Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound

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Query: EC:3.1.3.1 (alkaline phosphatase)
47,916 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Bone scintigraphy with 99mTc-MDP was performed on 8 patients with Paget's disease of bone. The radionuclide uptake by all the involved lesions was markedly increased, even in subclinical lesions without pain. Bone scintigraphy with 99mTc-phosphorous compounds were thought to be the most simple and sensitive technique to define the precise extent of the lesions, and to detect asymptomatic occult cases with Paget's disease. Possible A-V shunt was estimated in 3 cases by measuring the radioactivity over the lungs after the injection of 99mTc-MAA through a catheter into an artery which supplied the lesion. A-V shunt was calculated as 14.5%, 10.0% and 12.0%, respectively. An uptake study of 99mTc-MDP was attempted to quantify the effect of calcitonin treatment using a gamma camera combined with a computer. An "uptake ratio" was obtained for each lesion by dividing the count rate over the bone lesion by that over the control bone. Three cases of Paget's disease were treated with synthetic eel calcitonin analogue ([Asu1,7] E-CT) in a dose of 40 MRC unit per day. The effectiveness of CT therapy was evaluated by the X-ray film, the serum alkaline phosphatase activity (S-Al-P), the serum phosphate level, the serum calcium level and the "uptake ratio". No remarkable changes were obtained on bone X-ray films at one year after the initiation of the CT treatment in all cases. The S-Al-P levels did not show significant difference in the 2 cases, in which the S-Al-P levels were within the normal range before the treatment. In all cases, however, the "uptake ratio" of the diseased bone fell remarkably within the first three months and the rate of the fall was parallel to the decrease in the bone pain. It was considered that the "uptake ratio" on bone scintigraphy offered the most sensitive and reliable information in evaluating the CT treatment for Paget's disease.
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PMID:[Clinical feature and calcitonin therapy on Paget's disease of bone (author's transl)]. 57 27

A case of adult onset hypophosphatemic vitamin D resistant osteomalacia is described. A 40-year-old female who complained of thorax and lumbar pain and gait disturbance was admitted to our hospital on 7 November, 1988. The patient had hypophosphatemia with normal plasma calcium, parathyroid hormone and 25-hydroxy vitamin D3 concentrations, but had decreased tubular reabsorption of phosphate and decreased plasma 1, 25-dihydroxy vitamin D3 concentrations. The iliac crest bone biopsy showed osteomalacic changes. The 99mTc-MDP bone scintigram showed evidence of increased bone turnover with raised plasma alkaline phosphatase concentrations. After treatment with oral 1 alpha-hydroxy vitamin D3 (3-6 micrograms/day) and intravenous or oral phosphate supplement (0.47-1.74g/day), the subjective and clinical findings improved.
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PMID:[A case of adult onset hypophosphatemic vitamin D resistant osteomalacia]. 144 82

Osteomalacia is characterized by large osteoid seams and a preserved volume of bone trabeculae. The mineralization of newly formed bone requires adequate concentrations of calcium and phosphate: the Ca.P product has been regarded as a useful, empirical diagnostic test of osteomalacia. It decreases in patients with osteomalacia mainly because they have very low plasma phosphate levels. At present total body bone mineral and total body bone density can be directly measured by whole body absorptiometry, which indicates the lowest total mineral content of the skeleton which can increase quickly after adequate treatment. The main symptoms of osteomalacia are: bone pain; muscular weakness (commonly as pelvic girdle myopathy); Looser-Milkman pseudofractures or more often a pattern of generalized demineralization at X-ray. The main biochemical parameters in osteomalacia include: defective calcium absorption with hypocalcemia and hypocalciuria; defective intestinal phosphate absorption with hypophosphatemia; there is often increased renal phosphate clearance due to hypocalcemia and secondary hyperparathyroidism; elevated alkaline phosphatase and osteocalcin levels; high bone turnover confirmed by kinetic studies carried out with radiocalcium or 99mTc-MDP. An etiological classification of the osteomalacias includes: 1) nutritional osteomalacia: a) inadequate exposure to sunlight and/or insufficient vitamin D intake; b) defective intestinal absorption of vitamin D because of malabsorption syndromes (e.g. jejuno-ileal bypass for obesity).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The osteomalacias. 166 41

