Rate of feed passage in Japanese quail.

The rate of passage (ROP) in the gastrointestinal tract (GIT) influences the exposure time of food to the digestion and absorption processes. Consequently, ROP affects the efficiency of nutrient utilization and energy from the diet. This study aimed to determine the physiological parameters that characterize the digestive response, such as first appearance time (FAT), ROP, mean retention time (MRT) and transit time (TT) in adult Japanese quail (Coturnix coturnix japonica), and to evaluate the effects of sex, apparent metabolizable energy corrected for nitrogen balance (AMEn) content in the diet and different types of markers on these parameters. In the first trial, we investigated the effects of sex and AMEn level (high- and low-energy diet) on the FAT parameter. Thirty-two male and 32 female Japanese quail were randomly allocated to 8 battery cages and assigned to 4 treatments in a 2 × 2 factorial design with 4 replicates of 4 birds for each treatment. To determine the FAT, ferric oxide (1%) was added to the diet, and the excreta of the quail was monitored until the first appearance of the marker. The results indicated significant differences (P < 0.05) in the FAT between males (100 min) and females (56 min), regardless of the AMEn content. In the second trial, thirty-two 32-week-old female Japanese quail in the laying phase were assigned to four treatments in a 2 × 2 factorial design, in which the main independent variables were type of marker (Cr or Ti) and AMEn level (high- and low-energy diets). In order to determine ROP (ET1%), MRT and TT (ET100%), the markers (0.5%: Cr2O3 and 0.5%: TiO2) were added to the diets, and the excreta were collected for 750 min. The excretion times for 1% (ET1%), 25% (ET25%), 50% (ET50%), 75% (ET75%) and 100% (ET100%) were estimated using cumulative excretion curves. No effect was detected for the AMEn level (P > 0.05); however, the effect of different marker types was significant (P < 0.05). This difference increased with time and ET100% was estimated to occur at 59 min. The ROP was estimated to be 68 min. The TT was estimated to be 540 min using Cr and 599 min using Ti, with an average MRT value of 0930 h. Taken together, our findings support the hypothesis that Japanese quail digestion through the GIT can be dynamic and differ based on sex or marker type.

Genetic growth potential characterization in the Japanese quail: a meta-analysis.

The description of the growth of the Japanese quails is necessary to characterize the genetic potential of these birds raised in different countries. Thus, the aim of this study was to describe the genetic potential of Japanese quails by conducting a meta-analysis considering studies conducted in different countries. Only data about the subspecies Coturnix coturnix japonica were considered; studies regarding Coturnix coturnix coturnix were not examined. The criteria investigated were BW (W), age (t), year of publication and location of the study. Each set of genetic material within a publication was coded as one study. The Gompertz function was used to interpret the growth of laying quails; thus, each study was represented by Gompertz parameters. The W and t data were applied to estimate the values of Gompertz growth parameters, including BW at maturity (Wm), BW at birth (Wi), maturity rate (B) and inflection point (IP). The age at which the maximum growth rate was achieved (t*) was calculated considering the parameters Wm, Wi and B. To estimate these parameters, random regression was used to randomize the parameter Wm. The parameters estimated for each assay were used in exploratory, grouping, and principal component analyses. The values of Wi ranged from 4.1 to 11.6 g. The values of B ranged from 0.0393 to 0.1039/day, and consequently, the values of t* and IP ranged from 14 to 31 days and 9.21 to 31.03 g, respectively. These results show that there is considerable variability in the growth potential of Japanese quails. To better understand this variation, two groups were examined: Brazil and other countries, according to the grouping of Wi, Wm, B and t*; parameter B was the variable that presented the highest specificity, indicating that both groups modified the maturity rate. For the principal component analysis, the year of publication showed a relationship with the growth parameters but only for studies performed in Brazil. For studies carried out in other countries, the changes in growth parameters were not related to the year of publication. In Brazilian studies, there was a decrease in the maturity rate, but the weight at maturity was higher. Therefore, it appears that different strategies of genetic selection were adopted in Brazil compared to other countries.

Metabolisable energy partition for Japanese quails.

