• Asian Pacific Journal of Cancer Prevention
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• 제13권12호
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• pp.6501-6504
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• 2012

Background: Multiple myeloma is the most common malignant plasma cell dyscrasia and ranks second among primary haematological malignancies. This study describes the epidemiologic, clinical and pathologic profile of monoclonal gammopathies seen in the University Hospital of the West Indies (UHWI), a tertiary care referral centre. Materials and Method: A retrospective analysis of 85 cases diagnosed at UHWI over the 5-year period 2003-2007 was conducted. The cases were identified from the bone marrow records as well as the computerized database of the Medical Records Department. Clinical presentation, family and personal history and demographic data were retrieved. Haematological and biochemical results were also analyzed. Results: There were 85 patients diagnosed with monoclonal gammopathies. The M:F ratio was 1.2:1 and the mean age was $65.7{\pm}1.3$ years. Eighty percent of the patients had skeletal pain and 40% experienced weight loss. Of the patients experiencing bone pain 56.7% had multiple lytic lesions, 26.7% had pathological fractures and 26.7% had compression fractures. Seventy-four patients (87.1%) had a haemoglobin level <12.0 g/dL with 52.9% having values <8.0 g/dL. Renal impairment was evident at diagnosis in 36.5%. Hypercalcemia was seen in 26.5% and hyperuricemia in 45.9%. Of the 79 patients who had serum protein electrophoresis performed, 77.2% had at least one monoclonal band and of these 24.6% had a monoclonal protein also present on urine protein electrophoresis. Conclusions: The demographic profile in this group of patients is largely similar to other studies in predominantly Caucasian populations; however there was a notable increase in prevalence of severe disease at presentation, with the majority of patients presenting at the most advanced stage. It is probable that these differences reflect socioeconomic factors and not merely inherent ethnic variation in disease biology.

• 대한두개안면성형외과학회지
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• 제13권2호
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• pp.156-158
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• 2012

Purpose: Although lipoma is known as one of the most common soft tissue tumors, calcification in lipoma is very rare in its occurrence. This calcified lipoma has been reported by some as a result of regression of lipoma, but its genesis is not clearly known yet with various opinions being discussed regarding its possible metabolic relation to hypercalcemia or hyperphosphatemia to be considered as a regression phase of lipoma. The authors would like to present this unusual case of calcified lipoma. Methods: A 50-year-old male patient visited our hospital with complaint of an enlarging mass on his right forehead which has been acknowledged for 5 years' period. On physical examination, a mass was observed on his forehead as palpable, non-tender, mobile and firm in its consistency. Ultra sonogram examination revealed a well-demarcated mass (1.92 cm) with central echoic zone at deep layer of forehead. Mass excision and biopsy were performed subsequently. Results: According to the pathological report, the diagnosis confirmed the lipoma consisting of grown-up adipocyte and calcification. Neither growing lipoma nor relapse was observed for postoperative three years' follow-up of the patient. Conclusion: Now that the calcified lipoma was successfully removed and cured by a simple mass excision, authors hereby report the case of calcified lipoma on forehead.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권2호
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• pp.106-111
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• 2009

Bisphosphonates have been approved for Paget's disease, cancer-related hypercalcemia, bone involvement in multiple myeloma or solid tumors and osteoporosis. Although, underlying pathophysiological mechanisms remain unclear, it seems that bisphosphonates inhibit osteoclast precursor cells, modulate migratory and adhesive characteristics and induce apoptosis of osteoclasts. Furthermore impacts on angiogenesis, microenvironment and signal transduction between osteoclasts and osteoblasts. In this report, we present a case of oral bisphosphonates induced osteonecrosis of the mandible in a 84-year-old patient who received for two years. Two tapered screw vent implants(Zimmer, USA) were placed in the area of first and second molar. Two weeks later after crowns restored, some inflammatory signs and symptoms were observed on the second molar area. Sequestrum was formed and the sequestrum was removed with the implant. Frequent follow-up checks and oral hygiene maintenances were done and the first molar implant was restored. There is insufficient evidence suggests that duration of oral bisphosphonate therapy correlates with the development and severity of osteonecrosis. Therefore, dentists should not overlook the possibility of development of bisphosphonate induced osteonecrosis in patients who have taken oral forms of medication for less than three years.

