Advances in management of bone disease in breast cancer
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Paraneoplastic dermatomyositis associated with testicular malignancyA 25-year-old Taiwanese male came to our dermatologic clinic due to muscle weakness, facial erythema, and peri-orbital swelling for 3 weeks (Figure 1A).He was diagnosed with testicular embryonal carcinoma with lung metastasis (Figure 1E,F) and had just received orchiectomy 2 weeks prior to cutaneous manifestations.Upon physical examination, Gottron's papules (Figure 1C) were seen along with trunk erythema.Skin biopsy in right dorsal hand showed hyperkeratosis, acanthosis, and papillary dermal edema with mucin deposition in the dermis (Figure 1G,H).Direct immunofluorescence revealed scattered ovoid bodies over the dermal-epidermal junction.Laboratory exam showed increased levels of CPK (2663 IU/L), LDH (293 IU/L), and alpha-fetoprotein (34.83 ng/mL).Dermatomyositis (DM) was impressed.Prednisolone with 30 mg per day was given initially, but the symptoms persisted.After administered first chemotherapy with bleomycin, etoposide, and cisplatin (BEP) for testicular cancer, his symptoms and skin erythema significantly improved (Figure 1B,D) along with declined level of CPK and tumor markers.Auto-antibody of anti-transcription intermediary factor 1-gamma (TIF1-γ) showed positive result (1+), and therefore, paraneoplastic DM related to
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Breast cancer and osteoporosis are common diseases that affect the survival and quality of life in postmenopausal women. Women with breast cancer are more likely to develop osteoporosis than women without breast cancer due to certain factors that can affect both diseases simultaneously. For instance, estrogen and the receptor activator of nuclear factor-κB ligand (RANKL) play important roles in the occurrence and development of these two diseases. Moreover, chemotherapy and hormone therapy administered to breast cancer patients also increase the incidence of osteoporosis, and in recent years, neuropeptide Y (NPY) has also been found to impact breast cancer and osteoporosis.Y1 and Y5 receptors are highly expressed in breast cancer, and Y1 and Y2 receptors affect osteogenic response, thus potentially highlighting a potential new direction for treatment strategies. In this paper, the relationship between breast cancer and osteoporosis, the influence of NPY on both diseases, and the recent progress in the research and treatment of these diseases are reviewed.
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MicroRNA (miRNA), which are stably present in serum, have been reported to be potentially useful for detecting cancer. In the present study, we examined the expression profiles of serum miRNA in several large cohorts to identify novel miRNA that can be used to detect early stage breast cancer. We comprehensively evaluated the serum miRNA expression profiles using highly sensitive microarray analysis. A total of 1280 serum samples of breast cancer patients stored in the National Cancer Center Biobank were used. In addition, 2836 serum samples were obtained from non‐cancer controls, 451 from patients with other types of cancers, and 63 from patients with non‐breast benign diseases. The samples were divided into a training cohort including non‐cancer controls, other cancers and breast cancer, and a test cohort including non‐cancer controls and breast cancer. The training cohort was used to identify a combination of miRNA that could detect breast cancer, and the test cohort was used to validate that combination. miRNA expressions were compared between patients with breast cancer and non‐breast cancer, and a combination of five miRNA (miR‐1246, miR‐1307‐3p, miR‐4634, miR‐6861‐5p and miR‐6875‐5p) was found to be able to detect breast cancer. This combination had a sensitivity of 97.3%, specificity of 82.9% and accuracy of 89.7% for breast cancer in the test cohort. In addition, this combination could detect early stage breast cancer (sensitivity of 98.0% for Tis).
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Bone disease
Drug Development
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A lifestyle-related disease and osteoporosis are diseases to increase with aging and a lifestyle-related disease has an influence on the bone metabolism. Because the number of patients with lifestyle-related disease is getting larger, it is necessary to prevent fracture in those. Unfortunately, substantial randomized control studies are yet to be done in patients with lifestyle-related disease to clarify if anti-osteoporotic drugs are effective to prevent fractures. It is suggested by the subanalysis in the existing clinical study with usefulness of bisphosphonates with evidence as an osteoporotic therapeutic drug in life-related disease. Here I will review about the effective and problem with bisphosphonate for the lifestyle-related disease with arteriosclerosis.
Bone disease
Bone remodeling
Metabolic bone disease
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Objective To investigate the relationship between the hypertention and osteoporosis in middle aged male.Methods 115 males with essential hypertention(group A) and 91 males without hypertention(group B) were studied,the blood pressure and bone mineral density(BMD)were measured to observe the diference between the two groups.Results The BMD in essential hypertention patient were significantly lower than those without hypertention.There were statistical differences between the incidence of osteoporosis in group A and that in group B.Conclusion The middle aged males with essential hypertention have a higher rate of osteoporosis.
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