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Oral clodronate improves the quality of life in lung cancer patients with bone metastases
580
581
ORAL CLODRONATE IMPROVES THE QUALITY OF LIFE IN LUNG CANCER PATIENTS WITH DONE METASTASES. p Puoliiokx. K. Liiuno. (Intr. by H. Puolijo-
HYPERCALCIURIA.
k;). Department of Diseases of the Chest, IJniversity of Turku, TurkU, Finland. Several trials Rave verified the efficacy of clodronate in the treatment of bone resorption e.g. in multiple myeloma, breast and prostate cancer. We studied the effect of oral clodronate (BonefosR capsules: 2400 mg-1600 mg/day) in 7 male patients (age 64-78 years) having squamous cell lung cancer with painful rib metastases and hypercalcaemia (S-Ca 3.4-3.7 mmol/l, mean 3.5). Bone metastases were diagnosed 13 months (mean) after the primary treatment (surgery in 5, radiotherapy plus ch@motherapy in 1 arndsymptomatic in 1 case). In all patients treatment with clodronate reduced S-Ca into the normal range (~2.6 mmol/l, mean 2.4) in 7 days (p
TUBULAR
HANDLING
OF SODIUH CIND
Hu-CFF.uFRJ and Oiv.Endocrinol.EPH. Brazil Tubular reabsorptioa o* raleiua is alter& Jo
1093
%mal Hypercalciurra (RH) .In order to elucidate whether the defect resides on proximal or distal segments, we studied lithium, sodium, lonlc ca]cium and phosphate dynamics along the nephron, we1 1 as as urinary rAt4P (AlA) and serum 1,25(OHl2D3 (RRA,Incstar) in 18 healthy subjects (C) and 5 patients with RH. Got h groups were submitted to a low calcium diet for 5 days, and studied on the 6th day during fast (phase I) and after an oral load of is calcrum (phase If).fnulin clearance (GFR) was similar in C and RH, as WI?11 as Urinary CkHP and serum calcium, phosphate and 1,25(OH)2D3. Fractional Excretion of Ca++ during fast was higher in RH than in C (0.837 f 8.612 vs 0.015 f 8.804 p(.0601). The ealciuric response to IO of calcium was less important RH than in C, and did not carrel ate tf 1,25(OH)2D3. Proximal tubular function was apparent ly preserved in RH patients considering that : a) Fractional Excretion of Phosphate and
no
urinary CARP were
positively correlated during
both phas@si b) Fractional Proximal Reabsorption of Na+(estrmated by Li clearance) was very simi-
lar to normal(B.7S f 8.85 vs 8.75 2 fast; showed
c)
Fractional
Excretion
of
%.BB)during
Na+ and of
Ca44
Positive correlation, reflecting
the physiological paralelism of Na+ and Ca++ dynamics in this segment. On the other hand, Fractional Distal Reabsorption of Na+ in phase I was slightly lower in RH patients (8.87 + 8.07) than in C (8.09 + 0.@3) We conclude that patients with RH most likely Present a defect in distal tubuPar calcium reabsorption.
583
582
OF BONE MINERAL CONTENT IN HYPERAND NORMAL CHILDREN. L. Garcia. A. Ber-
CBMPARISON
SERUM PARATHYROID HORMONE-RELATEDPROTEIN IN DOGS WITH HUMORAL HYPERCALCENIA OF MALIGNANCY.
