Search

To determine the effect of consecutive oral administration of 1αOHD3 or 1,25(OH)2D3 on the metabolism of 1,25(OH)2D3, seven-month-old female rats were given 1αOHD3 (0.4 µg/kg/day) or 1,25(OH)2D3 (0.2 µg/kg/day) for 14 days. After the oral administration of 2 μCi of3H-1αOHD3 or3H-1,25(OH)2D3, the rats were sacrificed at 2,6 or 24 h, and the distribution of these tracers and their metabolites in the serum, intestines, liver, kidneys and bone were studied. The consecutive treatment with 1,25(OH)2D3 or 1αOHD3 did not basically alter the elution patterns of3H labeled metabolites on HPLC. The tissue levels of3H-1,25(OH)2D3, administered or converted from3H-1αOHD3, were lower in the treated rats than those in the controls at 24 h, indicating the accelerated disappearance of 3H-1,25 (OH)2D3 following the treatment with 1αOHD3 or 1,25(OH)2D3. The degree of acceleration, however, was less following the treatment with 1αOHD3 than that after treatment with 1,25(OH)2D3. The degree ofacceleration, however, was less following the treatment with 1αOHD3 than that after treatment with 1,25(OH)2D3. This finding might indicate that, when 1αOHD3 or 1,25(OH)2D3 is consecutively administered, the 1,25(OH)2D3 converted from 1αOHD3 by the liver remains longer in the tissues including bone than 1,25(OH)2D3 absorbed directly from the intestine.

Chelating agent, such as CaEDTA, CaDTPA, D-penicillamine, DMSA, desferoxamine, NTA, cysteine ethyl ester, BAL, alpha-MPG, phthalein complexone, were tested as a possible contrast enhancing agent for tumor imaging with 67Ga-citrate. The intravenous administration of a chelating agent to Ehrlich's tumor bearing mice, one hour after the injection of 67Ga-citrate, accelerated the blood clearance with only a very slight change of activity in the target, increasing the tumor-to-blood ratio, and consequently achieving a better visualization. Among the tested chelating agents, D-penicillamine showed the highest target-to-nontarget ratio at a shorter time: a good tumor-to-blood ratio, performed after 24 hr with non-treated animals, was achieved in only 1-3 hr with post-treated animals. Thus, D-penicillamine hold a considerable promise as a contrast enhancing agent for future clinical use.

Bone scintigraphy using 99mTc-MDP was performed on 2 patients with Paget's disease of bone before and after the treatment with a synthetic eel calcitonin analogue ( (Asu1, 7) -eel calcitonin, ECT) ) at a dose of 40 U per day. All pagetie lesions showed markedly the increased accumulation of the radionuclide. The uptake ratio, defined as the count rate of 99mTc-MDP over each bone lesion to that over the control bone, was calculated. The response to the calcitonin therapy was evaluated with the uptake ratio of the radionuclide. The uptake ratio decreased markedly within the first 3 months of the treatment, in association with a palliation of bone pain, while the serum alkaline phosphatase activities which had been within the normal range or slightly high before the treatment did not show any significant change or did not reflect a clinical feature (e.g, bone pain) with the treatment. Thus, the uptake ratio on the bone scintigram seemed to offer the most sensitive and most reliable information for the evaluation of calcitonin treatment of Paget's disease of bone.

