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Biomedical subjects

R Willvonseder

Publications and source records attributed to R Willvonseder.

At least 19 recordsLinked to original sources

The influence of partial gastrectomy on biochemical parameters of bone metabolism and bone density.

Since it has been suggested that gastric resections are followed by changes in bone metabolism, the aim of our study was to determine the biochemical parameters of bone metabolism and radial and lumbar bone density in 15 male ulcus patients treated by partial gastrectomy (Billroth II). Comparing the data with those of a corresponding control group, the lumbar bone density measured by quantitative computed tomography was statistically significantly lower (P less than 0.04) in the patient group, whereas the peripheral bone mass of the distal part of the nondominant forearm measured by single-photon absorptiometry showed no statistically significant difference. In addition, a marked increase in alkaline phosphatase (P less than 0.002) and urinary excretion of hydroxyproline (P less than 0.003) was found in gastrectomy group, whereas the 25-hydroxy-vitamin D levels were found to be significantly decreased (P less than 0.04). Osteocalcin, a biochemical marker for osteoblast activity, and the carboxy-terminal propeptide of type I procollagen (PICP), a marker of collagen formation, were slightly but not significantly higher in gastrectomy-treated patients. The serum parathyroid hormone levels were similar in both groups. As none of the patients had any radiologic evidence of osteopenia, the changes in biochemical parameters of bone metabolism and bone mass in patients who had undergone partial gastrectomy could be a marker of latent bone loss.

Absorptiometry, Photon

Bone mass and biochemical parameters of bone metabolism in men with spinal osteoporosis.

With advancing age both sexes have an increased incidence of osteoporotic fractures, although fractures are more common in women than in men. Whereas in women several potential risk factors have been identified, less is known about osteoporosis in men. A total of 27 Austrian men (mean age: 65 +/- 2 years) with atraumatic spine fractures were studied. In all patients, medical history gave no evidence of disease or medications causing osteoporosis. Peripheral bone mass was determined by single-photonabsorptiometry on the distal non-dominant forearm; lumbal bone density was measured by quantitative computed tomography. Serum levels of calcium, phosphate, alkaline phosphatase, osteocalcin, testosterone, estrogen, parathyroid hormone and 25-hydroxy-vitamin D as well as 2-h-urinary-OH proline and calcium excretion were measured. All data were compared with those of an age and sex matched control group consisting of 19 healthy males. A significant difference in mean peripheral and axial bone mass (SPA: P less than 0.004; QCT: P less than 0.0001) was observed between osteoporotic men and controls. When compared to controls, serum levels of alkaline phosphatase (P less than 0.012), urinary OH proline (P less than 0.05) and urinary calcium excretion (P less than 0.003) were significantly higher in the osteoporotic males. Additionally, there was a significant positive correlation between serum alkaline phosphatase and urinary OH proline excretion (r = 0.32; P less than 0.04) in the osteoporotics. All other biochemical parameters showed no significant differences. Our results may lead to the assumption that osteopenia in men is related to increased bone turnover.

Aged

[Therapy of senile osteoporosis using sodium fluoride--continuous and intermittent long-term therapy].

To evaluate a therapeutic effect, biochemical parameters of bone metabolism and photonabsorption densitometry have been compared in patients with senile osteoporosis under long-term continuous or intermittent sodium fluoride treatment. A comparable increase of trabecular bone density is found after continuous and intermittent therapy for at least one year. The well-known effect of defective mineralization under long-term continuous therapy with sodium fluoride corresponds to a statistically significant increase in urinary hydroxyproline and calcium excretion and a trend towards a rise in serum alkaline phosphatase in this study. Similar findings cannot be observed in patients on intermittent sodium fluoride treatment. The increase in bone density without concomitant changes in biochemical parameters suggests a beneficial therapeutic effect without biochemical evidence for defective mineralization.

Age Factors

Calcitonin load in absorptive hypercalciuria type I.

The persistence of hypercalciuria (HCU), despite long-lasting calcium restriction in the diet in patients with absorptive HCU type I gives evidence of an additional endogenous source of calcium contributing to the pathogenesis of this disorder. The role of calcium mobilization from the bone is documented by the effective suppression of enhanced calcium mobilization from the bone, by means of calcitonin load in 5 patients with absorptive HCU type I and comparison with 7 normal controls.

Adult

[Hypotrypsinemia in diabetes mellitus].