Knowing how energy intake is partitioned between maintenance, growth and egg production (EP) of birds makes it possible to structure models and recommend energy intakes based on differences in the BW, weight gain (WG) and EP on commercial quail farms. This research was a dose-response study to re-evaluate the energy partition for Japanese quails in the EP phase, based on the dilution technique to modify the retained energy (RE) of the birds. A total of 300 VICAMI® Japanese quail, housed in climatic chambers, were used from 16 weeks of age, with averages for BW of 185 g and EP of 78%, for 10 weeks. To modify the RE in the bird's body, a qualitative dilution of dietary energy was used. Ten treatments (metabolisable energy levels) were distributed in completely randomised units, with six replicates of five quails per experimental unit. Metabolisable energy intake (MEI), egg mass (EM) and RE were expressed in kJ/kg0.67. The utilisation efficiency (kt) was estimated from the relationship between RE and MEI. The metabolisable energy for maintenance was given by RE = 0. The net energy requirement for WG was obtained from the relationship between RE in the BW as a function of the BW. The utilisation efficiency for EP (ko) was obtained from the relationship between EM and RE corrected MEI for maintenance and WG. Based on these efficiencies, the requirements for WG and EM were calculated. The energy intake by Japanese quails was partitioned according to the model: MEI = 569.8 × BW0.67 + 22 × WG + 13 × EM. The current study provides procedures and methods designed for quails as well as a simple and flexible model that can be quickly adopted by technicians and poultry companies.

Weight gain responses of laying-type pullets to methionine plus cystine intake.

Each individual in the population has a distinct maximum growth potential, and the growth curve may vary depending on the response to nutrient intake, growth phase and variability among animals. The present study aimed to (1) model weight gain (WG) response to methionine+cystine (Met+Cys) supply using different mathematical functions, (2) identify functions that better fit the growth responses of pullets, (3) determine the Met+Cys requirements that maximize WG based on breeding standards and (4) partition the Met+Cys requirements for WG and maintenance. Three trials were performed using 1448 laying-type pullets. We adopted a completely randomized design with eight treatments and six replicates. The first trial (2 to 6 weeks, P1) used 15 pullets per experimental unit. The second and third trials (8 to 12 weeks, P2; 14 to 18 weeks, P3) were used eight pullets per replicate. The Met+Cys levels were obtained using a dilution technique. The mathematical functions used to describe WG responses to Met+Cys intake were broken line, broken line with curvilinear ascendancy, Michaelis-Menten, saturation kinetics and three logistic and three exponential models. Models were selected using the Bayesian information criterion and evaluated by residual analysis. It was possible to model the responses using the studied functions. The best functions were obtained by logistic and sigmoidal models in P1 and P2, and with the broken line by the curvilinear ascendancy model in P3. The Met+Cys intake that determined the maximum potential for WG (WGmax) in P1, P2 and P3 were 313, 381 and 318 mg/day, respectively. The Met+Cys requirements for WG were 20, 22 and 27 mg/g, and for maintenance were 214, 53 and 30 mg/kgBW0.75 for P1, P2 and P3, respectively.

Estimate of choline nutritional requirements for chicks from 1 to 21 days of age.

Choline is an essential nutrient in poultry diets because it performs various important metabolic functions. The objective of this study was to re-evaluate the choline requirements of male broiler chickens from 1 to 21 days of age at two levels of methionine. Two assays using 2,160 Cobb® chickens (1,080 in each assay) were conducted. The study design was completely randomized and consisted of six treatments and six replicates, with 30 animals per experimental unit. The semipurified basal diet was formulated with corn, soya bean meal, soya protein concentrate, starch and sugar, providing 390 mg/kg choline and 0.593% digestible methionine (requirement level) in Assay 1 and a reduction of about one-quarter in the requirement level of digestible methionine (0.440%) in Assay 2. Choline chloride (62.5%) was added by a supplementation technique to both basal diets to compose crescent levels of choline supplementation (715, 1,040, 1,365, 1,690 and 2,015 mg/kg). The weight gain responses were fitted using quadratic polynomial (QP) and broken-line (BL) models. The ideal intake of choline (mg/bird.day) was estimated from the first intercept of the QP with the BL plateau (BL + QP). The results showed that the diet with the 25% reduction in digestible methionine limited the maximum weight gain by approximately 10%. The choline requirements of broilers from 1 to 7, 1 to 14 and 1 to 21 days of age were 27,013, 44,458 and 62,535 mg/bird.day, respectively, for the requirement level of digestible methionine and 26,796, 41,820 and 56,578 mg/bird.day for the broilers receiving the diet with the 25% reduction in digestible methionine.

Optimal in-feed amino acid ratio for broiler breeder hens based on deletion studies.

