Herta Spencer

Chronic alcoholism. Frequently overlooked cause of osteoporosis in men.

A radiographic survey was made of 96 fully ambulatory male patients who were admitted to a rehabilitation center for patients with chronic alcoholism in an attempt to estimate the incidence of skeletal demineralization in these patients. The age of the patients ranged from 24 to 62 years. Forty-five of the 96 male patients, or 47 percent of this group, showed radiographic evidence of extensive bone loss. Fourteen or 31 percent of these 45 patients with bone loss were relatively young (age 31 to 45 years), and half of this group of 14 patients were less than 40 years old. The majority of the 45 patients with radiographic evidence of osteoporosis, namely, 31 patients or 69 percent, were older and ranged in age from 46 to 62 years. One third of the patients in this group were less than 50 years old. The radiographic survey of the 96 patients indicates the high incidence of extensive bone loss, most likely osteoporosis, in relatively young and middle-aged ambulatory men with chronic alcoholism. In 12 additional patients with chronic alcoholism who were observed in the Metabolic Research Ward, and who were not part of this survey, bone biopsy specimens confirmed the radiographic diagnosis of osteoporosis.

Liver morphology and function tests in obesity and during total starvation.

SummaryFive markedly obese patients were subjected to complete starvation of several weeks, for the purpose of weight reduction, for periods of 10–28 days. Studies of liver function and structure were conducted prior to, during, and after the period of starvation.Liver function, including BSP excretion, was normal in 4 of the 5 patients prior to starvation, but all 5 patients had some degree of hepatic steatosis.During starvation, distinctly impaired BSP excretion occurred. During the periods of refeeding with a low-calorie diet, this liver function improved. Fatty metamorphosis tended to decrease during starvation as did the apparent glycogen content. An increase in prominence of fibrous tissue and of hemosiderin deposits was observed after starvation.

Hydroxyethyl Starch: Extracellular Cryophylactic Agent for Erythrocytes

Studies in vitro indicate that hydroxyethyl starch is an effective extracellular cryoprotective agent for erythrocytes. It is as effective as polyvinylpyrrolidone in cryophylactic ability. It is degraded to glucose units in the circulation, is not retained in tissues, and is inexpensive to produce. Changes in the size and degree of hydroxyethylation of the branched-chain starch may result in a more effective cryoprotective agent.

Metabolism of Zinc-65 in Man

In view of the importance of zinc in many enzyme systems, and of the fact that zinc is an essential trace element in the human body, a study of the excretion, retention, and tissue distribution of Zn65 in man was performed. Zinc-65 is also a neutron-induced radionuclide and is, therefore, potentially an internal radiation hazard. The dose from Zn65 is a function of the y-particle distribution and turnover in the body. The tissue distribution and excretion of Zn65 have been investigated in animals (1, 2), and more recently these studies have been extended to man (3, 4). In the present investigation the blood levels, excretions, and tissue distribution of Zn65 in man were also related to the retention of Zn65 in the body as determined by the whole-body counting technique.

Changes in metabolism in obese persons during starvation.

Abstract Metabolic balance studies were performed under strictly controlled conditions during a period of starvation. The data were compared to those obtained during a period of full calorie intake prior to starvation and during a period of refeeding with a low-calorie diet in the same patients. The duration of the phase of starvation ranged from twelve to twenty-four days. The marked catabolism and loss of body weight in the phase of starvation was associated with a net loss of large amounts of nitrogen, phosphorus, calcium, potassium, sodium and water. The rate of catabolism tended to diminish during the later stages of starvation. The hypercalciuria in starvation paralleled the degree of decrease in the plasma carbon dioxide combining power. The serum uric acid level increased markedly during starvation. Refeeding with a calorie deficient diet (600 calories) resulted in a prompt phase of anabolism as evidenced by the net gain of nitrogen, phosphorus, calcium, potassium and sodium. There was also retention of water and stabilization of the body weight on the low calorie diet. The serum uric acid promptly returned to normal levels.

Fluoride Metabolism in Man

Fluoride balances were measured in man under strictly controlled dietary conditions before and during the intake of sodium fluoride, and after its discontinuation. Fluoride intake averaged 4.4 mg/day in the control perlod and 13.8 mg during the addition of an average of 21 mg sodium fluoride/day. The main pathway of fluoride excretion was via the kidney. Urinary fluoride excretion corresponded to about 50 per cent of the fluoride intake in the control study and during the intake of sodium fluoride. Fecal fluoride excretion was very low, averaging 0.29 mg/day in the control period and 0.88 mg/day during the sodium fluoride study. Fluoride balances were positive in all study phases and averaged +1.9 mg/day in the control period and +5.4 mg/day during the addition of 9.1 mg fluoride/day given as sodium fluoride. Fluoride retention corresponded to 42.9 per cent of the fluoride intake in the control period and to 39.3 per cent in the sodium fluoride study. Following the discontinuation of sodium fluoride, the fluoride balances were lower than in the control study. The loss of fluoride in sweat was not determined in these balance studies.

