3.Bone Mineral Density in Mild and Advanced Ankylosing Spondylitis.
Kazim CAPACI ; Simin HEPGULER ; Mehmet ARGIN ; Isil TAS
Yonsei Medical Journal 2003;44(3):379-384
To compare the bone mineral density (BMD) and determine the frequency of osteoporosis in mild and advanced ankylosing spondylitis (AS) cases. Seventy three patients with AS were enrolled in this study. The BMD was analyzed at the lumbar spine and hip by dual energy X-ray absorptiometry. The patients were diagnosed as being "normal, osteopenia, or osteoporosis" according to the WHO classification. Using the BASRI-lumbar and BASRI-hip scores, the patients were grouped in mild and advanced AS categories. The mean BMD in the lumbar spine and hip of patients with mild and advanced AS was similar (p > 0.05). While 61.6% of the patients were found to have osteopenia or osteoporosis in the lumbar spine, 46.6% had osteopenia or osteoporosis in the total hip. Of the patients with advanced AS 54.3% had osteopenia or osteoporosis in the lumbar spine, 75% in the total hip. Of the patients with mild AS patients had 68.4% osteopenia or osteoporosis in the lumbar spine, and 42.3% in the total hip. The osteopenia or osteoporosis frequency of the mild and advanced cases of AS in the lumbar spine was similar (p > 0.05). In the advanced AS patients, osteopenia or osteoporosis frequency was significantly higher in the total hip than in the mild AS patients (p < 0.05). In conclusion, there was evidence of osteoporosis in both the advanced AS and mild AS patients. The reason why the anteroposterior lumbar DXA results in the advanced AS patients were similar to the mild ones may be due to the existence of syndesmophytes and ligament calcification. In these cases, it is more convenient to use a hip DXA for assessing the extent of osteoporosis.
Adult
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*Bone Density
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Bone Diseases, Metabolic/etiology
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Disease Progression
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Female
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Human
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Male
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Middle Aged
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Osteoporosis/etiology
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Spondylitis, Ankylosing/complications/*physiopathology
4.The influence of gastrectomy on the change of bone metabolism and bone density.
Sung Joon KWON ; Joon Soo HAHM ; Yun Ju CHO ; Youhern AHN ; Dong Ill SHIN
The Korean Journal of Internal Medicine 2000;15(1):25-31
OBJECTIVES: Abnormalities of bone metabolism could be followed in gastrectomized patients as a late complication. Nowadays, many biochemical and radiologic measurements are applied to detect these abnormalities. The aim of our study is to determine the valuable parameter as an appropriate screening test during long-term follow-up periods and define the usefulness of new biochemical markers for bone metabolism by comparing with traditional markers. METHODS: Fifteen patients who had undergone partial gastrectomy were chosen randomly and fifteen healthy controls were compared. Then, several biochemical and radiologic tests were measured. We excluded subjects who proved to have other causes of bone metabolism abnormalities. Ten patients and 10 controls were finally selected. RESULTS: Comparing the data with those of a corresponding control group, the lumbar bone density measured by quantitative computed tomography (QCT) was statistically significantly lower in the patient group (p +ADw- 0.01). The urinary deoxypyridinoline, a biochemical marker for bone resorption, was statistically higher in the patient group (p +ADw- 0.025). Osteocalcin, Procollagen I C-terminal peptide (PICP) and Type I collagen C-terminal telopeptide (ICTP) were slightly but not significantly higher in the patient group. The serum parathyroid hormone (PTH) and 25-hydroxy vitamin D levels were similar in both groups. CONCLUSION: We could suggest that urinary deoxypyridinoline and QCT are appropriate parameters as screening tests for the detection of bone metabolism abnormalities in gastrectomized patients during long-term follow-up. Urinary deoxypyridinoline may be a simple and rapid test which could replace cumbersome 24-hour urinary hydroxyproline.
Absorptiometry, Photon
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Adult
;
Biological Markers/analysis
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Bone Density/physiology+ACo-
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Bone Diseases, Metabolic/etiology+ACo-
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Bone Diseases, Metabolic/diagnosis
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Bone Diseases, Metabolic/blood
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Comparative Study
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Gastrectomy/methods
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Gastrectomy/adverse effects+ACo-
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Human
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Male
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Middle Age
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Reference Values
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Sensitivity and Specificity
5.Inherited Vitamin K Deficiency: Case Report and Review of Literature.
