Amiloidosis cardíaca: revisión de una serie de casos / Cardiac amyloidosis: a review of a series of cases

Resumen Antecedentes y objetivo: La amiloidosis cardíaca es una entidad que permanece infradiagnosticada, a pesar de los avances recientes en su diagnóstico y tratamiento. El objetivo de este estudio es revisar una serie de casos de amiloidosis cardíaca para describir los principales datos clínicos y los hallazgos en las pruebas de imagen. Materiales y métodos: Estudio retrospectivo de pacientes con diagnóstico principal o secundario de amiloidosis cardíaca en los informes de alta de pacientes hospitalizados en este centro desde 2006 hasta 2016. Se revisaron los datos clínicos de los pacientes, así como las pruebas de imagen (ECG, ecocardiograma, gammagrafía cardíaca, resonancia magnética cardíaca). Se realizó seguimiento de los pacientes hasta enero de 2018. Resultados: Se analiza a 30 pacientes (20 varones) con media de 65 años. Los principales datos ecocardiográficos fueron dilatación biauricular, disfunción diastólica e hipertrofia ventricular izquierda (HVI) en un 97%. Sólo el 6.7% cumplía criterios de HVI en el electrocardiograma. Hasta un 33% tenía disfunción sistólica. Se realizó gammagrafía y resonancia magnética cardíaca en un 33%. La supervivencia a los 12 meses fue de 61%. Conclusión: La presencia de insuficiencia cardíaca, fibrilación auricular o trastornos de conducción junto a datos ecocardiográficos indicativos debe alertar al clínico. Otros datos como disfunción sistólica o sexo femenino no deben disminuir la sospecha. El estudio debe completarse con gammagrafía y resonancia magnética cardíaca, ya que el diagnóstico temprano tiene implicaciones pronósticas y terapéuticas.

Abstract Background and objective: Cardiac amyloidosis is an entity that remains underdiagnostic, despite recent advances in its diagnosis and treatment. The aim of this study is to review a series of diagnosed cases of cardiac amyloidosis to describe the main clinical data and the findings in the imaging tests. Materials and methods: Retrospective study of patients with primary or secondary diagnosis of cardiac amyloidosis in discharge reports of patients hospitalized in our center from 2006 to 2016. The clinical data of the patients were reviewed, as well as the imaging tests (ECG, echocardiogram, cardiac scintigraphy, cardiac magnetic resonance). Patients were followed until January 2018. Results: We analyze 30 patients (20 men) with an average of 65 years. The main echocardiographic data were biatrial dilatation, diastolic dysfunction and left ventricular hypertrophy (LVH) in 97%. Only 6.7% met criteria for LVH in the electrocardiogram. Up to 33% had systolic dysfunction. Scintigraphy and cardiac magnetic resonance were performed in 33%. Survival at 12 months was 61%. Conclusion: The presence of heart failure, atrial fibrillation or conduction disorders with suggestive echocardiographic data should alert the clinician. Other data such as systolic dysfunction or female sex should not decrease the suspicion. The study should be completed with gammagraphy and cardiac magnetic resonance since early diagnosis has prognostic and therapeutic implications.

Cut-off points of the Portuguese version of the Montreal Cognitive Assessment for cognitive evaluation in Parkinson's disease / Valores de corte da versão em português do "montreal cognitive assessment" para avaliação cognitiva na doença de parkinson

ABSTRACT. The Movement Disorder Society has published some recommendations for dementia diagnosis in Parkinson disease (PD), proposing the Montreal Cognitive Assessment (MOCA) as a cognitive screening tool in these patients. However, few studies have been conducted assessing the Portuguese version of this test in Brazil (MOCA-BR). Objective: the aim of the present study was to define the cut-off points of the MOCA-BR scale for diagnosing Mild Cognitive Impairment (PD-MCI) and Dementia (PD-D) in patients with PD. Methods: this was a cross-sectional, analytic field study based on a quantitative approach. Patients were selected after a consecutive assessment by a neurologist, after an extensive cognitive evaluation, and were classified as having normal cognition (PD-N), PD-MCI or PD-D. The MOCA-BR was then applied and 89 patients selected. Results: on the cognitive assessment, 30.3% were PD-N, 41.6% PD-MCI and 28.1% PD-D. The cut-off score on the MOCA-Br to distinguish PD-N from PD-D was 22.50 (95% CI 0.748-0.943) for sensitivity of 85.5% and specificity of 71.1%. The cut-off for distinguishing PD-D from MCI was 17.50 (95% CI 0.758-0.951) for sensitivity of 81.6% and specificity of 76%.