Plasma concentrations of vitamin D3, 25-OH-D3, 24, 25(OH)2D3 and 1, 25(OH)2D3 were measured in patients with various diseases using the multiple assay system previously reported. In patients with hyperparathyroidism, the plasma levels of 1, 25(OH)2D3 tended to increase, while the levels of 24, 25(OH)2D3 tended to decrease in many cases. On the other hand, plasma 1, 25(OH)2D3 levels were low, while 24, 25(OH)2D3 levels were high in patients with hypoparathyroidism. No significant differences in the levels of plasma D3 derivatives among idiopathic-, postoperative- and pseudo- hypoparathyroidism were observed. In a majority of hemodialyzed patients with advanced renal failure who showed no overt bone changes on X-ray films, both the plasma 1, 25(OH)2D3 and 24, 25(OPH)2D3 levels were distributed from normal to very low. In a majority of patients with osteoporosis and hypoparathyroidism, plasma 1, 25(OH)2D3 levels rose quickly after the administration of 1 alpha-OH-D3. In hypophosphatemic vitamin D resistant rickets, however, the response to the relatively large amounts of 1 alpha-OH-D2 was poor, although the concentrations of plasma 24, 25(OH)2D3 were elevated by the 1 alpha-OH-D3 administration in most of these cases. The plasma 1, 25(OH)2D3 and 24, 25(OH)2D3 concentrations in patients with senile osteoporosis were distributed from lower to higher range than those of normal adults. There was a relatively good correlation between plasma levels of 25-OH-D3 and D3 only in cases with plasma D3 levels higher than 5 ng/ml. In addition, a hyperbolic regression curve was obtained between the plasma D3 and 25-OH-D3 ratio. These results may indicate that a possible negative feedback homeostatic mechanism exists between plasma levels of D3 and 25-OH-D3, but only with low plasma levels of D3.

To improve the scintigraphic differential diagnosis of thyroid nodules, Tc-99m pertechnetate-Tl-201 Cl subtraction scintigraphy (Tc-Tl subtraction scanning) was performed in 106 patients with various histologically proven thyroid nodules. Results were evaluated by comparison with surgical findings and preoperative ultrasonographic results. Thyroid nodules were more successfully detected by Tc-Tl subtraction scanning than by either Tc-99m pertechnetate or Tl-201 Cl scintigraphy alone. Detection of nodules was further improved when images recorded by the three methods were integrally observed (sensitivity 83%, accuracy 89%), with detectability approaching that of ultrasonography. False-positive or -negative Tc-Tl subtraction scans were obtained principally when multiple nodules were present (7 cases) or when no discrepancy existed between the accumulations of Tc-99m pertechnetate and Tl-201 Cl (18 cases). Most colloid nodules exhibited irregular margins, heterogeneous internal accumulations of Tl-201 Cl, and distorted shapes on Tc-Tl subtraction scans, while the majority of adenoma were oval-shaped with smooth margins. Carcinoma were characterized by homogeneous internal accumulation of Tl-201 Cl and distorted shapes.

A simple and precise method has been developed for the determination of 25-hydroxyvitamin D in 1 ml of human plasma. The method consists of methanol/chloroform extraction, purification by high pressure liquid chromatography and a competitive protein binding assay using vitamin D deficient rat serum. The ethanol extract from vitamin D deficient chick serum was added to the sample before CPBA to eliminate the non-specific interference in the CPBA system as a vitamin D free serum extract. The assay was sensitive to 0.72 ng/ml of plasma. Satisfactory results were obtained in the dilution and recovery tests. The coefficients of variation were 5.8 approximately 9.1% for the within-assay, and 7.4 approximately 10.3% for the between-assay. Plasma concentrations of 25-hydroxyvitamin D in 46 samples of normal human plasma were 21 +/- 10.5 ng/ml (mean +/- SD), and the seasonal variation was demonstrated. Plasma levels for 25-hydroxyvitamin D were high in patients receiving vitamin D2 and low in patients suffering from liver cirrhosis.

