• Title/Summary/Keyword: 고칼슘혈증

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A Clinical Study on the Hypercalcemia in Primary Bronchogenic Carcinoma (고칼슘혈증을 동반한 원발성 폐암의 임상적 특징)

  • Park, Hye-Jung;Shin, Kyeong-Cheol;Moon, Young-Chul;Chung, Jin-Hong;Lee, Kwan-Ho;Sung, Cha-Kyung;Lee, Hyun-Woo
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.208-218
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    • 1999
  • Background: Lung cancer-associated hypercalcemia is one of the most disabling and life-threatening paraneoplastic disorders. Humoral hypercalcemia is responsible for most lung cancer-associated hypercalcemia. Patients with hypercalcemia are usually in the advanced stage with obvious bulky tumor and carry a poor prognosis. Materials and Methods: Total 29 patients satisfied the following criteria: histologically proven primary lung cancer, corrected calcium level ${\geq}$ 10.5 mg/dL, and symptoms which could possibly be attributed to hypercalcemia. In this retrospective study, we evaluated the various clinical aspects of hypercalcemia, in relation to cancer stage, histologic cell type, mass size, bone metastasis, performance status, and other possible characteristics. Results: Total 29 lung cancer patients with hypercalcemia were studied, and most of them had squamous cell carcinoma in their histologic finding. The incidence of hypercalcemia was significantly higher between 50 and 69 years of age, and in the advancement of cancer stage. Although serum calcium level showed positive correlation with mass size, performance status, and bone metastasis, it was not significant statistically. Altered consciousness was significantly more frequent in the patients with higher serum calcium level. There were no differences in effectiveness among therapeutic regimens. Hypercalcemia was more frequently in the later stage of disease than during the initial diagnosis of lung cancer. Most of the patients died within 1 month after development of hypercalcemia. Conclusion: We concluded that hypercalcemia in lung cancer is related to extremely poor prognosis, and may be one of the causes of death and should be treated aggressively to prevent sudden deterioration or death.

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A Retrospective Study of 94 Hypercalcemic Dogs(2002-2004) (94 마리 고칼슘혈증 개들에 대한 회고연구(2002-2004))

  • Cho, Tae-Hyung;Kang, Byeong-Teck;Park, Chul;Jung, Dong-In;Yoo, Jong-Hyun;Kim, Ju-Won;Kim, Ha-Jung;Lim, Chae-Young;Lee, So-Young;Kim, Jung-Hyun;Woo, Eung-Je;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.24 no.4
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    • pp.479-485
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    • 2007
  • A retrospective study of 94 hypercalcemic dogs was performed to find out most common causes that lead to hypercalcemia through investigating dogs referred to the Veterinary Teaching Hospital of Konkuk University from 2002 to 2004. During the study period, hypercalcemia was found in 94 dogs of 19 breeds, and they were evaluated as case group. Control group was made up of 94 dogs of 18 breeds without hypercalcemia admitted for the same study period. For general signalments, there were no significant differences between case and control group with the exception of age distribution. Shih-tzu(17.02%) and Yorkshire terrier(26.60%) was the most common breed in case and control group, respectively. The most common diseases associated with hypercalcemia were chronic renal failure (18.09%), acute renal failure(14.89%), and renal calculi(6.38%). Malignant neoplasia(lymphoma, hemangiosarcoma, chronic lymphocytic leukemia, mammary gland tumor, and multiple myeloma) and endocrinopathies(hyperadrenocorticism, hyperthyroidism, hypoadrenocorticism, and hypothyroidism) occupied 8.5% and 6.4%, respectively. This report is a first retrospective study of hypercalcemic dogs in South Korea.

Systemic Amyloidosis in a Cocker Spaniel (Cocker spaniel 견에서 발생한 전신성 아밀로이드증)

  • Pak Son-Il;Kim Doo;Han Jeong-Hee
    • Journal of Veterinary Clinics
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    • v.23 no.2
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    • pp.186-189
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    • 2006
  • A 7-month-old female Cocker spaniel dog was examined for chronic anemia. Based on information provided by local clinician the patient had had a 'flu-like' illness three weeks before submission of the sample, had a fever of $40.9^{\circ}C$, and had mild hepatomegaly. This dog had also history of weight loss, vomiting, anorexia, dehydration, lethargy, ascites, polyuria and polydipsia. A blood smear showed non-regenerative anemia. Thoracic radiograph showed irregular shadowing in the left mid-zone. Serum biochemical results showed a hypercalcemia, azotemia, hypercholesterolemia, hyperphosphatemia, hypoalbuminemia, and metabolic acidosis. Results of urinalysis showed proteinuria, slightly acidic with isosthenuria. Histopathologic examination of tissue sections revealed amyloid deposits in multiple sites including kidneys, liver and spleen.