• 한국임상수의학회지
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• 제23권2호
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• pp.186-189
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• 2006

7개월된 암컷 Cocker spaniel견이 3주전부터 체중감소, 구토, 탈수, 식욕저하를 보이면서 지속적인 미열을 동반한 다음과 다뇨를 주증상으로 시내 병원에 내원하였다. 담당 수의사의 진료내역을 검토한 결과 복수와 간종대, 혈액 도말 검사에서 비재생성빈혈과 흉부방사선 사진에서 좌측 중심부에 불규칙한 음영이 관찰된 것으로 기록되었다. 이후 prednisolone으로 치료하였지만 증상의 경과가 호전되지 않아 정밀진단을 위하여 환자의 혈액을 강원대학교 부속동물 병원에 분석, 의뢰하였다. 혈액화학검사에서 고칼슘혈증, 고질소혈증, 콜레스테롤혈증, 고인혈증, 저알부민혈증 및 대사성 산증을 보였으며 뇨검사에서 단백뇨를 동반한 약산성의 등장뇨가 관찰되었다. 임상증상과 실험실 소견에 근거하여 간과 신장에 대한 정밀한 검사를 위하여 입원을 요청하였으나 다음 날 환자는 폐사한 상태로 병원에 후송되었다. 보호자의 동의를 얻어 부검과 조직병리학적인 검사를 실시한 결과 간, 신장, 비장 등의 전신 장기에 과량의 아밀로이드가 침착되어 있음을 확인하였다.

• 대한핵의학회지
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• 제28권1호
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• pp.31-36
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• 1994

$^{201}Tl-^{99m}Tc$ 감영스캔이 시행되었던 65명의 환자에서 $^{201}Tl-^{99m}Tc$ 감영스캔의 진단적 가치와 위 음성과 위 양성의 원인에 대해 조사하였다. 이들 중 21예가 부갑상선선종으로 확진되었고, 이들에서 $^{201}Tl-^{99m}Tc$ 감영스캔의 예민도는 90.5%, 특이도는 97.6%였다. 위 음성을 보인 예는 낭종성 괴사를 보인 부갑상선선종과 크기가 $1.5{\times}1{\times}0.8 cm$ 정도로 작은 종양이었다. 위 양성을 보인 1예는 무 기능성 갑상선종이었다. 결론적으로 $^{201}Tl-^{99m}Tc$ 감영스캔은 부갑상선 종괴를 찾아내는데 특이도와 예민도가 높은 검사로 생각된다.

• 대한두경부종양학회지
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• 제13권2호
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• pp.241-246
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• 1997

It has become evident in recent years that parathyroid adenoma and well differentiated thyroid cancer occur together more than would be expected by chance alone. However, the association between them is not well understood. We have experienced 4 cases of coexistent parathyroid adenoma and well-differentiated thyroid cancer during the past 16 years. None of them had a familial incidence or a history of radiation exposure. Three cases showed symptomatic hypercalcemia(including renal stones, bone pain, joint pain) and in two of them(patient 1 and patient 2), thyroid abnormalities were detected preoperatively by neck ultrasonography or neck CT for evaluation of parathyroid lesions. However, in patient 3, a parathyoid humor was identified and removed incidentally during the course of thyroidectomy. In 3 cases, surgeries for thyroid carcinoma and parathyroid adenoma were performed during the same exploration of the neck, but in patient 4, thyroidectomy preceded parathyroidectomy; The interval between thyroidectomy and subsequent parathyroidectomy was 11 yeras. The thyroid tumors in 3 cases were papillary carcinoma, the sizes of which ranged from 1.0 cm to 1.5 cm in greatest diameter. The remaining case(patient 4) was minimal invasive follicular carcinoma. Total or near-total thyroidectomy with various types of cervical lymphnode dissection and bilateral neck exploration for the parathyroid lesion was performed in 3 cases with papillary carcinoma. Ipsilateral lobectomy and contralateral partial thyroidectomy with consequent unilateral neck exploration for the parathyroid tumor was performed in the case of follicular cancer. In our experience, parathyroid adenoma and well-differentiated thyroid carcinomas can be coexistent and we felt that the attention to the hypercalcemic patients would be needed for detection of this rare condition.

• 대한두경부종양학회지
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• 제14권2호
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• pp.206-213
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• 1998

Primary hyperparathyroidism is still uncommomn disease in Korea. However the frequency of this disease has been slowly increased with routine measurement of serum calcium and increasing awareness of hyperparathyroidism in recent years. The diagnosis is established by a persistent elevation of serum calcium and parathyroid hormone and by clinical evaluation. This is a report of eleven patients with primary hyperparathyroidism treated with surgical operation during a period from 1983 to 1997 at Department of Hospital. Authors analyzed the cases to evaluate clinical characteristics and outcome of surgical treatment retrospectively. The result was as follows. 1) In sex distribution, female patients were eight and three were male, the age distribution ranged from 18 to 67 years. 2) The presenting clinical manifestations were renal and urinary stone in eight, bone pain or fracture in six, muscle weakness in four, neurologic symptoms in four, neck mass in three, hypertension in two, and G-I symptoms in one. 3) All patients showed hypercalcemia and elevated serum parathyroid hormone level. 4) Preoperative localization study was performed with computerized tomography, ultrasonography, MRI, arteriography and thyroid scaning. 5) The tumor locations were left lower in eight, left upper in one, right lower in one, and right upper location was one case. 6) Histopathologic findings disclosed adenoma in all cases. 7) All patients were treated by surgical excision and postoperatively transient hypocalcemia occurred in six patients, but no other complication was developed.