Weekly administration of teriparatide has been shown to reduce the risk of vertebral and non-vertebral fractures in patients with osteoporosis at higher fracture risk in Japan. However, its efficacy for hip fracture has not been established. To gain insight into the effect of weekly teriparatide on the hip, hip structural analysis (HSA) based on dual-energy X-ray absorptiometry (DXA) was performed using the data of 209 postmenopausal osteoporotic women who had participated in the original randomized, multicenter, double-blind, placebo-controlled trial assessing the effects of once-weekly 56.5μg teriparatide for 72weeks. The DXA scans, obtained at baseline, 48weeks and 72weeks, were analyzed to extract bone mineral density (BMD) and cross-sectional geometrical indices at the narrowest point on the neck (NN), the intertrochanteric region (IT), and the proximal shaft. Compared with placebo after 72weeks, the teriparatide group showed significantly higher BMD, average cortical thickness, bone cross-sectional area, and section modulus, and lower buckling ratio at both the NN and IT regions. No significant expansion of periosteal diameter was observed at these regions. There were no significant differences in BMD and HSA indices at the shaft region. The results indicate that overall structural strength in the proximal femur increased compared to placebo, suggesting that once-weekly teriparatide effectively reverses changes in hip geometry and strength with aging.

Introduction In 1998, the first Japanese practice guidelines on osteoporosis was published. It has been updated several times, with the most recent being the full-scale 2011 edition and its abridged edition. The present guidelines provide information for the managements of primary osteoporosis in postmenopausal women and men over 50 years old, a summary of the evidence for the treatment of secondary osteoporosis, and a summary of the evidence for the prevention of osteoporosis in younger people. Method The present Executive Summary is primarily based on the content of the 2011 Japanese abridged edition. One of the key changes is revision of the criteria for initiation of pharmacological treatment, along with an introduction of the fracture risk factors used in FRAX®. Key figures and tables were selected from the Japanese abridged edition and a reference list was added. Result and conclusions The essential points of the Japanese practice guidelines on osteoporosis were translated into English for the first time. It is hoped that the content of the guidelines becomes known throughout the world.

Once-weekly administration of 56.5 μg teriparatide improved cortical bone parameters and biomechanical parameters at the proximal femur by CT geometry analysis. Introduction: The aim of this study was to evaluate the effects of weekly administration of teriparatide [human PTH (1-34)] on bone geometry, volumetric bone mineral density (vBMD), and parameters of bone strength at the proximal femur which were longitudinally investigated using computed tomography (CT). Methods: The subjects were a subgroup of a recent, randomly assigned, double-blind study (578 subjects) comparing the anti-fracture efficacy of a once-weekly subcutaneous injection of 56.5 μg teriparatide with placebo (TOWER trial). Results: Sixty-six ambulatory postmenopausal women with osteoporosis were enrolled at 15 study sites having multi-detector row CT, and included women injected with teriparatide (n = 29, 74.2 ± 5.1 years) or with placebo (n = 37, 74.8 ± 5.3 years). CT data were obtained at baseline and follow-up scans were performed at 48 and 72 weeks. The data were analyzed to obtain cross-sectional densitometric, geometric, and biomechanical parameters including the section modulus (SM) and buckling ratio (BR) of the femoral neck, inter-trochanter, and femoral shaft. We found that once-weekly teriparatide increased cortical thickness/cross-sectional area (CSA) and total area, and improved biomechanical properties (i.e., decreasing BR) at the femoral neck and shaft. Teriparatide did not change the cortical perimeter. Conclusions: Our longitudinal analysis of proximal femur geometry by CT revealed that once-weekly administration of 56.5 μg teriparatide improved cortical bone parameters at the femoral neck and shaft and also improved biomechanical parameters., Osteoporosis International, 25(3), pp.1163-1172; 2014

