By H. Fleisch (auth.), Professor Dr. Kurt W. Brunner, Professor Dr. Herbert Fleisch, Professor Dr. Hans-Jörg Senn (eds.)

This quantity informs the reader approximately simple chemical and experimental elements of the bisphosphonates, their software in neoplastic hypercalcemia, and the elemental results of those medicines in neoplastic osteolysis. preliminary experiences, which want affirmation through better randomized reviews, additionally take care of the long-term program and probably favorable impact of bisphosphonates in metastatic bone illness. it's important for clinical oncologists and internists to maintain abreast of modern details during this new region of scientific melanoma examine.

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In hypercalcemia of malignancy, an increase in bone resorption is observed in most patients. However, in many cases an increased tubular reabsorption of Ca has been documented as well. This phenomenon when present after adequate rehydration is probably due to the secretion by the tumoral cells of a parathyroid hormone-related peptide (PTHrP). This factor has been recently identified as a protein containing 141 amino acids. This protein or some very close analogs have been shown to be secreted by lung, kidney and also breast carcinoma.

In conclusion, from the clinical point of view clodronate is a very useful adjunct to the other available therapy for malignancy-associated hypercalcemia. It has an acute hypocalcemic effect in most patients and normocalcemia can generally be maintained during long-term therapy using oral administration. Summary Increased bone resorption and increased renal tubular reabsorption of calcium are involved in the pathogenesis of hypercalcemia of malignancy. Clodronate and calcitonin inhibit bone resorption and have been used as therapy for malignancyassociated hypercalcemia.

J Bone Min Res 1: 555-562 Thomas BJ, Amstutz HC (1985) Results of the administration of diphosphonate for the prevention of heterotopic ossification after total hip arthroplasty. J Bone Joint Surg 67 A: 400-403 Trechsel U, Schenk R, Bonjour JP, Russell RGG, Fleisch H (1977) Relation between bone mineralization, Ca absorption, and plasma Ca in phosphonate-treated rats. Am J Physiol 232: E298-E305 Troehler U, Bonjour JP, Fleisch H (1975) Renal secretion of diphosphonates in rats. ). Lancet 1 : 803-805 Van Breukelen FJM, Bijvoet OLM, Frijlink WB, Sleebloom HP, Mulder H, von Oosterom AT (1982) Efficacy of amino-hydroxypropylidene bisphosphonate in hypercalcemia: observations on regulation of serum calcium.

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