PubMed Health⌕ Search

Biomedical subjects

J Jowsey

Publications and source records attributed to J Jowsey.

At least 19 recordsLinked to original sources
PubMed1980

Effect of sodium fluoride, calcium carbonate, and vitamin D on the skeleton in multiple myeloma.

Fifteen patients with multiple myeloma were treated with sodium fluoride (50 mg twice daily) plus calcium carbonate (1 g four times daily) or with the same fluoride-calcium dosage plus vitamin D (50,000 U twice weekly). All patients had increased bone formation, as shown by microradiography and videodensitometry. Ten patients had osteosclerosis demonstrated by roentgenograms. Compressive strength of the vertebral bodies was greater among those who received fluoride-calcium than among controls. Densitometry studies were not helpful. Side-effects were minimal and consisted of nausea and fibrositic symptoms. Hypocalcemia occurred less frequently in patients who received vitamin D along with fluoride-calcium. Administration of sodium fluoride and calcium carbonate produces an increase in bone mass and is a useful adjunct treatment for patients with multiple myeloma.

Bone Diseases↗
PubMed1979

An unique form of osteomalacia associated with end organ refractoriness to 1,25-dihydroxyvitamin D and apparent defective synthesis of 25-hydroxyvitamin D.

A 28-yr-old woman presented with hypocalcemia, hypophosphatemia, secondary hyperparthyroidism, and biopsy-proven osteomalacia despite treatment with vitamin D2, (17.5 mg/day). Three weeks after vitamin D2 treatment was stopped, she was found to have a low normal serum 25-hydroxyvitamin D (25OHD) and high serum 1 alpha, 25-dihydroxyvitamin D [1,25(OH)2D] of 18.6 ng/ml and 21.2 ng/dl, respectively. The fractional intestinal calcium absorption was low at 0.26. Treatment with 25OHD3 (20--50 micrograms/day) corrected the hypocalcemia and secondary hyperparathyroidism, raised intestinal calcium absorption, and reversed the skeletal lesions of osteomalacia. Serum 25OHD concentration rose to 51 ng/ml, while 1,25(OH)2D remained elevated. This case illustrates the probable operation of dual abnormalities in vitamin D metabolism. An impaired end organ responsiveness to 1,25(OH)2D was suggested by a low intestinal calcium absorption in the face of high serum 1,25(OH)2D. Moreover, there may have been a defective vitamin D-25-hydroxylase, since there was a relative refractoriness to treatment with large doses of vitamin D2, an inappropriately low serum 250HD after vitamin D2 therapy, and a responsiveness to treatment with 25OHD3.

Adult↗
PubMed1978

Quantitative measurement of fractional bone volume using digital scanning videodensitometry.

A method is described for reproducible and rapid quantitative measurements of fractional bone volume in sections of a bone biopsy. The presence or absence of bone is determined at several thousand points over the entire surface area of each specimen by high-speed digitization and computer analysis of video scans of enlarged microradiographic images of bone sections. An operator interactive light-pen assembly permits selective delineation of desired areas of the video image to facilitate computation of regional bone mass within each specimen. Tests of the reproducibility of the method of performed and are described. The results obtained from application of the method to determine the amount of bone in various age groups and in two groups of patients before and after therapy are also presented. These data indicate the potential of this technique for high volume, high resolution measurements of the fractional bone volume in both investigative and clinical diagnostic studies of age dependent and disease dependent processes.

Absorptiometry, Photon↗
PubMed1978

Osteomalacia and celiac disease: response to 25-hydroxyvitamin D.

In this 54 year old woman with celiac disease, osteomalacia developed while she was on a gluten-free diet which had caused regression of her steatorrhea. She was not responsive to large doses of parenterally administered dihydrotachysterol and calcium, but she was responsive to the oral administration of 25-hydroxyvitamin D3 (25-OHD3). The data suggest that 25-OHD3 is the treatment of choice for patients with vitamin D deficiency due to intestinal malabsorption.

Administration, Oral↗
PubMed1978

The frequency of bone abnormality in patients on anticonvulsant therapy.

