• Korean Journal of Clinical Pharmacy
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• v.23 no.2
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• pp.142-150
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• 2013

Background: Secondary hyperparathyroidism (SHPT) is common in patients with chronic kidney disease, affecting most of those who are receiving dialysis. Cinacalcet, a novel calcimimetic, targets the calcium-sensing receptor to lower PTH levels in dialysis patients. Objective: This study aimed to assess efficacy, safety and appropriateness of use of cinacalcet in dialysis patients. Method: This retrospective study was performed on total 24 cases with identified intact parathyroid hormone (iPTH), serum calcium and phosphorus levels before and 4 weeks after cinacalcet initiation at a teaching hospital from July 1st, 2011 to October 31st, 2012. Results: Cinacalcet decreased iPTH by 19% from baseline after 4weeks treatment and it was statistically significant (p<0.001). Cinacalcet also significantly decreased iPTH levels regardless of dialysis modality (hemodialysis group versus peritoneal dialysis group) and severity of SHPT (iPTH 300-800 pg/ml group versus iPTH >800 pg/ml group). Serum calcium, phosphorus and Ca x P levels were decreased without statistical significance. Gastrointestinal events, headache and hypocalcemia were the most common side effects. Monitoring for iPTH and serum calcium was not performed appropriately. 43.7% patients initiated cinacalcet therapy at serum calcium level< 9.0 mg/dl. Conclusion: In conclusion, cinacalcet lowers parathyroid hormone levels with no serious side effects. However, it is required to avoid cinacalcet treatment in patients with low serum calcium levels and monitor iPTH and serum calcium levels during cinacalcet administration.

• Journal of Medicine and Life Science
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• v.16 no.1
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• pp.31-33
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• 2019

Hypercalcemia is often seen in patients, but most of them showed mild to moderate hypercalcemia. The severe hypercalcemia with a blood calcium level of 14.0 mg/dL or more is known to be associated mainly with malignant tumors. Because this is emergency status, most clinicians tried to decrease serum calcium level to near normal range to improve symptoms related to hypercalcemia. A 71-year-old female patient visited the emergency room with dizziness and general weakness. Her serum calcium level was very high (15.6 mg/dL), but serum PTH, 25-OH vitamin D, and PTH related peptide were normal. We can exclude hyperparathyroidism, familial hypocalciuric hypercalcemia, other connective tissue diseases, and hypercalcemia due to malignant tumors as a cause of severe hypercalcemia. Conclusively, we diagnosed as severe hypercalcemia due to high-dose vitamin D injections treated one week ago. High dose vitamin D injections have recently been shown to increase the frequency of prescription as the various causes and the clinicians needed to carefully monitor the serum calcium levels in the patients after treating with high dose vitamin D.

• The Journal of Korean Obstetrics and Gynecology
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• v.19 no.2
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• pp.107-126
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• 2006

Purpose : This study was peformed to evaluate the effect of Kamijoaguiem(JGE) on the bone mass and its related factors. Methods : We used ovariectomized rat as an estrogen-deficient animal model. The model rats of osteoporosis showed a significant decrease in bone density, bone ash density, calcium content of femur bone. At the 7th day after operating ovariectomy, rats were administered with JGE per orally, and continued for 10 weeks. And osteoporosis related parameters were determined to investigate the effect of JGE. Results : Bone density, bone ash density, bone calcium, magnesium and phosphorus was decreased in osteoporotic rats. JGE improved the decreased bone density, bone ash density and the decreased bone magnesium, but JGE didn't improve the decreased bone calcium and phosphorus in osteoporotic rats. Osteocalcin in serum and hydroxy-proline excretion in urine were increased in osteoporotic rats. Their levels were decreased when JGE was administered. ALP activity in serum was increased in osteoporotic rats. JGE didn't induce any significant changes. JGE showed significant increase in serum calcium level, total protein level, albumin level, BUN level, serum LDH activity. JGE didn't show significant increase in serum T-cholesterol density, triglyceride density, HDL-cholesterol density. JGE didn't show significant increase in RBC number, hemoglobin level, platelet number, hematocrit level. JGE showed inhibitory effect on the degradation of bone-matrix in osteoporotic rats, in histological examination to Hematoxylin-eosin stain. Conclusion : JGE might improve bone density due to inhibition of bone resolution in osteoporotic rats. It suggest that JGE may be useful prescription in osteoporosis.