Plasma concentrations of immune-reactive trypsin (IRT) were determined in 212 patients with juvenile-onset, insulin-dependent diabetes (Type I) and in 158 patients with maturity onset diabetes (Type II) in comparison to 121 healthy individuals. Significantly increased IRT levels were obtained in the type I diabetics, whereas IRT concentrations were normal or increased in the type II diabetic patients. Hypotrypsinemia occurred predominantly in type I diabetics with high IgG-insulin antibodies or islet-cell antibodies. No correlation was noted between the IRT-levels and the beta-cell residual capacity in the type-I diabetics.

Diabetes Mellitus

[Clinical significance of the radioimmunological determination of beta-thromboglobulin and platelet factor 4].

Recently new radioimmunoassay methods have been established to measure plasma concentrations of beta-thromboglobulin (beta-TG) and platelet factor 4 (PF4), platelet release products which are set free when platelets aggregate. Plasma concentrations of beta-TG and PF4 were investigated in disorders with increased thromboembolic risk. Extremely high concentrations of these platelet proteins were found in patients with venous thrombosis, pulmonary embolism, polycythemia vera, and chronic renal failure. Moderately increased beta-TG and PF4 levels were observed in patients with peripheral vascular disease, coronary artery disease, chronic rheumatoid arthritis, multiple myeloma, and diabetes mellitus. These data indicate, that plasma concentrations of beta-TG and PF4 are useful parameters for the evaluation of the "in vivo" platelet activity. By using these new methods for clinical applications special blood sampling conditions have been taken into account; moreover one has to consider that the plasma levels of the platelet "release products" are dependent from renal function.

Arthritis, Rheumatoid

[Ferrokinetic studies in haemoglobin Wien haemolytic anaemia (author's transl)].

Ferrokinetic studies in two patients with haemolytic anaemia due to haemoglobin Wien revealed increased haemoglobin synthesis and an increase in effective erythropoiesis. Haemolysis is due to an instability of the haemoglobin itself. The spleen does not appear to play any appreciable role in the aetiology of this condition. There was no extramedullary erythropoiesis in our patients.

Adolescent

Copper in ankylosing spondylitis and rheumatoid arthritis.

To study the role of copper in inflammatory rheumatic diseases, serum copper, serum ceruloplasmin concentration, erythrocyte sedimentation rate, and radio-copper studies were performed in 11 male patients with ankylosing spondylitis, in 12 female patients with rheumatoid arthritis and in 7 normal male subjects. The occurrence of elevated serum copper and serum ceruloplasmin levels can be confirmed in our study for patients with ankylosing spondylitis and rheumatoid arthritis when compared with normal controls. A significant correlation was found for these parameters and the inflammatory activity, characterized by the erythrocyte sedimentation rate. If groups with similar inflammatory activity are compared, higher ceruloplasmin concentrations are found in ankylosing spondylitis than in rheumatoid arthritis, the plasma incorporation of radiocopper also being higher in ankylosing spondylitis patients. Therefore, and because of comparable total serum copper concentrations, the non-ceruloplasmin bound copper level is found to be significantly higher in rheumatoid arthritis patients than in the group of ankylosing spondylitis patients. The significant correlation between erythrocyte sedimentation rate and the cumulative 120-hour urine excretion of radiocopper is in good agreement with the chemical finding of an elevated urinary copper excretion found by others, supporting the concept that the elevation of serum and urine copper levels in inflammatory rheumatoid diseases can be considered as an acute phase response.

Adolescent

[Pseudohypoparathyroidism type I and vitamin D therapy].

In pseudohypoparathyroidism type I pharmacologic dosis of vitamin-D can correct hypocalcemia. Several authors who had investigated vitamin-D-metabolism in these patients, found impaired renal conversion of 25-hydroxyvitamin-D to 1,25-dihydroxy-vitamin-D. Treatment of 2 patients with pseudohypoparathyroidism type I with vitamin-D-3 and 1 alpha-Hydroxycholecalciferol consecutively resulted in a nonuniform response with regard to the normalisation of serum-calcium. This led us to the conclusion that the disturbances of vitamin-D-metabolism in pseudohypoparathyroidism type I is heterogenous.

Adolescent

[Platelet retention and hypothyroidism: an investigation in patients with thyroid carcinoma treated by total thyroidectomy (author's transl)].

