strontium-radioisotopes and Osteoporosis

To describe drugs used in the non-hormonal treatment of metastatic prostate cancer.. Bibliographical search was performed from the database Medline (National Library of Medicine, PubMed) and websites of the HAS and the ANSM. The search was focused on the characteristics, the mode of action, the efficiency and the side effects of the various drugs concerned.. The metabolic radiotherapy although under-used for this indication, kept a place at the beginning of the disease. Radium-223 chloride seems to have to occupy an important place in the coming years. The chemotherapy, the only recourse until very recently in the castration-resistant prostate cancer, must redefine its place partially. The denosumab provide an interesting alternative to bisphosphonates.. The non-hormonal treatment of the metastatic disease of the prostate cancer is changing rapidly with the emergence of new molecules. Urologist must know perfectly these new drugs.

Topics: Antibodies, Monoclonal, Humanized; Antineoplastic Agents; Bone Density Conservation Agents; Cisplatin; Denosumab; Docetaxel; Etoposide; Humans; Male; Mitoxantrone; Organometallic Compounds; Organophosphorus Compounds; Osteoporosis; Prostatic Neoplasms; Radiation Protection; Radioisotopes; Radium; RANK Ligand; Strontium; Strontium Radioisotopes; Taxoids

Osteoporosis is a systemic skeletal disease responsible for the high incidence of fractures in older subjects, particularly in postmenopausal women. The increasing prevalence with population ageing and prolonged life expectancy raises the rates of associated morbidity, loss of independence, and mortality. BMD and previous fracture history are two main risk factors associated with osteoporosis such that the presence of prior fractures can predict future fractures. Strontium ranelate is an agent developed for the management of postmenopausal osteoporosis, demonstrated to reduce vertebral, nonvertebral, major nonvertebral, and hip fractures. It has been demonstrated to be effective for a broad spectrum of patients, including women with osteopenia, osteoporosis, and severe disease.

Topics: Aged; Bone Density Conservation Agents; Female; Humans; Male; Middle Aged; Osteoporosis; Osteoporotic Fractures; Risk Assessment; Strontium Radioisotopes

To assess directly the effect of ionic dissociation on the bioavailability of calcium, we used the double isotope inverse convolution method to compare the absorption of calcium gluconate and calcium pyrrolidone carboxylate, an organic, highly dissociated salt. Two tests were performed at a 2 day interval, using in random sequence either salt as a carrier. Forty-eight subjects of various age and clinical condition were studied. The use of the more dissociated salt consistently and significantly increased fractional absorption in a rather constant ratio. Moreover, it slowed absorption in normal subjects whatever their age, and accelerated it in patients with chronic renal failure or osteoporosis, leading to inferences on the alteration of calcium absorption in these conditions.

Topics: Adult; Aged; Aging; Biological Availability; Calcium Gluconate; Calcium Radioisotopes; Female; Gluconates; Humans; Intestinal Absorption; Kidney Failure, Chronic; Kinetics; Male; Middle Aged; Osteoporosis; Pyrrolidinones; Pyrrolidonecarboxylic Acid; Strontium Radioisotopes

The present paper focuses on the analysis of data resulting from 50-y studies involving assessment of the hemopoiesis state in Techa riverside residents chronically exposed to radiation and evaluation of the bone tissue status for people with Sr incorporation at late time after the intakes.. 1. In the late period after the start of chronic radiation exposure (50 y later) only a few individuals with red bone marrow doses reaching about 1.8 Gy (mean dose of 0.66 Gy) had a marked peripheral blood leucopenia, and the incidence of neutropenia, lymphopenia and thrombocypenia in the exposed group did not exceed that noted in the control group. The results of our observations indicate the spontaneous recovery of the hemopoietic system of residents of the Techa riverside villages. Thus, the adaptation mechanisms of hemopoiesis to the long-term chronic exposure in the range of low to intermediate doses are sufficiently effective; 2. About half of the people with Sr incorporation and the control group have changes in bone tissue expressed by different stages of osteoporosis. Age is a determinative factor of bone tissue involution in women while some tendency of Sr influence on the intensity of osteoporosis is revealed in the male group.