RESUMO. A Movement Disorder Society publicou algumas recomendações para o diagnóstico de demência na doença de Parkinson (DP), propondo o Montreal Cognitive Assessment (MOCA) como ferramenta de triagem cognitiva nesses pacientes. Entretanto, poucos estudos foram aplicados à versão em português (MOCA-BR). Objetivo: o presente estudo tem o objetivo de definir os valores de corte na escala de MOCA-BR para diagnosticar o Comprometimento Cognitivo Leve (DP-CCL) e Demência (DP-D) em pacientes com DP. Métodos: trata-se de um estudo transversal, analítico, com uma abordagem quantitativa. Os pacientes foram selecionados depois de avaliações consecutivas por um neurologista, após avaliação cognitiva extensa, e foram classificados como cognição normal (DP-N), DP-CCL e DP-D e então o MOCA-BR foi aplicado, sendo selecionados 89 pacientes. Resultados: na avaliação cognitiva, foram encontrados 30.3% de DP-N, 41.6% de DP-CCL e 28.1% DP-D. O valor de corte no MOCA-BR para distinguir entre DP-N de DP-D foi 22.5 (IC 95%; 0.748-0.943), sensibilidade de 85.5% e especificidade de 71.1%. Para distinguir DP-P de CCL, o ponto de corte foi de 17.5 (IC 95%; 0.758-0.951), sensibilidade de 81.6% e especificidade de 76%.

Altered Biodistribution of (99m)Tc-DPD on Bone Scan After Intravenous Iron Supplement / 대한핵의학회잡지

We report a casewith altered biodistribution of (99m)Tc-dicarboxypropane diphosphonate ((99m)Tc-DPD) on whole body bone scan after intravenous iron supplement therapy. A 47-year-old male patient who had recently been detected with a hepatic mass suggestive of hepatocellular carcinoma underwent bone scan as staging work-up before surgery. Bone scan images at 3 h after injection of (99m)Tc-DPD demonstrated unusually increased blood pool activities in the heart, liver, and spleen with usual skeletal uptakes. The patient had been treated for severe anemia from hemorrhoid with two intravenous administration of ferric hydroxide carboxymaltose complex at approximately 22 h and 2 h prior to the (99m)Tc-DPD injection, which we consider as themost probable cause of altered biodistribution of (99m)Tc-DPD.

Changes of biochemical mark and bone histomorphology in male rats with different age / 中国医师杂志

Objective To investigate the aged-related changes of biochemical mark and bone histomorphology in rats and to explore the effects ofαD3 on aged rats. Methods Sixty male Wistar rats with different age were divided into four groups, including group A (6-week-old male wistar rat), group B (6-month-old male wistar rat), group C (24-month-old male wistar rat) and group D (24-month-old male wistar rat +αD3). Group D was treated with αD3 three times per week for 10 weeks at a does of 0.05μg/(kgrameters. The left femur and mandible were collected for histomorphology. Results Compared with group A, ALP (alkaline phosphatase) and BGP in group B, C and D were decreased with age increased [(87.30 ±12.22)mmol/L VS (257.20 ±92.26) mmol/L, (55.23 ± 18. 18 ) mmol/L VS (257.20 ±92. 26) mmol/L,(46.17 ± 16. 6) mmol/L VS (257. 20 ±92. 26 mmol/L); (4. 37 ± 1.46) ng/L VS (9. 03 ±2. 04) ng/L,(3.80±1.00) ng/L VS (9.03 ±2.04) ng/L, (3.59 ±0.64) ng/L VS( 9.03±2.04) ng/L, P <0. 05]. TRACP5b in group C and D increased more than that in group B [( 15.69 ± 1.62 ) pg/L VS ( 7. 26 ±2.13) pg/L, ( 14.16 ± 1.88 ) pg/L VS ( 7. 26 ± 2. 13 ) pg/L, P < 0. 05]. Testosterone decreased significantly with age increased, but no significant difference was found among four groups. Testosterone was positive related with trabecular area of mandible. Bone gla protein was positive related with alkaline phosphatase and negative related with tartrate - resistant acid phosphatase 5b. Trabecular areas of femur increased in group C and D were greater than that in group B[(220310. 6 ±76360. 50) μm2 VS ( 105093.5 ±73242. 2) μm2, (293085.9 ±68230. 78) μm2 VS ( 105093.5 ±73242. 2) μm2, P <0. 05]. Compared with group B,the trabecular thickness of group C was increased by 53%, while trabecular separation was increased 123%. Trabecular area of group D was increased by 33% compared with group C. Conclusions Theresults showed that bone formation was decreased and absorption was increased with age increased. Testosterone was positive related with trabecular area of mandible. Alfacalcidol had the effects to promote the bone mass of mandible.

