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Chapter Ⅵ . Calcium Homeostasis

Chapter Ⅵ . Calcium Homeostasis. PS Wang/2004.05. W.F.Ganong: Review of Medical Physiology 1983 12th Ed. Fig21-2 #1440. Remodeling of Bone. Bone Marrow or Fibrous Periosteum Mesenchymal Stem Cells Osteoclasts Bone Absorption Osteoblasts Bone Deposition (new bone)

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Chapter Ⅵ . Calcium Homeostasis

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  1. Chapter Ⅵ. Calcium Homeostasis PS Wang/2004.05

  2. W.F.Ganong: Review of Medical Physiology 1983 12th Ed. Fig21-2 #1440

  3. Remodeling of Bone Bone Marrow or Fibrous Periosteum Mesenchymal Stem Cells Osteoclasts Bone Absorption Osteoblasts Bone Deposition (new bone) Osteocytes PS Wang/2004.05

  4. Guyton & Hall : Textbook of Medical Physiology 10th ed.2000 fig.79-4 #365

  5. Mechanism of Bone Absorption • Osteoclasts (lysosomes) proteolytic enzymes organic matrix digest or dissolute 2. Osteoclasts acids (citric acid & lactic acid) bone salts solution 3. Bone salts & collagen villi from osteoclasts digestion phagocytosis PS Wang/2004.05

  6. M. Azria: The Calcitonins (Physiology and Pharmacology). 1989. fig.34a

  7. L.E. Mcdonald: Veterinary Endocrinology and Reproduction. 1976 2nd Ed. fig.4-15 #38

  8. W.F. Ganong:Review of Medical Physiology 1983 12th Ed. #1439

  9. 9 L.E. Mcdonald: Veterinary Endocrinology and Reproduction. 1976 2nd Ed. #29

  10. W.F. Ganong:Review of Medical Physiology 2003 20th Ed. fig.21-9 #187

  11. M. E. Hadley: Endocrinology 4th ed. 1996 fig.9.1 #1992

  12. W.F.Ganong: Review of Medical Physiology 2003 20th Ed. #188 fig.21-10

  13. Guyton & Hall : Textbook of Medical Physiology 10th ed.2000 fig.79-9

  14. Functional Cytology of the Parathyroid Gland 1. Chief cells---- secrete PTH 2. Oxyphil cells (1) absent in many animals & in young human beings (2) increase in numbers with advancing age (3) probably age-chief cells (4) poorly developed ER, Golgi apparatus, & secretory granules 3. Transitional oxyphil cells PS Wang/2004.05

  15. Biological Effects of PTH 1. blood [Ca2+]( absorption of Ca2+ & PO4-3 from bone) 2. blood [PO4-3]( excretion of renal phosphate) 3. urine [PO4-3]and urine [Ca2+] 4. the rate of skeletal remodeling and the net rate of bone resorption 5. osteocytic osteolysis in bone (rapid effect) and the numbers and/or activation of osteoclasts on bone surface (slow phase) 6. urinary excretion of hydroxyproline-containing peptides 7. activation of adenyl cyclase in target cells. 8. formation of active vit. D metabolites by the kidney. PS Wang/2004.05