Eldecalcitol reduces the risk of vertebral fractures in comparison to alfacalcidol in osteoporotic patients under vitamin D repletion. The aim of this study was to evaluate the effects of eldecalcitol on the spinal location of incident vertebral fractures, the severity of the fractures, and the changes in health-related quality of life (HRQOL) compared with those of alfacalcidol. The post hoc analysis has been performed on the data from the three-year, double-blind, randomized, head-to-head clinical trial of eldecalcitol versus alfacalcidol conducted in Japan. A total of 1054 patients were enrolled and randomized to take 0.75 μg eldecalcitol or 1.0 μg alfacalcidol daily for 3 years. The incidence of vertebral fractures was re-evaluated based on the location on the spine (upper T4-T10; lower T11-L4). The severity of vertebral fractures was determined by the semi-quantitative method, and the change in HRQOL was analyzed by using the Medical Outcomes Study Short Form 36-item questionnaire. The incidence of vertebral fracture at the lower spine was less in the eldecalcitol group than in the alfacalcidol group (p = 0.029). The incidence of severe vertebral fracture (Grade 3) was 3.8 % in the eldecalcitol group and 6.7 % in the alfacalcidol group, demonstrated a significant difference between the 2 groups (p = 0.036). Both eldecalcitol and alfacalcidol improved HRQOL in osteoporotic patients. Although no significant differences in each HRQOL scores were observed between eldecalcitol and alfacalcidol during the observational period, overall improvement from baseline of HRQOL scores were clearly observed in the eldecalcitol group. In conclusion, the incidences of lower spinal vertebral fractures and severe vertebral fractures were reduced further by eldecalcitol compared to alfacalcidol in the 3-year clinical trial. Daily treatment with eldecalcitol is effective in improving HRQOL, possibly owing to the reduced risk of lower spinal vertebral fractures and/or severe vertebral fractures.

Two patients with polymyositis showed abnormal muscular uptake of Tc-99m-methylene diphosphonate (MDP) during routine bone imaging. Imaging with Tc-99m MDP is a useful tool in monitoring the activity of the diseased muscle.

A newly developed dual photon absorptiometry system (DCS-600, ALOKA Co., LTD.) using two monochromatic X-rays for the determination of bone mineral in the peripheral bone was fundamentally studied, in comparison to single photon absorptiometry system (SPA). The accuracy and precision in DCS-600 were equal to or better than SPA system. Furthermore, in DCS-600 the forearm could be imaged, and the manipulation was easy. Thus DCS-600 was found to be a good instrument as a quantifying system of bone mass.

A 45-year-old male suffered from bilateral putaminal hemorrhages that occurred simultaneously, followed by pseudo-bulbar palsy. Administration of anticoagulants appeared to have caused the bleeding. Cerebral blood flow was markedly decreased in both hemispheres disproportionally to the small size of the hemorrhages, probably due to a bilateral “diaschisis phenomenon, ” and the patient experienced severe neurological sequelae.

A parathyroid adenoma imaged by Ga-67 citrate in a 17-year-old man with primary hyperparathyroidism and a palpable solid tumor in the neck is presented. Although preoperative examination and intraoperative findings suggested a parathyroid carcinoma, histologic studies showed a parathyroid adenoma with predominant chief cell type.

Intense accumulation of radioactivity during 67Ga-citrate scanning was observed in the leg of a patient with advanced mycosis fungoides after repeated radiotherapy and chemotherapy. Infiltration of the calf muscle by neoplastic lymphoid cells was confirmed at autopsy. Radionuclide visualization of an uncommon involvement of the skeletal muscle by the disease has not been previously reported.

Semi-quantitative method of N-isopropyl-(123I)-p-iodoamphetamine (123I-IMP) accumulation in cerebrum by using 123I-IMP SPECT was tried. Ratio of counts in whole cerebrum to those in normal cerebellum was calculated, and this accumulation is defined as cerebrum to cerebellum accumulation ratio. In group of patients with dementia or patients who were remaining in bed, significantly low accumulation ratio was observed, while in "normal" group, no differences in sex and aging were observed. Calculation of cerebrum to cerebellum accumulation ratio was concluded as a useful method of evaluating the accumulation of 123I-IMP in cerebrum.