Study for Reliability of Interpretation of the Three Phase Bone Scintigraphy in Patients with Post-traumatic Complex Regional Pain Syndrome / 핵의학분자영상

PURPOSE: We performed this study to evaluate reliability on interpretation of three phase bone scintigraphy (TPBS) in patients with post-traumatic complex regional pain syndrome (PT-CRPS). METHODS: Based on International Association for the Study of Pain guideline in 1994, 34 patients with PT-CRPS were selected for this study. Two nuclear medicine physicians evaluated identical TPBS according to the uptake pattern, extent and intensity of the lesion, and their agreements (kappa values) were analysed. The final diagnosis based on arbitrary criteria of each physician were compared with those obtained by the criteria for PT-CRPS established in this study, which are hyperactivity on all phases (criteria 1), hyperactivity of whole joints on delayed phase (criteria 2), and hyperactivity of either whole or focal joints on delayed phase (criteria 3). RESULTS: Intra-observer agreements were good for uptake pattern, intensity, and extent on TPBS. Inter-observer agreements were also good, except extent on blood pool phase (0.55). The inter-observer agreements on final diagnosis improved when criteria 1-3 were applied (0.77-0.88), compared to when physician's own criteria were used (0.63). Those also improved from 0.29 to 0.47-0.82 for acute stage, and from 0.37 to 1.0 for chronic stage. The sensitivities of chronic stage were relatively lower to those of acute stage. CONCLUSIONS: Inter-observer's variations in diagnosis of the patients with PT-CRPS using TPBS were observed. These results were attributed to different criteria set by observers. In order to improve agreement on interpretation of TPBS, common positive criteria should be established, especially considering uptake pattern and clinical stages.

Intake of dietary phytoestrogen and indices of antioxidant and bone metabolism of pre- and post-menopausal Korean women

A group of 101 women, aged 40-65 years consisted of 48 premenopausal subjects and 53 postmenopausal ones living in Daegu and Gyeongbuk area in Korea were evaluated with their general characteristics, lifestyle factors, nutrient and phytoestrogen intakes, blood and urinary indices concerning antioxidant status and bone metabolism. Body mass index (BMI), waist hip ratio (WHR) and systolic blood pressure (SBP) of the postmenopausal women were significantly higher (23.8, 0.86, and 126.9 mmHg, respectively) than those of the premenopausal women (22.6, 0.82, and 115.9 mmHg; respectively). Nutrient intakes of the postmenopausal and premenopausal groups were not different except lower fat intake and higher dietary fiber and iron intakes in the postmenopausal group. Daily total phytoestrogen intake was significantly higher in the postmenopausal group (48.54 mg) than the premenopausal (31.41 mg) and was resulted mostly from higher intakes of daidzein and genistein from soy and soy products (45.42 mg vs 28.91 mg). Serum genistein level and excretion of enterolactone, major lignan metabolite, were not very different between the two groups. Serum retinal and alpha- tocopherol levels were higher in the postmenopausal group but TBARS levels were not different between the two groups. Serum osteocalcin (7.18 ng/mL) and urinary deoxypyridinoline (7.15 nmol/mmol creatinine), in the postmenopausal group were significantly higher than those in the premenopausal group (4.80 ng/mL, 5.95 nmol/mmol creatinine). Urinary excretion of enterolactone was positively correlated with serum osetocalcin in premenopausal women and serum genistein negatively correlated with the urinary DPD in postmenopausal women. Dietary phytoestrogen intake was negatively correlated with serum level of TBARS in all subjects. It is concluded that the effect of total phytoestrogen intake is beneficial on body antioxidant status in all middle-aged women regardless of menopause but the effect on bone metabolism appears different by the type of the phytoestrogen and the menopausal state.