Ca edes. 8. Barilla. Y. Cardona. FL Martinis. V. PazMartinez. ‘andVIJ.R. Weisinaer. Divisions of Nephrology and
Rasal. T.J. Hammer. D.J. Chew. R.D. AVl. J-L. Peterson, C.L. Steinmever. C.C. Caner). Depts. of Vet. Pathobiology and Clinical Sciences, Ohio State University, Columbus, OH, USA. Humoral hypercalcemia of malignancy is a clinical condition in dogs with common lymphoma, anal sac adenocarcinoma (Ca), and Parathyroid other miscellaneous tumors. hormone-related protein (PTHrP) Concentration was measured in dog serum or plasma by a Nterminal radioimmunoassay kit for human PTHrP (Incstar). control dogs (8) had undetectable Serum plasma levels (c 1.8 PM) of PTHrP. PTHrP was detected in dogs with cancer as follows [means and ranges are from doss with detectabie PTHrP only):
~&%s~;l;lC
Endocrinology, Hospital Pediatric0 “Elias Toro” and Division of Nephrology. Hospital Universitario de Caracas. Venezuela. Hypercalciuria (H) appears to be another factor in the appearance of low bone mass In the adult population, probably secondary to a persistently negative calcium balance. In fact, when we compared the bone mineral status of 114 women with urolithiasis with 818 women of similar ages, without previous renal stones, there was a significant reduction on trabecular, cortical and total bone mineral content, as determined by dual absorptiometry, in the renal stone population. In order to study the effect of H during early stages, we determined trabecular. cortical and total bone mineral content in 21 hypercalciuric children with a mean age of 9.33 f 2.08 years, urinary calcium (Ca) excretion of 4.73 f 0.94 mglkglday and fasting fractional excretion of Ca (FeCa) of 0.29 i 0.16. We compared these results with those obtained in a group of 9 normal children (C) with similar age (9.31k2.39 years), size and sex distribution (urinary Ca 1.16iO.52 mglKg/day, pcO.001, and FeCa of 0.056~0.032. peO.001). The results of the bone mineral content as determined with dual photon absorptiometry in the lumbar spine (Lumbar), femoral neck (neck), Ward’s triangle (Ward) and total bone mineral (TBM) expressed in gram&cm* were: WARD TBM NECK jJJ&lAR 0.75+0.11 0.82iO.12 0.87+0.12 C (n=9) 0.65,.0.04 0.68iO. 11 0.77;;13 0.83&0.08 H (n=21:) 0.55&.09 NS NS be 0.03
Normocalcemic
These results suggest that hypercalciuric children when compared to similar controls tend to have lower trabecular with conservation of cortical bone mineral content, and that the decrese
in the serum of dogs and is increased in uogs with humoral hypercalcemia of malignancy, but is also detectable in some dogs with cancer and normocalcemia.
in bone mineral content could start at earlier stages.
221
581
ORAL CLODRONATE IMPROVES THE QUALITY OF LIFE IN LUNG CANCER PATIENTS WITH DONE METASTASES. p Puoliiokx. K. Liiuno. (Intr. by H. Puolijo-
HYPERCALCIURIA.
k;). Department of Diseases of the Chest, IJniversity of Turku, TurkU, Finland. Several trials Rave verified the efficacy of clodronate in the treatment of bone resorption e.g. in multiple myeloma, breast and prostate cancer. We studied the effect of oral clodronate (BonefosR capsules: 2400 mg-1600 mg/day) in 7 male patients (age 64-78 years) having squamous cell lung cancer with painful rib metastases and hypercalcaemia (S-Ca 3.4-3.7 mmol/l, mean 3.5). Bone metastases were diagnosed 13 months (mean) after the primary treatment (surgery in 5, radiotherapy plus ch@motherapy in 1 arndsymptomatic in 1 case). In all patients treatment with clodronate reduced S-Ca into the normal range (~2.6 mmol/l, mean 2.4) in 7 days (p
TUBULAR
HANDLING
OF SODIUH CIND
Hu-CFF.uFRJ and Oiv.Endocrinol.EPH. Brazil Tubular reabsorptioa o* raleiua is alter& Jo
1093
%mal Hypercalciurra (RH) .In order to elucidate whether the defect resides on proximal or distal segments, we studied lithium, sodium, lonlc ca]cium and phosphate dynamics along the nephron, we1 1 as as urinary rAt4P (AlA) and serum 1,25(OHl2D3 (RRA,Incstar) in 18 healthy subjects (C) and 5 patients with RH. Got h groups were submitted to a low calcium diet for 5 days, and studied on the 6th day during fast (phase I) and after an oral load of is calcrum (phase If).fnulin clearance (GFR) was similar in C and RH, as WI?11 as Urinary CkHP and serum calcium, phosphate and 1,25(OH)2D3. Fractional Excretion of Ca++ during fast was higher in RH than in C (0.837 f 8.612 vs 0.015 f 8.804 p(.0601). The ealciuric response to IO of calcium was less important RH than in C, and did not carrel ate tf 1,25(OH)2D3. Proximal tubular function was apparent ly preserved in RH patients considering that : a) Fractional Excretion of Phosphate and
no
urinary CARP were
positively correlated during
both phas@si b) Fractional Proximal Reabsorption of Na+(estrmated by Li clearance) was very simi-
lar to normal(B.7S f 8.85 vs 8.75 2 fast; showed
c)
Fractional
Excretion
of
%.BB)during
Na+ and of
Ca44
Positive correlation, reflecting
the physiological paralelism of Na+ and Ca++ dynamics in this segment. On the other hand, Fractional Distal Reabsorption of Na+ in phase I was slightly lower in RH patients (8.87 + 8.07) than in C (8.09 + 0.@3) We conclude that patients with RH most likely Present a defect in distal tubuPar calcium reabsorption.