The widespread clinical use of hemodialysis has prolonged the survival of a vast number of uremic patients, but it has also yielded some problems including renal osteodystrophy. Recently, it has become well known that the clinical use of active vitamin D metabolites is effective in many patients with renal osteodystrophy. However, there are many patients with bone diseases resistant to such treatment. Several lines of evidences implicate aluminum as one of the causal factors in the production of such diseases. We recently found 20 patients with bone diseases associated with the deposition of aluminum in front of active calcification in the bone. All of them were undergoing maintenance hemodialysis with softened water thrice weekly and taking aluminum containing antacids and 1 alpha-(OH)D3. The age of the patients ranged between 30 y.o. and 62 y.o. (46.5 +/- 9.0, mean +/- s.d.). All of them had severe bone pain and 8 of them had bone fractures. Bone X-ray, bone scintigraphy, serum Ca, P, ALP, serum aluminum and bone histology were examined. Based on the bone histology, they were classified into four types; inactive type (9), osteomalacia type (6), mild type (4) and mixed type (1). There were no significant differences among each group concerning serum values of Ca, P and aluminum. Serum value of ALP tended to be high in the osteomalacia type, and that of c-PTH was significantly low in the inactive type compared with the other types. Our finding suggest that aluminum associated bone disease is not so rare in Japan and show that the diagnosis of this disease should be made histologically and that clinical and blood chemical features are not reliable for the diagnosis of aluminum associated bone disease in hemodialysis patients.

We used a combination of bone and bone-marrow scintigraphy to study 25 patients with prostatic cancer. Of the 18 cases whose 99mTc-methylene diphosphonate (MDP) bone scans showed hot spots in the lower lumbar region of the spine and/or the pelvic bone, 8 had normal bone-marrow scintigrams. These 8 patients were subsequently shown to have senile, degenerative changes of the spine. On the other hand, in 9 of the 10 patients whose bone-marrow scintigrams showed accumulation defects, follow-up study and characteristic X-ray findings confirmed the presence of metastases. In all 6 cases with extensive bone metastases shown by 99mTc-MDP bone scintigraphy, 99mTc-sulphur-colloid bone-marrow scintigraphy showed multiple accumulation defects. In conclusion, bone-marrow scintigraphy was found to be useful in distinguishing metastatic lesions from benign degenerative changes in the cases with suspected bone involvement, as well as in evaluating equivocal lesions in the pelvis.

Carcinoembryonic antigen (CEA) and calcitonin (CT) were simultaneously determined in sera and tumor tissues from 15 patients with medullary carcinoma of the thyroid (MCT). Serum CEA was increased in all but one patient, and CT did in all of them. Both levels were significantly related to the weight of excised tumor, but not to the presence of metastasis. Furthermore, a significant correlation was noted between the basal levels of CT and CEA. Both levels fell to normal after a radical operation had been performed. Tissue concentrations of CEA and CT in the MCT were more than 100 times those in hyperthyroidism, and the ratios of tissue over serum levels averaged 770 in CEA and 1000 in CT. In the calcium infusion test, CEA levels were not significantly changed in contrast with a distinct increase in CT levels. The results indicate that CEA and CT represent separate activities of the tumor cells, and that circulating CEA together with CT is a useful indicator in the diagnosis and follow-up of the disease.

Three rare cases of moyamoya-like diseases with moyamoya type vessels caused by spontaneous internal carotid artery occlusion, spontaneous middle cerebral artery occlusion, and internal carotid artery occlusion due to cervical irradiation are presented. They resulted in ventricular hemorrhages. One patient died and two survived. Postoperatively, the collateral circulation of the survivors was evaluated by single photon emission tomography using N-isopropyl-[123I]-p-iodoamphetamine. The effectiveness of reconstructive surgery is shown, and moyamoya-like diseases that have been reported are reviewed.

A patient with a muscle hernia in the thigh showed increased muscle uptake of radioactivity during bone imaging using 99mTc-pyrophosphate. The area of excessive accumulation corresponded well to the location and extent of the herniated muscle tissue observed at surgery. Microscopic examination revealed chronic muscle damage, which was assumed to be responsible for the abnormal muscle labelling found in this patient.