An ideal amino acid ratio (IAAR) for breeder hens is needed for maximum nitrogen retention (NR) taking into account nitrogen deposition in body (NDB ), feathers (NDF ) and egg mass (NEM) to improve dietary protein efficiency. Thus, the aim of this study was to apply the deletion method to derive the IAAR for broiler breeder hens. The nitrogen balance trials were performed from 31 to 35 weeks and from 46 to 50 weeks. Twelve treatments with eight replicates and one hen per cage were used. A balanced diet (BD) was formulated to meet the requirement of all nutrients. The other diets were formulated diluting 55% of BD with corn starch and refilled with amino acids (AAs) and other ingredients, except the AA tested. Each trial lasted 25 days. Feather losses, egg production and egg weight were recorded daily, and the samples were stored to further determine NEM and nitrogen in feather losses (NDFL ). At the start and the end of each period, a group of birds were slaughtered to further determine NDB and NDF . The NR was calculated as the sum of NDB , NDF , NDFL , NEM and the nitrogen maintenance requirement (NMR). The deletion of valine greatly depressed the NR in peak production (31 to 35 weeks) while the deletion of the isoleucine greatly depressed the NR of the hens from 46 to 50 weeks of age. The percentual reduction in NR and the per cent of the AA to delete from the BD were used to calculate the AA requirement. The average IAAR was Lys 100, Met+Cys 86, Trp 23, Thr 80, Arg 113, Val 90, Ile 91, Leu 133, Phe+Tyr 108, Gly+Ser 94 and His 35. The IAAR was in line with the recommendation from the literature, validating deletion method with the advantages from a rapid and low-cost procedure.

Maintenance valine, isoleucine, and tryptophan requirements for poultry.

Poultry maintenance requirements for valine, isoleucine, and tryptophan were measured by nitrogen balance using different unit systems. The nitrogen balance trial lasted 5 d with 48 h of fasting (with roosters receiving only water+sucrose) and the last 72 h for feeding and excreta collection. Forty grams of each diet first-limiting in valine, isoleucine, or tryptophan was fed by tube each day (3 d) to give a range of intakes from 0 to 101, 0 to 119, and 0 to 34 mg/kg BW d of valine, isoleucine, and tryptophan, respectively. A nitrogen-free diet containing energy, vitamins, and minerals, meeting the rooster requirements, was offered ad libitum during these three d. To confirm that the amino acids studied were limiting, a treatment was added with a control diet formulated by adding 0.24 g/kg of L-valine, 0.21 g/kg of L-isoleucine, and 0.10 g/kg of L-tryptophan to the diets with lower amino acid level. Excreta were collected during the last 3 d of the balance period and the nitrogen content of the excreta was analyzed. For each amino acid, a linear regression between nitrogen retention (NR) and amino acid intake was performed. The equations from linear regression were: NR=-98.6 (±10.1)+2.4 (±0.2)×Val, NR=-46.9 (±7.1)+2.3 (±0.1)×Ile, NR=-39.5 (±7.7)+7.3 (±0.4)×Trp; where Val, Ile, and Trp are the intakes of valine, isoleucine, and tryptophan in mg/kg body weight per d, respectively. The valine, isoleucine, and tryptophan required to maintain the body at zero NR were calculated to be 41, 20, and 5 mg/kg body weight per d, respectively. For the system unit mg per kg of metabolic weight, the intake of valine, isoleucine, and tryptophan was 59, 32, and 9, respectively. Considering the degree of maturity of the animal and body protein content (BPm (0.73)×u), the amounts of valine, isoleucine, and tryptophan required for maintenance were calculated to be 247, 134, and 37 mg per unit of maintenance protein (BPm (0.73)×u) per d. Maintenance requirement is more adequately expressed as body protein content.

Establishing an essential amino acid profile for maintenance in poultry using deletion method.

