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J Stĕpán

Publications and source records attributed to J Stĕpán.

At least 19 recordsLinked to original sources

[Extragenital endometriosis as a subject of interest for the surgeon].

Endometriosis is a common gynaecological disorder, affecting 10-15% of the fertile female population. Most frequently, it affects internal genitalia, the main symptoms being pelvialgia and infertility. In 5% of the cases the disorder may also affect extragenital structures and present itself as endometriomas of the appendix, the small or the large intestine, the umbilicus, the inguinal canal, the residual scars after laparotomies or the diaphragm. They may also imitate a malignancy. The diagnostic key is the cyclic character of the pain or of the bleeding to the tract and the laparoscopic confirmation of the presence of the foci. When the diagnosis is known, a simple excision, extirpation or resection suffices. In case the malignancy cannot be excluded, a more extensive procedure is indicated. The authors present two case-reviews during a twelve-year period, in both cases the sigmoid was affected. In the first case, a radical resection of the rectosigmoid due to a suspected malignancy was performed, while in the second case, a simple excision of the endometrioma where the diagnosis was known was performed. The authors stress-out advantages of the interdisciplinary approach to the treatment of the complicated cases of endometriosis, so that the disorder would be solved in one surgical procedure.

Adult↗

[Total body composition in adult patients with growth hormone deficiency before and after its administration].

Effect of growth hormone (GH) on the growth and development of children is generally known. Effects of GH in adults are favorable, though. The aim of the work was to verify effects of GH administration on body composition in adult patients with GH deficit (GHD). The authors examined 15 adult patients with GHD originated in 13 of them in adulthood and in two of them in childhood. Their mean age was 43.9 +/- 11.3 years, the mean body mass was 80.0 +/- 15.2 kg. The GH deficit was verified by the stimulation insulin tolerance test. For the period of 12 months, they were subcutaneously administered recombinant human GH in a substitution dose of 0.5 to 1.5 IU/m2 body surface/day. A stable substitution of the hormone was applied for the period of at least six months in all these patients provided any deficit of other hormones had not been demonstrated. The examination by whole-body dosimeter Lunar DPX-L was made in the patients before the GH treatment began and after 12 months of therapy. It enabled to determine the amount of lean body mass (LBM) and fatty mass. After 12 months of GH treatment the mean level of insulin-like growth factor (IGF-I) was increased (P = 0.002). A statistically significant increase of total LBM (48.6 +/- 9.8 vs. 50.8 +/- 9.9 kg, P = 0.004) developed, the fatty mass did not change. Nine of these 15 patients were further followed and the administration of GH proceeded for six months. The densitometric examination was repeated, but no change of LBM was observed. The administration of GH was halted and after the period of 12 months the whole-body densitometric examination was done. The increase of LBM lasted. The amount of fat mass did not change, a decrease of fatty mass was observed after the GH administration ended. After 12 months of GH treatment there was also an increase of maximal output reached on bicycle ergometer (157.3 +/- 34.2 vs. 197.5 +/- 68.1 W, P = 0.006). A positive correlation between LBM and maximal output reached on bicycle ergometer before GH administration (r = 0.58, P = 0.02) was observed. A favorable effect of the substitution dose of GS administered to adult patients with GHD on the increase of LBM and physical output was confirmed.

Adult↗

[Bone metabolism in individuals dependent on heroin and after methadone administration].

BACKGROUND: The aim of the work was to determine how the prolonged opioid addiction influence bone metabolism. In heroin addicts and after one year of methadone maintenance we investigated bone mineral density, biochemical markers of bone metabolism and serum levels of testosterone. METHODS AND RESULTS: The study involved 37 persons, 31 men and 6 women in average age of 26 years (variation 18 to 39 years). Values of type I collagen cross-linked telopeptide, osteocalcin, propeptide of type I collagen and testosterone in serum were measured by radioimmunoassy and immunoanalysis. Bone mineral density was measured by dual energy absorptiometry. Body Mass Index was calculated. In heroin addicts at the femoral neck and in distal forearm osteopenia was found. After one year of methadone maintenance treatment the bone density remained unchanged. Concentrations of osteoresorption marker (type I collagen cross-linked telopeptide) and osteoformation markers (osteocalcin and propeptide of type I collagen) were in heroin addicts in comparison with control group significantly increased (averages 814 ng/l, 43.1 mu/l, 76.4 mu/l). Testosterone level in serum in addicted men was significantly decreased (3.3 nmol/l). After one year of methadone maintenance treatment biochemical markers of bone metabolism restored when compared with the control group, testosterone levels remained unchanged. Statistical measurements were performed by t-test and paired t-test. CONCLUSIONS: Prolonged heroin addiction is associated with accelerated bone turnover and osteopenia in cortical bone without evidence of metabolic bone disease. Methadone maintenance treatment restores altered bone turnover only. One possible explanation of high bone turnover in heroin addicts may be the influence of hypopituitary-hypothalamo-gonadal axis. However, it may not be the only mechanism involved.