Biochemical and bone morphometric measurements were evaluated in 12 patients who were on long-term anticonvulsant therapy with barbiturates. Half of the patients had no symptomatic bone disease, and half presented with bone disease and pain. Serum biochemical values were normal except for a few patients who had an elevated serum level of parathyroid hormone; the concentration of serum 25-hydroxy vitamin D was decreased in the majority of patients in whom it was measured. Bone absorptiometric values were normal but proved to be misleading: the Singh Index and videodensitometric measurements indicated that bone mass was below normal in all patients. Bone morphometric data indicated that bone resorption was 3 times greater than normal, and there was no evidence of osteomalacia. Vitamin D and possibly calcium have been suggested as potentially useful agents in the treatment of the bone disease associated with chronic anticonvulsant therapy.

Adult↗
PubMed1978

Effect of concurrent calcium ingestion on intestinal absorption of fluoride.

It has been suggested that calcium interferes with absorption of fluoride and that it diminishes the effect this ion has of increasing the bone mass when taken orally. Normal volunteers were given a combination of fluoride and calcium carbonate or fluoride alone, and serum levels of fluoride were measured to determine the effect, if any, of the concomitant administration of calcium on absorption of fluoride. The results indicate that 1.3 g of calcium, as the carbonate, decreases the integrated blood fluoride values by 22%.

Adult↗
PubMed1978

Calcium and salmon calcitonin in treatment of osteoporosis.

Calcitonin has been considered of therapeutic value in osteoporosis because of its effects in tissue culture. In the whole animal, however, the predominant result seems to be hypocalcemia, which might be expected to have the opposite effect of stimulating parathyroid hormone secretion and therefore resorption of bone. Indeed, in a short term study of 3- and 4-month duration in osteoporotic women, this was found to be so. A combination of calcium and calcitonin was therefore considered a more promising therapeutic alternative for this disease. Calcium was given to 26 patients, alone or with vitamin D, for a period of 15 months, and the effects on serum and urine calcium and phosphorus and on bone resorption and formation were evaluated. Calcium and vitamin D decreased serum parathyroid hormone levels, reduced bone resorption, and increased urinary calcium. The addition of calcitonin to the calcium and vitamin D did not seem to change these effects. Neither form of treatment resulted in change of bone mass. Calcium, with or without vitamin D supplements, may prevent the development of osteoporosis, but it seems unlikely that calcitonin has any additional desirable effect in the disease.

Aged↗
PubMed1977

Hypoparathyroidism: a possible cause of osteomalacia .

A 17 year old man with longstanding hypocalcemia and hyperphosphatemia presented with incapacitating bone pain and progressive weakness nad bowing of the legs. The serum abnormalities were due to idiopathic hypoparathyroidism as evidenced by a decreased serum concentration of parathyroid hormone and an appropriate rise in urinary cyclic AMP and phosphate excretion, and serum calcium concentration, in response to exogenously administered parathyroid extract. The serum concentration of 1,25-dihydroxycholecalciferol was appropriately decreased. The bone findings were due to osteomalacia as documented by physical findings, bone roentgenograms, and bone biopsy. Normal renal tubular function, blood pH, and serum concentration of 25-hydroxycholecalciferol and elevated serum alkaline phosphatase excluded the common causes of osteomalacia. The data are consistent with the hypothsis that lack of parathyroid hormone causes both hypocalcemia and a decreased serum concentration of 1,25-dihydroxycholecalciferol which, in turn, limit the availability of calcium and cause defective synthesis of bone matrix resulting in abnormal mineralization.

Adolescent↗
PubMed1977

Effect on bone growth of daily versus alternate-day corticosteroid administration: an experimental study.

Young rabbits that received large doses of corticosteroids on an alternate-day basis grew normally and showed muscle and bone turnover patterns indistinguishable from those of untreated animals. In contrast, the daily administration of corticosteroids profoundly affected the skeletal system: growth ceased, and there were marked narrowing and premature closure of the epiphyseal plates. Osteoporotic changes were present at 1 week and progressed during the next 9 weeks. Muscle atrophy occurred early in the course of treatment and was associated with increased muscle fat deposition. Thus, in this study, alternate-day administration of corticosteroids clearly lessened the corticosteroid side effects of growth retardation, osteoporosis, and muscle wasting.

Animals↗
PubMed1976

The use of methylmethacrylate in the fixation of mandibular fractures in dogs. Experimental results.

