Studies on the Mode of Action of Irradiated Ergosterol

Bauer, Walter; Marble, Alexander; Claflin, Dorothy

doi:10.1172/jci100392

Cited by 39 publications

(15 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our findings and those of Bauer (18) and Taubenhaus (19) make it clear that the change in serum calcium in acute hypoparathyroidism may precede the change in serum phosphorus. This is in contrast with the primary change in serum phosphorus in acute hyperparathyroidism (13) (14) It has been established, beyond reasonable doubt, that a sudden marked decrease in the physiologically active fraction of the serum calcium leads to the symptom complex of tetany in man, whereas some patients with chronic hypoparathyroidism may have no symptoms for years, in spite of markedly diminished concentrations of calcium in the serum (11) (20) (21).…”

Section: Discussionsupporting

confidence: 64%

“…per 100 cc. Bauer and his associates (18) pointed out that the concentration of calcium was abnormally low in this patient at the time when carpopedal spasms were first manifest, but that only subsequently did the concentration of serum inorganic phosphorus rise to an abnormally high level. Likewise, Taubenhaus (19) observed a patient who developed symptoms of severe tetany five days after subtotal thyroidectomy, at which time the inorganic phosphorus of the serum was 5.0 mgm.…”

Section: Discussionmentioning

confidence: 62%

“…There are, however, a few observations early in the course of postoperative tetany in man which accord with this finding (18) (19). Bauer, Marble and Claflin (18) observed carpopedal spasm three days after a second stage removal of the thyroid in a patient in whom the concentration of serum inorganic phosphorus was only 4.6 mgm. and the concentration of serum calcium 6.8 mgm.…”

Section: Discussionmentioning

confidence: 95%

See 2 more Smart Citations

Therapeutic Effect of Total Ablation of Normal Thyroid on Congestive Heart Failure and Angina Pectoris. Ix. Postoperative Parathyroid Function. Clinical Observations and Serum Calcium and Phosphorus Studies1

Gilligan¹,

Berlin²,

Volk³

et al. 1934

J. Clin. Invest.

View full text Add to dashboard Cite

The occurrence of tetany as an infrequent postoperative complication following subtotal removal of the abnormal thyroid gland is well recognized (1) (2). McCullagh in 1932 (2), reported an incidence of tetany of 1.3 per cent in a series of 11,500 cases in which thyroidectomy was performed at the Cleveland Clinic.The anatomical proximity of the parathyroid glands to the thyroid, the similarity of the signs and symptoms of postoperative tetany to those of idiopathic hypoparathyroidism, and the specific effect of calcium therapy, offer strong evidence that tetany following thyroid surgery is due to removal of, or injury to, the parathyroid glands during operation. Means and Richardson (1) observed that the frequency of postoperative parathyroid tetany depends roughly upon the amount of thyroid tissue removed. Thus, tetany rarely occurs after unilateral thyroidectomy; and is less common after the subtotal removal of adenomatous goitre than after that of exophthalmic goitre (1).Blumgart and his associates (3) (4) (5) (6) have shown that in patients without thyroid disease, complete removal of the normal thyroid must be performed to assure a persistently subnormal basal metabolic rate. To accomplish complete ablation of the thyroid gland, the region of the parathyroid bodies must be deliberately invaded. It was feared, therefore, that intractable tetany might frequently follow this operation.The present communication is a report of our clinical observations, and studies of serum calcium and serum phosphorus in relation to parathyroid function following the total removal of the normal thyroid gland for the relief of intractable heart disease and other conditions.2 Studies of the

show abstract

Section: Discussionsupporting

confidence: 64%

Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 95%

See 1 more Smart Citation

Therapeutic Effect of Total Ablation of Normal Thyroid on Congestive Heart Failure and Angina Pectoris. Ix. Postoperative Parathyroid Function. Clinical Observations and Serum Calcium and Phosphorus Studies1

Gilligan¹,

Berlin²,

Volk³

et al. 1934

J. Clin. Invest.

View full text Add to dashboard Cite

show abstract

“…Failure to increase serum calcium because of low dietary calcium during vitamin D treatment of hypoparathyroidism also failed to decrease the serum phosphorus. 19 But in these studies, it could be argued that an increase in serum calcium was not the cause of the decrease in serum phosphorus; rather, vitamin D or dihydrotachysterol may have resulted in stimulation of FGF23 production. However, in 1965 Eisenberg demonstrated in hypoparathyroid patients that the phosphaturia was independent of vitamin D by showing that a 48-hour infusion of calcium sufficient to normalize the serum calcium concentration also was phosphaturic and decreased the serum phosphorus.…”

