• Asian Pacific Journal of Cancer Prevention
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• v.13 no.9
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• pp.4373-4378
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• 2012

Introduction: Hypercalcemia is mainly caused by bone resorption due to either secretion of cytokines including parathyroid hormone-related protein (PTHrP) or bone metastases. However, hypercalcemia may occur in patients with or without bone metastases. The present study aimed to describe the effect of chemotherapy treatment, regimens and doses on calcium levels among breast and lung cancer patients with hypercalcemia. Methods: We carried a review of medical records of breast and lung cancer patients hospitalized in years 2003 and 2009 at Penang General Hospital, a public tertiary care center in Penang Island, north of Malaysia. Patients with hypercalcemia (defined as a calcium level above 10.5 mg/dl) at the time of cancer diagnosis or during cancer treatment had their medical history abstracted, including presence of metastasis, chemotherapy types and doses, calcium levels throughout cancer treatment, and other co-morbidity. The mean calcium levels at first hospitalization before chemotherapy were compared with calcium levels at the end of or at the latest chemotherapy treatment. Statistical analysis was conducted using the Chi-square test for categorical data, logistic regression test for categorical variables, and Spearman correlation test, linear regression and the paired sample t tests for continuous data. Results: Of a total 1,023 of breast cancer and 814 lung cancer patients identified, 292 had hypercalcemia at first hospitalization or during cancer treatment (174 breast and 118 lung cancer patients). About a quarter of these patients had advanced stage cancers: 26.4% had mild hypercalcemia (10.5-11.9 mg/dl), 55.5% had moderate (12-12.9 mg/dl), and 18.2% severe hypercalcemia (13-13.9; 14-16 mg/dl). Chemotherapy lowered calcium levels significantly both in breast and lung cancer patients with hypercalcemia; in particular with chemotherapy type 5-flurouracil+epirubicin+cyclophosphamide (FEC) for breast cancer, and gemcitabine+cisplatin in lung cancer. Conclusion: Chemotherapy decreases calcium levels in breast and lung cancer cases with hypercalcemia at cancer diagnosis, probably by reducing PTHrP levels.

• Imaging Science in Dentistry
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• v.35 no.3
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• pp.127-131
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• 2005

Purpose : We performed the present study to investigate whether osteotropic hormomes play roles on the nitric oxide (NO) production in culture of ROS 17/12.8 osteoblastic cells. Materials and Methods : The osteoblastic cell line ROS17/2.8 cells were cultured In F12 medium supplemented with $5\%$ fetal bovine serum (FBS) at $37^{\circ}C$ in a humidified atmosphere of $5\%\;CO_2$ in air. ROS17/2.8 cells were plated in 96-well plates at a density of $2-3\times10^3cells/well$ and grown to confluence. Then the cells were pretreated with osteotropic hormones (parathyroid hormone (PTH) 20-500 ng/mL, 1, 25-dihydroxycholecalciferol $(1,\;25[OH]_2D_3)$ 1-100 nM; prostaglandin $E_2 (PGE_2)$ 20-500 ng/mL in the medium supplemented with $0.4\%$ FBS for 72 hours and the cells were treated with cytokines $(TNF{\alpha}\;and\;IFN{\gamma})$ in phenol red-free F12 medium for an additional 48 hours. NO synthesis was assessed by measuring the nitrite anion concentration, the reaction product of NO, in the cell culture medium using Griess reagent. Results : PTH and $1,\;25[OH]_2D_3$ pretreatment induced a significant increase in NO production in the presence of $TNF{\alpha}\;and\;IFN{\gamma}.\;PGE_2$ slightly induced NO production compared to the control group. But, $PGE_2$ pretreatment did not affect in NO production in the presence of $TNF{\alpha}\;and\;IFN{\gamma}$. Conclusions : These results suggest that the actions of osteotropic hormones In bone metabolism may be partially mediated by NO in the presence of cytokines.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.17 no.1
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• pp.47-51
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• 2014