A Study of Occurrence of Secondary Complications and Chronic Diseases due to Aging of Spinal Cord Injury (척수손상환자의 고령화에 따른 2차합병증 발생과 만성질환발병에 관한 연구)

  • Min, Yeo Jin;Kim, Jong Bae
    • 재활복지
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    • v.22 no.4
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    • pp.83-102
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    • 2018
  • The purpose of this study is to provide basic data for effective management and prevention of chronic diseases and secondary complications as elderly spinal cord injuries(SCI). The subjects were 200 spinal cord injuries admitted to S hospital from April, 2013 to April, 2018. We investigated the occurrence of chronic diseases and secondary complication through medical records. The results showed that SCI were affected chronic diseases and secondary complications over 50years. The prevalence of chronic diseases and secondary complications over 50 years of age had the odds ratio 11.8 times higher in hypertension and 6.7 times diabetes mellitus. Secondary complications had the odds ratio Osteoporosis 7.5 times, Pneumonia 5.2 times, and central pain 0.4 times. We suggest that continuous management and service of chronic diseases and secondary complications of elderly SCI are necessary. It will be necessary to expand the target population and to study various characteristics including.

Ga-67 Citrate and Tc-99m MDP Uptake in the Lung and Stomach Associated with Hypercalcemia (고칼슘혈증 환자에서 폐와 위에 나타난 Ga-67 Citrate와 Tc-99m MDP의 섭취 증가 소견)

  • Sohn, Myung-Hee;Lim, Seok-Tae;Jeong, Young-Jin;Kim, Dong-Wook;Jeong, Hwan-Jeong;Yim, Chang-Yeol
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.4
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    • pp.366-367
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    • 2009
  • Ga-67 scintigraphy demonstrated increased uptake in the lungs and stomach in a 26-year-old man with hypercalcemia. A primitive neuroectodermal tumor was confirmed by bone marrow examination. Tc-99m MDP uptake in the same locations as Ga-67 revealed by bone scintigraphy was consistent with metastatic calcification. Although the mechanism of Ga-67 uptake in metastatic calcification is not understood, the presence of an inflammatory process is suggested.

High dose vitamin D injection induced severe hypercalcemia (비타민 D 고용량 주사로 인한 심한 고칼슘혈증 발생 1예)

  • Lee, Sang Ah;Moon, Jae Cheol
    • 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.

Clinicopathological Analyses and Outcome of Acute Renal Failure with Grape Ingestion in Dogs (개에서 포도중독에 의한 급성신부전의 임상병리학적 평가)

  • Pak, Son-Il
    • Journal of Veterinary Clinics
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    • v.30 no.1
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    • pp.57-60
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    • 2013
  • Ingestion of grapes or raisins has been reported to the occurrence of acute renal failure (ARF) in dogs, although the mechanism remains undetermined. The prognosis often depends on the severity or clinical course of the disease at the time of presentation and is poor if the dog becomes anuric phase. To explore the characteristics and outcome of ARF caused by grape or raisin poisoning, sequentially collected data, from 2005 to 2008, of the Veterinary Medical Teaching Hospital at the Kangwon National University for clinical evaluation were retrospectively analyzed. Of the 11 clinically affected dogs, 4 cases made a full recovery, 3 died and 4 were euthanized. All but one case (raisin ingestion) had a history of grape exposure, but the exact quantity of fruit ingested was not known. The female dogs accounted for 72.7% (8 cases). Overall, the mean age was 5.3 years (range 0.2-11.3 years), and the mean body weight was 4.1 kg (range 1.4-13 kg). The average duration of hospital stay was 7.1 days (range 2-22 days). Vomiting and anorexia was reported in all dogs. Diarrhea (4 cases), oliguria (5 cases), and anuria (4 cases) with or without isosthenuria were also reported. Five dogs of 11 had mild to moderate anemia, with a decrease in packed cell volume and hemoglobin. All dogs had elevations in serum phosphorous, creatinine, and blood urea nitrogen values, but calcium values were variable; 2 dogs with hypocalcemia, 2 dogs with hypercalcemia, and the remaining 7 cases within reference interval. Dogs (n = 8) with measured on blood gas parameters had metabolic acidosis. In addition, higher serum enzyme activities were observed; amylase in 8 (72.7%) dogs, alkaline phosphatase in 7 (63.6%) dogs, and alanine aminotransferase in 5 (45.5%) dogs. Non-survived dogs revealed lower counts of platelet and lymphocyte subpopulation, as compared to the survived dogs.