The effectiveness of the 24-hour whole body retention of Tc-99m MDP in monitoring disease activity was evaluated in 58 patients with Paget's disease of bone. Patients had baseline 24-hour retention studies, bone scans, radionuclide bone blood-flow studies, and alkaline phosphatase and OH-Proline level measurements. Increased retention of Tc-99m MDP was present in 88% (51/58) of individuals while alkaline phosphatase and OH-Proline were respectively elevated in 100% (58/58) and 64% (35/55) of patients. Forty-seven examinations were further obtained to evaluate changes in retention with therapy. Retention correctly reflected response to treatment in 89.3% of follow-ups versus 85.1% with alkaline phosphatase (n = 47). It was accurate in 90.9% of patients versus 75% for OH-Proline (n = 44). We conclude that the retention study, while not absolutely correlative with Pagetic activity, still is useful in grading the condition. It is a simple additional step that monitors the global severity of lesions localized on bone scans.
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PMID:Whole body retention of Tc-99m phosphate in Paget's disease of bone. 186 58

This retrospective study aimed to assess the usefulness and clinical importance of current, commonly used, diagnostic staging procedures in breast cancer. The analysis comprises all 398 women clinically staged I-III (UICC criteria), and irradiated with radical intent in the Professorial Unit of Radiotherapy at the Middlesex Hospital over a ten-year period (1978-1987). The routine initial screening in this institution included the following staging investigations within 4 weeks of referral: 99mTc MDP bone scan; chest X-ray; liver function tests (including serum alkaline phosphatase) and liver ultrasound scan. Further enquiry and examination of the patient, clear progression of disease, additional radiographs or a recommended repeat interval scan provided sufficient additional information to confirm metastatic disease. The overall rate of detection of metastatic disease at three months was 29/389 (7.4%) for skeletal scintigraphy, 10/386 (2.6%) for chest radiographs, 8/271 (2.9%) for liver ultrasound and 3/347 (0.8%) for serum alkaline phosphatase. In total 37/398 (9.3%) of patients were confirmed to have metastatic disease by three months. Skeletal scintigraphy alone appears to identify 78% (29/37) of those with detectable metastatic disease at 3 months. Skeletal scintigraphy and liver ultrasound will identify 95% (35/37).
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PMID:How far investigations for occult metastases in breast cancer aid the clinician. 203 84

The reproducibility and diagnostic value of local bone to soft tissue uptake ratio of 99mTc(Sn)-MDP as a bone tracer was examined in a prospective study in 35 patients who were under investigation and/or treatment for postmenopausal osteoporosis. The ratio of tracer uptake in the second lumbar vertebra (L2) and both femoral shafts was calculated from the number of counts in suitable regions of interest. Results obtained with settings and calculations in the routine practice were compared to the results obtained by revision of all raw data in one run by one person. The results were compared to the serum alkaline phosphatase activity (AP) and to local bone mineral mass as determined by dual photon absorptiometry (DPA). In 15 patients serial measurements during fluoride therapy were also compared to serum osteocalcin values and to bone histomorphometric data. The precision error of the calculation of uptake ratios from raw counts (including selection of region of interest) was 13.9% for the femoral shaft and 14.7% for L2. The mean difference between left and right femoral shaft in individuals was not significant and its variance was small P greater than 0.1). There was a weak but significant linear correlation between local uptake ratio in the spine and AP in the total material (r = 0.328 P less than 0.01). However, changes in local uptake ratio during therapy with fluoride in 15 patients were too small to be of any value and did not correlate with changes in alkaline phosphatase or osteocalcin or trabecular surface covered with osteoblasts.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The value of local 99mTc(Sn)-MDP bone to soft tissue uptake ratio in osteoporosis, before and during fluoride therapy. 236 58

