New Techniques in Metabolic Bone Disease

Preface List of Contributors1 Humoral and Local Factors Affecting Bone Formation and Resorption The Cells of Bone Experimental Approaches Regulation of Bone Cell Activity Cytokines and Growth Factors as Local Regulators of Bone Metabolism The Interactions Among Cytokines Cytokines and Growth Factors Made by and Found in Bone and Cartilage Coupling of Bone Formation and Resorption Systemic Versus Local Effects of Cytokines Mode of Action of Steroids (Glucocorticoids, Oestrogens, androgens and Anabolic Steroids) on Bone The Mode of Action of Drugs on Bone Possible Roles for Cytokines in Bone and Joint Disease Prospects for the Future 2 Bone Cell Physiology and in Vitro Techniques in its Investigation Introduction Function and Origin of Bone Cells Methods for Studying Bone in Organ Culture Methods for Studying Bone Cells in Culture Cloned or Transformed Cells Concluding Remarks 3 New Concepts of Vitamin D Physiology 4 Physiology of Parathyroid Hormone and Assessment of Parathyroid Function Biosynthesis and Secretion of PTH Metabolism of PTH Pth Action, Receptors Structure-Function Relationships of the PTH Peptide Primary Hyperparathyroidism Parathyroid Function in Chronic Renal Failure Parathyroid Function in Pseudohypoparathyroidism (PHP) 5 Calcitonin Gene Peptides and Bone Metabolism Introduction Calcitonin Calcitonin Receptors Action of Calcitonin on Osteoclasts Action of Calcitonin on Osteoblasts Other Actions of Calcitonin Function of Calcitonin in Humans PDN-21 (Katacalcin) Calcitonin-Gene-Related Peptide 6 New Perspectives in Hormone Measurement Introduction Radioimmunoassay: Potential Alternatives Particle Immunoassay Enzyme Immunoassay Fluorescence Immunoassay Luminescence Immunoassay Monoclonal Antibodies Summary 7 The Use of Biochemical and Isotopic Studies in the Investigation of Bone Disorders Introduction Routine Biochemical Indices Biochemical Markers of Bone Formation Biochemical Markers of Bone Resorption Radioisotope Techniques Bone Turnover: Methodological Intercomparisons Isotopic Bone Scanning 8 Bone Biopsy and Histomorphometry in Metabolic Bone Disease Introduction Bone Biopsy Procedure Histomorphometry Morphometric Techniques New Developments 9 Recent Advances in Photon Absorptiometric Techniques for Measurement of Bone Mass Introduction Methodology Study 1 Study 2 Study 3 Conclusion 10 Developments in Computerized Axial Tomography Scanning and Its Use in Bone Disease Measurement Accuracy and Precision Types of QCT Ct and DPA Summary 11 The Measurement of Calcium and Other Body Elements by in Vivo Neutron Activation Analysis Introduction The Physics of Neutron Activation Practical Requirements of IVNA Analysis of the Gamma Ray Spectrum and Calculation of Calcium Content Normalization of Total-Body Calcium The Application of Neutron Activation to the Study of Osteoporosis Paget's Disease Other Endocrine Disorders Renal Disease Comparison with Other Techniques of Bone Mass Measurement Conclusions12 Magnetic Resonance Imaging of Bone Marrow Introduction History Physical Principles Pulse Sequences Chemical Shift Imaging Understanding the Image and Normal Appearances Physiological Considerations Bone Infarction Metastatic Bone Disease Primary Bone Tumors Infection Leukemia The Spinal Column Trauma Miscellaneous Observations Technical Considerations Patient Care Safety Considerations Glossary of Terms 13 Clinical, Biochemical and Molecular Aspects of Bone Collagen Disorders Inherited Abnormalities of Collagen Clinical and Genetic Classification Pathology Biochemistry of Collagen Structural Properties of Interstitial Collagens Collagen Genes Gene Analysis Technical Aspects Restriction Enzymes DNA Cloning Molecular Mechanisms of Disease in Osteogenesis Imperfecta Restriction Fragment Length Polymorphisms (RFLP) Possible Drawbacks of Using RFLPs in Linkage Studies 14 The Pathogenesis, Prevention and Treatment of Osteoporosis Epidemiology of Osteoporosis Pathogenesis Risk Factors Bone Mass Measurements Prevention of Bone Loss Treatment 15 Controversies in the Use of Hormone Replacement Therapy Introduction Background Endometrial Cancer Ovarian Cancer Breast Cancer Thrombotic Disease Conclusions 16 Current Problems with Rickets and Osteomalacia Definition and Diagnosis Vitamin D Deficiency Vitamin D - The Active Form? Rickets/Osteomalacia in Asian Immigrants Malabsorption of Vitamin D Osteomalacia Related to Impaired Vitamin D-25-Hydroxylase Function Anticonvulsant Therapy Osteomalacia Due to Defective 25(OH)D-1α-Hydroxylase Activity Renal Osteodystrophy Vitamin D-Dependency Rickets X-Linked Hypophosphataemic Rickets/Osteomalacia Other Causes of Hypophosphataemic Rickets Osteomalacia Due to Toxic Substances Hypophosphatasia Prematurity Conclusion 17 Paget's Disease of Bone Epidemiology Aetiology Pathogenesis Clinical Features Investigations and Diagnosis Management Cessation of Therapy Future Outlook GlossaryIndex