We examined 17 patients with primary hyperparathyroidism for their serum 1,25 dihydroxyvitamin D levels and for their fractional intestinal calcium absorption rates using a whole body counter and calcium-47. As controls, 10 normal volunteers were examined both before and after administration of 1 alpha-hydroxyvitamin D to increase serum 1,25 dihydroxyvitamin D. Values of serum 1,25 dihydroxyvitamin D were 71.6 +/- 37.6 pg/ml (mean +/- SD) in patients with primary hyperparathyroidism and 75.3 +/- 27.7 pg/ml (mean +/- SD) in normal volunteers after administration of 1 alpha-hydroxyvitamin D, while values of intestinal calcium absorption rate were 61.5 +/- 16.5% (mean +/- SD) in patients with primary hyperparathyroidism and 34.1 +/- 5.1% (mean +/- SD) in normal controls, respectively. There was a positive correlation between values of serum 1,25 dihydroxyvitamin D and intestinal calcium absorption in both groups. However, in patients with primary hyperparathyroidism, intestinal calcium absorption was more increased than that in normal volunteers when compared to their serum values of 1,25 dihydroxyvitamin D. This suggests that another factor than 1,25 dihydroxyvitamin D plays an important role in the intestinal calcium absorption in patients with primary hyperparathyroidism.

Intense accumulation of radioactivity was observed in a case of histologically proven benign cystic teratoma of the ovary during routine bone scans with 99mTc-methylene diphosphonate. To our knowledge, imaging of a benign ovarian tumor with a 99mTc-phosphorus complex has not been previously reported.

A histologically proven case of extraosseous xanthomatosis is presented. Both Ga-67 citrate and Tc-99m-MDP imagings demonstrated tumor uptake of radiotracers. A second Ga-67 imaging taken after excisional biopsy of the left knee lesion revealed disappearance of the lesional uptake of the tracer seen on the preoperative Ga-67 scan. Radiotracer accumulation in extraosseous xanthomatosis has not been reported previously.

A histologically proven case of pulmonary alveolar microlithiasis that demonstrated intense lung uptake of Tc-99m-MDP on a bone scan is presented. The spatial distribution within the lungs of the radioactivity and density was assessed either by single photon emission computed tomography (SPECT), or x-ray computed tomography (CT) respectively, and the regional magnitude of the two parameters were compared. The quantitative study of regional radioactivity and density revealed that both the parameters distributed symmetrically, showing gradual increase in magnitude from the upper to the lower lung regions. The radioactivity-density association observed in our patient may indicate on-going formation of microcalculi throughout the lungs, the degree of which is greater at the sites of more severe involvement.

The hypocalcemic effect of liposomal-entrapped calcitonin (CT) was evaluated in rats. Salmon CT and human CT were entrapped in liposomes composed of egg phosphatidylcholine with or without an equimolar amount of cholesterol. The liposomes were separated by Sepharose 4B chromatography into fractions consisting of large multilamellar vesicles and small unilamellar vesicles. The incorporation of CT was monitored by counting [125I]CT and by specific RIA. Liposomal entrapment enhanced the hypocalcemic potency of parenterally administered salmon CT and human CT. After iv administration, the large multilamellar vesicles were more potent than small unilamellar vesicles in their hypocalcemic effect; cholesterol inclusion in the MLV liposome preparation prolonged the hypocalcemia. However, with im administration, the cholesterol-free liposomes were more potent than their cholesterol-containing counterparts regardless of size. These studies demonstrate that liposomal entrapment can be used to enhance the hypocalcemic potency of CT. It appears that both the size and composition of the liposome preparation are important in this effect, as is the route of administration. It may be possible to produce liposome-CT preparations with advantageous pharmacological characteristics.