We have used 99Tcm-MDP to develop a measure of overall skeletal activity for use in renal disease. The method utilizes the relative clearances of 99Tcm-MDP and 51Cr-EDTA from the blood after simultaneous injection. This is expressed as a ratio and the upper limit in normals is 1.4. This ratio has been evaluated in 42 patients with chronic renal failure and compared with appearances of left-hand radiographs. The ratio was elevated in these patients and the level corresponded to the degree of severity of the subperiosteal resorption. Similarly, there was a close correlation between the ratio values and the serum alkaline phosphatase measurements and parathyroid hormone values. Thirty-three patients had sequential studies performed at intervals of up to 2 years. Twenty-one patients showed no change on clinical, biochemical or bone scan evaluation. Of these, only one patient showed a change in ratio value of greater than 20%. Twelve patients showed evidence of change based either on clinical, biochemical or bone scan alteration and all 12 patients showed changes in ratio values greater than 20%. The 51Cr-EDTA/99Tcm-MDP ratio appears to offer not only a single plasma sample method for the detection and evaluation of renal bone disease, but our results also suggest that it may be valuable in the follow-up of these patients.
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PMID:51Cr-EDTA/99Tcm-MDP ratio: a simple non-invasive method for assessing renal osteodystrophy. 249 84

To improve the understanding of diphosphonate affinity to metabolically active bone, the underlying diphosphonate kinetics have been evaluated and compared to Cr-EDTA kinetics. MDP binds to plasma proteins, varying from 25% initially to approximately 70% after 24 h. The renal clearance of diphosphonate is found to be equal to Cr-EDTA clearance. Using simultaneous bolus injection of 99Tc-MDP and 51Cr-EDTA, it has been possible to obtain a coarse estimate of bone uptake of MDP. This uptake is found to correlate well with s-alkaline phosphatase, but since MDP binding to bone is reversible, the plasma elimination curve is not monoexponential. Therefore it has not been possible to describe the uptake of MDP in bone mathematically.
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PMID:Studies on diphosphonate kinetics. Part I: Evaluation of plasma elimination curves during 24 h. 310 90

Clinical effects of EHDP on relief of bone pain, changes in bone lesions on X-ray and 99mTc-MDP scintigram and performance status were investigated in 19 patients with bone metastasis from urogenital cancers (4 renal cell cancers, 1 renal pelvic cancer, 4 bladder cancers and 10 prostatic cancers). EHDP was effective in relieving bone pain in prostatic cancer patients with osteoblastic lesions. Bone lesions on X-ray and 99mTc-MDP scintigram were slightly improved in prostatic cancer patients with osteoblastic lesions. Administration of EHDP did not improve the performance status. Changes in laboratory data such as serum alkaline phosphatase, serum calcium and urinary total hydroxy-proline following EHDP administration indicated inhibition of osteolytic activity with no effect on bone formation in the early period of treatment (in 4 weeks) and development of both osteolytic activity and bone formation in the later period (from 8 to 12 weeks). No marked side effects were observed. EHDP seems to be effective in relieving bone pain in prostatic cancer patients with osteoblastic bone metastasis. Moreover, some diphosphonate groups including EHDP are expected to be useful to the patients with malignant hypercalcemia.
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PMID:[Effects of etidronate disodium (EHDP) on urogenital malignancies with bone metastasis: a multicentered collaborative evaluation]. 313 34

Bone scintigraphy using 99mTc-MDP was performed on 2 patients with Paget's disease of bone before and after the treatment with a synthetic eel calcitonin analogue [Asu1,7)-eel calcitonin, ECT] at a dose of 40 U per day. All pagetic lesions showed markedly the increased accumulation of the radionuclide. The uptake ratio, defined as the count rate of 99mTc-MDP over each bone lesion to that over the control bone, was calculated. The response to the calcitonin therapy was evaluated with the uptake ratio of the radionuclide. The uptake ratio decreased markedly within the first 3 months of the treatment, in association with a palliation of bone pain, while the serum alkaline phosphatase activities which had been within the normal range or slightly high before the treatment did not show any significant change or did not reflect a clinical feature (e.g. bone pain) with the treatment. Thus, the uptake ratio on the bone scintigram seemed to offer the most sensitive and most reliable information for the evaluation of calcitonin treatment of Paget's disease of bone.
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PMID:Evaluation by using radionuclide uptake of bone in Paget's disease of bone: special reference to treatment with calcitonin. 321 30


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