This study aimed to estimate the essential amino acid profile and the ideal ratio for the maintenance of poultry by deletion method. A nitrogen balance (NB) trial was conducted using 198 adult roosters, housed individually in metabolic cages. The treatments were 33 purified diets being 11 diets with an amino acid mixture providing high protein intake of 500 mg N/BWkg (0.75) per day, 11 diets providing medium protein intake of 250 mg N/BWkg (0.75) per day (in each diet, one amino acid tested was diluted 50%) and 11 diets providing low protein intake of 125 mg N/BWkg (0.75) per day (made by omitting the amino acid tested). Each treatment had six replicates. After 48 h of fasting receiving water plus sucrose, the roosters were fed 40 g of the diets by tube once a day for 3 days. The excreta were collected within 72 h after the first feeding. The diets and excreta were analysed for nitrogen content. For each amino acid studied, a linear regression was fitted by NB and amino acid intake (AAI). The maintenance requirements were estimated as the AAI to maintain the NB equal to zero. The daily amino acid requirements for maintenance were estimated to be Lys 11, Met 29, Thr 23, Trp 5, Arg 50, Val 29, His 6, Gly 54, Phe 49, Leu 78 and Ile 21 mg/BWkg (0.75) per day. Therefore, the amino acid ratio for maintenance was concluded to be Lys 100, Met 276, Thr 220, Trp 48, Arg 467, Val 275, His 60, Gly 511, Phe 467, Leu 735 and Ile 198% independent of the scale. The essential amino acid profile and the ideal ratio for the maintenance of poultry estimated in this study contributed to improve the factorial model for estimating essential amino acid requirements for poultry.

Effects of immunosuppressive drugs on gastrointestinal transit of rats: effects of tacrolimus, cyclosporine, and prednisone.

Triple immunosuppressive therapy after organ transplantation may cause several gastrointestinal disturbances. It is difficult to identify which drug causes more complications, requiring an appropriate animal model. The aim was to compare the gastrointestinal transit in immunosuppressed rats under triple immunosuppressive therapy. Male rats were immunosuppressed by gavage during 14 days with tacrolimus (n = 10), cyclosporine (n = 12), and prednisone (n = 9). Animals received a magnetic pellet before (control) and after treatment that was monitored at predetermined intervals by AC biosusceptometry, a noninvasive and radiation-free technique. The following parameters were measured: creatinine serum, mean time of gastric emptying (MGET), mean time to reach cecum (MCAT), and mean transit time through small bowel (MSBTT). The differences were analyzed by ANOVA (Tukey). Our results showed that MGET of animals treated with prednisone, cyclosporine, and tacrolimus were reduced compared with control subjects (P < .03, P < .009, and P < .002, respectively). There was no difference in MCAT, whereas MSBTT was longer for tacrolimus and prednisone compared with control subjects (P < .004 and P < .004, respectively). Also, prednisone and tacrolimus presented a reduced MGET (P < .05 and P < .01, respectively) compared with cyclosporine. Our data showed a low serum creatinine level and no difference among groups regarding renal function. In summary, cyclosporine has less effect on the gastrointestinal transit; however, all of these drugs should be carefully prescribed to prevent gastrointestinal symptoms and improve quality of life after transplantation.

Identification of descendants of an extinct bovine population from the Algarve region of Portugal using numerical taxonomy analysis of morphological traits.

The morphology of a sample of four bulls and 43 cows, presumed to be descendants of the extinct cattle breed 'Algarvia' (AG), was used to assign their relationship with animals from other Portuguese autochthonous breeds - Arouquesa (AR), Barrosã (BA), Cachena (CA), Marinhoa (MA), Maronesa (MO), Minhota (MN), Mirandesa (MI), (only bulls), Alentejana (AL), Garvonesa (GA), Mertolenga (ME) and Preta (PR). Standard numerical taxonomic methods were applied to a set of 183 (cows) and 170 (bulls) traits, to derive average pairwise taxonomic distances among the sample of 257 cows and 76 bulls. Distance coefficients (morphological index of distance) ranged from 0.22 to 2.62 (cows) and from 0.49 to 2.13 (bulls). Unweighted pair group method using arithmetic averages (UPGMA)-based phenograms and a principal coordinate analysis showed that bulls were highly clustered and cows showed a tendency to cluster according to their geographical and breed origin. The AG population grouped together with GA, AL, ME and MN breeds in the Red Convex group. The average taxonomic distance among breeds was 1.02, the highest being 1.39 (ME versus BA) and the lowest being 0.64 (MA versus AR). The approach allowed for the identification of a phenotypically differentiated set of animals, comprising 19 cows and four bulls representative of the AG breed, and which can be targeted in further studies aiming at the recovery of this extinct breed.

Infrahepatic terminolateral cavocavostomy: a case report.

Infrahepatic vena cavocavostomy has been reported to be a rescue therapy when venous outflow from a liver allograft is obstructed due to stenosis of a piggyback anastomosis. The authors have described herein two consecutive adult liver transplantations using this technique as the primary venous anastomosis. Using a caval clamp positioned above the retrohepatic portion, partial hemodynamic obstruction of caval flow was well tolerated, avoiding use of a venovenous bypass. Although additional studies regarding this technique are needed, we believe that an infrahepatic vena cavocavostomy should be considered to be an alternative technique in carefully selected cases.

