[Monstrous tumourous changes of the facial bones in secondary hyperparathyroidism (author's transl)].
Explore the source record for details and available documents.
SEARCH · PubMed Health
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Explore the source record for details and available documents.
At present, bone histomorphometry remains the gold standard for the diagnosis of the various types of renal bone disease. In the search for a non-invasive method of diagnosis, biochemical serum markers of bone remodelling, in addition to serum intact parathyroid hormone and aluminium determinations, have been proposed as the most reliable tools and are at present widely used in clinical practice. Their respective diagnostic values, as separate items and in combined analysis, are thoroughly discussed in the present review.
Explore the source record for details and available documents.
To identify patients at risk from renal bone disease we compared the demographic characteristics of 243 patients with end stage renal failure grouped according to the presence (97 (40%] or absence of severe renal bone disease as judged by histological criteria. Youth, female sex, tubulointerstitial types of nephropathy, and a long duration of uraemia were all identified as significant independent risk factors for the development of bone disease. The relative risks from being female and having tubulointerstitial renal disease were separately identifiable when the estimated observation of renal failure was short (less than four years). The identification of patients at high risk from bone disease may clarify the pathogenesis and treatment strategies of renal osteodystrophy.
Quantitative histological studies have been done on 80 sequential bone biopsies taken at yearly intervals from 37 patients with chronic renal failure on long-term haemodialysis treatment. Twenty-three patients were studied at the start of dialysis, and in about half the bone was abnormal. During dialysis mean osteoid area and the maximum number of unmineralized osteoid lamellae increased, and mineralized bone area decreased. The loss of bone during dialysis was also reflected in reduction of the width of individual trabeculae. These trends were less obvious in patients already established on dialysis at the time of the initial biopsy. The course of osteitis fibrosa appeared to be unaffected by dialysis.
Explore the source record for details and available documents.
We studied 21 dialysis patients who became hypercalcemic without vitamin D or calcium therapy and compared them to 28 dialysis patients who were not hypercalcemic. In the hypercalcemic group, the mean ionized-calcium level was elevated compared to normal subjects (5.4 +/- 0.4 vs. 4.9 +/- 0.1; p less than 0.001), while the ionized-calcium level in the control dialysis patients was below normal (4.5 +/- 0.4 vs. 4.9 +/- 0.1; p less than 0.001). Bone biopsies were performed in all patients. Two thirds of the hypercalcemic patients had low-turnover osteodystrophy (LTO, predominantly osteomalacia), a fraction significantly higher than in the control dialysis patients (13/21 vs. 8/28, respectively; p less than 0.05). The hypercalcemic patients with LTO had markedly elevated surface bone aluminum (63 +/- 24% of all trabecular surfaces). In contrast, the nonhypercalcemic dialysis patients with LTO and all patients with osteitis fibrosa had minimal surface bone aluminum. Hypercalcemic patients with osteitis fibrosa had a significantly lower mean N-terminal parathyroid hormone (PTH) value than did nonhypercalcemic patients with osteitis fibrosa (149 +/- 81 vs. 278 +/- 135 pg/ml, respectively; p less than 0.005). Both mean values were markedly elevated in comparison with those obtained in normal subjects (16 +/- 5 pg/ml). In contrast, patients with LTO, irrespective of the calcium level, had mean PTH values that were not significantly different from those of normal subjects. A PTH level greater than 100 pg/ml was 95% sensitive and 87% specific for osteitis fibrosa, as demonstrated by histomorphometry in nonhypercalcemic dialysis patients. However, this level was only 62% sensitive and 77% specific for a diagnosis of osteitis fibrosa in hypercalcemic dialysis patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Fifty-eight patients with osseous or fibro-osseous conditions affecting the craniofacial bones are reviewed in order to determine difficulty of diagnosis, natural history, and management. In many patients separation into individual categories is possible on clinical grounds alone. However, by correlating clinical examination with radiological and histological findings, it is clear that each of the pathological conditions discussed is a separate entity and not merely part of a broad spectrum of bony disorders.
Fourteen aged Sprague-Dawley rats had typical renal secondary hyperparathyroidism. The renal disease was severe glomerulosclerosis with tubular dilation. The parathyroid glands were enlarged and had hyperplasia of chief cells. Bone lesions were generalized osteodystrophia fibrosa and osteosclerosis. All rats had osteodystrophia fibrosa and it was severe in 10 rats. Only four rats had osteosclerosis and it was moderate. Metastatic calcification was seen in various soft tissues in 13 rats.
Explore the source record for details and available documents.
The correction of cranio-facial disfigurement in the upper part of the face is the most difficult to achieve. Various materials have been utilized and are still in use. Each has advantages and disadvantages. Autogenous bone has been used with good results, except for the unacceptable irregularities of the forehead and upper orbital region. The combination graft offers the advantages of both: the bone graft will be in contact with the dura, the periorbita and the contaminated sinuses. The polyrane implant produces a smooth and contoured forehead and immediately protects the vital structures during osteoneogenesis. Twenty-six selected patients had this technique used to correct their deformity without any incidence of major complication.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.