Topics: Aged; Aged, 80 and over; Bone and Bones; Bone Marrow; Case-Control Studies; Environmental Exposure; Female; Hematopoiesis; Humans; Leukopenia; Male; Middle Aged; Osteoporosis; Russia; Strontium Radioisotopes; Water Pollutants, Radioactive

The aim of this study was to evaluate the contribution of a low calcium diet to the cortical and trabecular osteoporosis seen in ovariectomized rats after 7 weeks on a low calcium diet and to investigate the effects of the bisphosphonate clodronate on this development of osteoporosis. Thirty-six mature, female Wistar rats were randomized into four groups: Ovx-B (bisphosphonate) and Ovx-C (control) were ovariectomized, and Sham-Ca (low calcium) and Sham+Ca (normal calcium) were sham operated. The first three groups were fed a low calcium diet (0.01%) and Sham+Ca normal rat chow (Ca 1.1%). The Ovx-B received 10 mg/kg s.c. clodronate daily for nine weeks, and Ovx-C, Sham-Ca, and Sham+Ca received the same volumes of saline. Bone mineral turnover measured as 85Sr-uptake was increased in all low calcium groups compared to Sham+Ca. The Sham+Ca femora had higher dry weight and ash weight than the other groups, and Ovx-C had higher dry weight compared with Ovx-B and Sham-Ca. Calcium content was lower in both Ovx groups compared to both Sham groups. Magnesium was lower in all groups compared to Sham+Ca and higher in Ovx-B compared with Ovx-C. In the femoral shaft, Sham+Ca had significantly higher ultimate bending moment, energy absorption, and deflection compared to the other three groups. Ultimate bending moment was higher in Sham-Ca than in Ovx-C. Stiffness was increased in both Sham+Ca and Ovx-B compared to Ovx-C. The maximum stress in the femoral midshaft was higher in Sham+Ca than in the other groups, and higher in Ovx-B than in Ovx-C. Histomorphometry showed increased medullary area in all low calcium groups compared to Sham+Ca and larger cortical area in Sham+Ca and Ovx-B compared to Ovx-C. Compared to Sham+Ca the trabecular bone volume was decreased to 30% in Sham-Ca and to 9% in Ovx-C, but was unchanged in Ovx-B. The low calcium diet generally increased bone mineral turnover and reduced the tibial bone volume. Femoral changes led to a reduction of cortical fracture strength and maximal stress. Ovariectomy in addition to a low calcium diet reduced femoral strength even more. Daily injections of clodronate to ovariectomized rats on a low calcium diet increased femoral shaft stiffness and maximum stress, and clodronate preserved both trabecular and cortical tibial bone volume completely.

Topics: Animals; Calcium, Dietary; Clodronic Acid; Disease Models, Animal; Female; Femur; Osteoporosis; Ovariectomy; Rats; Rats, Wistar; Strontium Radioisotopes; Tibia

Previous studies have shown that treatment with daily injections of human parathyroid peptide (hPTH) 1-34 increase axial cancellous bone mass partially at the expense of peripheral cortical bone. In the present work the same hPTH 1-34 regime given for 12 months has been combined with oestrogen or nandrolone therapy to control peripheral bone resorption. Spinal and iliac cancellous (but not cortical) bone increased by 40%-50% above initial values while no perceptible changes occurred in radial cortical or cancellous bone. The evidence of radiokinetic and histomorphometric studies performed before and in the last months of treatment suggested that bone remodeling had proceeded through a transient anabolic phase with increased activation, but that activation had become normal after 11-12 months in the cancellous bone of the ilium whereas it continued to be raised elsewhere in the skeleton. It is concluded that in combination with oestrogens, hPTH peptides given daily injections hold great promise for the treatment of patients with osteoporosis who have already lost substantial amounts of spinal cancellous bone.

Topics: Absorptiometry, Photon; Bone and Bones; Bone Density; Calcium; Humans; Kinetics; Osteogenesis; Osteoporosis; Parathyroid Hormone; Peptide Fragments; Spinal Diseases; Strontium Radioisotopes; Teriparatide; Tomography, X-Ray Computed

In 20 untreated patients with idiopathic or postmenopausal osteoporosis, kinetic studies of skeletal blood flow (using 18F) and bone turnover (using 85Sr) were combined with dynamic histomorphometry performed on transiliac biopsies taken within 6 weeks of each other. In 8 patients the combined studies were repeated after treatment. A further 5 patients were studied only while receiving treatment. As expected, skeletal blood flow measured by 18F correlated with an index of 85Sr uptake into the exchangeable pools of bone. Additionally and independently, skeletal blood flow correlated with an index of the work rate of the osteoblasts in each multicellular unit of bone (the corrected apposition rate of Parfitt). These correlations were statistically significant in both the untreated patients (P less than 0.05) and the whole group (P less than 0.001). Further indices related to bone turnover at the level of the skeleton as a whole were significantly associated with skeletal blood flow only in the combined group.

