Once-Weekly Injection of Low-Dose Teriparatide (28.2 μg) Reduced the Risk of Vertebral Fracture in Patients with Primary Osteoporosis.

We conducted a randomized, double-blind trial to assess the effect of 28.2 μg teriparatide versus placebo (1.4 μg teriparatide) on reduction of the incidence of vertebral fractures.

Ultrasonographic evaluation of geniohyoid muscle movement during swallowing: a study on healthy adults of various ages.

Our purpose in this study was to investigate the application of B+M-mode ultrasound (B/M-mode) imaging as a new approach to quantifying activity patterns of the geniohyoid muscles during swallowing and to assess how these patterns differ according to age and gender. Sixty healthy volunteers (30 men, 30 women) were divided into three age groups (20-39, 40-59, 60-79 years). The subjects were then given 10 ml of mineral water.

Sonographic measurement of transient synovitis in children: diagnostic value of joint effusion.

In an evaluation of the diagnostic criteria for ultrasonography (US) of transient synovitis in children, in a prospective study, 34 consecutive children with a painful hip underwent US. The ultrasonographic joint space (UJS) and the effusion space were measured in both hips, and the width of the UJS thickness in the asymptomatic hips was compared with that in the symptomatic hips. US showed the presence of a joint effusion in 31 of the 34 children and a bilateral effusion in 3.

Comparison of the effects of elcatonin and risedronate on back and knee pain by electroalgometry using fall of skin impedance and quality of life assessment using SF-36.

Back and knee pain is a widespread health problem and a serious threat to the quality of life (QOL) in middle-aged and older adults, as it frequently accompanies osteoporosis and osteoarthritis. In order to compare the effects of elcatonin and risedronate on such pain, 20 units of elcatonin was intramuscularly injected to 18 patients, and 5 mg of risedronate was orally administered daily to 20 others with similar backgrounds. Exercise-induced pain was analyzed by measuring the fall of skin impedance by electroalgometry (EAM), and subjective pain was recorded by a visual rating system (VRS) on a scale of 0 (no pain) to 100 (unbearable pain).

Sonographic assessment of hyoid bone movement during swallowing: a study of normal adults with advancing age.

Our aim in this study was to evaluate hyoid bone movement trajectories and the age-related changes during swallowing in healthy subjects by ultrasonography. Data were obtained from 30 healthy volunteers (15 men, 15 women) in three age groups (20-39, 40-59, 60-79 years). The subjects were examined while sitting in an upright position, with the back against a wall to control movement.

Analgesic effect of raloxifene on back and knee pain in postmenopausal women with osteoporosis and/or osteoarthritis.

To assess the effect of raloxifene on bone and joint pain, 24 postmenopausal women with back or knee pain or both were randomly divided into two groups, based on the chronological sequence of consultation, to be treated with 60 mg raloxifene and 1 microg alfacalcidol (RA)/day (group RA) or 1 microg alfacalcidol alone (A)/day (group A), respectively, for 6 months. Pain following knee loading (KL) by standing up from a chair and bending the knee by squatting, knee and spine loading (KSL) by walking horizontally and ascending and descending stairs, and spine loading (SL) by lying down supine on a bed and leaving the bed to stand was evaluated by electroalgometry (EAM), based on measurement of the fall of skin impedance, and a visual rating scale (VRS), recording subjective pain on a scale of 0-100 between no pain and unbearable pain. The two groups showed no significant difference as to age, indices of mineral metabolism, back and knee pain, and bone status.

Comparison of the analgesic effects of bisphosphonates: etidronate, alendronate and risedronate by electroalgometry utilizing the fall of skin impedance.

Analgesic effects of etidronate, alendronate and risedronate were compared in patients with osteoporosis and/or osteoarthritis by measuring the fall of skin impedance along with conventional subjective pain-estimation by visual rating scale (VRS). One hundred ninety-nine postmenopausal women consulting the Osteoporosis and Osteoarthritis Clinic of Katsuragi Hospital complaining of back and/or knee pain were randomly divided into four groups; Group A (49 subjects) given 5 mg/day alendronate, Group E (50 subjects) 200 mg/day etidronate, Group R (50 subjects) 2.5 mg/day risedronate and Group P no bisphosphonate.

Analgesic and chondroprotective effects of risedronate in osteoarthritis assessed by electroalgometry and measurement of collagen type II fragments in urine.

We evaluated the effect of the bisphosphonate, risedronate, on pain and cartilage metabolism in 33 patients with osteoarthritis of the knee, randomized into two groups. Group RC was treated with risedronate (2.5 mg/day) and calcium (900 mg/day); group C received calcium (900 mg/day) alone.

Sonographic visualization of the normal stomach: left lateral decubitus position.

The aim of this study was to evaluate the usefulness of an imaging technique that takes into account the effect of posture change on the stomach in transabdominal ultrasonography (US). A total of 240 adult patients (healthy subjects) underwent gastric US. In all subjects, the lesser curvature of the stomach (LCS) and left liver were measured in two different positions [left lateral decubitus (LLD) and supine].