583
582
OF BONE MINERAL CONTENT IN HYPERAND NORMAL CHILDREN. L. Garcia. A. Ber-
CBMPARISON
SERUM PARATHYROID HORMONE-RELATEDPROTEIN IN DOGS WITH HUMORAL HYPERCALCENIA OF MALIGNANCY.
Ca edes. 8. Barilla. Y. Cardona. FL Martinis. V. PazMartinez. ‘andVIJ.R. Weisinaer. Divisions of Nephrology and
Rasal. T.J. Hammer. D.J. Chew. R.D. AVl. J-L. Peterson, C.L. Steinmever. C.C. Caner). Depts. of Vet. Pathobiology and Clinical Sciences, Ohio State University, Columbus, OH, USA. Humoral hypercalcemia of malignancy is a clinical condition in dogs with common lymphoma, anal sac adenocarcinoma (Ca), and Parathyroid other miscellaneous tumors. hormone-related protein (PTHrP) Concentration was measured in dog serum or plasma by a Nterminal radioimmunoassay kit for human PTHrP (Incstar). control dogs (8) had undetectable Serum plasma levels (c 1.8 PM) of PTHrP. PTHrP was detected in dogs with cancer as follows [means and ranges are from doss with detectabie PTHrP only):
~&%s~;l;lC
Endocrinology, Hospital Pediatric0 “Elias Toro” and Division of Nephrology. Hospital Universitario de Caracas. Venezuela. Hypercalciuria (H) appears to be another factor in the appearance of low bone mass In the adult population, probably secondary to a persistently negative calcium balance. In fact, when we compared the bone mineral status of 114 women with urolithiasis with 818 women of similar ages, without previous renal stones, there was a significant reduction on trabecular, cortical and total bone mineral content, as determined by dual absorptiometry, in the renal stone population. In order to study the effect of H during early stages, we determined trabecular. cortical and total bone mineral content in 21 hypercalciuric children with a mean age of 9.33 f 2.08 years, urinary calcium (Ca) excretion of 4.73 f 0.94 mglkglday and fasting fractional excretion of Ca (FeCa) of 0.29 i 0.16. We compared these results with those obtained in a group of 9 normal children (C) with similar age (9.31k2.39 years), size and sex distribution (urinary Ca 1.16iO.52 mglKg/day, pcO.001, and FeCa of 0.056~0.032. peO.001). The results of the bone mineral content as determined with dual photon absorptiometry in the lumbar spine (Lumbar), femoral neck (neck), Ward’s triangle (Ward) and total bone mineral (TBM) expressed in gram&cm* were: WARD TBM NECK jJJ&lAR 0.75+0.11 0.82iO.12 0.87+0.12 C (n=9) 0.65,.0.04 0.68iO. 11 0.77;;13 0.83&0.08 H (n=21:) 0.55&.09 NS NS be 0.03
Normocalcemic
These results suggest that hypercalciuric children when compared to similar controls tend to have lower trabecular with conservation of cortical bone mineral content, and that the decrese
in the serum of dogs and is increased in uogs with humoral hypercalcemia of malignancy, but is also detectable in some dogs with cancer and normocalcemia.
in bone mineral content could start at earlier stages.
221