Adolescent↗

[Acute biochemical effects of calcium: comparison of two dosage forms of calcium carbonate (powder and effervescent tablets) and milk in healthy women].

BACKGROUND: The aim of this study was to assess acute biochemical changes after the administration of two different pharmaceutical forms of calcium carbonate or milk. METHODS AND RESULTS: The group of 12 young (aged 20-27 years) and 12 older women (aged 63-71 years). After overnight fasting, each of the volunteers received a 1 g of elemental calcium in either form of the tested preparation: powder form of calcium carbonate--Vitacalcin pulvis (Slovakofarma, SR) or effervescent tablet--Calcium 500 mg Pharmavit (Pharmavit, MR) or in 250 ml of milk enriched with the milk calcium complex. Between each test the interval of 1-2 weeks was held. Samples of blood and urine were taken in the fasting state before and during 5.5 h following ingestion of the calcium load. Both calcium carbonate and milk induced a significant increase in the serum ionised calcium (iCa) and a significant decrease in plasma parathormone level (PTH) in comparison with the baseline levels in both groups of women. Comparison between individual preparations and between preparations and milk did not reveal any significant differences in suppression of PTH. Comparison of the effects between young and elderly women did not show any statistically significant difference in any measured parameter. CONCLUSIONS: Our results confirmed the good bioavailability of calcium from milk and from both calcium preparations in both age groups of women. Significantly more frequent hypercalcemia in the young women (p < 0.05) and also the slightly higher hypercalciuria occurred after the application of calcium in the pharmaceutical form of effervescent tablet than after the application of calcium in the form of powder or after the application of milk.

Adult↗

The serologic screening for celiac disease in the general population (blood donors) and in some high-risk groups of adults (patients with autoimmune diseases, osteoporosis and infertility) in the Czech republic.

The prevalence of celiac disease (CD) was determined in healthy blood donors and in high-risk groups of adults (a total of 1835 adults--randomly selected 1312 healthy blood donors, 102 patients with primary osteoporosis, 58 patients with autoimmune diseases and 365 infertile women). It was calculated on the basis of a two-step serologic screening method--in the first step IgA and IgG antigliadin antibodies (AGA) and IgA anti-gamma-glutamyltransferase ('transglutaminase') antibodies (ATG) were estimated, in the second step sera positive for IgA AGA and/or IgA ATG were examined for antiendomysial IgA (AEA) antibodies. Immunoenzymic assay (ELISA) was used for determining of AGA and ATG antibodies; immunofluorescence method, performed on human umbilical cord tissue, was used for assaying of AEA antibodies. Total serum IgA level in only IgG AGA positive subjects was measured by routine turbidimetric method. 0.45% of healthy blood donors, 0.98% of osteoporotic patients, 2.7% of patients suffering from autoimmune disease and 1.13% of women with infertility considered as immunologically mediated were found to be positive in both steps of serologic screening (AGA and/or ATG and antiendomysium positive). The presumed high prevalence of seropositivity for CD in apparently healthy Czech adult population was confirmed. In the high-risk groups, the prevalence of seropositivity for CD was approximately 2-4 times higher than in healthy blood donors. The real prevalence of CD in the tested groups, however, can be estimated after performing small intestinal biopsy in the seropositive patients.

Adolescent↗

[Hyperlipoproteinemia, the Apo-E genotype and bone density].

