The kidneys are thought to be the only organs capable of 1 alpha-hydroxylation of vitamin D and its metabolites. We have examined the in vivo conversion of 3H-(25,26)-25-hydroxyvitamin D3(25OHD3) to 3H-(25,26)-1 alpha,25-dihydroxyvitamin D3 [1 alpha,25(OH)2D3] in vitamin D-deficient, pregnant and nonpregnant rats. As expected, nephrectomy of nonpregnant, vitamin D-deficient rats prevented the conversion of 25OHD3 to 1 alpha,25(OH)2D3. In contrast, nephrectomy of pregnant, vitamin D-deficient rats reduced but did not abolish the formation of 1 alpha,25(OH)2D3 from its precursor. The identity of the radioactive metabolite formed from 3H-25OHD3 which circulated in nephrectomized, pregnant rats was established as 1 alpha,25(OH)2D3 by comigration with synthetic 1 alpha,25(OH)2D3 on high-pressure liquid chromatography. The simultaneous absence of 1 alpha,25(OH)2D3 in the fetal kidneys indicated that the site of 1 alpha-hydroxylation after nephrectomy of the pregnant rat was probably extra-renal in origin. Two sites of 1 alpha-hydroxylation of 25OHD3, one renal and the other extra-renal, either fetoplacental or maternal, may exist in the pregnant, vitamin D-deficient rat.

The action of a single intraperitoneal injection of 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) was investigated in thyroparathyroidectomized (TPTX) vitamin D-deficient phosphate-depleted rats. After 14 h, plasma inorganic phosphorus (Pi) was significantly greater in animals receiving 1,25(OH)2D3 than in D-deficient controls, but urinary Pi excretion was very low in both groups and not significantly different in the rats given 1,25(OH)2D3. Clearance studies indicated that the D-deficient controls reabsorbed more than 99% of their filtered Pi. Avid Pi reabsorption continued even after the infusion of sufficient phosphate to raise the plasma and filtered Pi to approximately 3 times normal. Fractional calcium excretion (FECa) exceeded fractional sodium excretion (FENa) by severalfold, but FECa decreased strikingly during phosphate infusion. In animals that manifested a substantial elevation of plasma Pi after 1,25(OH)2D3, FECa was significantly less than in D-deficient controls. Therefore, the increase in plasma Pi following 1,25(OH)2D3 administration occurs independently of any effect on renal Pi reabsorption and may be responsible, at least in part, for the amelioration of hypercalciuria after 1,25(OH)2D3 treatment.

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We evaluated the potential of the carboxy-terminal propeptide of type I procollagen (PICP), the carboxy-terminal telopeptide of collagen I (ICTP), and the amino-terminal propeptide of type III procollagen (PIIINP) to differentiate osteogenesis imperfecta (OI) from Ehlers-Danlos syndrome (EDS) and idiopathic juvenile osteoporosis (IJO) in paediatric patients. Markedly decreased serum concentrations of PICP were found in type I OI, while in IJO they were much less diminished, and in EDS they were near to normal. In type III and IV OI, the serum PICP level was lowered in prepubertal patients, whereas at puberty it was comparable to that in controls. Serum ICTP and PIIINP levels in patients with OI did not differ significantly from the levels in EDS and IJO. Measurements of serum PICP levels seem to be useful in discriminating OI from EDS and IJO in prepubertal children. In pubertal children, however, they lose their diagnostic power.

Background Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disease of unknown etiology that produces a progressive degeneration of the musculoskeletal system [1]. The management of RA rests on drug treatment and non-pharmacological measures such as exercise, occupational and psychological therapeutic approaches [2]. Exercise in RA is believed to improve joint mobility, muscle strength, and physical function [3]. Therapeutic exercise is important for pain control. Stretching is often included in physical therapy interventions for management knee pain. One of stretching techniques is post-isometric relaxation (PIR) [4]. Objectives In this study we wanted to check effectiveness of reducing pain using kinesiotherapy and post-isometric relaxation in RA patient with knee pain. Methods The patient were examined at entry to the hospital. Patient who had RA were eligible for the study if they fulfilled inclusion and exclusion criteria. They were separated into 2 groups: I (kinesiotherapy) [n=19] and II post-isometric relaxation (PIR) [n=19]. Kinesiotherapy was performed once a day for 30 minutes. Group II had kinesiotherapy as I group and PIR on 3 groups of muscle: knee flexors, knee extensors and plantar flexors of the foot. Therapy lasted for 10 days. The knee pain of the patients was assessed by visual analogue scale (VAS) pain score (0-100 mm, with higher scores indicating more pain). Results See Table 1. Table 1.Characteristics of patients with rheumatoid arthritis and knee pain Group I (SD) Group II (SD) P/Anova Age [years] 59.1 (8.5) 61.4 (11.2) 0.4440 BMI 30.6 (6,2) 28.7 (4.2) 0.2432 DAS28 5.07 (0.75) 4.70 (1.19) 0.2128 Statistically significant differences in VAS were noted after treatment in both groups: Group I - it decreased from 59.9 (10.85) to 45.9 (19.19), p=0.0016; Group II - it decreased from 67.5 (14.9) to 32.7 (15.8), p=0.0000. Therapy in Group II was statistically significant better than Group I, p=0.0147. Conclusions The study showed positive, statistically significant effects of kinesiotherapy alone and kinesiotherapy with post-isometric relaxation on the pain in these research. However, due to the relatively small groups it is difficult to draw firm conclusions. Because of positive effects of treatment on knee pain in patient with RA, research should be continued in this area. References Aletaha D, Neogi T, Silman AJ, et al. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis. 2010 Sep;69(9):1580-8. Smolen JS, Landewé R, Breedveld FC, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs. Ann Rheum Dis. 2010;69(6):964-75. Hurkmans E, van der Giesen FJ, Vliet Vlieland TP, Schoones J, van den Ende EC. Dynamic exercise programs (aerobic capacity and/or muscle strength training) in patients with rheumatoid arthritis. Cochrane Database Syst Rev. 2009 Oct 7;(4):CD006853. ...