The structure-function relationship of calcitonin (CT) was investigated using a synthetic eel CT (E-CT) analog and its fragments. Adenylate cyclase activation and competitive binding to rat renal receptors were used as parameters of function. [Asu1,7]E-CT analog, synthesized by replacing the S-S bond of Cys1-Cys7 in the natural hormone with ethylene linkage of 1-amino suberic acid (Asu), and E-CT fragment 11-32 had about 1/5th and 1/50th the potencies of synthetic E-CT, respectively, in both adenylate cyclase activation and competitive inhibition of 125I-labeled [Asu1,7]iodo-E-CT binding on rat renal plasma membranes. The minimal chain length required to activate adenylate cyclase in rat renal plasma membranes was between 12-18 amino acids, and the minimal chain length required to affect the CT receptor binding was between 6-12 amino acids, near the C-terminus. Fragments, including the C-terminus, show a disproportionate and potent inhibition of the binding compared with the potency required for adenylate cyclase activation. Thus, the amino acid sequence near the C-terminus probably plays an important role in the binding of CT to the receptor. (Endocrinology 108: 698, 1981.)

In a patient with synovial sarcoma, routine bone survey showed no abnormality, while bone marrow scintigraphy with Tc-99m sulfur colloid revealed a defect in the fifth lumbar vertebra. At surgery, tumorous invasion was noted in the fifth lumbar vertebra and the surrounding tissues. It was suggested that the bone marrow scintigraphy was particularly useful in the detection of tumorous invasion into the bone marrow at the early stage before the destruction of skeletal tissue.

A case of right adrenal pheochromocytoma was described which presented as an acute abdominal emergency and resulted in shock due to spontaneous rupture into the retroperitoneum. Spontaneous remission of clinical symptoms followed and the tumor was safely resected later. Scintigraphic imaging using 131I-metaiodobenzylguanidine clearly demonstrated the tumor when endocrinological examinations were within normal ranges.

99m-Tc-methylene diphosphonate (99mTc-MDP) was found to accumulate in one of the two radiolucent areas of the bilateral femoral neck, both of which were radiographically typical of the so-called conversion defects of the proximal femur, a type of normal roentgen variant. The mechanisms possibly involved in this previously unreported phenomenon are discussed in relation to the apparent discrepancy regarding radionuclide uptake by the two lesions of the same entity in one patient.

Epidemiological studies show that dietary intake of natto, which contains significant amount of vitamin K(2), reduces the risk of bone formation loss. However, many confounding factors, such as calcium and isoflavone, are found in natto, because it is made from soybeans. In this study, the direct effects of MK-7, a vitamin K(2) analogue, were assessed in osteoblasts. Osteoblastic MC3T3E1 cells were cultured with or without MK-7 for 10 days and the number of cells was calculated. The cell count was not different between MK-7 treated cells and control cells for 1, 2, and 4 days. However, it was significantly suppressed in MK-7 treated cells at 10 days, suggesting that MK-7 suppressed cell proliferation. Real-time PCR analysis showed that mRNAs of osteocalcin (OC), osteoprotegerin (OPG), and the receptor activator of the NFkappaB ligand (RANKL) were induced after MK-7 administration to the culture medium. RANK mRNA expression was also enhanced by MK-7 administration. Immunocytochemical analysis showed that MK-7 increased the protein levels of OC and RANKL. RANK protein was also enhanced, but this induction was suppressed by anti-RANK antibody administration. This suppression was recovered when anti-RANK antibody and MK-7 were administered. These observations suggest that MK-7 may directly affect MC3T3E1 cells and stimulate osteoblastic differentiation, not proliferation.

Four patients with sternocostoclavicular hyperostosis showing characteristic abnormal uptake on bone imaging are described. Bone imaging was useful in the diagnosis of sternocostoclavicular hyperostosis.

A /sup 201/Tl-chloride scan was performed on a patient with primary hyperparathyroidism. /sup 201/Tl-chloride accumulated in the region of the right lower thyroidal pole and a diagnosis of parathyroid adenoma was confirmed intraoperatively. /sup 201/Tl-chloride imaging of a hyperfunctioning parathyroid gland seems to be useful for the detection and preoperative localization of a parathyroid adenoma.