Clinical effect of bisphosphonate and vitamin D on osteoporosis: reappraisal of a multicenter double-blind clinical trial comparing etidronate and alfacalcidol.

As inhibitors of bone resorption, bisphosphonates and vitamin D derivatives have been extensively used for the treatment of osteoporosis in various parts of the world, but the clinical effects of these two groups of agents have rarely been compared in detail. A multicenter, prospective, double-blind controlled study was started comparing the effects of etidronate and alfacalcidol (1-alpha-hydroxycholecalciferol) in 414 patients with established osteoporosis from 36 centers. Among these patients, 135 were given 400 mg etidronate daily at bedtime for 2 weeks followed by 10 weeks off treatment, and this cycle was repeated four times along with a placebo indistinguishable from the alfacalcidol capsule daily throughout the 48 weeks of study (Group A, High Dose Etidronate Group).

Postural stabilizing effect of alfacalcidol and active absorbable algal calcium (AAA Ca) compared with calcium carbonate assessed by computerized posturography.

Sway and postural instability have drawn attention as a risk factor for osteoporotic fracture, in addition to low bone mineral density (BMD) and poor bone quality. In view of the fracture-reducing effect of alfacalcidol and active absorbable algal calcium (AAA Ca) not readily explained by rather mild increases of BMD, attempts were made to evaluate postural stabilizing effect of alfacalcidol, AAA Ca, and calcium carbonate (CaCO(3)) by computerized posturography. Track of the gravity center was analyzed to calculate parameters related to tract length, track range, and track density to express the degree of sway before and after supplementation in 126 subjects ranging in age between 20 and 81 years randomly divided into four groups.

[Bone and bone related biochemical examinations. Significance of measurement of serum calcium, phosphorus, alkaline phosphatase, corrected calcium and urine calcium].

Classical clinical calcium endocrinology was built on measurements of serum Ca, P and alkaline phosphatase as well as urinary Ca. Serum Ca, the most strictly maintained biological constant, occupies the central role among them, controlling PTH secretion and bone metabolism. Ca is strongly bound to proteins especially albumin, so that total serum Ca values are sometimes misleading, necessitating the use of corrected or ionized Ca.

[Homeostasis and magnesium--comparison with calcium].

Although Mg and Ca, bivalent cations commonly coexisting in nature and living organism, share some similar chemical properties, the role played by Mg in biological regulation and signal transduction is far less important than that by Ca. In contrast to the vast extra- and intra-cellular concentration gradient of Ca as high as 10,000, intracellular Mg is only 3 times as high as extracellular Mg. Systemic Mg metabolism including serum Mg only controlled by renal tubular reabsorption is not as precisely regulated as the Ca counterpart most precisely controlled by parathyroid hormone (PTH), 1,25 (OH)(2) vitamin D and bone.

Volumetric and projective bone mineral density.

Projectional bone mineral density measurement so far used extensively in radiogrammetry and single and dual source absorptiometry is confronted with a serious limitation for the accurate evaluation of true density artifactually providing higher values along with the increase of body size and bone depth on account of the omission of one dimension. Computed tomography is capable of measuring true volumetric density and also accomplishes a separate measurement of trabecular and cortical bone especially on application to the distal and mid-radius with abundant cortical bone in peripheral computed tomography (pQCT). New lines of information may be obtained by such separate trabecular and cortical bone measurement in decreases of bone density due to various causes, estrogen withdrawal, corticosteroid, diabetes mellitus, renal failure, etc.

Effect of age on body sway assessed by computerized posturography.

The swaying and postural instability frequently seen in elderly subjects had not been analyzed quantitatively in detail until the introduction of computerized posturography. In order to assess the changes of body sway with aging, we performed computerized posturography in 144 subjects (51 men and 93 women, between the ages of 22 and 88 years) without specific neurological or metabolic disorders. The total and timed track length of the center of gravity, reflecting the distance of sway, increased with advancing age, with a highly significant positive correlation, without marked sex differences.

Active Absorbable Algal Calcium (AAA Ca): new Japanese technology for osteoporosis and calcium paradox disease.

Active Absorbable Algal Calcium (AAA Ca) is made by submaximally (800 degrees C) heating cleaned oyster shell under reduced pressure and mix it with similarly heated seaweed (Cystophyllum fusiforme). AAA Ca, best absorbed from the intestine among available calcium compounds, consequently most efficiently suppresses parathyroid hormone secretion, increases bone mineral density and decreases vertebral fracture. Aging is associated with calcium deficiency, mostly because of the decreased biosynthesis of 1,25 (OH)2 vitamin D in the kidney.

[Active absorbable algal calcium (AAACa) changes calcium paradigm].

