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At least 289 records · Page 16Linked to original sources

PubMed1985

Technetium 99m-methylene diphosphonate bone scans in children with reflex neurovascular dystrophy.

Eleven children with reflex neurovascular dystrophy were investigated by technetium-labeled methylene diphosphonate bone scanning. Eight of 12 scans demonstrated abnormal findings, four showing diffusely decreased uptake and four diffusely increased uptake of the radionuclide in the affected site. Three scans showed normal findings initially, as did one previously abnormal scan when repeated in the asymptomatic patient 6 months later. Diffusely abnormal findings can be helpful in the diagnosis of childhood reflex neurovascular dystrophy, but a normal scan does not exclude the diagnosis.

Adolescent↗

PubMed1979

Effects of disodium dichloromethylene diphosphonate on Paget's disease of bone.

19 patients with Paget's disease were treated orally for 6 months with disodium dichloromethylene diphosphonate. 1600 mg/day (10 patients) significantly reduced urine hydroxyproline, serum alkaline phosphatase, urine calcium, and the number of pagetic bone osteoclasts. Tetracycline double labelling revealed undisturbed bone mineralisation. There was improvement on quantitative bone-scans and bone pain diminished. There was a transient increase in parathyroid hormone level in 13 of the 19 patients during treatment, which was associated with a high serum 1,25 (OH)2D3. No adverse clinical side-effects have been observed and biochemical remission has persisted for 9 months.

Administration, Oral↗

PubMed1980

Effect of dichloromethylene diphosphonate in Paget's disease of bone and in hypercalcaemia due to primary hyperparathyroidism or malignant disease.

30 patients with disorders of calcium metabolism were treated with dichloromethylene diphosphonate (C1(2)MDP, or clodronate disodium), an inhibitor of bone resorption. 13 patients with Paget's disease of bone were given C1(2)MDP by mouth (1.6 g/day). Serum-alkaline-phosphatase and urinary hydroxyproline fell to normal or near-normal within 3-7 months, and there was a clinical improvement in all but 1 patient. C1(2)MDP (0.8-3.2 g/day) also reduced plasma-calcium and urinary calcium in 17 patients with hypercalcaemia due to primary hyperparathyroidism or secondary to malignant disease. C1(2)MDP seems to be an effective oral drug for inhibiting excessive bone resorption in man.

Alkaline Phosphatase↗

PubMed1985

Comparison of aminohydroxypropylidene diphosphonate, mithramycin, and corticosteroids/calcitonin in treatment of cancer-associated hypercalcaemia.

Thirty-nine patients with cancer-associated hypercalcaemia were randomly allocated to receive aminohydroxypropylidene diphosphonate (APD), mithramycin, or corticosteroids and salmon calcitonin. Corticosteroids/calcitonin had the fastest calcium-lowering effect, owing mainly to an acute reduction in renal tubular calcium reabsorption; continued therapy over 9 days failed to suppress accelerated bone resorption, however, and most patients remained hypercalcaemic. Mithramycin also substantially reduced serum calcium within 24 h. A further dose on day 2 generally controlled hypercalcaemia until day 6 by reducing both bone resorption and renal tubular calcium reabsorption. By day 9, however, about 50% of the mithramycin-treated patients had started to relapse as bone resorption increased again. With APD serum calcium levels fell more slowly but progressively owing to effective suppression of bone resorption; by day 9 the control of hypercalcaemia was significantly better than in the other treatment groups. Symptoms of hypercalcaemia were greatly relieved, especially by APD.

Calcitonin↗

PubMed1984

[Diphosphonates in the treatment of hypercalcemia].

The diphosphonates (DP) represent a new class of therapeutic agents, the main property of which is to block bone resorption, irrespective of its stimulus. Apart from their remarkable results in Paget's disease of the bone, DP are very effective in the treatment of hypercalcaemia the osseus origin of which is nearly always essential. In malignant hypercalcaemia, EHDP, C12 MDP and APD, the three DP tested in man, cause a fall in serum calcium in a few days when administered intravenously. The latter two preparations are also effective when given orally. DP are also valuable in controlling hypercalcaemia in primary hyperparathyroidism. Research is under way to determine the role of DP in the prevention of malignant osteolysis, as distinct from the effects of chemotherapy.

Bone Neoplasms↗

PubMed1981

Determination of (dichloromethylene) diphosphonate in physiological fluids by ion-exchange chromatography with phosphorus-selective detection.

An analytical method is presented for the determination of (dichloromethylene) disphosphonate (Cl2MDP) in serum and urine. Cl2MDP is isolated from biological samples by adsorption onto precipitated calcium phosphate. Orthophosphate is separated from Cl2MDP by anion-exchange chromatography using AG 1-X8 resin. Detection is accomplished on-line using a flame photometric detector. Potentially interfering condensed phosphates are removed by acid hydrolysis. Sample handling losses are corrected by monitoring the recovery of a [14C] Cl2MDP spike added to the samples. Determinations of Cl2MDP to concentrations as low as 2 mumol/l are possible. Extension of the method to determine other diphosphonates is discussed.