Topics: Aged; Bone and Bones; Bone Development; Calcium; Female; Humans; Ilium; Male; Middle Aged; Osteoporosis; Regional Blood Flow; Strontium; Strontium Radioisotopes

Bone formation and resorption have been measured in patients with idiopathic osteoporosis by histomorphometry of 7.5-mm trephine biopsies and in the whole body by 85Sr radiotracer methodology and calcium balances. The studies were synchronized and most were preceded by double in vivo tetracycline labeling. Correlations between histological and kinetic bone formation indices were better when better when based on the extent of double tetracycline labels than on measurements of osteoid by visible light microscopy. Correction of the kinetic data for long-term exchange, using 5 months' serial whole body counting of retained 85Sr, improved the fit of the kinetic to the histological data. A statistical analysis of the measurement uncertainties showed that the residual scatter in the best correlations (between exchange-corrected bone formation rates and double-labeled osteoid surface indices) could be attributed to measurement imprecision alone. The exchange-corrected resorption rate correlated fairly well with iliac trabecular resorption surfaces, and using a volume referent rather than a surface referent for the histological index improved the statistical fit when patients with therapeutically accelerated bone turnover were included. A much better correlation was obtained by including osteoid volume acting as an independent predictor of bone resorption in a bivariate regression with a resorption surface index. The residual errors could then be accounted for by known measurement uncertainties. Whereas osteoid taking a double label closely predicted the kinetic rate of bone formation, further analysis suggested that osteoid that took no label or a single label was more closely related to bone resorption, presumably as a secondary result of the coupling of bone formation to bone resorption. The idea that continued bone loss in some patients is associated with defective osteoblastic bone formation is supported by the low rates found in some patients by both techniques. Heuristically these studies validate both in vivo tetracycline labeling for dynamic histomorphometry and corrections for long-term exchange in kinetic studies of bone formation, providing a quantitative framework for the design and analysis of future studies of bone remodeling in the osteoporoses.

Topics: Adult; Aged; Bone Development; Bone Resorption; Female; Humans; Male; Middle Aged; Osteoporosis; Strontium Radioisotopes; Tetracycline

In 37 female patients with primary osteoporosis, urinary hydroxyproline excretion, determined in 18 24-h consecutive complete urine collections was compared with two radioisotopic measurements of bone resorption rate measured simultaneously using 85Sr. A somewhat better fit was obtained when the kinetically determined bone resorption rate was corrected for long-term exchange processes within bone. Regression analysis showed that the intercept of the regression of hydroxyproline excretion on resorption rate, corrected or uncorrected for exchange, was significantly higher than zero at about 100 mumol/day. This is consistent with a substantial fraction of urinary hydroxyproline arising from non-bony sources. Fifteen paired studies were analysed and the results suggested that intra-individual variability in these relationships (when studies were separated by a year or more) were similar to inter-individual variability. We calculated the precision with which an estimate of bone resorption could be determined based on the calculated regressions. As a means of non-invasive quantitation of whole body bone resorption rate, the excretion rate of hydroxyproline, measured over 5 days, for example, appeared competitive with isotopic methods making no correction for exchange and relatively little worse than our exchange corrected method.

Topics: Aged; Bone Resorption; Calcium; Creatinine; Female; Humans; Hydroxyproline; Kinetics; Middle Aged; Osteoporosis; Regression Analysis; Strontium Radioisotopes

The ration of late to early uptake of several radionuclides was examined as a method for distinguishing states of abnormal bone metabolism. Nutritional osteoporosis (secondary hyperparathyroidism) and osteomalacia were produced in young rats and compared to a control group. The ratio of early (3-6 hrs.) to late (4-6 days) uptake of barium-131, nitrate, indium-111 EDTMP, and lead-203 were studied, as was that of strontium-85 chloride, a calcium analogue. Ratios of late to early uptake were found to distinguish osteomalacia from osteoporosis in the models when strontium-85 or barium-131 were used. Barium-131 may be a clinically useful alternative to strontium-85 in the evaluation of metabolic bone disease due to its shorter half-life and lower radiation dose.

Topics: Animals; Barium; Diagnosis, Differential; Indium; Lead; Osteomalacia; Osteoporosis; Radiation Dosage; Radioisotopes; Radionuclide Imaging; Rats; Strontium Radioisotopes; Tetracycline; Time Factors

1. Evidence has accumulated that the rate of accretion (A) of calcium to bone is the sum of two fluxes; apposition involving the laying down of new bone and augmentation which is the result of slow exchange of non-surface bone calcium with plasma calcium pools as the result of solid state diffusion. 2. A method has been devised for separating A into its two components. It requires the use of 45Ca or, for clinical studies, 85Sr as a calcium tracer. Studies which are initiated with a combined accretion rate--calcium balance study, are concluded with an estimate of the exponent of the power function which has been found to describe the whole body retention of tracer from the second month onward. 3. The impulse response function of the skeleton for the tracer is then calculated, making the assumption that in any uniform volume of bone, osteoclastic resorption is a first order process. Making in addition certain simplifying assumptions, which are shown to have a modest influence on the final results, a mean rate of bone resorption can be calculated using a development of the well known Stewart-Hamilton formula. The apposition rate is calculated as the sum of the resorption rate and the calcium balance. Augmentation and diminution, defined as equal and opposite exchange processes, are given by the difference between A and the apposition rate. 4. The results of our first thirteen studies in normal subjects and patients with metabolic bone disease are presented, together with analyses of some data from the literature. It is concluded that the development of an atraumatic method for measuring rates of bone formation and resorption in the whole body would be an important advance in the study of metabolic bone disease, and this work is presented so that critical comparisons may be initiated between this tracer method and independent histological methods for measuring these parameters.