  16. M. E. Hadley: Endocrinology 2nd ed. 1988 fig.9.3 #1993

  17. L.E. Mcdonald: Veterinary Endocrinology and Reproduction. 1976 2nd Ed. fig.4-5 #32

  18. L.E. Mcdonald:Veterinary Endocrinology and Reproduction. 1976 2nd Ed. fig.4-6 #33

  19. Guyton & Hall : Textbook of Medical Physiology 10th ed.2000 fig.79-10 #367

  20. L.E. Mcdonald:Veterinary Endocrinology and Reproduction. 1976 2nd Ed. fig.4-12 #36 p69

  21. W.F.Ganong:Review of Medical Physiology 2003 20th Ed. fig.21-6 #1441

  22. Christiansen, C. “New Horizon in Osteoporosis” The Parthenon Publishing Group, Lancs, UK, 1988, pp.15

  23. L.E. Mcdonald:Veterinary Endocrinology and Reproduction. 1976 2nd Ed. Fig.4-18 #41

  24. L.E. Mcdonald:Veterinary Endocrinology and Reproduction. 1976 2nd Ed. Fig.4-23 #42

  25. Calcitonin, CT • Source ---(1) in animals :parafollicular cells (C- cells) of thyroid gland (2) in lower animals : C-cells in ultimobranchial glands • Chemistry --- (1) polypeptide, 32 A.A. (2) MW = 3,000 • Effects---(1) hypocalcemia : • ↓activity of osteoclasts (rapid effect) • ↑ osteoblastic activity(transient effect) • ↓ formation of new osteoclasts from the osteoprogenitor cells (prolonged effect) • (2) hypophosphatemia • Regulation of Secretion ---- • (1) blood [Ca2+] ↑→↑CT • (2) gastrin, pacreozymin, & glucagon → ↑ CT PS Wang/2004.05

  26. W.F.Ganong:Review of Medical Physiology 2003 20th Ed. #1442 fig.21-16

  27. W.F.Ganong:Review of Medical Physiology 1983 12th Ed. #1443 fig.21-13

  28. W.F.Ganong:Review of Medical Physiology 1983 12th Ed. #189 fig.21-11

  29. Comparison of Calcitonin Effects with PTH Effects • PTH ---- slowly, need several hrs. CT ----- rapidly, less than 1 hr. (2) PTH ---- long-term regulation CT ----- short-term regulation PS Wang/2004.05

  30. L.E. Mcdonald:Veterinary Endocrinology and Reproduction. 1976 2nd Ed. #43 p.84

  31. W.F.Ganong:Review of Medical Physiology 2003 20th Ed. fig.21-7 #182

  32. M. E. Hadley: Endocrinology 2nd ed. 1988 fig. 9.9 #1995

  33. M. E. Hadley: Endocrinology 2nd ed. 1988 fig. 9.10 #1996

  34. Guyton & Hall : Textbook of Medical Physiology 10th ed.2000 fig.79-6 #366

  35. W.F. Ganong:Review of Medical Physiology 1983 12th Ed. Fig. 21-14 #1444

  36. L.E. Mcdonald:Veterinary Endocrinology and Reproduction. 1976 2nd Ed. #44 p.85

  37. L.E. Mcdonald:Veterinary Endocrinology and Reproduction. 1976 2nd Ed. #45 p.86

  38. Hyperparathyroidism Secondary Hyperparathyroidism • Tumors • Osteoclasts active • Blood [Ca++]↑ • Broken bone (decalcification) • Cystic bone (osteoclasts tumors) • Osteoblasts active • Kidney stones (calcium phosphate) ↑ • low Ca2+ diet • pregnancy • lactation blood[Ca2+][PTH]rickets • osteomalacia PS Wang/2004.05

  39. L.E. Mcdonald:Veterinary Endocrinology and Reproduction. 1976 2nd Ed. #47 p.94

  40. L.E. Mcdonald:Veterinary Endocrinology and Reproduction. 1976 2nd Ed. #48 p.95

  41. L.E. Mcdonald:Veterinary Endocrinology and Reproduction. 1976 2nd Ed. #49 p.96

  42. Hypoparathyroidism • Symptoms: blood[Ca2+]↓ osteoclasts inactive no. of osteoblasts ↓ bone strong tetany ↑ death • treatment: PTH --- expensive, long-term effects Ab ↑ Vit. D ----↑absorption of Ca2+ from GI & bone ↓rickets (children) PS Wang/2004.05

  43. Rickets • Causes --- in children, lack of vit. D blood[Ca2+] • Symptom---- blood[PO4-3]↓↓↓, blood [Ca2+]↓ (∵ Parathyroid↑ bone absorption ↑ & PO4- 3 excretion ↑) bone weaker osteoblastic activity ↑, but calcification rate↓ parathyroid gland hyperplasia tetany ↑(when blood [Ca2+]↓) respiratory spasm death • Treatment ---- (1)↑↑ Ca2+, PO4-3& vit. D in diet (2) exposed to sunlight PS Wang/2004.05

  44. Adult Rickets = Osteomalacia • Causes (1) fat absorption ↓ vit. D ↓ ↓ Ca2+ & PO4-3 absorption Osteomalacia (2) kidney damage 1,25-DiOH-CC ↓ PS Wang/2004.05

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