BACKGROUND: Both atherosclerosis and osteoporosis often appear together, especially in the elderly; usually they are regarded as independent entities. Only recently epidemiological evidence occurred suggesting possible associations between these diseases. Several groups of factors (genetic, hormonal and biochemical) have been studied to account for this association. Among the genetic factors, apolipoprotein E has been studied most extensively; some results indicate that carriers of E4 allele are at increased risk of osteoporosis. A possible influence of plasma lipoproteins and of tissue ischaemia on bone metabolism has also been studied. AIM OF THE STUDY: To test the hypothesis that there is an association between apolipoprotein E, plasma lipid concentrations and bone mineral density. METHODS: We examined 18 apolipoprotein E2/2 and E4/4 homozygotes and 130 postmenopausal women. Bone mineral density and plasma triglycerides, total and HDL cholesterol were determined in both groups; in apolipoprotein E homozygotes biochemical markers of bone turnover were also measured. RESULTS: No significant differences in bone mineral density and bone remodelling were found between the E2/2 and E4/4 homozygotes. A negative correlation between lumbar spine bone mineral density and cholesterol and triglyceride concentrations (r = 0.20-0.39) was observed both in postmenopausal women and apolipoprotein E homozygotes. CONCLUSION: We didn't observe any association of apolipoprotein E genotype with bone mineral density and biochemical markers of bone metabolism. A negative association between plasma lipid concentrations and bone mineral density supports the hypothesis of harmful effect of hyperlipidaemia on bone metabolism.

Alleles↗

[X-ray densitometry and ultrasonography of the heel bone--sensitivity and comparison with densitometry of the axial skeleton].

BACKGROUND: The aim of the study was to determine the relationship between dual energy x-ray absorptiometry (DXA) and quantitative ultrasonometry (QUS) of calcaneus and their correlation with axial bone mineral density. METHODS AND RESULTS: 1284 subjects were tested for BMD (Bone Mineral Density) by DXA at the spine and hip (707 subjects by DPX-L, Lunar, and 577 subjects by QDR-4500 A, Hologic) and calcaneus (by PIXI, Lunar). The calcaneus was also measured using the QUS (Achilles Plus, Lunar), on the same day. The mean age of the patients was 56.5 +/- 11.6 years, mean height 166 cm, mean weight 70 kg. Three subjects were selected for precision error measurement with low, medium and high BMD of calcaneus (T-score of -2.2, -0.77 and 2.02, respectively) and scanned with re-positioning at the right heel (PIXI and Achilles Plus) 21 times on one day for short term precision error and over 21 consecutive days for long term precision error. The in vivo short term precision error of the heel measurement (BMD, SOS, BUA) in subjects with normal BMD was 0.67%, 0.47% and 1.87%, respectively; the long term in vivo precision error was 1.14%, 0.26% and 2.95%, respectively. No significant difference was found between BMD values on the right and left heel. A statistically significant correlation (p < 0.001) was found between BUA and BMD (r = 0.71), SOS and BMD (r = 0.73), Stiffness and BMD (r = 0.77). The heel BMD was also significantly correlated to BMD of the femoral neck (r = 0.64) and BMD of total femur (r = 0.70) and BMD of lumbar spine (r = 0.59). CONCLUSIONS: The DXA of the heel underestimates the prevalence of osteoporosis. The results of the heel QUS (Stiffness) appear to be better correlated to femoral BMD than heel BMD. The observed correlation coefficient of 0.77 between QUS and DXA at the heel was statistically significant, but it explains only 60% of variability of the QUS of the heel.

Absorptiometry, Photon↗

Increase of adhesion molecules, fibrinogen, type-1 plasminogen activator inhibitor and orosomucoid in growth hormone (GH) deficient adults and their modulation by recombinant human GH replacement.