Active Absorbable Algal Calcium (AAA Ca) is made by submaximally (800 degrees ) heating cleaned oyster shell under reduced pressure and mixing it with similarly heated seaweed (Cystophyllum fusiforme). AAA Ca, the best absorbed from the intestine than other available calcium compounds, consequently most efficiently suppresses parathyroid hormone secretion, increases bone mineral density and decreases vertebral fracture. Aging is associated with calcium deficiency, mostly because of the decreased biosynthesis of 1,25 (OH)2 vitamin D in the kidney.

[Alzheimer disease and calcium].

Calcium deficiency due to insufficient nutritional intake, poor intestinal absorption or excessive urinary loss leading to secondary hyperparathyroidism, increase of calcium influx into nerve cells causing cell death may lead to neuronal dysfunction and cell death as in dialysis encephalopathy with EEG changes and decrease of nerve conduction velocity in chronic renal failure and Alzheimer's disease in aging. Intracellular free calcium (Ca i) is increased in nerve cells showing neurofibrillar tangles associated with tau protein in Alzheimer's disease. Increase of Ca i facilitates presenilin mutation with consequent augmentation of short chain amyloid beta production which further increase Ca i.

Reappraisal of Katsuragi calcium study, a prospective, double-blind, placebo-controlled study of the effect of active absorbable algal calcium (AAACa) on vertebral deformity and fracture.

A prospective, double-blind, placebo-controlled study of the effect of supplementation with 900 mg/day of calcium, as active absorbable algal calcium (AAA Ca) or calcium carbonate (CaCO(3)), on lumbar bone mineral density (BMD) carried out in elderly inpatients with osteoporosis at Katsuragi Hospital was re-evaluated in terms of the effects on vertebral fracture and spondylotic deformity. In addition to the already reported increase in lumbar BMD, AAA Ca was found to inhibit new occurrence of vertebral fracture. Intra-individual variations in L(1)-L(4) BMD (expressed by the coefficient of variation, indicating the degree of spondylotic deformity, were also inhibited significantly in the group supplemented with AAA Ca (group A), but not in group B (supplemented with CaCO(3)), from the level in the placebo-supplement group (group C) after 18 months of supple-mentation.

Intra-individual variation in lumbar bone mineral density as a measure of spondylotic deformity in the elderly.

In an attempt at quantitative assessment of spondylotic deformity, the intra-individual variation in L(1)-L(4) bone mineral density (BMD) was calculated, as the standard deviation (SD) and coefficient of variation (CV), obtained by dividing the SD by mean L(1)-L(4) BMD, in 463 subjects. The subjects ranged in age from their second to tenth decades. Dual-energy X-ray absorptiometry (DXA), using the Lunar DPX-L, was employed to assess the BMD.

The effect of active absorbable algal calcium (AAA Ca) with collagen and other matrix components on back and joint pain and skin impedance.

The effect of active absorbable algal calcium (AAA Ca) with collagen and other matrix components on aging-associated skin changes and backache and joint pain was tested in a case-controlled study of 40 test subjects and 40 age-matched control subjects (mean age, 65 years) complaining of backache and knee joint pain due to osteoarthritis, spondylosis deformans, and/or osteoporosis. Supplementation with 900 mg calcium (given as AAA Ca) and 3.5 g collagen and other matrix components, including glucosamine, daily for 4 months resulted in a marked alleviation of subjective pain, assessed by the face scale.

Parathyroid hormone in the treatment of osteoporosis.

Parathyroid hormone (PTH), especially intact human PTH [hPTH(1-84)] and its various fragments [hPTH(1-31), (1-34), (1-36), (1-38) and their modifications], has been used for the treatment of osteoporosis over the last 10 years. Although chronic continuous excess of PTH markedly increases bone resorption, as seen in the typical example of primary hyperparathyroidism and osteitis fibrosa generalisata, intermittent PTH administration has been found to stimulate bone formation in animals, providing a basis for the use of PTH as a therapeutic agent for osteoporosis. In addition to dramatically increasing trabecular bone density and also sustaining cortical bone density, PTH administration increases bone strength and reduces the fracture rate, despite occasional increases in cortical porosity.

Analgesic effect of etidronate on degenerative joint disease.

In the present study, 80 patients with degenerative joint disease, spondylosis deformans, and/or osteoarthritis of the knee with back or joint pain, especially on movement and strain, were randomly divided into four groups. Group A received no etidronate, while groups B, C and D received 66, 133 and 200 mg/day etidronate, respectively, for 12 months. Every 3 months, after evaluating subjective pain on a visual rating scale (VRS), skin impedance was measured with subjects in a quiet sitting position and with the application of various strains on the spine and knee, including standing up from quiet sitting on a chair, bending forward to flex the spine, squatting to flex the knee, walking 20 paces on a flat floor, ascending 10 stair steps and descending 10 stair steps.

Calcium paradox: consequences of calcium deficiency manifested by a wide variety of diseases.

Calcium deficiency is a global problem, especially in the aging population. Among various nutrients, calcium is one of the few that is still deficient in industrialized countries such as Japan and many Western countries. Calcium deficiency is readily connected with osteoporosis, which is a decrease of bone calcium content.