The Effects of Erect Bipedal Stance Exercise on Bone Formation and Resorption in Rats

The effects of the erect bipedal stance exercise on bone mass and the biomarkers of bone formation and resorption were investigated in rats. Five-week old rats were assigned into control and exercise groups. The rats of exercise group were weight-bearing-trained for 13 weeks in the cage designed to adjust progressively the height from 26.5 cm to 31.5 cm to force the rats rising an erect bipedal stance for feeding and drinking. There was no significant difference in food intakes between two groups. But body weight gain was significantly increased in control group. The lengths of femur, tibia, humerus and radius were significantly longer in control group than exercise group, but the femur and tibia weights per body weight were significantly higher in exercise group than control group. Also the breaking force of femur and tibia in exercise group were higher than control group significantly. The calcium contents of femur and tibia were significantly increased in exercise group than control group. The activity of bone specific alkaline phosphatase (B-ALP) and the osteocalcin contents of serum (the biomarkers of bone formation) in exercise group were higher than control group, but the carboxyterminal propeptide of type I procollagen (P1CP) contents of serum did not show any difference between two groups. However the urinary deoxypridinolin (DPD) excretion, biomarker of bone resorption, was significantly lower in exercise group than control group. From these results, it has been indicated that the erect bipedal stance exercise enhanced the density and the strength of femur and tibia by increasing biomarkers of bone formation and suppressing a biomarker of bone resorption in rats.

Hip joint fracture and bone metabolic biochemical index of the aged patients / 中国矫形外科杂志

[Objective] To study the bone metabolic biochemical index of the aged patients with hip fracture,for better predicting the future risk of the old people' s hip fracture.[Method]50 cases of sufferers(over 60 years old) with hip fracture(28 males,and 22 females) and 30 cases of healthy aged people(15 males,and 15 females) were selected to analyze Ⅰ Collagen crosslinked c-telopeptide(ICTP),deoxypyridino line(Dpd) in urine,and serum bone glaprotein(BGP).[Result](1)The mean level of ICTP and Dpd in urine in aged hip fracture group was higherthan that of the control group(P0.05).[Conclusion]Bone absorbability in the aged hip fracture patients is higher than in the aged healthy people.The analysis of ICTP and Dpd in urine may /might give some reference value in preventing and treatlng aged hip fracture patients.

Visualization of the Gastric Calcification due to Cancer on Tc-99m DPD and Abdominal CT Images / 대한핵의학회잡지

A 69-year-old woman was presented with progressed dysphagia, gastric soreness and weight loss during 2 months. She was performed abdomen x-ray, EGDS and abdomen CT. Abdomen x-ray demonstrated punctuate calcification on LUQ. EGDS showed an ulceroinfiltrative mass with bleeding on cardia to antrum of stomach. And CT showed diffuse gastric wall thickness with multiple calcifications. Biopsy of the stomach and esophagus during EGDS examination revealed an adenocarcinoma, with signet ring cell type, infiltrating the wall of the stomach and the distal esophagus. Then Bone scan was performed a few days later. It revealed intense uptake in LUQ, corresponding to the calcium containing neoplasm seen on the abdomen x-ray, EGDS and abdomen CT. And there was no evidence of any metastatic lesion and thyroid uptake on the bone scan. There are many reports about accumulation of the tracer in extraosseous lesion, but only a few literatures were reported about gastric calcification in stomach cancer. More over, no reports showed CT images. We are performed many diagnostic examinations and found well correlation between them. The reason of gastric calcification is considered with calcium deposition within extracellular space due to hemorrhage or necrosis. Other possibility offered to explain gastric calcification have been increased blood flow and/or increased neovascularity with capillary leaks of tracer, and specific enzymatic (phosphatases) receptor binding of tracer. So, it was happened ion exchange between intracellular calcium and phosphate groups of tracer.