• 대한수의학회지
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• 제39권6호
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• pp.1141-1150
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• 1999

Renal failure is one of the main causes of economic impacts in the poultry industry and complex syndrome with different severity of clinical signs caused by multiple nephropathogenic factors such as infectious bronchitis viral infection and excess salt and calcium in diet. To evaluate the correlation between severity of renal failure and the causative nephropathogenic factors, one-day-old specific pathogen free chickens were treated with either single causative factor or multiple causative factors described as above. Each group was designed as control for non-treated control, IB for infectious bronchitis virus (IB virus) infection, IBHNa for IB virus infection with high diet salt, IBHCa for IB virus infection with high diet calcium, IBHNC for IB virus infection with high diet salt and calcium, HNa for high diet salt, HCa for high diet calcium and HNC for high diet salt and calcium. Chickens were inoculated with IB virus at 1-day-old and remained on their respective diets until 21 day of age. Plasma $Na^+$, $Cl^-$, BUN, creatinine, calcium and uric acid values were examined. The results obtained were as follows ; IB virus and high dietary calcium combined treatment showed elevated plasma uric acid. BUN and creatinine values were not characteristic on chicken renal failure. But plasma uric acid values were increased according to renal lesion. Hypercalcemia and hyperuricemia did not induce urate deposition and mineralization in the kidney.

• Nuclear Medicine and Molecular Imaging
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• 제40권2호
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• pp.82-89
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• 2006

Bone metastasis is a common sequelae of solid malignant tumors such as prostate, breast, lung, and renal cancers, which can lead to various complications, including fractures, hypercalcemia, and bone pain, as well as reduced performance status and quality of life it occurs as a result of a complex pathophysiologic process between host and tumor cells leading to cellular invasion, migration adhesion, and stimulation of osteoclastic and osteoblastic activity. Several sequelae occur as a result of osseous metastases and resulting bone pain can lead to significant debilitation. A multidisciplinary approach is usually required not only to address the etiology of the pain and its complicating factors but also to treat the patient appropriately. Pharmaceutical therapy of bone pain, includes non-steroidal analgesics, opiates, steroids, hormones, bisphosphonates, and chemotherapy. While external beam radiation therapy remains the mainstay of pain palliation of a solitary lesions, bone seeking radiopharmaceuticals have entered the therapeutic armamentarium for the treatment of multiple painful osseous lesions. $^{32}P,\;^{89}SrCl,\;^{153}Sm-EDTMP,\;^{188}Re/^{186}Re-HEDP,\;and\;^{177}Lu-EDTMP$ can be used to treat painful osseous metastases. These various radiopharmaceuticals have shown good efficacy in relieving bone pain secondary to bone metastasis. This systemic form of metabolic radiotherapy is simple to administer and complements other treatment options. This has been associated with improved mobility in many patients, reduced dependence on narcotic and non-narcotic analgesics, improved performance status and quality of life, and, in some studios, improved survival. All of these agents, although comprising different physical and chemical characteristics, offer certain advantages in that they are simple to administer, are well tolerated by the patient if used appropriately, and can be used alone or in combination with the other forms of treatment. This article illustrates the salient features of these radiopharmaceuticals, including the usual therapuetic dose, method of administration, and indications for use and also describe about the pre-management checklists, and jndication/contraindication and follow-up protocol.

• 한국식품영양과학회지
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• 제24권1호
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• pp.1-9
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• 1995

1, 25(OH)2-23ene-D3 is a novel vitamine D3 analog which has a double bond between C-23 and C-24. We describe the effects of this analog on cell differentiation and cell proliferation in vitro using the human histiocytic lymphoma cell line U937, and on calcium metabolism in rats in vivo. In the present investigation 1, 25(OH)2-23ene-D3 was compared to the natural metabolite of vitamin D3, 1$\alpha$, 25-dihydroxycholecalciferol[1, 25(OH)2-23ene-D3 was more potent than 1, 25(OH)2-23ene-D3 for inhibition of proliferation and induction of differentiation of U937 cells. Especially, its effect on induction of differentiation, as measured by superoxide production and nonspecific esterase(NSE) activity, was about 20-fold more potent that 1, 25(OH)2-23ene-D3. This analog morphologically and functionally differentiated U937 cells to monocyte-macrophage phenotype showing a decrease of N/C ratio in Giemsa staining and the increase of adherence ability to surface. Intraperitoneal administration of 1, 25(OH)2-23ene-D3 to rats showed that the compound had at least 50 times less activity than 1, 25(OH)2-23ene-D3 in causing hypercalcemia and hypercalciuria. The strong direct effects of 1, 25(OH)2-23ene-D3 on cell proliferation and cell differentiation, coupled with its decreased activity of calcium metabolism make this compound an interesting candidate for clinical studies including patients with leukemia, as well as several skin disorders, such as psoriasis.