Decreased plasma calcitonin response to a calcium clamp in primary hyperparathyroidism

In order preoperatively to evaluate the calcium induced plasma calcitonin (CT) response in patients with mild primary hyperparathyroidism (PHPT), 7 postmenopausal (PM) females with PHPT and 14 PM healthy subjects underwent a 2 h calcium infusion. The infusions were performed by means of the 'calcium clamp' technique previously described by us in order to obtain an identical calcium stimulus in all subjects. Immunoreactive calcitonin (iCT) was determined by means of a sensitive RIA utilizing rabbit antibodies directed against the carboxy-terminal amino acid sequence of the CT molecule. All patients with PHPT had normal basal plasma iCT levels: 10 +/- 5 pg-eq/ml (mean +/- SD) as a group and not different from the control group: 13 +/- 5 pg-eq/ml. In the control group significantly increased plasma iCT was seen at 30, 60, 90 and 120 min in contrast to that of the PHPT group where a blunted response was observed. The results indicate a diminished CT reserve in these patients which may imply an impaired defence against the PTH mediated bone resorption seen in patients with PHPT.

Calcitonin-like immunoreactivity in human milk, longitudinal alterations and divalent cations

The concentration of immunoreactive calcitonin (iCT) in human milk was 10-40 times the serum level. Thus in milk samples collected from 29 mothers within one week and from 46 mothers three months post partum the levels of iCT were respectively 2.46 +/- 0.99 ng/ml (mean +/- SD) and 0.58 +/- 0.08 ng/ml. Eight of the 29 mothers delivered milk at two occasions, 1-2 and 4-6 days after delivery. There was a significant decline of iCT with about 20% during this period. One mother delivered milk for two months. During the first week after delivery the iCT decreased from 1.4 to 0.5 ng/ml and after that the iCT content remained rather constant. The level of ionized calcium (Ca++) was correlated to iCT the first week post partum (r = 0.72 p less than 0.01) but not in milk samples obtained after three months. The concentration of magnesium was weakly correlated to iCT during the first week post partum (r = 0.37 p less than 0.05). There was no correlation between iCT and the total calcium level nor to the concentration of zinc. The high concentration of iCT in milk compared to serum suggests a local production of iCT within the mammary gland or a specific transport and concentration mechanism.

Heterogeneity of immunoreactive calcitonin in human milk

Immunoreactive calcitonin (ICT) has been detected in human milk by radioimmunoassay (RIA), using antibodies raised against synthetic human calcitonin (hCT). The level of ICT was 10-40 times higher than the reference level of human serum. Gel chromatography of human milk disclosed a molecular weight heterogeneity of ICT, with at least two forms larger than the monomer (Mr greater than 70000 and 30000 approximately). The 30000 peak constituted the major fraction of ICT. No detectable amount of ICT was coeluted with [125I]CT. Reduction with disulphide cleaving agents, denaturation or acidification did not alter the gel chromatographic properties of ICT, while tryptic digestion caused partial degradation of ICT and formation of new ICT molecules with an approximate molecular weight of 6000.

Quantitation of phenobarbital and its main metabolites in human urine

A method for the quantitative determination of phenobarbital and free and conjugated p-hydroxyphenobarbital in urine samples is described. The method includes initial extraction, purification on a small chromatographic column and finally determination by gas chromatography. The barbituric acids are methylated by trimethylanilinium hydroxide which serves as a "flash heater" methylating agent. The conjugate of p-hydroxyphenobarbital, which appears to be a glucuronide, is hydrolysed with hydrochloric acid.