Purpose: Neonatal late-onset hypocalcemia is defined as hypocalcemia developed after postnatal 3 days and associated with hypoparathyroidism, high phosphate diets and vitamin D deficiency. We experienced the increment of neonatal late onset hypocalcemia over 1 year. We tried to evaluate the relationship between late onset hypocalcemia and maternal hypovitaminosis D. Methods: The medical records in the neonates with late-onset hypocalcemia during January 2007 to July 2008 were retrospectively reviewed. Among those patients, 17 paired sera of mothers and neonates had collected. The levels of 25-OH vitamin D (25OHD) and intact parathyroid hormone (iPTH) were measured and were compared with neonate and the mother. Results: The mean gestational age was $38^{+1}$ weeks, and the mean body weight was 2,980 g. The onset time of hypocalcemia was 5.9 days of age. Most of them (88.2%) were feeding with formula and no one was only breast milk feeding. Of the 17 patients, 13 were born in spring or in winter. The median levels of calcium, phosphorus, alkaline phosphatase, iPTH and 25OHD were 7.0 mg/dL, 8.6 mg/dL, 191.0 U/L, 57.2 pg/mL and 24.0 ng/mL in neonates. The levels of 25OHD of 6 neonates were <20 ng/mL. A total of 16 mothers were considered vitamin D-deficient (<20 ng/mL), and vitamin D insufficient (20<25OHD<30 ng/mL). Conclusion: Neonatal late-onset hypocalcemia in our study seems to be influenced by maternal vitamin D deficiency and insufficiency. Sun tanning and vitamin D supplements from winter to spring would be helpful to prevent maternal vitamin D deficiency, one of the causes of neonatal late-onset hypocalcemia.

• Clinical and Experimental Pediatrics
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• v.55 no.11
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• pp.438-444
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• 2012

Mucolipidosis II (ML II) or inclusion cell disease (I-cell disease) is a rarely occurring autosomal recessive lysosomal enzyme-targeting disease. This disease is usually found to occur in individuals aged between 6 and 12 months, with a clinical phenotype resembling that of Hurler syndrome and radiological findings resembling those of dysostosis multiplex. However, we encountered a rare case of an infant with ML II who presented with prenatal skeletal dysplasia and typical clinical features of severe secondary hyperparathyroidism at birth. A female infant was born at $37^{+1}$ weeks of gestation with a birth weight of 1,690 g (<3rd percentile). Prenatal ultrasonographic findings revealed intrauterine growth retardation and skeletal dysplasia. At birth, the patient had characteristic features of ML II, and skeletal radiographs revealed dysostosis multiplex, similar to rickets. In addition, the patient had high levels of alkaline phosphatase and parathyroid hormone, consistent with severe secondary neonatal hyperparathyroidism. The activities of ${\beta}$-D-hexosaminidase and ${\alpha}$-N-acetylglucosaminidase were moderately decreased in the leukocytes but were 5- to 10-fold higher in the plasma. Examination of a placental biopsy specimen showed foamy vacuolar changes in trophoblasts and syncytiotrophoblasts. The diagnosis of ML II was confirmed via GNPTAB genetic testing, which revealed compound heterozygosity of c.3091C>T (p.Arg1031X) and c.3456_3459dupCAAC (p.Ile1154GlnfsX3), the latter being a novel mutation. The infant was treated with vitamin D supplements but expired because of asphyxia at the age of 2 months.

• Journal of Yeungnam Medical Science
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• v.34 no.1
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• pp.69-74
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• 2017

Background: Chronic kidney disease is considered a risk factor for thyroid nodules as well as thyroid dysfunction such as hypothyroidism. Among patients on hemodialysis, we assessed the size of thyroid nodule and goiter at baseline and 1 year later with ultrasonography. Methods: We prospectively selected 47 patients with hemodialysis at January 2012 and reviewed their medical records. We checked goiter and thyroid nodules at January 2012 and December 2012. Results: In the hemodialysis patients (n=47), 24 patients (51.1%) had thyroid nodules and 33 patients (70.2%) had goiter at baseline. Parathyroid hormone (PTH) was higher in patients with thyroid nodules ($204.4{\pm}102.9$ vs. $129.9{\pm}93.6pg/mL$, p=0.01). Thyroid ultrasonography was conducted in 29 patients after 1 year. The thickness of the thyroid isthmus increased ($2.8{\pm}1.6$ vs. $3.2{\pm}1.9mm$, p=0.003), but the number of nodules did not change ($1.2{\pm}1.9$ vs. $1.4{\pm}2.0$, p=0.109). PTH was associated with the enlargement of thyroid nodules significantly through logistic regression analysis. Conclusion: Thyroid goiter and nodules in hemodialysis patients were more prevalent than in the general population. PTH influenced the production of thyroid nodules in hemodialysis patients. Regular examination with thyroid ultrasonography and thyroid function test should be considered in hemodialysis patients.

