The impact of a senior dancing program on spinal and peripheral bone mass.

Because activity and regular exercise are important factors to maintain general good health in senior citizens, we investigated whether senior dancing has any effect on peripheral or lumbar bone density. We performed a prospective study over a12-mo period on bone density at a spinal and peripheral measuring site in 28 female senior members (mean age: 67 +/- 2 yr) of a dancing group in Vienna. Lumbar bone mineral density was assessed by quantitative computed tomography (qCT) and radial bone density by single photon absorptiometry of the distal forearm. The mean training time per week was 3.2 +/- 0.8 h. In the entire group of female dancers, no significant effects of dancing on radial or lumbar bone density could be observed. Linear regression analysis showed that the lower the qCT at the beginning of the observation period, the higher was the percentage increase of spinal qCT in the entire group during 12 mo of dancing (r = 0.52, P < 0.0001). For additional evaluation, females were divided into two subgroups, osteoporotic or nonosteoporotic, based on x-rays and lumbar bone mineral density (BMD) as measured by qCT. The group classified as dancers with osteoporosis (group I) showed a significant increase in lumbar bone density, whereas in the group of dancers without signs of osteoporosis (group II), BMD remained unchanged. Additionally, radial bone density did not show any changes in either group. Group I showed a significant correlation between basal spinal BMD and the percentage change of BMD during the observation period (r = 0.7, P < 0.001). Changes of the biochemical parameters were observed in the bone-specific isoenzyme of alkaline phosphatase, a marker of osteoblastic activity, in group I giving additional evidence of increased bone formation.

Hepatic artery embolotherapy of hepatic metastases from carcinoid tumors: value of using a mixture of cyanoacrylate and ethiodized oil.

OBJECTIVE: Transcatheter embolization of the hepatic arterial supply is a well-known palliative treatment of tumor deposits in the liver. We performed a prospective study to evaluate the use of a mixture of N-butyl-2-cyanoacrylate and ethiodized oil with which a permanent vascular occlusion can be obtained, as an embolizing agent for transcatheter hepatic artery embolization for treatment of carcinoid hepatic metastases. SUBJECTS AND METHODS: Six patients had clinical symptoms from hormonal release by carcinoid hepatic metastases as well as elevated levels of 5-hydroxyindole acetic acid (5-HIAA) in the urine. Unilobar sequential transcatheter embolization of both the hepatic artery and the segmental hepatic arteries of both lobes of the liver was performed with a mixture of N-butyl-2-cyanoacrylate and ethiodized oil. CT and CT arterial portography (CTAP) were done to assess hepatic metastases and were used to monitor follow-up. Each patient had three CTAP studies; the third CTAP, performed 3 months after complete arterial devascularization, was compared with the first CTAP to evaluate tumor size. CT studies were performed routinely every 3 months thereafter and were compared with the initial CT scan to evaluate further tumor regression or progression. Tumor decrease and biochemical and symptomatic response rates were defined according to World Health Organization criteria. All complications and side effects of the treatment were documented. RESULTS: All patients showed complete symptomatic relief after embolization. The previously elevated levels of 5-HIAA in the urine returned to normal in three patients and in the other three patients were reduced by a mean of 89% of preembolization values. A decrease in tumor size by more than 50% was demonstrable in one patient; in five patients, hepatic lesions decreased in size by 25-50%. No new sites of metastatic liver disease were demonstrable in any patient during follow-up. No deaths or serious complications were directly attributable to the embolization procedure. All patients are alive after 12, 17, 18, 19, 19, and 19 months (mean, 17.3 months), respectively, with permanent relief of symptoms so far. CONCLUSION: Transcatheter embolization of both the hepatic artery and the segmental hepatic arteries with a mixture of N-butyl-2-cyanoacrylate and ethiodized oil provided excellent palliation in patients with carcinoid hepatic metastases. Complete and long-lasting relief of symptoms, a significant decrease or normalization of levels of 5-HIAA in the urine, and a reduction of metastatic tumor in the liver seem most likely to be the effect of sustained ischemia obtained with this permanent embolizing agent.

[Evidence of fluoride-induced effects on the calcaneus by measurements of broadband ultrasound attenuation (BUA)]. / Hinweis auf fluoridinduzierte Effekte am Kalkaneus durch Messungen der Breitband-Ultraschallabschwächung (BUA).

We measured broadband ultrasound attenuation (BUA) of the calcaneus as well as radial (RBD) and spinal bone density (SBD) in normal and osteoporotic females (n = 188) both before treatment and after long-term fluoride therapy. RBD was measured using single photon absorptiometry of the non-dominant distal forearm (SPA) and spinal bone density (SBD) was assessed using quantitative CT (QCT). In untreated osteoporotic patients (n = 62), BUA as well as the other densitometric methods showed significantly lower values (p < 0.05) when compared to age matched controls (n = 75). Females with osteoporosis and long-term treatment with fluoride (n = 51) had both significantly higher BUA values and higher spinal bone density when compared to women with untreated osteoporosis. BUA and SBD were correlated in the entire group (r = 0.5, r < 0.0001) as well as in the subgroups of untreated (r = 0.48, p < 0.001) and fluoride-treated patients with osteoporosis (r = 0.4, p < 0.05). These results suggest that BUA provides further evidence of an osteogenic response to fluoride at peripheral weight-bearing skeletal sites such as the calcaneus.

Reduced vertebral bone density in hypercalciuric nephrolithiasis.

Dual-energy x-ray absorptiometry and single-photon absorptiometry were used to determine bone density at the lumbar spine and radial shaft in 62 patients with absorptive hypercalciuria, 27 patients with fasting hypercalciuria, and 31 nonhypercalciuric stone formers. Lumbar bone density was significantly lower in patients with absorptive (-10%) as well as in those with fasting hypercalciuria (-12%), with 74 and 92% of patients displaying values below the normal mean, whereas only 48% of the nonhypercalciuric stone formers had bone density values below the normal mean. In contrast, radial bone density was similar in all three groups of renal stone formers investigated. The comparison of urinary chemistry in patients with absorptive hypercalciuria and low normal bone density compared to those with high normal bone density showed a significantly increased 24 h urinary calcium excretion on random diet and a trend toward a higher 24 h urinary uric acid excretion and a higher body mass index in patients with low normal bone density. Moreover, among the patients with absorptive hypercalciuria we found a statistically significant correlation between the spinal bone density and the 24 h sodium and sulfate excretion and the urinary pH. These results gave evidence for an additional role of environmental factors (sodium and animal proteins) in the pathogenesis of bone loss in absorptive hypercalciuria. In conclusion, our data suggest an osteopenia of trabecular-rich bone tissues in patients with fasting and absorptive hypercalciurias.