Topics: Bone and Bones; Bone Diseases; Bone Resorption; Calcification, Physiologic; Calcium; Calcium Radioisotopes; Female; Humans; Kinetics; Male; Mathematics; Models, Biological; Osteoporosis; Strontium Radioisotopes

The left front legs of two beagle dogs were immobilized for 2 months; the right front legs of each were used as weight-bearing controls. Bone mineral replacement after immobilization was studied by giving intravenous injections of 85Sr. (Stroutium-85). After allowing the radioisotope to disappear from the soft tissues, measurements were made on only that remaining in the bone. The 85Sr uptake in the bone of the leg which had been immobilized was up to 400% higher than that in the control leg. This increased 85Sr uptake probably resulted from only a few percent loss in bone mineral during immobilization and suggests that losses of less than 1% can be detected and located. The sensitivity, simplicity and minimal radiation dose associated with this technique indicates potential application for use in human bedrest and space-flight studies.

Topics: Animals; Bone and Bones; Calcification, Physiologic; Calcium; Dogs; Immobilization; Minerals; Osteoporosis; Radionuclide Imaging; Space Flight; Strontium; Strontium Radioisotopes; Technetium; Weightlessness

1. A new method for calculating the accretion rate (A) of bone calcium is proposed, based on an impulse analysis of 47Ca data. The method is free of most of the assumptions inherent in previous methods of analysis and appears to give more accurate estimates. 2. In fourteen normal subjects and twelve patients with metabolic bone disease, measurements of A by the new method gave very similar results to the mineralization rate calculated by the method of Burkinshaw et al. (1969). Analysis of twelve studies performed by Neer et al. (1967) gave good agreement with their five compartment model. A close relation between A and Marshall's (1964) A5 was observed, but the latter gave systematically higher results. 3. In sixteen studies both 47Ca and 85Sr were injected simultaneously. Although there were no systematic differences between the values of A for the two tracers, the differences between individual values were greater than the known experimental errors.

Topics: Adult; Aged; Bone and Bones; Calcification, Physiologic; Calcium; Female; Humans; Male; Middle Aged; Models, Biological; Monte Carlo Method; Osteoporosis; Strontium; Strontium Radioisotopes

Topics: Americium; Arthritis, Rheumatoid; Bone and Bones; Bone Diseases; Bone Neoplasms; Calcium Radioisotopes; Fluorine; Humans; Iodine Radioisotopes; Osteitis Deformans; Osteomalacia; Osteoporosis; Radioisotopes; Radionuclide Imaging; Spondylitis, Ankylosing; Strontium Radioisotopes; Technetium

Topics: Acrylic Resins; Animals; Arthroplasty; Bone Cements; Carcinogens; Elbow; Gentamicins; Hemophilia A; Humans; Infections; Joint Diseases; Joint Prosthesis; Knee; Male; Metals; Osteoporosis; Plastics; Polyethylenes; Strontium Radioisotopes

Topics: Adult; Follow-Up Studies; Fractures, Bone; Humans; Methods; Middle Aged; Osteoporosis; Radiography; Strontium Radioisotopes; Talus; Time Factors; Wound Healing

Topics: Aged; Female; Humans; Immunoglobulin A; Immunoglobulin G; Male; Middle Aged; Multiple Myeloma; Myeloma Proteins; Osteoporosis; Pain; Radiography; Skull; Spine; Strontium Radioisotopes

Topics: Bone Neoplasms; Breast Neoplasms; Feces; Female; Hodgkin Disease; Humans; Injections, Intravenous; Kinetics; Male; Neoplasm Metastasis; Osteolysis; Osteoporosis; Prostatic Neoplasms; Radionuclide Imaging; Spinal Neoplasms; Strontium; Strontium Radioisotopes; Time Factors

Topics: Acetabulum; Bone Neoplasms; Breast Neoplasms; Diagnosis, Differential; False Negative Reactions; Femoral Neoplasms; Half-Life; Humans; Lung Neoplasms; Neoplasm Metastasis; Osteoporosis; Pelvic Neoplasms; Posture; Pubic Bone; Radiography; Radionuclide Imaging; Ribs; Spinal Neoplasms; Strontium Radioisotopes

Topics: Aged; Bone and Bones; Bone Diseases; Calcium; Calcium Radioisotopes; Female; Fluorine; Gallium; Humans; Intestinal Absorption; Magnesium; Osteoporosis; Radioisotopes; Radionuclide Imaging; Strontium Radioisotopes; Technetium