OBJECTIVE: GH deficiency (GHD) is usually associated with a higher incidence of cardiovascular disease (CVD). The aim of this study was to establish whether patients with GHD, like those with CVD, show an increase in fibrinogen (FBG), type-1 plasminogen activator inhibitor (PAI-1), acute phase response proteins (APR), and soluble adhesion molecules. The effect of recombinant human GH (rhGH) replacement, on these parameters was also investigated. PATIENTS AND DESIGN: Concentrations of PAI-1 antigen (Ag), adhesion molecules sE-selectin, sP-selectin, and intercellular adhesion molecule-1 (sICAM-1), FBG and levels of APR orosomucoid (ORM), and 'negative APR' transferrin (TRF) were established in 11 panhypopituitary (PHP) patients (eight men and three women, age median 39.0 years, body mass index (BMI) 27. 49 +/- 3.89 kg/m2) before and after 12-month replacement with rhGH. Control values were obtained by examination of 33 healthy age and sex matched subjects (24 men and nine women with BMI 24.16 +/- 1.99 kg/m2). RESULTS: PHP patients had higher concentrations of ORM (0.80 +/- 0.25, vs. 0.61 +/- 0.20 g/l; P = 0.05), FBG (3.22 +/- 0.48, vs. 2.57 +/- 0.47 g/l; P = 0.001), PAI-1 Ag (97.12 +/- 33.23, vs. 44.11 +/- 21.40 microgram/l; P = 0.001), sE-selectin (72.42 +/- 28.35, vs. 42. 80 +/- 12.60 microgram/l; P = 0.004), sP-selectin (221.26 +/- 75.12, vs. 104.79 +/- 26.01 microgram/l; P = 0.001) sICAM-1 (409.75 +/- 137.78, vs. 228.10 +/- 37.54 microgram/l; P = 0.001), and lower levels of TRF (2.14 +/- 0.40, vs. 2.76 +/- 0.39 g/l; P = 0.001) than controls. After 12-month rhGH replacement the patients showed an increase of TRF (2.64 +/- 0.84 g/l, P = 0.037) and decrease of soluble adhesion molecules (sE-selectin 57.98 +/- 27.04 microgram/l, P = 0.01, sP-selectin 121.74 +/- 50.42 microgram/l, P = 0.007; and sICAM-1 279.95 +/- 88.32 microgram/l, P = 0.005), which then, similarly to the ORM (0. 67 +/- 0.12 g/l) and FBG level (2.82 +/- 0.51 g/l), did not statistically differ from the values in the control group. CONCLUSION: rhGH replacement led to modulation of the 'inflammatory response' in panhypopituitary patients. This modulation occurred locally at vascular endothelium level where after rhGH replacement, sE-selectin, sP-selectin and sICAM-1 concentrations decreased, a similar effect as in the systemic inflammatory response, as was also apparent from the changes in acute phase response protein levels.

Adult↗

[Molecular cytogenetic diagnosis of Klinefelter's syndrome in men more frequently detects sex chromosome mosaicism than classical cytogenetic methods].

BACKGROUND: It was found by classical cytogenetic methods that approximately 80% of X-chromatin positive mates have karyotype 47,XXY and the rest have mosaicism of sex chromosomes. More sensitive molecular-cytogenetic studies allow to evaluate even non-dividing cells of different tissues and therefore they suggest that there could be more frequent occurrence of patients with numerical changes of gonosomes than quoted in the literature. The aim of this study was to detect numerical changes of sex chromosomes by means of double-colour fluorescence in situ hybridisation (FISH) in dividing and non-dividing nuclei of peripheral lymphocytes of males with Klinefelter's syndrome, to compare clinical findings with cytogenetic results, to determine differences in sensitivity of classical and molecular-cytogenetic methods and estimatere the values obtained with controls (healthy males). METHODS AND RESULTS: 26 males with previously diagnosed Klinefelter's sy were examined. Classical cytogenetic studies consisted of evaluation of at least 20 G-banded mitoses of 72 h cultivated peripheral blood. The results we obtained: 19 patients with 47,XXY, 5 mosaics 47,XXY/46,XY, 1 patient mosaic 46,XX/47,XXY and 1 patient 48,XXYY karyotype. The results of double colour FISH and classical cytogenetics were compared and mosaics of cells with normal karyotype 46,XY was found. As a control 10 healthy males were examined and mosaics of gonosomes were not detected. CONCLUSIONS: FISH method has a higher sensitivity for detection of sex chromosomes mosaics than classical cytogenetics. The existence of small cellular side clones with 46,XY karyotype or numerical sex chromosomes changes which were not determined previously can be proved by FISH in patients with Klinefelter's sy.

Cytogenetics↗

[Economic aspects of osteoporosis].

BACKGROUND: The objective of this study was to evaluate expenditures and efficacy of osteoporosis treatment in the Czech Republic (CZ) (1.38 million women and 0.99 million men > 55 years of age). METHODS AND RESULTS: Demographic data, incidence of hip fractures and prevalence of osteoporosis and osteopenia in Czech women and men, cost burden to healthcare agencies due to hip fractures and costs of diagnostic procedures, preventive measures and therapies of osteoporosis were obtained from published data and from database of the main health insurance agency (VZP) and the State Institute for Drug Control. The direct costs for treatment of hip fractures in the CZ in 1997 averaged Kc (Czech Crown) 2.5 billion, diagnosis of osteoporosis, Kc 150 million, prevention of osteoporosis using hormone replacement therapy, Kc 66 million, and treatments of osteoporosis which has been applied to less than 5% of osteoporosis patients, 482 million. However, despite the continuously increasing expenditures for treatments of osteoporosis, the incidence of hip fractures doubled in the last 10 years. This is mainly due to increased life expectancy in Czech women and men. CONCLUSIONS: The results of this first economic evaluation of diagnosis, treatment and consequences of osteoporosis in the CZ indicate a need for conceptual decisions in both treatment and prevention of osteoporosis.