Chromatography, Ion Exchange↗

PubMed1996

Clinical effectiveness of 99mTc-diphosphonate scintigraphy of revascularized iliac crest flaps.

Clinical assessment of the perfusion of the musculocutaneous portion of composite iliac crest free flaps was compared to 99mTc-diphosphonate (HDP) uptake in 14 patients who underwent primary oromandibular reconstruction after ablative cancer surgery. Bone scanning was performed on average at the 9-10th postoperative day (range 4-48) 3 h after intravenous injection of 550 MBq 99mTc-HDP. Eleven patients showed complete concordance between 99mTc-HDP uptake and soft-tissue status. Two patients showed uptake and viable muscle in spite of necrotic skin. One patient had a viable musculocutaneous flap but a photopenic defect in the bone graft; 6 months later, a small corresponding part of the bone was sequestrated. In this study, bone scanning and clinical assessment of muscle perfusion were 100% accurate in predicting viability of bone grafts. Skin viability was a less reliable parameter. It is concluded that bone scanning is not indicated as a routine investigation for revascularized iliac crest flaps and that clinical assessment of muscle perfusion is a reliable monitor of the early function of such flaps.

Adult↗

PubMed2005

Pillared layered structures based upon M(III) ethylene diphosphonates: the synthesis and crystal structures of M(III)(H(2)O)(HO(3)P(CH(2))(2)PO(3)) (M = Fe, Al, Ga).

A three-dimensional iron(III) diphosphonate, Fe(III)(H(2)O)(HO(3)P(CH(2))(2)PO(3)), I, has been synthesized hydrothermally and characterized by single-crystal X-ray diffraction. The compound crystallizes in the orthorhombic space group Pbca (no. 61) where a = 9.739(5) A, b = 9.498(5) A, c = 15.940(8) A, V = 1474.4(1) A(3), Z = 8, and R(1) = 0.0380. The structure consists of inorganic sheets pillared by the 1,2-ethylenediphosphonate groups. The sheets are composed of Fe(H(2)O)O(5) octahedra connected through PO(3)C tetrahedra. The corresponding isostructural aluminum (II) and gallium (III) compounds were also synthesized and indexed: II, a = 9.534(1) A, b = 9.255(2) A, c = 15.724(1) A, V = 1387.5(1) A(3); III, a = 9.670(1) A, b = 9.357(2) A, c = 15.862(4) A, V = 1435.4(1) A(3).

Aluminum↗

PubMed1987

gem-Diphosphonate and gem-phosphonate-phosphate compounds with specific high density lipoprotein inducing activity.

New diphosphonate compounds and related derivatives were synthesized and investigated for their activity in specifically inducing plasma high density lipoproteins (HDL) and high density lipoprotein cholesterol (HDL-C) in normal rats. The screening of numerous compounds has permitted the determination of the structural variations leading to optimal plasma lipid altering activity, indicating antiatherosclerotic potential. Among the compounds observed to be the most active, dimethyl alpha-(dimethoxyphosphinyl)-p-chlorobenzyl phosphate (20, SR-202, mifobate) was selected for further pharmacological and subsequent clinical development.

Animals↗

PubMed1980

Pulmonary calcification in hemodialyzed patients detected by technetium-99m diphosphonate scanning.

Metastatic pulmonary calcification, a well-known complication in patients with chronic disease, has been demonstrated postmortem in patients with a negative chest X-ray. Recently, scintigrams with bone-seeking radionuclides have been used to detect such subclinical pulmonary calcium deposits. We describe 23 patients on maintenance hemodialysis with no evidence of pulmonary calcification on chest X-ray who were prospectively studied by lung scanning with a bone-seeking radionuclide and pulmonary function testing. Of the 23 patients, 14 (61%) had a positive technetium-99m diphosphonate (99mTc-DP) scan (group 1). These patients were on dialysis 38 +/- 5 months compared with 12 +/- 4 months in 9 patients with a negative scan (group 2) (P less than 0.01). Age, sex, blood pressure, hematocrit, serum calcium, phosphorous, bicarbonate, magnesium, and calcium X phosphorus product, as well as parathyroid hormone level did not differ between the two groups. Of 10 group-1 patients tested, 7 had abnormal pulmonary diffusion capacity compared with non in 5 group-2 patients tested (P = 0.014). Histologic examination of the lung in 1 group-1 patients who expired revealed calcification (amorphous on X-ray diffraction), whereas none was found in 1 group-2 patients autopsied. These observations suggest that in patients on maintenance hemodialysis, pulmonary scanning with 99mTc-DP is a sensitive method for detecting pulmonary metastatic calcification, which may be associated with an abnormality in pulmonary diffusion capacity.