Effects of Soy and Isoflavones on Bone Metabolism in Growing Female Rats

The purpose of this study was to determine which differences in the source of protein (soy vs casein) and isoflavones in soy protein are responsible for the differential effects of bone marks and hormones in growing female rats. Forty-two 21-day-old Sprague-Dawley female rats were randomly assigned to one of three groups, consuming casein (control group), soy protein isolate (57 mg isoflavones/100 g diet), or soy protein concentrate (about 1.2 mg isoflavones/100 g diet). All rats were fed on experimental diet and deionized water ad libitum for 9 weeks. Bone formation was measured by serum osteocalcin and alkaline phosphatase (ALP) concentrations. And bone resorption rate was measured by deoxypyridinoline (DPD) crosslinks immunoassay and corrected for creatinine. Serum osteocalcin, growth hormone, estrogen and calcitonin were analyzed using radioimmunoassay kits. Diet did not affect weight gain and mean food intake. Food efficiency ratio was lower in the soy protein groups. The soy isolate group had a higher ALP and osteocalcin concentration and lower crosslinks value than the casein group. Therefore, the soy isolate groups had a higher bone formation/resorption ratio than the casein group. And, the soy group had significantly higher growth hormone than the casein group. The findings of this study suggest that soy protein and isoflavones are beneficial for bone formation in growing female rats. Therefore, exposure to these soy protein and isoflavones early in life may have benefits for osteoporosis prevention.

Comparative observation of bone metabolic indices and serum TRACP5b after drug treatment in ovariotomy rats / 中华风湿病学杂志

Objective To investigate the role of bone metabolic indices in the diagnosis and monitoring of therapeutic effects in osteoporosis, the serum tartrate-resistant acid phosphatase form 5b(TRACP5b) level and other parameters such as Dpd in urine of osteoporosis animal model (ovariotomy rats) in different timing point were measured and analyzed. Methods Eighty female SD rats were divided into five groups and had ovariotomy operation (one group was pseudo-operated). Drug treatment began at the third day after the operation. Six rats in each group were sacrificed after 4 weeks and 14 weeks respectively, the bone metabolic indices were measured and bone histomorphometric data were collected. Results Four weeks after operation, the Dpd/Cr and TRACP5b in ovariotomy group were significantly higher than those in the pseudo-operated group, and TRACP5b was still higher after 14 weeks. In the drug treatment groups, serum E2 level was not changed 4 weeks later, however, Dpd/Cr and TRACP5b had changed greatly. After 14 weeks of drug treatment, there was only a significant decrease of TRACP5b among the bone resorption parameters, but other indices had no change.Bone histomorphometric data showed that the bone volume was improved in each drug treatment group. Conclusions Serum TRACP5b level can reflect the activitiy of osteoclasts and the situation of osteoporosis either in the early stage (high turnover period) or in later stage (low turnover period) of osteoporosis. The drugs used in this experiment can inhibit the ostoclast activity and reduce the level of bone resorption parameters, especially the TRACP5b level. Bone histomorphometric results suggestes that the function and manners of different drugs vary in improving of bone volume.

The influence of exposure to UVβ of fluorescent light on the bone remodeling of hypoestrogenic macaca fascicularis.

The prevention of osteoporosis is a spesific problem that should be dealt with by increasing the women's lift expectation. The decrease of calcitriol and estrogen levels, which have a receptor in the osteoblast, will result in bone mineralization (due to calcitriol) and the information of type 1 collagen (due to estrogen). The formation of calcitriol with the main basic materials from vitamin D3 is achieved with the aid of sunray UVβ, The changes in the lifestyle of women, which make them now accustomed to performing indoor activities and prevent them from being exposed to UVβ all day, have resulted in the decrease of vitamin D3 in calcitriol in women. In addition, when entering the menopausal age they will be threatened with early osteoporosis. The exposure to the UVβ of fluorescent light with the wave length identical to sun of 290-320 nm has long been known as a modality for treating skin diseases in the hope that the production of vitamin D3 will be increased. We exposed Macaca fascicularis, whose estrogen levels were set at normal, beginning low, beginning very low levels, to UVβ of fluorescent light. It showed that the Macaca fascicularis that were exposed to UVβ experienced an increase in osteocalcin with unchanged DPD which means that bone remodeling remains unchanged. By contrast, Macaca fascicularis with normal, beginning low, and beginning very low estrogen levels which were not exposed to UVβ were found to experience a decrease in osteocalcin and unchanged DPD levels. This means that a change has occurred in the bone remodeling toward bone resorption.