• Journal of Korean Neurosurgical Society
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• v.63 no.5
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• pp.623-630
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• 2020

Objective : A primary degenerative sagittal imbalance has been considered because of unique lifestyles such as the prolonged crouched posture during agricultural work and performing activities of daily living on the floor. Previous papers have reported that sagittal imbalance disease is often seen distinctly in the farming districts of "oriental" countries such as Korea and Japan. However, this finding was only evaluated with the use of X-ray, and other factors such as magnetic resonance imaging (MRI), muscle volume, compression fracture, and laboratory results were not considered. Thus, using these, we evaluate the agricultural work-associated factors for Korean elderly spinal sagittal imbalance. Methods : We recruited 103 Korean participants who had a sagittal vertical axis (SVA) of >5 cm in this Korean Elderly Sagittal Imbalance Cohort Study. The following were evaluated : radiological parameters, MRI, compression fracture, vitamin D, parathyroid hormone, C-terminal telopeptide, osteocalcin, bone mineral density and muscle fatty change, muscle volume, and health-related quality of life from patients' survey. Moreover, in this survey, the farmers' annual working hours were investigated. Subsequently, we analyzed the associated factors for spinal sagittal imbalance depending on occupation. Results : A total of 46 participants were farmers, and the others were housewives, sellers, and office workers. The farmer group had more SVA (141 vs. 99 mm, p=0.001) and pelvic tilt (31° vs. 24°, p=0.004) and lesser lumbar lordosis (20° vs. 30°, p=0.009) and thoracic kyphosis (24° vs. 33°, p=0.03) than non-farmer group. A significantly positive correlation was noted between the working hour and SVA in the farmer group (p=0.014). The visual analogue scale score for back pain (8.26 vs. 6.96, p=0.008) and Oswestry Disability Index (23.5 vs. 19.1, p=0.003) in the farmer group were higher than that in the non-farmer group, but the Short Form-36 score was not significantly different between the two groups. The Mini-Mental State Exam score was significantly lower in the farmer group than in the non-farmer group (24.85 vs. 26.98, p=0.002). Conclusion : The farmer group had more sagittal imbalance and back pain in proportion to the working hours even though the muscle and bone factors and general laboratory condition were not significantly different between the two groups. These results supported that the long hours spent in the crouched posture while performing agricultural work were a risk factor for severe sagittal imbalance.

• Journal of Nutrition and Health
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• v.31 no.1
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• pp.46-61
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• 1998

This study was carried out to evaluate the effects of vitamin D nutritional status on bone mineral density of adults (21-49 years). To attain the aim, we measured bone mineral density (BMD) of the subjects at distal radius by single-photon absorptiometry (SPA). Serum level of 25-hydroxyvitamin D(25-(OH)D) , known to be the best indicator of indicator of vitamin D status in humans was analyzed . The factors affecting this vitamin D level were also investigated in autumn in 122 young adults. Serum level of 25-(OH)D was measured by high pressure liquid chromatography(HPLC) and biochemical variables, general health status, time spent outdoors, and dietary intakes of the subjects. BMD of the male subjects was significantly greater than that of female subjects. Weight, activity and total energy expediture (TEE) showed a positive correlation with distal BMD. The mean level of serum 25-(OH)D was 24.4$\pm$11.0 ng./ml and by sex, 26.0$\pm$6.8ng/ml for males and 23.3$\pm$12.3ng/ml for females , the level was significantly higher in male (p<0.01). there was significant correlation between BMD at distal-radius and s-25(OH)D levels (p<0.001). The serum level fo parathyroid hormone (PTH) showed a negative correlation with BMD(p<0.05), with the more obvious correlation in females. Vitamin D intake was estimated to be 3.75$\pm$2.19ug/day in average. Among the nutrients studied, protein ,fat, calcium , and vitamin D intake were positively correlated with distal BMD. When food frequencies were concerned , milk and dairy products showed a significant positive correlation with the BMD level, and driedfoods, eggs , fats and oils, and cereals also showed a positive correlation. Time spent outdoors was estimated to be about 70 minutes in average and positively correlated with the distal BMD level(p<0.01). During the day, the specific time between 12 :00pm and 2:00pm showed the most significant correlation with BMD (p<0.001). Multiple regression analysis with the variables showed that distal BMD could be fit 31.9% by the time spent outdoors a day, intake of Ca and vitamin D, and TEE. The standardized estimates were 0.344 for vitamin D intake, 0.284 for Ca intake 0.179 for the time spent outdoors a day and 0.273 for TEE. For males, s-25*OH)D level, TEE and time spent outdoors during a day showed a significant correlation. For females, intake of Ca and vitamin D could fit about 27.1% of the distal BMD.