Adult↗

PubMed1977

[Role of renal function and calcemia in demonstration of kidneys in 99mTc-diphosphonate skeletal scintigrams (author's transl)].

Normally, in 99mTc-diphosphonate-skeletal scintigrams the kidneys are delineated with the same intensity as the lumbar spine; This is not the case in patients with reduced renal function. In a series of 20 patients with varying degrees of renal insufficiency, a continuous decrease in the renal intensity with increasing serum creatinine was seen: clearly recognizable decreased renal intensity in patients with serum creatinine over 2 mg%, and no visualization of the kidneys in patients with serum creatinine over 8 mg%. This effect is intensified through a simultaneously existing hypercalcemia has the opposite effect, i.e., the intensity decrease is partially prevented. In patients with normal renal function a hypercalcemia even leads to an increased renal intensity. As a further cause for excessive renal intensity, an increased parenchymal transit time was found in the radionephrography in 5 out of 11 patients with normal serum creatinine in whom the increased renal intensity in the skeletal scintigram was a chance finding.

Calcium↗

PubMed2000

Hypocholesterolaemic and antiatherosclerotic effects of tetra-iso-propyl 2-(3,5-di-tert-butyl-4-hydroxyphenyl)ethyl-1,1-diphosphonate (SR-9223i).

Tetra-iso-propyl 2-(3,5-di-tert-butyl-4-hydroxyphenyl)ethyl-1,1-diphosphonate (CAS 126411-13-0, SR-9223i) is a member of a new class of compounds with multiple antiatherosclerotic activities. This report not only describes the cholesterol-lowering properties in four species of animals fed normocholesterolaemic diets but also reductions in lipid deposition in the arteries of cholesterol-fed New Zealand white rabbits following the administration of SR-9223i. Plasma cholesterol concentrations were reduced in mice by 27% (200 mg/kg/day administered in the diet for 10 days), in hamsters by 33% (200 mg/kg/day administered in the diet for 8 days), in dogs by 16% (25 mg/kg/day p.o. for 28 days) and 23% (75 mg/kg/day p.o. for 28 days) and in monkeys by 22% (25 mg/kg/day p.o. for 28 days). Further, the deposition of cholesterol, especially in the esterified form, in the aortae of cholesterol-fed New Zealand white rabbits was inhibited by SR-9223i (50 and 100 mg/kg/day p.o.). At the higher dose, the cholesteryl ester content of the aorta was half that of control animals. SR-9223i, at both doses, also inhibited the accumulation of cholesterol in the liver. SR-9223i has been shown to suppress HMG CoA reductase activity, inhibit ACAT activity and prevent lipid oxidation. These activities, demonstrated in vitro, have now been shown to translate into lipid lowering and antiatherosclerotic activities in vivo.

Animals↗

PubMed1993

Effect of aminohydroxypropylidene diphosphonate on the bone metabolism of patients with parathyroid adenoma.

Aminohydroxypropylidene diphosphonate (APD), a potent inhibitor of bone resorption, is used to control hypercalcemia in various diseases. It is less effective, however, in the management of hypercalcemia induced by primary hyperparathyroidism. We investigated the effect of APD on the bone metabolism of five patients with parathyroid adenoma. Before parathyroidectomy, 30 mg of APD was administered intravenously. Serum calcium decreased in all cases one to two days after APD administration, although it did not decrease to the normal range. Serum phosphorus also decreased. Urine calcium and hydroxyproline excretion, markers of osteoclasts activity, decreased dramatically. Serum alkaline phosphatase (ALP) and osteocalcin, markers of osteoblast activity, decreased after APD administration. Serum intact parathyroid hormone (PTH) and 1,25-dihydroxy-vitamin D (1,25[OH]2D) increased. These results indicate that APD is partially effective in the management of preoperative serum calcium level in patients with parathyroid adenoma. As osteoclasts activity is inhibited by APD, osteoblasts activity is also suppressed. Elevation of PTH and 1,25(OH)2D after APD-induced decrease in serum calcium level may explain the partial and limited effect of APD on lowering serum calcium in patients with parathyroid adenoma.

Adenoma↗

PubMed1984

Paradoxical acute hypercalcemic effect of salmon calcitonin in patients having Paget's disease of bone after treatment with dichloromethylene diphosphonate.