Platelet retention was investigated using a standardized technique with a glass pearl column in 18 patients with malignant thyroid disease treated by thyroidectomy before and after high-dose radioiodine treatment (80 or 150 mCi). As compared with the normal controls platelet retention was significantly lower in 13 hypothyroid patients in whom thyroidectomy had been undertaken at least 6 months previously and hormone substitution therapy had been interrupted 3 weeks before the period of investigation. The remaining 5 patients, studied about 18 days following thyroidectomy, were euthyroid and displayed platelet retention values within the lower limits of the normal range except for one patient with markedly reduced values. Thyroid substitution therapy with synthetic preparations induced recovery of platelet retention in both groups examined over a 4 week period, the increase being highly significant in the group of hypothyroid patients. A transient increase in platelet retention was observed 24 hours after a therapeutic dose of radioiodine, and initial values being regained after a further 24-hour period. This phenomenon was found in both, the euthyroid and hypothyroid group, however, it was more pronounced in the latter patients. Our results indicate a dependence of platelet retention on thyroid hormone concentration. The observed transient increase after radioiodine may be due to a radiation effect.

Adolescent

A case-report of idiopathic juvenile osteoporosis with particular reference to 47-calcium absorption.

Calcium metabolism was studied in a 12-year-old girl preseting with idiopathic juvenile osteoporosis. Absorption of orally administered 47-Ca was high. Serum calcium and phosphorus, serum immunoreactive PTH and CT and tubular phosphate reabsorption were found to be within normal limits. The data suggest that calcium malabsorption, nutritional calcium deficiency, hyperparathyroidism, a dysfunction related to sex hormones, and Cushing's syndrome cannot be implicated in the aetiology of the osteoporosis in this case who recovered spontaneously with sexual maturation.

Bone and Bones

[Incorporation of radioactive calcium and technetium pyrophosphate in to bones].

A method is given for simultaneous in vivo measurement of mineral and collagen metabolism of the bone. Accretion rates of 47-calcium as a chlorid into the bone are representative for bone mineralisation and of 99m-technetium labelled pyrophosphate for collagen metabolism. Compartmental models used for analysis are presented. Bone accretion rates are given in mg, or mMol respectively per unit time for the skeleton, by computation of the specific activity of 47-calcium and 99m-Technetium pyrophosphate and rational bone accretion as registered by total body profile scanning technique. The results obtained in five normal volunteers are presented.

Apatites

[Value of photon-absorption densitometry for the assessment of bone density].

Senile osteroporosis itself is asymptomatic unless pain is induced by the static insufficiency of the skeleton, in long lasting disease. Conventional procedures for early diagnosis and control of patients are invasive and therefore not suitable for routine purposes. The efficiency of sodium fluoride for the treatment of senile osteoporosis after a minimum of 12 months has been established by invasive methods. It is the purpose of this study, to examine the value of photoabsorption-densitometry with double-isotope-method (125-J, 241-Am) for the evaluation of a therapeutic effect in this disorder. 7 patients with clinical and radiological evidence of senile osteoporosis (6 female, 1 male patient with ages of 56 to 87 years) underwent regular follow-up examinations for one year while on a regimen of 25mg. sodium fluoride, as retard, twice daily. The bone mineral content registered 1 cm. proximal of the proc. styloideus ulnaris (representative for the trabecular bone) and 8 cm proximal from the proc. styloideus ulnaris of the right forearm (representative for cortical bone) was not statistically different from the measurements registered prior to the study. However, the bone mineral content registered in both regions increased significantly, after 12 months treatment (p less than 0.05). This indicates that the assessment of bone mineral content by photonabsorptiondensitometry is a valuable method for therapeutic control of this disorder. The method is recommended as a routine procedure for the early diagnosis and for follow up of sodium fluoride therapy geriatric patients.

Aged

[Age-corrected analysis of glucose tolerance in blood relations of patients with juvenile onset diabetes mellitus].

Intravenous glucose tolerance test(taking the age dependent variabilities of the glucose assimilation into consideration) was performed in 68 blood relations (30 siblings, 19 parents, 19 children) of 19 patients with juvenile onset diabetes mellitus (JODM). In 29,4% of the first degree relatives (in 20% of the siblings, in 42% of the parents and in 31,6% of the children) an abnormal glucose tolerance was found. Four of the siblings presented with insulin dependent JODM. Glucose intolerance was detected more often (42%) in siblings and parents of patients with later onset (after age 25) JODM than in siblings and parents of JODM-patients with onset before age 25 (20%).

Adolescent