The efficacy of self-curing acrylic resin in the fixation of fractured mandibles was studied in eight adult mongrel dogs. Three dogs were killed at 1 month, two at 3 months, and three at 6 months after insertion of the resin. Roentgenograms taken after operation and after the dogs had been put to death demonstrated satisfactory fracture reduction and bony healing. The retentive grooves appeared larger on the postmortem roentgenograms, apparently from fibrous tissue that formed between the acrylic resin and the bone. Sections through the groove and fracture site did not show any fibrocartilage formation between the bone and the resin. Active osteoblastic activity was present at the fibrous capsule-bone interface as well as in the fracture calluses. Most sections showed acute inflammation, with a few giant cells. Whether the inflammatory component resulted from tissue breakdown over the acrylic resin or from the polymethylmethacrylate itself was not determined. There was no evidence of abnormal healing or nonunion along the fracture line and no evidence of necrotic bone. The undecalcified tetracycline-labeled sections confirmed active bone formation at the fibrous capsule-bone interface and in the fracture calluses at 1, 3, and 6 months. No mobility could be detected across the fracture site at any time after the insertion of the acrylic resin. Two of the three dogs that were killed at 1 month had incomplete bony union, as demonstrated by mobility along the fracture line seen in the resected specimens. Mucosal dehiscence over the superior acrylic fixation bar was a consistent finding. Once the resin had been either exfoliated or removed, the mucosa healed uneventfully. The insertion of methylmethacrylate did not result in blood pressure change in the dogs. The dogs maintained their preoperative weight, appetite, and jaw mobility. Although satisfactory bony healing resulted from the intraoral open reduction and fixation with self-curing acrylic resin in dogs, several factors need additional investigation before this technique can be considered for use in human subjects. The following findings in this study may contribute to healing complications in man: (1) loosening of the acrylic resin due to fibrous tissue formation between it and the bone, (2) mucosal dehiscence, (3) inflammation in and around the fibrous tissue adjacent to the acrylic resin, and (4) the necessity of bone removal to facilitate the insertion of the resin.

Animals↗
PubMed1976

The acro-osteolysis syndrome: Morphologic and biochemical studies.

The acro-osteolysis syndrome consists of dissolution of terminal phalanges of the hands and feet, dolichocephaly with multiple wormian bones, delayed closure of cranial sutures, absence of frontal sinuses, a prominent occipital ridge, skeletal demineralization, vertebral and extremity fractures, joint laxity, and coarse hair. Studies of bone morphology reveal diminished bone density and bone formation. Osteoblasts have widely dilated smooth endoplasmic reticulum. It is postulated that an abnormality of a structural protein is the pathogenic basis of this disease.

Abnormalities, Multiple↗
PubMed1976

Effects of oral therapy with calcium and vitamin D in primary osteoporosis.

Eighteen patients (17 women and 1 man) with primary osteoporosis were divided into two groups of 9 patients each. Group A received 2.0 to 2.5 g of calcium and 400 units of vitamin D per day orally and was studied before and after short-term (3 to 4 months) treatment; group B received 1.5 to 2.0 g of calcium per day and 50,000 units of vitamin D twice weekly and was studied before, after short-term, and after long-term (1 year) treatment. In group A there was a decrease (P is less than 0.01) in bone-resorbing surfaces (microradiography of bone biopsy samples) after short-term treatment. In group B there was a decrease (P is less than 0.01) in bone-forming and bone-resorbing surfaces after both short-tern and long-term treatment. Fasting-state (morning) serum immunoreactive parathyroid hormone (iPTH) concentrations decreased after short-term treatment (combined data of groups A and B) and after long-term treatment (group B). We conclude that the principal effect of the oral calcium and vitamin D therapy in primary osteoporosis is to decrease bone turnover. The most probable mechanism for this effect on bone is a partial inhibition of PTH secretion.

Administration, Oral↗
PubMed1976

Effects of phosphorus supplementation on serum parathyroid hormone and bone morphology in osteoporosis.

The effect of phosphorus (inorganic phosphate) supplementation was studied in seven postmenopausal women with osteoporosis. Prior to supplementation, all chemical parameters studied in serum and urine were normal. Bone density was below the fifth percentile for age in all but one patient, and the percentage of bone surface involved in resorption was higher than normal. During administration of the phosphorus supplement, fasting serum concentrations of calcium and immunoreactive parathyroid hormone showed no significant changes, while serum phosphorus, urinary calcium, and tubular reabsorption of phosphorus decreased. In four patients studied by balance techniques, calcium balance became positive or less negative. Bone-forming surface decreased and bone-resorbing surface increased in all patients. Bone-resorbing surface was highly correlated with total phosphorus intake. Density of the distal radius changed variably, while density of the midradius increased slightly in all patients.

Aged↗