Evaluation of Serum CTX and Osteocalcin Using Elecsys 2010 / 대한임상병리학회지

BACKGROUND: In contrast with bone formation markers, most of available indices of bone resorption are urine markers and show relatively high degree of variability. The serum resorption assay has therefore been developed. We evaluated serum bone-derived degradation products of type I collagen C-telopeptide (s-CTX) and serum osteocalcin by Elecsys 2010 (Hitachi Boehringer Mannheim, Tokyo, Japan). METHODS: For 18 healthy controls, 15 osteopenic and 7 osteoporotic patients samples, serum CTX and serum osteocalcin were measured by Elecsys 2010 using -CrossLaps/serum (Roche Diagnostic Corp., Indianapolis, USA) kit and N-MID Osteocalcin (Roche Diagnostic Corp. kit, respectively. DPD by Immulite (Diagnostic Products Corp., LA, USA) using Pyrilinks-D(TM) (Diagnostic Products Corp.) kit and serum osteocalcin for correlation by Gamma counter (Hewlett Packard, Meriden, USA) using ELSA-OSTEO (CIS, Cedex, France) kit were measured. RESULTS: The within-run and between-run coefficient of variation (CV) values of s-CTX were 6.41% and 6% in low concentrations and 3.84% and 7% in high concentrations, respectively. The within-run and between-run CV values of serum osteocalcin were 2.21% and 6% in low concentrations and 1.25% and 3% in high concentrations, respectively. The dilution recovery of s-CTX and serum osteocalcin was 100-169% (mean, 134%) and 80-138% (mean, 104%), respectively. S-CTX and DPD (R=0.369, P=0.019), and serum osteocalcin by Elecsys 2010 and RIA (R=0.889, P<0.001) showed positive correlations, respectively. CONCLUSTIONS: S-CTX and serum osteocalcin by Elecsys 2010 exhibits good analytical performance and correlate with DPD and serum osteocalcin by RIA, respectively. Therefore, these may replace DPD and serum osteocalcin by RIA and can be used for bone resorption and formation markers, respectively.

Biochemical Bone Markers in Postmenopausal Women with Hormone Replacement Therapy / 대한산부인과학회잡지

OBJECTIVES: To investigate the patterns of biochemical bone markers, such as urinary deoxypyridinoline (DPD), N-telopeptide of type I collagen (NTX), and serum osteocalcin (OC), bone-specific alkaline pbosphatase (BSAP) in postmenopansal women with hormone replacement therapy (HRT). Materials and METHOD: From July 1997 to January 1998, total 239 postmenopausal women were emolled in the present study, and 198 healthy premenopausal women with regular menstruation were served as control. The postmenopausal women were pouped into the HRT group and the non-HRT group. The women in the HRT poup have received estrogen with continuous or cyclic progestin therapy far more tban 6 months. The biochemical bone markers of all women were assayed. Results were analysed with Students t-test. RESULTS: The urinary DPD of the non-HRT group was sigaificantly higher than both the HRT poup and the premenopausal group(5.51 +/- 2.47 vs. 3.36 +/- 1.02 and 4.01 +/- 3.86 nM/mM, p < 0.05, repectively). The urinary NTX of the non-HRT group was also higher in comparison to the HRT group and the premenopausal group(48.71 +/- 11.54 vs. 33.70 +/- 17.43 and 33.70 +/- 17.43 nM BCE/mmol, p < 0.05, repectively). However, there were no significant differences in the concentrations of serum BSAP and OC among the three poups. CONCLUSION: The urinary DPD and NTX were more sensitive indicators of bone metabolism tban serum BSAP and OC in postmenopausal women undergoing HRT.

Comparison of Nutrient Intakes, Bone Metabolism and Risk Factors of Chronic Diseases between Postmenopausal Lacto-Ovo-Vegetarian and Omnivores in Kyunggi-Do / 대한지역사회영양학회지

The amount and type of dietary protein that effects affect bone mineral loss after menopause and different dietary patterns may influence anthropometric measurements, biochemical values, and bone metabolism. Objective : Our objective was to investigate bone metabolism and chronic disease factors in two different dietary patterns. Design: The sample consisted of 40 lacto-ove-vegetarians(LOV) and 49 omnivores aged from 47 to 85 years in good condition without any medical problems. Results : The average energy intake of LOV was 1414.0 kcal and omnivores, 1403.2 kcal. The difference between means was not statistically significant. The differences of means of body weight and BMI between the two groups were not significant but the systolic blood pressure of LOV group was significantly lower than omniovores(p0.05) and plant iron(p0.05) and animal iron(p>0.05) had negative correlations with the urinary pH. The level of urinary biochemical marker of bone resorption, deoxpyidinoline(DPD) of LOV was significantly lower than the other group(p>0.05). The T-scores of bone mineral density for the two sites in the two groups were not significantly different. Conclusions : The DPD level and urinary pH value of LOV were more desirable for the bone metabolism that the omnivores. The diet of LOV had lower risk factors of chronic diseases than the other group.