Aged↗

[Selective estrogen receptor modulators as a new concept in preventing health risks of menopause].

Long-term estrogen deficiency after menopause is responsible for different disorders, which not only make the quality of life in the older age worse but also are the major causes of women's mortality. It is especially the case for cardiovascular disease, osteoporosis and dementia. The risk for these disorders can significantly be reduced by hormone replacement therapy (HRT). Unfortunately, the mean duration of the postmenopausal administration of HRT is too short to demonstrate its efficacy in preventing the mentioned diseases. In this review the new therapeutic possibilities are discussed, called selective estrogen receptor modulators (SERMs). These structurally heterogeneous compounds interact with estrogen receptors and act as either estrogen-agonists or--antagonists according to the type of organ and physiological context (i.e., dose, target tissue and hormone concentration in the tissue). The evaluation of the effects of these compounds led to the better understanding of both antiestrogens and the whole steroid signaling system. The research of the clinical properties of SERM showed their potential benefit in the long-term care of the women in their non-reproductive period of life and demonstrated the possibility to overcome some drawbacks of HRT.

Cardiovascular Diseases↗

[Prevalence of osteoporosis in the Czech Republic].

BACKGROUND: The objective of this study was to evaluate the prevalence of osteoporosis and osteopenia in Czech women and men aged 50 to 75 years. METHODS AND RESULTS: Bone mineral density was assessed in an age-stratified random sample of 713 women and 429 men from two cities (Prague and Litomĕrice) in the lumbar spine, proximal femur and total body by dual X-ray absorptiometry and in the distal forearm by single X-ray absorptiometry. The proportion of women and men in each age group with bone density below specified levels at any of these skeletal sites was projected to the population structure of the Czech Republic. With advancing age, in women at 55 years and in men at 65 years of age the population with normal bone mineral density becomes smaller, and a greater proportion has osteopenia or osteoporosis. Overall, an estimated 428,000 women and 195,000 men over age 50 have osteoporosis and another 680,000 women and 435,000 men have osteopenia. CONCLUSIONS: The results of this first population-based cross sectional study in the Czech Republic document a high prevalence of osteoporosis and osteopenia which is comparable with that published for the Netherlands and the United States. The results offer a basis for economical considerations in diagnosis, treatment and consequences of osteoporosis.

Adult↗

[Biochemical markers of bone remodeling in assessment of osteoporosis].

The diagnostic significance of biochemical markers of bone remodelling is limited and it should always be evaluated together with results of other methods. Unlike bone densitometry, biochemical markers do not reflect bone mass and cannot be therefore used in diagnosis of osteoporosis. Markers enable for differential diagnostics of metabolic and neoplastic bone diseases and can be used for assessment of activity of bone disease and its monitoring. Different markers reflect aspects of bone remodelling. The sensitivity and specificity of the markers differ according to the type of bone disease and its treatment. The application of markers in monitoring treatment in individual patients requires an acceptable long-term biological variability of the marker (C.V. < 12%). In postmenopausal osteoporosis, osteocalcin measurements suffice in assessment of activity of the disease and for monitoring treatment. Lack of improvement in the marker can indicate poor compliance of the patient, a diagnostic error or an and-organ resistance to treatment. The biochemical measurement predicts changes in bone mass about one year prior to bone densitometry, thus enabling for decision concerning urgency of therapeutic intervention. In individual patients, however, a single measurement of a biochemical marker cannot be used to predict long-term changes in bone mass. Osteokalcin is cleared from the circulation by kidney and cannot be used to assess bone remodelling in chronic renal failure patients. This is not true with bone-specific alkaline or acid phosphatase isoenzymes. Low serum osteocalcin concentrations have special significance in hypercortisolism. Considering their high cost, the markers should be clinically applied under specified indications and only when standardised.

Biomarkers↗

[Spontaneous remission of corticosteroid osteopenia after successful surgical treatment of Cushing's syndrome. A cross-sectional study].