Measurement of magnesium absorption in man using stable 26Mg as a tracer.

Abstract The stable isotope 26 Mg was compared to the radioisotope 28 Mg to estimate magnesium absorption in four healthy male subjects confined to a metabolic ward and consuming a constant diet for 146 days. Two isotopes tests were carried out in each subject on days 66 and 109 of the constant-diet period. In test 1, a solution containing 50 mg 26 Mg and 30 μC 28 Mg were taken orally during breakfast. In test 2, 50 mg 26 Mg were administered orally followed three hours later by an i.v. injection of 20 μC 28 Mg. True magnesium absorption was estimated by: (1) oral/i.v. ratios of 28 Mg in plasma and urine, or oral/i.v. 26 Mg/ 28 Mg ratios in urine; (2) the difference between intake and fecal excretion of total dietary magnesium over a period of 10 days, or of a single dose of either isotope, corrected for endogenous fecal magnesium. Estimates made in individual subjects by different procedures based on data derived solely by use of 28 Mg varied as much as estimates made by comparable procedures with data derived from either 26 Mg or 28 Mg. Measurements of 26 Mg enrichment in urine and feces were made by neutron activation analysis which loses precision at enrichment levels below 10% above natural abundance. With the doses used in this investigation only fecal samples collected within 3–4 days and urine samples taken wihin 2–24 h contained adequately detectable 26 Mg enrichment levels. Despite this limitation, 26 Mg significantly expands the scope of investigation of magnesium absorption in man beyond that possible with the short lived 28 Mg alone.

Absorption of calcium in osteoporosis

Abstract The metabolic effects of long-term supplementation of calcium to the diet (one and a half to four years) were studied under controlled dietary conditions in three patients with postmenopausal osteoporosis. The calcium balances were slightly negative during periods of low calcium intake. Increasing calcium intake five to ten times by adding calcium gluconate tablets to the diet improved the calcium balances. However, this improvement was considerably less than in young persons and in patients without osteoporosis. Radioisotope and balance studies revealed that the high fecal calcium excretion during high calcium intake was principally due to unabsorbed calcium and not to increased excretion of endogenous fecal calcium. The data suggest that patients with osteoporosis have a decreased ability to absorb added calcium from the intestine as compared to young persons or to patients of comparable age without osteoporosis.

Biosynthesis of Hemoglobin Ann Arbor: Evidence for Catabolic and Feedback Regulation

Hemoglobin Ann Arbor, in which arginine replaces leucine in position 80 of the a chain, occurs in aflected individuals in low proportion to hemoglobin A. Biosynthetic studies were perforined on reticulocytes of a patient heterozygous for this hemoglobin. These studies suggested that the low percentage of hemoglobin Ann Arbor is prinlarily due to preferential destruction of the abnormal component. The reduced concentration of α Ann Arbor chains was also reflected in a decreased synthesis of normal β chains.

Influence of dietary calcium intake on Ca47 absorption in man

Abstract The absorption of calcium, using Ca 47 as the tracer, was determined in twenty-one patients under controlled dietary conditions during both low and high calcium intake; each patient served as his own control. The absorption of Ca 47 , determined from the fecal Ca 47 excretion and as judged by the Ca 47 plasma levels, varied greatly in different persons on the same constant low calcium intake and also during a period of constant high calcium intake. The Ca 47 absorption differed significantly during low and high calcium intake in the same patients. The average per cent absorption of Ca 47 in the twenty-one patients was 63.6 per cent during low calcium intake and 30.5 per cent during high calcium intake. The Ca 47 plasma curves were similar during low and high calcium intake, the highest level being attained at four hours after the ingestion of the dose under these study conditions. The Ca 47 plasma level in all patients was significantly lower during high than during low calcium intake, the lower Ca 47 plasma levels corresponding to the higher fecal Ca 47 excretion in the high calcium study. The studies emphasize three observations: (1) the importance of calcium intake in estimating calcium absorption from radiocalcium data in man, (2) the great variability in calcium absorption of persons on the same calcium intake (low or high), and (3) the need for stool collections over a period sufficiently long to permit estimations of radiocalcium absorption from fecal radiocalcium excretion.