Zerrin ORBAK ; Ayse SELIMOGLU ; Hakan DONERAY
Yonsei Medical Journal 2003;44(5):923-927
Vitamin K is the cofactor for the hepatic carboxylation of glutamic acid residues in a number of proteins including the procoagulants factors ll, Vll, lX, and X. The role of vitamin K in normal bone function is not fully understood. Inherited deficiency of vitamin K dependent coagulation factors is a rare bleeding disorder reported only in a few patients. Here we present an 18-month old child who presented with osteopeni due to inherited vitamin K deficiency. While the patient had high bone specific alkaline phosphatase and parathyroid hormone levels and low osteocalcin and bone mineral density values, with the regular supplementation of vitamin K all the mentioned parameters returned to normal values.
Bone Density
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Bone Diseases, Metabolic/etiology
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Human
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Infant
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Male
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Osteocalcin/blood
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Prothrombin Time
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Vitamin K Deficiency/blood/complications/*genetics
7.Clinical application of alendronate for osteoporosis/osteopenia secondary to hyperthyroidism.
Li-Juan YANG ; Fei-Xia SHEN ; Jing-Chen ZHENG ; Hai-Ling ZHANG
China Journal of Orthopaedics and Traumatology 2012;25(2):133-137
OBJECTIVETo evaluate the efficacy and safety of alendronate for the treatment of osteoporosis/osteopenia secondary to hyperthyroidism.
METHODSFrom April 2008 to November 2009, 27 patients with hyperthyroidism with osteoporosis/ osteopenia measured by dual energy X-ray absorptiometry (DXA) were included in this study, and then they were randomly divided into two groups (group A and group B) by simple random sampling. Group A consisted of 14 patients treated with antithyroid drug and caltrate D, the antithyroid drug change with thyroid function, and caltrate D 600 mg per day. Group B consisted of 13 patients treated with antithyroid drug, caltrate D and alendronate, antithyroid drug and caltrate D the same as group A, and alendronate 70 mg weekly. Meanwhile, 21 healthy voluntary adults were chosen as control group. And compared with the control group which was treated with nothing. Followed-up for one year, the bone mineral density (including T-score, Z-score, BMD) in lumbar spine (LS), femoral neck (FN) and distal radius (DR) and general information, were compared before and after treatment.
RESULTSBMD at FN and DR were significantly higher at 12 months after treatment than at the baseline in group A (P = 0.000); T-score, Z-score, and BMD at the LS, FN and DR were all significantly higher at 12 months after treatment than at the baseline in group B (P < 0.05), but these data could not arrive to normal level. In group A, the percentage increased in BMD at the LS, FN, and DR were (4.34 +/- 10.5)%, (3.21 +/- 1.38)%, (1.95 +/- 0.44)%, respectively, at 12 months after treatment. In group B, the percentage increased in BMD at the LS, FN, and DR were (6.10 +/- 8.12)%, (4.10 +/- 5.64)%, (3.10 +/- 3.23)%, respectively, at 12 months after treatment. There was significant difference in the rate of increase between two groups (P < 0.05). AKP decreased, weight, BMI increased, and thyroid function decreased, after treatment than those before in both of the two groups. (P < 0.05).
CONCLUSIONAlendronate can significantly increase BMD in treating patients with hyperthyroidism and osteoporosis/osteopenia. Compared with anti-thyroid drugs alone, treatment with alendronate can obtain more clinical effect and also very safety.
Adult ; Alendronate ; therapeutic use ; Bone Density ; Bone Density Conservation Agents ; therapeutic use ; Bone Diseases, Metabolic ; drug therapy ; etiology ; Female ; Humans ; Hyperthyroidism ; complications ; drug therapy ; Male ; Middle Aged ; Osteoporosis ; drug therapy ; etiology
8.Osteodystrophy in Posthepatitic Cirrhosis.