BACKGROUND: Osteoporosis is one of the most serious consequences of Cushing's syndrome. Only a small number of longitudinal observations on bone mineral density (BMD) in patients with treated Cushing's syndrome have been reported so far. To evaluate changes in bone mass in patients with Cushing's syndrome after surgical cure of the disease, BMD was evaluated cross-sectionally. METHODS AND RESULTS: BMD (DPX-L, Lunar) was measured in the lumbar spine and femoral neck (i.e. in skeletal areas with high proportion of trabecular and cortical bone, respectively) in 72 patients after successful surgical cure of Cushing's syndrome (8 men, 34 women before menopause and 30 women after menopause who were not on hormone replacement therapy). No other drug's interfering with skeletal metabolism were used. The reference group consisted of young healthy Czech women and/or men. The mean lumbar spine and femoral neck BMD increased to normal values within 3 and 5 years after surgery, respectively. In women after menopause, however, the significant positive relationship between BMD and time after surgery was negatively influenced by time after menopause. It is likely that several other factors contributed to the increase in bone mass in the patients (cure of hypercortisolism, recovery from hypogonadism and restoration of muscle strength). CONCLUSIONS: After surgical cure of Cushing's syndrome in premenopausal women and in men, BMD rapidly and substantially increases. The recovery is negatively affected by estrogen deficiency in postmenopause.

Adenoma↗

[Comparison of the effectiveness of 17-beta-estradiol and calcitonin in women with postmenopausal bone loss].

BACKGROUND: The objective of this study was to compare effects of 17 beta-estradiol and intranasal salmon calcitonin on bone mass and biochemical markers of bone turnover in postmenopausal women with an accelerated bone loss and osteopenia or osteoporosis. METHODS AND RESULTS: 72 women with significantly increased bone resorption were evaluated (urinary hydroxyproline/creatinine > or = 21.9 mmol/mol, mean age, 53.7 +/- 6.3 years, time since menopause 6.1 +/- 2.6 years). All patients received daily 500 mg Ca2+ and 400 IU vitamin D supplement. 48 patients with osteopenia and 24 patients with osteoporosis were randomly allocated to treatment with open-label 17 beta-estradiol (50 micrograms transdermally or 2 mg orally) or calcitonin (200 IU every other day). Bone mass was measured by dual-energy x-ray absorptiometry (DPX-L, Lunar, C.V., 1.10 +/- 0.55% and 1.41 +/- 0.55%, lumbar spine and femoral neck, respectively) every six month for 2.5 year, bone stiffness was measured by ultrasound (Achilles, Lunar, C.V., 3.88 +/- 1.95%). Biochemical markers of bone turnover (plasma osteocalcin and tartrate-resistant acid phosphatase, serum bone specific alkaline phosphatase and urinary hydroxyproline) were measured before and after 6, 12 and 24 month of treatment. Patients who received 17 beta-estradiol experienced significant increases (p < 0.05) in bone mass on the first and second year (by 2.6% and 2.1% at lumbar spine, 1.1% and 1.0%, at femoral neck, and 2.3% and 2% at the heel). A significant positive correlation was found between rates of bone mass change in all sites (p < 0.001). No statistically significant bone changes were found in calcitonin treated patients. In 17 beta-estradiol treated patients, biochemical markers of bone turnover decreased by 40-50% to the mean values in premenopausal women. In calcitonin treated patients, biochemical markers reached the upper normal limit. CONCLUSIONS: Estrogen replacement therapy increases bone mass in lumbar spine as well as in femoral neck. It is efficient for both prevention and treatment of postmenopausal osteoporosis. Salmon calcitonin effectively prevents bone loss. Efficacy of both the treatment can be assessed after 6 months using a biochemical marker of bone resorption and after 2 years using dual-energy x-ray densitometry.

Bone Density↗

[What do we know about the significance of vitamin D in Paget's disease of the bone?].

BACKGROUND: The authors present a report on the importance of vitamin D metabolites in Paget's disease of bone and on blood levels of some biologically active vitamin D metabolites in patients with Paget's disease of bone. Data on vitamin D metabolism in tests of new bisphosphonates are inadequate. METHODS AND RESULTS: In 18 men and 6 women the activity of Paget's disease of bone was investigated by assessment of the serum activity of the bone isoenzyme of alkaline phosphatase, the plasma osteocalcin concentration and urinary hydroxyproline excretion. The plasma concentration of the sum of hydroxylated vitamin D metabolites and 1.25 dihydroxyvitamin D were assessed by means of the radioreceptor test according to the winter standard and by radioimmunoanalysis. For statistical evaluation the paired Student's t-test and non-parametric Friedman test were used to assess the significance of differences between the mean (p < 0.01) and simultaneous testing at the 5% level of significance. CONCLUSIONS: In patients with a low activity and thus untreated Paget's disease of bone no deviations in plasma vitamin D metabolites were revealed.

Aged↗