• Journal of Chest Surgery
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• v.18 no.2
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• pp.205-213
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• 1985

It is well documented that calcium is essential to cardiac contraction and the amplitude of contractility is proportional to the ionized calcium not to total calcium. Changes of serum ionic calcium before and after extracorporeal circulation were observed in fifty two patients operated on at Dept. of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, from May 21st, 1984, to July 6th, 1984. They were 28 males and 24 females including 21 acyanotic congenital heart diseases, 21 cyanotic congenital heart diseases, and 10 acquired valvular heart diseases. In general, preoperative serum ionic calcium was around the normal level, but those of immediate postoperative day and postop-first day were decreased subnormally with significance [P<0.05 vs. preop.]. From postop-third day, serum ionic calcium was returned to normal range. No significant difference was noticed in subgroups divided by 10 Kg of body weight and by the methods of myocardial protection. But the change of serum ionic calcium in the patients with prolonged pump time over 90 minutes was remarkable and the values were as follow; on immediate postop-day 1.780.18 mEq/L vs. 1.970.20 mEq/L [P<0.005],on postop-first day, 1.940.20mEq/L vs. 2.060.12 mEq/L [P<0.025], on postop-third day, 2.030.11mEq/L vs. 2.150.13mEq/L [P<0.01], and on postop-seventh day, 2.030.09mEq/L vs. 2.190.11mEq/L [P<0.005]. In summary, the serum ionic calcium was lowered after extracorporeal circulation and even severer degree according to the prolongation of bypass time. So, after extracorporeal circulation esp. in the cases with prolonged bypass time, early correction of lowered serum ionic calcium would be helpful to the postoperative hemodynamics.

• Journal of Nutrition and Health
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• v.24 no.1
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• pp.30-39
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• 1991

This study was designed to investigate the effects of dietary calcium. serum estrogen level and physical activity on the bone status of 116 healthy elderly women living in urban area. Current calcium intake was assessed by convenient method(refered to as Ca intake) and calcium containing food frequency method(refered to as Ca index) Daily activity record was used for the estimation of physical activity level, and serum estrogen level was measured from fasting blood of subjects. The rate of bone resorption was evaluated by the determination of hydroxyproline(Hpr) in fasting urine with correction for creatinine excretion. The results of this study are summarized as follows : 1) Average daily Ca intake of subjects was 621.4$\pm$155.8mg, which is above the Korean recommended dietary allowances. However 44.8% of the subjects consumed Ca below RDA level. Ca index score was significantly correlated with the bone status(P<0.05), Ca intake did not show significant correlation with the bone status although a positive trend of influence was evident. 2) Average serum estrogen level of subjects was 18.7$\pm$9.8pg Contrary to our anticipation. estrogen level did not show any significant relation to age and bone status. 3) Daily physical activity was classified into four categories by activity intensity : sedentary. moderate, active and severe. The average physical activity of subjects belong to moderate level. and the bone status was significantly related to the physical activity(P<0.01) 4) Among other influential factors such as age, pocket-money. family type. drinking, smoking and BMI, there was a significant difference between bone status and BMI(P<0.05). 5) Multiple regression analysis of variables showed that physical activity has greater effect than other variables when the entire subjects were taken into account. However. eliminating the subjects whose bone status rated as excellent(Hpr/cr<0.009), Ca index showed higher correlation than physical activity. These results have demonstrated that dietary calcium intake is the primary important factor for keeping good bone health and that bone status of subjects with a sufficient calcium intake is affected by various factors such as physical activity, age, smoking. BMI and others.

• Journal of the East Asian Society of Dietary Life
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• v.6 no.3
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• pp.295-305
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• 1996

This study was done to evaluate the effectiveness of dietary calcium level(a diet which met 100% or twice the calcium level in AIN-76 diet) on preventing bone loss in ovariectomized rats. Forty female Sprauge-Dawley rats(body weight 200$\pm$5g) were divided into two groups. One group were ovariectomized(Ovx) while the others received sham operation(Sham). Thereafter, each rat group was further divided into normal calcium diet(NCD, 0.52%) and high calcium diet(HCD, 1.04%) sub-groups. All rats were fed on experimental diet and deionized water ad libitum for 8 weeks. Urinary pyridinoline & creatinine and serum estradiol, luteinizing hormone, calcium, phosphate, total protein, albumin, alkaline phosphatase and osteocalcin were determined. There were no significant differences in serum calcium. total protein and albumin in the two groups(Ovx vs Sham) of rats. Ovariectomized rats had significantly lower estradiol than sham operated rats. There was a highly significant correlation between total bone mineral density(TBMD) and overall level of esteradiol(r=0.59, p<0.05). Total bone mineral density did not correlate significantly with ALP or osteocalcin, although a negative trend was evident. However, the rats fed high calcium diet had a lower crosslinks value and osteocalcine than the rats fed normal calcium diet. An increased rate of bone turnover is usually associated with a decrease in bone mass bexause bone formation at each remodeling site is never as great as resorption. Ovariectomized rats fed high calcium diet had a lower crosslink value and osteocalcin; it means high cacium diet decreased bone turnover rate. The findings from the present study demonstrated that bone loss due to ovarian hormonal deficiency can be partially prevented by a high calcium diet. Futhermore, these findings support the strategy of the use of a high calcium diet in the prevention of estrogen depletion bone loss (postmenopausal osteoporosis).

