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Osteoporosis and spinal metastasis identification (report of 8 cases)
Expected to obtain the extension of survival time. Because of misdiagnosis, cancer metastasis to expand also the loss of operation time. 3.3 Identification of key points: (1) comprehensive and detailed history taking, physical examination, to establish a regular follow-up system is the key to prevent misdiagnosis. Misdiagnosis of most patients is due to history taking and physical examination are not careful, neglect or omission of important signs and symptoms. Very small number of patients may be by history and physical examination is still difficult to diagnose. Short-term follow-up is very important. Metastatic disease tend to deteriorate very quickly, back pain can not ease or worsen after the break. Osteoporosis after appropriate rest and (continued on page 73) l tongue № M: № Gai, ... c Chinese Journal of osteoporosis Orange 6 November 2000 Volume 73 No. 4 is related to bone mass in older men in more high serum E2 concentrations, therefore, estrogen skeletal bone mass in men plays an important role in the maintenance. Female bones, this effect of estrogen is more evident. ② the low normal range of serum testosterone concentration was not caused by reduced bone mineral density in elderly men and elderly men, sex hormone 4.3.4 Correlation of the total bone mass conclusions Overall, older men lose bone mass mainly related to estrogen levels lower secondary-related decrease in androgen levels. ① The total concentration of estrogen, but not total testosterone levels are related to bone mineral density in elderly men. ② biological activity than the overall concentration of estrogen in estrogen levels can more effectively predict the bone mineral density in elderly men. ③ biological activity of testosterone is also related to bone mineral density in elderly men, but inferior to biological activity related to estrogen levels. 4.4 selective estrogen receptor modulators (SERMs) 4.4.1 Estrogen treatment of osteoporosis in the bone to build the network plays an important role: the update process of bone: osteoclast bone absorption of the residual matrix (bonematrix) osteoblasts to generate a new class of bone (osteoid), and then osteoblasts make new bone calcification in a new class of bone, called bone to build. Systemic hormones, such as parathyroid hormone fell (PTH), calcitonin (CT), vitamin D (Vit.D), prostaglandin E2 (PGE2) and other, local cytokines, including transforming growth factor-B (TGF-B) , BMPs, a variety of insulin-like growth factors (IGFs), various prostaglandins (PGs), a variety of interleukin (Ils), tumor necrosis factor-a (TNFa), such as, calcium and phosphorus metabolism in target organs (kidney,[link widoczny dla zalogowanych], bone, intestines, etc.), and bone metabolism in target cells (osteoclasts and osteoblasts, etc.), etc., can participate in form of bone resorption and bone formation to build the network. Both women and men, coexist in older men (or older women) estrogen and androgen can also both act on the bone remodeling network. 4.4.2 applied to the new SERM osteoporosis in elderly men look forward to Riggs (jBoneMinerRes ,1998,13:763-773) that,[link widoczny dla zalogowanych], ① both women and men, the lack of estrogen will increase bone resorption rate, which may damage the generation of compensation increase bone formation. ③ estrogen deficiency must contribute to osteoporosis in elderly men. Bone to build and maintain bone health for life, mainly relying on the stimulating effect of estrogen. However, estrogen causes testicular atrophy and feminization of men; estrogen treatment of senile osteoporosis in women by endometrial cancer and breast cancer and other complications limit are looking for an ideal selective estrogen receptor modulators (SERMs): may retain the beneficial estrogen effect on bone and avoid the feminization of estrogen,[link widoczny dla zalogowanych], breast cancer, cervical cancer, and other side effects. Following the generation of Temoxifen after 1, Reloxifen come out. Reloxifen has been approved in Europe,[link widoczny dla zalogowanych], used in postmenopausal osteoporosis. Osteoporosis in older men is a clinical trial. People are looking forward to the new sERM male osteoporosis in elderly patients. (Continued from page 56) the proper treatment of pain relief. (2) Carefully read the piece, a typical x-ray diagnosis of the patients have no difficulty, when the only change showed flat vertebral bodies should pay special attention to the fine structure of the vertebral body. Vertebral osteoporosis, although variable flat, but there is still sparse compared to trabecular bone metastases seen a blur shadows. CT and MRI examination help identify changes and tumor destructive soft tissue mass. Laboratory investigations have metastatic cancer often see anemia, ESR increase, and AKP were significantly higher, see prostate-specific antigen prostate cancer (PSA) increased, while the performance of osteoporosis and more normal. In short as long as careful medical history, comprehensive physical examination, carefully read the x-ray film, be necessary for laboratory examination,[link widoczny dla zalogowanych], most patients can be diagnosed. Can be indeed difficult to identify the short-term followed up by correct diagnosis and timely ... ... ... ... ... ... ... ... ● We welcome submissions of Bone, Subscribe Youfa code 82-198 ... ... ... ... ... ... ... ... ● . '''
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