A low-cost fermentation medium for thermophilic protease production by Streptomyces sp. 594 using feather meal and corn steep liquor.

Protease production by Streptomyces sp. 594 was obtained after submerged fermentation (SF) and solid-state fermentation (SSF) using feather meal (FM) and corn steep liquor (CSL) as sole sources of carbon and nitrogen. Enzyme productions were 13.4 U ml(-1) in SF and 21.5 U g(-1) in SSF; these values were approximately 86% and 39% higher, respectively, than those obtained previously when yeast extract was used in place of CSL. The proteases, which belong to the serine and metalloproteinase classes, were active at high temperatures (55 degrees C to 90 degrees C) and over a wide range of pH values (5.0 to 10.0). Thus, these thermophilic proteases have shown interesting properties for industrial purposes. As far as we are concerned, this is the first contribution toward the microbial production of thermophilic proteases by a streptomycete using a low-cost medium composed of industrial poultry (FM) and corn processing by-products (CSL).

Thermophilic protease production by Streptomyces sp. 594 in submerged and solid-state fermentations using feather meal.

AIMS: Protease production by Streptomyces sp. 594 in submerged (SF) and solid-state fermentation (SSF) using feather meal, an industrial poultry residue, and partial characterization of the crude enzyme. METHODS AND RESULTS: Streptomyces sp. 594 produced proteases in SF (7.2 +/- 0.2 U ml(-1)) and SSF (15.5 +/- 0.41 U g(-1)), with pH increase in both media. Considering protease activity, values obtained in the liquid extract after SSF (6.3 +/- 0.17 U ml(-1)) were lower than those from SF. The proteases, which belong to serine and metalloproteinase classes, were active over a wide range of pH (5.0-10.0) and high temperatures (55-80 degrees C). Strain 594 was also able to degrade feather in agar and liquid media. Keratinase activity (80 U l(-1)) also confirmed the keratin degrading capacity of this streptomycete. CONCLUSIONS: Proteases produced using residues from poultry industry have shown interesting properties for industrial purposes. SIGNIFICANCE AND IMPACT OF THE STUDY: As far as we are concerned, this is the first contribution towards the production of thermophilic protease by a streptomycete in SSF using a keratinous waste.

Elemental anomalies in hair as indicators of endocrinologic pathologies and deficiencies in calcium and bone metabolism.

Analytical results obtained by ICP-MS of hair samples from a group of women from Rio de Janeiro city show that abnormal Ca and P concentrations in this compartment can be an indication of pathologies affecting the metabolism of these elements. The study was conducted initially on 900 women (outpatients, >40 years). From this group, approx. 24% showed anomalously high or low Ca concentrations in hair, in some cases correlated to anomalies of other elements. In 144 cases (16%), very high concentrations of Ca (up to 8,285 mg/kg) were measured, frequently correlated with a high concentration of P (up to 4,720 mg/kg), exceeding by far the reference intervals for this age/sex group. Follow-up studies of a few individuals from this group gave first indications that their abnormal hair compositions were related to endocrinologic pathologies affecting calcium/bone metabolism. Very low hair Ca-concentrations were observed in older women (72 cases, age >60 years) and related to senile osteoporosis. Complementary investigations of patients with recognized endocrinologic pathologies (hyperthyroidism, hyper- and hypoparathyroidism) and osteomalacia gave statistical support for the hypothesis that hair concentrations of Ca, P and various other trace elements are influenced characteristically by these diseases. In patients with hyperparathyroidism and hyperthyroidism, both elements showed significant increase in hair, whereas patients with rickets/osteomalacia had only elevated Ca concentrations, together with suspiciously high toxic levels of Cd and various other elements (Fe, Mn, Mg, Sr, Ba). Patients with hypoparathyroidism had significantly decreased Ca and P concentrations in hair. Statistical evaluation of these data by multivariant analysis (MANOVA) using a contrast matrix and by discriminant analysis showed that elemental hair anomalies can be used to diagnose correctly the above-mentioned pathologies, demonstrating the usefulness of hair analysis as a complementary tool for the detection of disturbances in calcium/bone metabolism.

[Non-adherence to tuberculosis treatment: a study on perceptions and knowledge of the disease and evaluation of health services from the patient perspective]. / Estudo de casos sobre abandono do tratamento da tuberculose: avaliação do atendimento, percepção e conhecimentos sobre a doença na perspectiva dos clientes (Fortaleza, Ceará, Brasil).