• Journal of Nutrition and Health
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• v.31 no.3
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• pp.279-288
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• 1998

This study explored the effect of calcium levels and/or ovariectomy on bone metabolism using female Sprague-Dawley weanling rats as a model . Rats received a low (0.1%) calcium diet for 8 weeks. The rats were then divided into three subgroups that were fed 0.1% ,0.5% and 1.5% calcium diets for 8 weeks after operation. The results of this experiment indicate that body weight gin was higher in ovariectomy groups than in sham groups regardless of calcium level and food intake. Serum Ca and P concentrations were of normal level regardless of calcium level and ovariectomy. Estrogen concentration was low in the ovariectomized group. Serum alkaline phophatase activity and urinary hydroxyproline have been used as markers of bone formation and resorption. These values were increased in ovariectomized groups. The weight, length and breaking force of femur were not significantly different between the groups. Ash, Ca, P and total lipid contents in femur and lumbar were decreased in the groups fed low calcium . Mg content was decreased in the ovariectomy and total protein content was not affected by calcium level and ovariectomy. The effect groups of ovarectomy on calcium contents of bone was more prominent in lumbar than in femur. In conclusion, though low calcium intakes during growth period may retard the attainment of peak bone mass, calcium supplementation after this period increased bone growth and mineral contents, but not significant effect in three calcium levels. Furthermore, calcium intake was shown to have a greater influence on the mineral contents of femur than of lumbar, and removal of endogenous estrogen production by ovariectomy was shown to be more deleterious on the ash and calcium contents of the lumbar than of femur.

• Asian-Australasian Journal of Animal Sciences
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• v.20 no.11
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• pp.1713-1720
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• 2007

Influence of -110, +110, +220 and +330 mEq/kg of dry matter (DM) dietary cation-anion difference (DCAD) on growth performance of Thalli lambs were examined in a randomized complete block design. Four DCAD diets were randomly allotted to four groups, with ten lambs in each group. A linear increase in nutrient intake was recorded with increasing DCAD level. The digestibilities of nutrients were higher in lambs fed -110 DCAD diet than those fed +110, +220 and +330 DCAD diets. Lambs fed +330 DCAD diet had higher nitrogen balance than those fed -110 and +110 DCAD diets. Blood pH and serum $HCO_3$ increased with increasing DCAD level. Serum chloride was higher in lambs fed -110 DCAD diet, while serum (Na+K)-(Cl+S) increased linearly with increasing DCAD level. Serum calcium increased with decreasing DCAD level while serum magnesium and phosphorus remained unaffected. Lambs fed -110 DCAD diet had higher Ca balance than those fed +110, +220 and +330 DCAD diets. Urine pH increased with increasing DCAD level. Lambs fed +220 and +330 DCAD diets gained more weight than those fed -110 and +110 DCAD diets. In conclusion, increased DCAD level not only increased the dry matter intake but also improved the weight gain of growing Thalli lambs.

• The Korean Journal of Food And Nutrition
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• v.6 no.3
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• pp.211-218
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• 1993

This study was carried out to estimate the dally intake of lead and the relationship among dietary In take, serum level, and urinary excretion of calcium In 30 healthy adults living In rural area of Korea (12 males and 18 females). Analyses for the nutritional status of the subjects were performed by 3-day dietary intake record, duplicated diet collection, 24-hour urine collection, and venous blood sampling. The results were as follows The mean daily intake of energy was 2,176.3kcal and 1,613.9kcal in males and (tamales of 20∼49years, and 1,914.8kcal and 1,517.9kcal in males and females of 50∼59years, respectively The ratio of carbohydrate : fat : protein was 73.4:13.6:13.0 in males and 76.4:10.3:13.3 In females. The mean daily intake of lead was 277.2Pg in males and 192.0ug in females. The mean daily intake, serum level, and urinary excretion of calcium were 491.1mg, 8.9mg/dl, and 80.7mg in males and 426.7mg, 8.8mg /dl, and 80.3mg in females, respectively. No significant correlation was found between the daily lead intake and the dietary intake, serum level, and urinary excretion of calcium. It was concluded that the daily lead intake was lower than the acceptable daily lead intake of FAO/WHO but a little higher than that of other investigations. And the daily lead intake was not level that relate to calcium status seriously.

• Journal of Nutrition and Health
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• v.27 no.1
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• pp.90-99
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• 1994

This study was carried out to examine how dietary protein and calcium levels in rats fed fat-enriched diet affect the total lipid and cholesterol contents of blood and tissues. Male Sprauge-Dawley rats weighing approximately 200g were fed six purified diets which contained 18%(w/w) beef tallow, 1% (w/w) cholesterol, two source of protein, casein or isolated soy protein (ISP) and three levels of dietary calcium, 0.1%, 0.4% and 1.0%, first, for four weeks, and second, for eight weeks. The contents of the total lipid, cholesterol and triglyceride in blood, liver, heart and feces were determined. After four weeks feeding serum lipid and cholesterol concentrations significantly decreased in rats fed 1.0% (w/w) level calcium, regardless of dietrary protein sources. After eight weeks, these concentrations were significantly lower in the rats fed soy protein than in casein-fed rats. As dietary calcium level increased serum and tissue lipid and cholesterol contents were decreased and fecal lipid excretion increased. It is concluded that hypolipidemic and/or hypocholesterolemic effects of soy protein and calcium were partly due to decrease in lipid absorption.