Mehmet Akif KARAN ; Nilgun ERTEN ; Cemil TASCIOGLU ; Ayse KARAN ; Dilsad SINDEL ; Guzin DILSEN
Yonsei Medical Journal 2001;42(5):547-552
This study investigated the incidence and severity of hepatic osteody strophy in patients with posthepatitic liver cirrhosis, and the role of hepatocellular injury in bone loss. Twenty-four patients (15 females and 9 males, mean age 49 +/- 13 years) with posthepatitic cirrhosis were enrolled in this study. The control group consisted of 22 healthy age and sex matched adults. The bone mineral density (BMD) was evaluated by dual energy x-ray absorptiometry of the L1-L4 vertebral bodies. A detailed questionnaire was used to assess the epidemiological findings. A statistically significant decrease in BMD of the patients was observed. There were no significant differences in the alkaline phosphatase, parathyroid hormone, calcitonin, 25-hydroxyvitamin D, osteocalcin, free testosterone, luteinizing hormone, follicle stimulating hormone, and estradiol levels, oral calcium intake, urinary calcium, phosphorus and hydroxypyroline excretion between patients and controls. The control group smoked more cigarettes, consumed more coffee and meat, and were exposed the sun light for a longer period than the study group. Multiple regression analysis showed that osteopenia depends significantly on the extent of liver disease. The data shows that the patients with posthepatitic cirrhosis had osteopenia, and that cirrhosis was a direct and independent risk factor.
Adult
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Bone Diseases, Metabolic/*etiology
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Female
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*Hepatitis B
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*Hepatitis C
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Human
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Liver/physiopathology
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Liver Cirrhosis/*complications/physiopathology/*virology
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Male
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Middle Age
9.Effect of androgen deprivation therapy on bone mineral density in prostate cancer patients.
Jun-Hong DENG ; Liu-Ping YANG ; Liang-Sheng WANG ; De-Fan ZHOU
Asian Journal of Andrology 2004;6(1):75-77
AIMTo evaluate the effect of androgen deprivation therapy (ADT) on bone mineral density (BMD) in prostate cancer patients.
METHODSForty-nine prostate cancer patients with their BMD determined were divided into two groups: the non-treated group included 21 patients before the commencement of ADT and the treated group, 28 patients, who had received ADT for more than 1 year. BMD was measured by dual energy X-ray absorptiometry (DEXA) in the lumbar spine (L2-4) and femoral neck.
RESULTSThirteen (62 %) non-treated and 23 (82 %) treated patients fulfilled the BMD criteria for osteopenia or osteoporosis. Z scores for age-matched control in lumbar spine and femoral neck were -0.9 +/- 0.7 and -0.6 +/- 0.5, respectively, in the treated group, and -1.8 +/- 1.1 and -1.6 +/- 1.0, respectively, in the non-treated group, the differences between the two groups were highly significant (P<0.01).
CONCLUSIONProstate cancer patients who received ADT for more than 1 year had a significantly lower BMD in the lumbar spine and femoral neck than those before the beginning of ADT.
Absorptiometry, Photon ; Aged ; Aged, 80 and over ; Androgens ; deficiency ; Bone Density ; Bone Diseases, Metabolic ; diagnosis ; etiology ; Gonadotropin-Releasing Hormone ; therapeutic use ; Humans ; Male ; Orchiectomy ; adverse effects ; Osteoporosis ; diagnosis ; etiology ; Prostatic Neoplasms ; therapy
10.MR Imaging in a Child with Scurvy: a Case Report.
Seung Woo CHOI ; Sun Won PARK ; Young Se KWON ; In Suk OH ; Myung Kwan LIM ; Won Hong KIM ; Chang Hae SUH
Korean Journal of Radiology 2007;8(5):443-447
Scurvy is very rare disease in industrialized societies. Nevertheless, it still exists in higher risk groups including economically disadvantaged populations with poor nutrition, such as the elderly and chronic alcoholics. The incidence of scurvy in the pediatric population is very low. This study reports a case of scurvy in a 5-year-old girl with cerebral palsy and developmental delay based on MRI findings.
Ascorbic Acid/blood/therapeutic use
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Bone Diseases, Metabolic/etiology
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Cerebral Palsy/complications
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Child, Preschool
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Cholecalciferol/blood
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Developmental Disabilities/complications
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Drainage
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Female
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Femur/pathology/radionuclide imaging/surgery
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Fever/etiology
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Follow-Up Studies
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Hematoma/diagnosis/etiology/surgery
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Humans
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Knee/radiography
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Magnetic Resonance Imaging/*methods
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Muscle Weakness/etiology
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Rare Diseases
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Scurvy/complications/*diagnosis/drug therapy
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Thigh/pathology
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Vitamins/therapeutic use