This research was developed in 1995-1996 in the Oliveira Pombo Health Center (CSOP), Fortaleza, Ceará, Brazil. The aim was to explore factors influencing non-adherence to tuberculosis treatment. Specific objectives were: dynamics of tuberculosis notification and treatment of non-adherence cases at the CSOP; demographic, social, economic, and cultural profiles of clientele (social actors); default reasons that interrupt treatment; and knowledge and perception of the disease. The methodological approach was based on descriptive epidemiology and on sociological interpretivism. A semi-structured interview was used for questions related to the social actors, such as: demographic, social, economic, cultural, and behavioral factors; knowledge and perceptions of tuberculosis and treatment; impact of the disease on patients' lives; and perspectives concerning health service attendance. Results show that treatment non-compliance involved multiple and complex interrelated factors.

Tratamento da osteoartrite erosiva pelo fosfato de cloroquina / Treatment of erosive osteoarthritis with phosphate of cloroquine

Os autores apresentam uma avaliação terapeutica em 25 pacientes com diagnóstico clínico e radiológico de osteoartrite erosiva (OEA), nos quais foi utilizado o fosfato de cloroquina, na dose de 150mg/dia, por um período de 12 meses. O tratamento foi considerado eficaz em 21 pacientes (84por cento), com boa tolerabilidade medicamentosa

Changes in renal hemodynamics and tubular function of surgically cured primary hyperparathyroid patients are probably due to chronic hypercalcemic nephropathy.

To understand the mechanisms responsible for the persistent hypercalciuria and reduced glomerular filtration rate (GFR) previously found in 6 of 10 patients surgically cured of primary hyperparathyroidism (PHPx), the tubular handling of lithium, sodium, calcium, and phosphate as well as the renal hemodynamics were evaluated in these 10 PHPx patients, in 10 control subjects, and in 5 patients with renal hypercalciuria (RH), during fasting and after an oral calcium load. A positive correlation between the fractional excretions of calcium and sodium was found in all groups, but the PHPx patients excreted more calcium for the same amount of sodium than control subjects. The fractional proximal sodium reabsorption (FPRNa), distal delivery, and fractional phosphate reabsorption were similar in all groups; a significant positive correlation was found between the fractional calcium reabsorption and the FPRNa, indicating that proximal tubular function was preserved and that the urinary calcium losses in RH and in the hypercalciuric PHPx patients (h-PHPx) occurred in the distal nephron. However, only h-PHPx patients had reduced renal plasma flow, renal blood flow, and GFR, as well as a high renal vascular resistance, which was even more evident after the calcium challenge. These findings lead us to conclude that RH and h-PHPx patients are very different, as far as kidney dysfunction is concerned, and that a hypercalcemic nephropathy is the most probable cause of the alterations in distal calcium reabsorption and renal hemodynamics found in the h-PHPx patients.

The cause of maintained hypercalciuria after the surgical cure of primary hyperparathyroidism is a defect in renal calcium reabsorption.

The hypercalciuria that eventually remains after the successful removal of a solitary parathyroid adenoma may originate from excessive intestinal calcium absorption, bone resorption or deficient renal reabsorption. In order to clarify this question, ten patients surgically cured from primary hyperparathyroidism (PHPx), ten age-matched normal subjects and five nephrolithiasic patients with renal hypercalciuria (RH) were studied after five days on a low calcium diet, either during fasting or after oral calcium load. Fasting serum calcium, amino-terminal and intact PTH levels and also urinary cAMP excretion were normal in every individual patient. Serum ionized calcium and inulin clearance (GFR) were used for calculations of the filtered load (FL Ca) and the fractional excretion of calcium (FE Ca). Six PHPx patients displayed fasting calciuria above the upper limit calculated for control subjects, despite having the lowest GFR and FL Ca (p < 0.05 vs control). These patients (h-PHPx) had a small calciuric response to oral calcium load. Serum 1,25-(OH)2D3 and 25OHD3 did not correlate with calciuria. Our findings exclude intestinal hyperabsorption and excessive bone resorption in h-PHPx patients, and strongly suggest a renal tubular defect in calcium reabsorption as the cause of their hypercalciuria. This defect could be primary, as in RH, but only three hPHPx patients had recurrent kidney stones before surgery. On the other hand, as a negative correlation between GFR and FE Ca was only found in PHPx patients, it seems probable that the disturbances in glomerular and tubular functions were secondary to the long standing hypercalcemic hyperparathyroidism.