such typical uremic complications as severe hypertension, hypertriglyceridemia or neuropathy, hemofiltration does not seem to be superior to hemodialysis. However, since most hemofiltration patients do not require phosphate binders and, additionally, remarkable amounts of parathyroid hormone are removed during one hemofiltration, it appears possible that hemofiltration might be an important therapeutic alternative for those renal patients who suffer from severe hyperphosphatemia and secondary hyperparathyroidism.

Adult↗
PubMed1977

The effect of 5,6-trans-25-hydroxycholecalciferol in relative vitamin D resistancy.

The relative vitamin D resistance in patients with chronic renal failure and in those with hypoparathyroidism is due to an impairment of 1-hydroxylation of cholecalciferol. 5,6-trans-25OHCC, which has a similar steric configuration as 1,25(OH)2CC was examined at a daily dose of 18,000 IU fro 14 days in both diseases. Intestinal 47calcium absorption as well as serum calcium level could be normalized in most patients with hypoparathyroidism. The improvement was less in patients with chronic renal failure, suggesting an additional depressing influence of uremia on calcium metabolism.

Calcium↗
PubMed1977

Comparison between the 5,6-cis and 5,6-trans isomers of 25-hydroxyvitamin D3 in chronic hypoparathyroidism.

Five patients with chronic post-operative hypoparathyroidism were treated with 450 microgram/day 5,6-trans-25-hydroxyvitamin D3 (5,6-trans-25OHD3) for 14 days, and the treatment was continued with 150 microgram/day for one year. At the end of this period the patients received 450 microgram/day 5,6-cis-25-hydroxyvitamin D3 (5,6-cis-25OHD3) for 14 days. Comparison of the effects of both isomers revealed a similar ability to enhance intestinal calcium absorption and to normalize serum calcium; serum phosphate and alkaline phosphatase, however, remained unaffected. Urinary phosphate and hydroxyproline excretion decreased on the cis-isomer and increased on the trans-isomer. During treatment with the lower dose of 5,6-trans-25OHD3 intestinal calcium absorption remained in the normal range for one year, whereas the serum calcium decreased to the levels observed before administration of 450 microgram/day within 6 weeks. The results suggest that in hypoparathyroidism 5,6-cis-25OHD3 and 5,6-trans-25OHD3 are equally effective on serum calcium and on intestinal calcium absorption, but that their mode of action on renal phosphate handling and on calcium release from bone is different.

Adult↗
PubMed1977

Parathyroid hormone-, 25-OH-vitamin D-, and digoxin levels in patients treated by chronic hemofiltration.

Immunoreactive parathyroid hormone (iPTH) was measured in the serum and filtrate before, during and after hemofiltration. iPTH regularly declines during hemofiltration; one patient, investigated for a longer period, showed a normalization of iPTH serum level with this treatment. The iPTH values found in the hemofiltrate were remarkably high, a finding that could be explained by non-specific effects, by the occurrence of hormone fragments or by an increased secretion rate. At any rate, the results suggest a filtration of parathyroid hormone and/or hormone fragments. On the other hand, it was impossible to detect any 25-OH-vitamin D in the hemofiltrate. Finally, digoxin could be found in the filtrate, but only in very low concentrations.

Digoxin↗