The hypocalcemia following administration of calcitonin may be an index to disease activity in Paget's disease of bone. Therefore, we assessed the effect of a single injection of 100 MRC units of salmon calcitonin (SCT) on plasma calcium in 28 patients with active Paget's disease before and after 6 months of treatment with dichloromethylene diphosphonate (Cl2MDP) at a dose of 400 mg/day (3 patients), 800 mg/day (8 patients), 1.600 mg/day (9 patients) or 2.600 mg/day (8 patients). The mean SCT-induced hypocalcemia was reduced by Cl2MDP and there was a significant positive correlation between the decrease of serum calcium induced by SCT and bone resorption evaluated by the number of osteoclasts on bone biopsy taken in pagetic iliac crest. After Cl2MCP treatment, 5 patients manifested a paradoxical hypercalcemic response to SCT injection ranging from +0.3 mg/dl to +0.5 mg/dl, which was sustained over the 9 hours following injection. As these patients had a dramatic inhibition of bone resorption induced by Cl2 MDP, it is suggested that the hypercalcemic response to SCT might reflect persistence or exaggeration of the early hypercalcemic effect of CT which reportedly precedes the hypocalcemic response to SCT.

Alkaline Phosphatase↗

PubMed1980

Effects of dichloromethylene diphosphonate on skeletal mobilization of calcium in multiple myeloma.

Dichloromethylene diphosphonate (Cl2MDP), an inhibitor of oestoclast activity, was evaluated for its ability to decrease the excessive mobilization of skeletal calcium that complicates multiple myeloma. Ten patients with active myeloma, wide-spread bone disease, and hypercalciuria were studied in a double-blind, placebo-controlled, crossover-designed trial in which they took Cl2MDP for eight weeks and placebos for eight weeks. Two patients died during the placebo phase; of eight patients who received Cl2MDP, seven had rapid, sustained, and highly significant (P less than 0.001) decreases in urinary excretion of calcium. Six also had significant decreases in hydroxyproline excretion, and five reported lessening of skeletal pain. On patient did not respond. Although the patients received concurrent chemotherapy during the study, concentrations of myeloma proteins actually increased or decreased only slightly, indicating the declines in hypercalciuria resulted from Cl2MDP and not from improvement in the underlying disease. We conclude that Cl2MDP is a potentially useful inhibitor of osteoclast-mediated bone erosion in multiple myeloma.

Adult↗

PubMed1983

Use of dichloromethylene diphosphonate in metastatic bone disease.

Dichloromethylene diphosphonate (clodronate), a new compound, has powerful activity against osteoclasts and has been used successfully to treat hypercalcemia associated with cancer. We studied its effects on calcium balance in patients with malignant osteolytic lesions. Ten normocalcemic patients with advanced metastatic bone disease or myeloma were evaluated in a baseline 20-day balance and calcium kinetic study. They were then randomized to a clodronate or placebo regimen, treated intravenously for two weeks and orally for a month, and finally reevaluated in another 20-day balance and kinetic study, conducted while they were still receiving treatment. The results show that both calcium balance and calcium absorption increased from base line in the clodronate group and that these changes were significantly different from those in the placebo group (mean change [+/- S.D.] in calcium balance [clodronate vs. placebo], 203.8 +/- 140.1 vs. -65.2 +/- 98.8 mg [5.1 +/- 3.5 vs. -1.6 +/- 2.5 mmol] of calcium per day, P less than 0.01; change in calcium absorption, 158.8 +/- 158 vs. -38.2 +/- 96.0 mg [4.0 +/- 4.0 vs. -1.0 +/- 2.4 mmol] per day, P less than 0.05). There was a marginal decrease in bone resorption in the clodronate group and no change in bone accretion. Our results suggest that clodronate may be a useful adjuvant in managing metastatic bone disease.

Bone Neoplasms↗

PubMed1983

(Dichloromethylene)diphosphonate-induced impairment of T-lymphocyte function.

The daily subcutaneous administration of (dichloromethylene)diphosphonate (clodronate) to 3-day-old normal inbred Wistar-Furth rats for 30 days produces osteopetrotic bone lesions resembling those of the osteopetrotic mutants. Furthermore, tooth eruption is prevented, growth slows down, and signs of runt disease appear. The weight of the thymus is decreased, and T cells from the thymus and spleen respond weakly to mitogens. These thymic disorders associated with defective bone resorption are very similar to those previously reported in the osteopetrotic mutant op rat and support the hypothesis of a link between the thymus and normal bone modeling and remodeling.

Alkaline Phosphatase↗

PubMed1986

Does radiolabelled diphosphonate retention reflect bone metabolism in the elderly?

The 24-h whole-body retention of diphosphonates (WBR), a useful measure of bone metabolism in young subjects, was measured in 27 elderly subjects (19 from home and eight in-patients). WBR rose with increasing age (r = 0.55, P less than 0.01) and was negatively correlated with renal function (r = -0.60, P less than 0.01). In five subjects given vitamin D, WBR did not fall. The measurement of WBR in the elderly has to be assessed in the light of an accurate assessment of renal function and so is rarely clinically useful.

Aged↗