The Effects of Hormone Replacement Therapy on Urinary Deoxypyridinoline of Postmenopausal Women / 대한산부인과학회잡지

OBJECTIVE: Our purpose was to determine whether the bone resorption rate is evaluated by Deoxypyridinoline(Dpd) i urine, and to evaluate the clinical utility of Dpd to monitor the hormone replacement therapy effect in postmenopausal women. STUDY DESIGN: We divided the patients into three groups, the control group was the women who were postmenopausal health state, and the experimental groups were the postmenopausal hormone replacement therapy group and the podtmenopausal nontherapy group. Urinary Dpd and serum FSH, Osteocalcin was measured in the both groups. RESULTS: The urinary Dpd and serum osteocalcin were significantly increase in postmenopausal group(6.63+/-3.09 pmol/nmol creatinine; 10.54+/-3.77 ng/ml) compared to premenopausal group(4.15+/-1.32 pmol/nmol creatinine; 7.85+/-2.17 ng/ml). The urinary Dpd and Serum osteocalcin were significantly decreased in the postmenopausal HRT group(3.31+/-1.79 pmol/nmol creatinine; 8.31+/-3.13 ng/ml) compared to the postmenopausal nontherapy group (6.63+/-3.09 pmol/nmol creatinine; 10.54+/-3.77 ng/ml). In postmenopausal nontherapy group, there was no correlation between urinary Dpd and serum osteocalcin. But these makers were good correlated in postmenopausal HRT group. CONCLUSIONS: It is concluded that the assay of urinary Dpd is useful for the resorption marker of postmenopausal osteoporosis and it should be useful for the monitoring of hormone replacement therapy effect in postmenopausal women. Furthermore, urinary Dpd may be an important indicator to determine when to resume the therapy during cessation of HRT.

The Study of Urinary Hydroxypyridinium Crosslinks Concentrations in Patients with RA or OA , and Its Clinical Significance / 대한내과학회지

OBJECTIVES: To evaluate the urinary concentrations of hydroxyridinium crosslinks of collagen in patients with osteoarthritis(OA) or rheumatoid arthritis(RA), and to compare its clinical correlation with the classic indices of the disease activity of RA. METHODS: Concentrations of urinary pyridinoline (Pyd) and deoxypyridinoline(Dpd) were measured in urinary samples collected from 18 control patients, 35 patients with OA, 45 patients with RA by competitive enzyme immunoassay using microplate coated with monoclonal antibody. RESULTS: 1) Mean urinary concentrations of Pyd in OA patients were 33.5nmol/mmol creatinine, in RA patients were 50.0nmol/mmol creatinine which were higher than the values in controls (25.1 nmol/mmol creatinine). Also, mean concentrations of Dpd in OA patients were 9.2nmol/mmol creatinine, in RA patients were 10.1nmol/mmol creatinine which were higher than the values in controls(5.6nmol/mmol creatinine)(p<0.01). 2) Mean urinary concentration of Pyd was 50.0 nmol/mmol creatinine in RA patients, which was significantly higher than the values in OA(33.5 nnmol/mmol creatinine)(p<0.05), but the mean Dpd concentratians were not significantly different between the two groups. 3) The concentrations of urinary Pyd in RA patients was significantly correlated with the biologic markers indicating inflammatory activity such as ESR(r=0.68, p<0.001), CRP(r=0.72, p<0.001) and the number of tender joint(r=0.66, p<0.01) CONCLUSION: Urinary concentrations of Pyd and Dpd were significantly higher in OA and RA patients than in controls, Especially urinary Pyd concentrations were significantly increased in RA patients than in OA patients, and strongly correlated with disease activity index of rheumatoid arthritis. The mean Dpd concentration, bone specific analogue, in RA patients was not significantly different from that of OA patients and it was not correlated with disease activity index Thus measurement of urinary Pyd might provide a sensitive, noninvasive biochemical marker for studying activity of RA.

Effect of Prednisone on Bone Metabolism in Children with Chronic Thrombocytopenic Purpura and the Interventional Effect of Vitamin D / 中国药房

0.05).The serum PICP in the non-intervention group was significantly lower after 4 weeks' treatment as compared with before treatment or control group,and the urine excretory rate of DPD significantly increased after treatment as compared with before treatment or control group(all P