• Journal of Nutrition and Health
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• v.45 no.2
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• pp.121-126
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• 2012

This study evaluated the effect of fish oil rich in n-3 fatty acids on bone characteristics in Sprague-Dawley rats. Weanling male rats were randomized to receive either a diet containing high fish oil (FO), fish oil blended with corn oil (FICO), or soy oil rich in n-6 fatty acids (SO) for 4 weeks. All diets provided 70 g/kg fat based on the AIN-93G diet. Growth and biomarkers of bone metabolism were analyzed, and femur bone characteristics were measured by dual-energy X-ray absorptiometry. After the dietary treatment, no significant differences among the diet groups were observed for serum concentrations of Ca, parathyroid hormone, calcitonin, or osteocalcin. Alkaline phosphatase activity was significantly greater in FO-fed rats compared to that in the FICO and SO groups, whereas no difference in deoxypyridinoline values was observed, supporting the positive effect of a FO diet on bone formation. These results were accompanied by a significant increase in femur bone mineral density (BMD) in FO-fed rats. These findings suggest that providing fish oil rich in n-3 fatty acids correlates with higher alkaline phosphatase activity and BMD values, favoring bone formation in growing rats.

• Childhood Kidney Diseases
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• v.1 no.1
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• pp.13-16
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• 1997

Steroid induced bone loss is a serious problem in frequently relapsing nephrotic syndrome especially in growing children. In order to evaluate whether $1-(OH)D_3$ (IL Sung Pharma.Co.) is effective in preventing steroid induced bone loss, we gave $0.5{\mu}g$ of $1-(OH)D_3$ for one year to forty patients with frequently relapsing nephrotic syndrome, receiving longterm prednisolone therapy (mean duration $50.12{\pm}29.40$ months). We checked the following markers before and after $1-(OH)D_3$ therapy. i.e. bone mineral density(BMD) using dual energy X-ray absorptiometry(DEXA) at the 2nd to 4th lumbar spine, serum calcium, phosphorus, parathyroid hormone(PTH), osteocalcin and urine pyridinoline(U-PYD). BMD($g/cm^2$) was increased even steroid therapy from $0.71{\pm}0.0\;to\;0.73{\pm}0.0$ (p<0.05). Lumbar spine BMD is a sensitive marker for evaluating steroid induced bone loss in children receiving longterm corticosteroid therapy and that $1-(OH)D_3$ appears to be effective in treating and preventing steroid induced bone loss.

• Journal of the East Asian Society of Dietary Life
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• v.27 no.4
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• pp.408-419
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• 2017

This study was carried out to compare the relationship between biochemical indices and bone mineral density (BMD) in 50 pre-menopausal and 50 post-menopausal women. The subjects were divided into normal and risk groups according to their bone status, as determined by T-scores of the lumbar spine and femur. The average T-score of the lumbar spine was higher (p<0.05) in pre-menopausal women ($0.42{\pm}0.18$) than post-menopausal women ($-0.08{\pm}0.21$). Serum levels of HDL-cholesterol, P, and Fe were significantly higher in the risk group than the normal group in pre-menopausal women (p<0.05). Serum levels of total protein, globulin, alkaline phosphatase (ALP), and osteocalcin were lower in the risk group than the normal group, whereas the level of estrogen was higher in the normal group than the risk group in post-menopausal women (p<0.05). In pre-menopausal women, P was positively correlated with Ca (p<0.01), and ALP was positively correlated with osteocalcin (p<0.01) and parathyroid hormone (PTH) (p<0.05). Further, insulin-like growth factor-I (IGF-I) was negatively correlated with the vitamin $25(OH)D_3$ and vitamin K (p<0.05). In post- menopausal women, the Ca was positively correlated with vitamin $25(OH)D_3$ (p<0.05) and vitamin K (p<0.01), and P was positively correlated with vitamin K (p<0.01), Ca (p<0.01), and IGF-I (p<0.05) and negatively correlated with PTH (p<0.05). IGF-I was negatively correlated with PTH (p<0.01) and estrogen (p<0.05), and ALP was positively correlated with osteocalcin (p<0.01) and negatively correlated with vitamin K and estrogen (p<0.05). In pre-menopausal women, the lumbar spine BMD was positively correlated with vitamin K level (p<0.01) and negatively correlated with P level (p<0.05). In post-menopausal women, the femur BMD was positively correlated with estrogen level and negatively correlated with PTH leves (p<0.05). These results suggest that vitamin K and P levels are associated with bone health in pre-menopausal women, and estrogen and PTH levels are associated with bone health in post-menopausal women.