Section: Discussionmentioning

confidence: 97%

“…17,18 The increase in FGF23 in the PTX rats during a calcium infusion and increased dietary calcium may provide potential insights into unexplained clinical observations from many years ago. In studies from the 1930s and 1940s, vitamin D or dihydrotachysterol was given to patients with hypoparathyroidism 19,20 and pseudohypoparathyroidism; 21 not only did vitamin D and dihydrotachysterol normalize the serum calcium, but they also decreased serum phosphorus by increasing urine phosphorus excretion. Failure to increase serum calcium because of low dietary calcium during vitamin D treatment of hypoparathyroidism also failed to decrease the serum phosphorus.…”

Section: Discussionmentioning

confidence: 99%

Calcium Deficiency Reduces Circulating Levels of FGF23

Rodríguez‐Ortiz

López²,

Muñoz‐Castañeda³

et al. 2012

Journal of the American Society of Nephrology

194

106

View full text Add to dashboard Cite

Fibroblast growth factor (FGF) 23 inhibits calcitriol production, which could exacerbate calcium deficiency or hypocalcemia unless calcium itself modulates FGF23 in this setting. In Wistar rats with normal renal function fed a diet low in both calcium and vitamin D, the resulting hypocalcemia was associated with low FGF23 despite high parathyroid hormone (PTH) and high calcitriol levels. FGF23 correlated positively with calcium and negatively with PTH. Addition of high dietary phosphorus to this diet increased FGF23 except in rats with hypocalcemia despite high PTH levels. In parathyroidectomized rats, an increase in dietary calcium for 10 days increased serum calcium, with an associated increase in FGF23, decrease in calcitriol, and no change in phosphorus. Also in parathyroidectomized rats, FGF23 increased significantly 6 hours after administration of calcium gluconate. Taken together, these results suggest that hypocalcemia reduces the circulating concentrations of FGF23. This decrease in FGF23 could be a response to avoid a subsequent reduction in calcitriol, which could exacerbate hypocalcemia. 23: 119023: -119723: , 201223: . doi: 10.1681 Fibroblast growth factor (FGF) 23 production is stimulated by both calcitriol and phosphorus intake. FGF23 acts through FGFR-klotho receptors in the kidney to induce phosphaturia, a decrease in 1-a-hydroxylase activity, and an increase in 24-hydroxylase activity. The latter two effects decrease the synthesis and increase the degradation of calcitriol, respectively. 1-4 Parathyroid cells also possess FGFR-klotho receptors, and experimental studies have shown that FGF23 inhibits parathyroid hormone (PTH) production and secretion. [5][6][7] However, in uremic animals, hyperplastic parathyroid glands fail to respond to FGF23 because the expression of FGFR-klotho is downregulated. [7][8][9][10][11] FGF23 effectively increases the output and decreases the input of phosphorus because it directly increases phosphaturia and indirectly decreases intestinal phosphorus absorption by decreasing calcitriol values. However, a conflict will arise if high FGF23 inhibits calcitriol production in a setting of calcium deficiency/hypocalcemia, where high calcitriol is needed to increase intestinal calcium absorption. We have previously observed in parathyroidectomized (PTX) rats with decreased serum J Am Soc Nephrol

show abstract

Calcium and Phosphorus Metabolism in a Verified Case of Pituitary Basophilism

Freyberg¹

1936

Arch Intern Med

View full text Add to dashboard Cite

Studies on the Mode of Action of Irradiated Ergosterol

Cited by 39 publications

References 28 publications

Therapeutic Effect of Total Ablation of Normal Thyroid on Congestive Heart Failure and Angina Pectoris. Ix. Postoperative Parathyroid Function. Clinical Observations and Serum Calcium and Phosphorus Studies1

Therapeutic Effect of Total Ablation of Normal Thyroid on Congestive Heart Failure and Angina Pectoris. Ix. Postoperative Parathyroid Function. Clinical Observations and Serum Calcium and Phosphorus Studies1

Calcium Deficiency Reduces Circulating Levels of FGF23

Calcium and Phosphorus Metabolism in a Verified Case of Pituitary Basophilism

Contact Info

Product

Resources

About