Human Parathyroid Hormone-Related Peptide Measurement in the Lung Cancer Patients (폐암환자에서 인체 부갑상선 호르몬 관련 단백에 대한 연구)

  • Chang, Joon;Kim, Se-Kyu;Lim, Sung-Kil;Lee, Hong-Lyeol;Kim, Sung-Kyu;Lee, Won-Young
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.6
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    • pp.855-861
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    • 1995
  • Background: Parathyroid hormone-related protein(PTHrp) was first identified as the cause of hypercalcemia in malignancy. Hypercalcemia can be found in malignancy, especially in the epidermoid carcinoma of the lung, even without extensive metastases to the bones. The application of sensitive assays for PTHrp may help in the early diagnosis of lung cancer, in the monitoring of treatment and in the detection of recurrence. Method: Serum PTHrp was measured by radioimmunoassay detecting the N-terminal 1~34 peptide of human PTHrp(PTHrp 1-34) in 63 histologically confirmed lung cancer patients and 22 healthy controls. Result: Serum PTHrp(mean$\pm$S.E.) was $312{\pm}68.9pg/ml$ in 63 lung cancer patients and $158{\pm}38.2pg/ml$ in 22 controls(p>0.05). PTHrp was $356{\pm}103.9pg/ml$ in 34 epidermoid carcinoma patients, $281{\pm}148.7pg/ml$ in 15 adenocarcinoma patients and $316{\pm}140.8pg/ml$ in 9 small cell carcinoma patients. In epidermoid carcinoma patients, PTHrp was $570{\pm}472.3pg/ml$ in stage II(n=3; p<0.05 vs controls), $166{\pm}22.4pg/ml$ in stage IIIa(n=9), $282{\pm}113.3pg/ml$ in stage IIIb(n=12) and $668{\pm}367.9pg/ml$ in stage IV(n=9; p<0.05 vs controls). PTHrp was significantly increased in 8 epidermoid carcinoma patients with bone metastases($1526{\pm}811.2\;pg/ml$; p<0.0005 vs controls). Hypercalcemia was observed in an epidermoid carcinoma patient whose PTHrp value was 244 pg/ml. Conclusion: The serum PTHrp was increased in advanced epidermoid carcinoma patients even without hypercalcemia. The measurement of PTHrp may be not helpful in the early diagnosis of lung cancer. But the lung cancer should be suspected in the marked elevation of PTHrp. It may be of value in detecting patients of advanced diseases with bone metastases or patients who might develop the malignancy associated hypercalcemia.

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Nonfunctional Parathyroid Carcinoma: A Case Report (비기능성 부갑상선암: 증례 보고)

  • Choi, Sang-Gyu
    • Radiation Oncology Journal
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    • v.28 no.2
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    • pp.111-116
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    • 2010
  • Parathyroid carcinoma is a rare endocrine malignancy accounting for 0.5% to 4.0% of all cases of hyperparathyroidism and commonly present as hypercalcemia and parathyroid hormone (PTH) elevation. Nonfunctional parathyroid carcinoma does not show symptoms of hyperparathyroidism and only showed a vague indication of being pathologic, even when detected late. The optimal treatment is en bloc resection of the cancer, but frequent local recurrence after surgery has been reported. Adjuvant local treatment such as radiotherapy may improve the likelihood local control in cases with incompletely resected or microscopic residual tumor. The results of this study point to a case of nonfunctional parathyroid carcinoma treated by external beam radiotherapy after en-bloc resection of cancer.

A Case with Perinatal Hypophosphatasia Caused by the ALPL Mutations (ALPL 유전자의 돌연변이를 가진 양성 주산기 저인산증 1례)

  • Kim, Joonil;Kang, Eungu;Kim, Yoon-Myung;Lee, Beom Hee;Kim, Gu-Hwan;Yoo, Han-Wook
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.16 no.3
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    • pp.141-147
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    • 2016
  • Hypophosphatasia is caused by the mutations in ALPL, which encodes tissue-nonspecific alkaline phosphatase (TNSALP). It can be inherited either in an autosomal dominant or recessive manner. Clinically, hypophophosphatasia is characterized by skeletal findings similar to those in rickets or osteomalacia, but serum alkaline phosphatase levels are decreased in the affected patients. Hypophosphatasia can be classified into six clinical forms according to age at diagnosis and severity of symptoms: perinatal lethal, infantile, childhood, adult, odontohypophosphatasia, and perinatal benign. As being a very rare disease, only one case has been reported in Korean population. Here we describe a case with perinatal benign hypophosphatasia with recessive ALPL mutations. Bowing of lower legs was detected in prenatal period and low serum alkaline phosphatase level was noted after birth. During the follow-up evaluation for 4.5 years, bone mineralization and legs bowing were improved but the growth retardation was persistent. As the recombinant bone-targeted human TNSALP became available, the clinical improvement of the affected patients is expected including the case described here with this treatment. More efforts are needed to identify the cases affected by hypophosphatasia.

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