200 



L. LUTWAK 



several weeks. This curve begins to resemble the normal pattern described previously. 

 The values obtained were approximately twice as high as those when the patient was 

 untreated. 



6 hours 7 



Fig. 2. ■'"Ca Arm Counts. 71 year old female, idio- 

 pathic hypoparathyroidism. 1, 2: untreated. 3: 400 

 units parathyroid extract daily. 4: 10,000 units 

 vitamin D daily. Ordinate, fraction of adminis- 

 tered dose; abscissa, hours 



Fig. 3. ■''Ca Arm Counts. 81 year old female, sprue. 1: un- 

 treated. 2: 6 weeks on gluten-free diet. 3: 12 weeks, glu- 

 ten-free diet. Coordinates as in Fig. 2 



Fig. 3 shows results obtained in an 81 year old woman with a malabsorption 

 syndrome, diagnosed as sprue. Curve 1 was measured when the patient was untreated 

 and was passing four to six fat-containing, foul smelling, watery stools daily. The 

 maximum value achieved is very similar to that seen in the previous patient with 

 idiopathic hypoparathyroidism, but even more striking, is the very gradual, slow 

 slope of the first portion of the curve. No detectable counts were obtained until 

 approximately an hour and a half after the ingestion of the isotope. Curve 2 was 

 obtained six weeks after the patient had been on a gluten-free diet. The values now 

 approximated a normal pattern in terms of the maximum level reached and the 

 increased rate of the first portion of the curve. The third curve was obtained during 

 a follow-up admission, after the patient had been on a gluten-free diet for 12 weeks, 

 and this is even closer to normal. Note, however, that the point of first appearance of 

 significant counts was still markedly delayed, occurring approximately one hour after 

 ingestion. 



Table 1 summarizes the estimates of "kj" and "a^", as well as percent apparent 

 absorption calculated from stool excretion, in a series of patients who have been 

 studied by this technique. It should be noted that there was no significant difference 



