Biomedical subjects

K Ichihara

Publications and source records attributed to K Ichihara.

At least 37 records · Page 2Linked to original sources

PubMed2001

[Establishment of a reference interval for highly sensitive CRP by exclusion of individuals with abnormal values in related laboratory tests].

In November, 1999, U.S. Food and Drug Administration approved a highly sensitive CRP(hs-CRP) assay that could assist medical doctors to predict the risk of cardiovascular accidents. Many doctors are now interested in the assay and trying to elucidate the relationship between serum CRP levels and cardiovascular diseases. In the past, it was difficult to establish a valid reference interval of serum CRP because of the poor analytical sensitivity and difficulty in sampling reference individuals. We have established a reference interval of serum CRP for the hs-CRP assay(Dade Behring). The study population consisted of 7,224 individuals(21-81 years old) who received a regular medical check-up. Potentially abnormal samples were excluded, depending on the results of other laboratory tests related to serum CRP variation. The upper limit of the reference interval was 0.15 mg/dl. The serum CRP was higher in smokers than in non-smokers, especially in men.

Adult↗

PubMed2001

[Identification of microbial subtypes from antibiotic susceptibility data in clinical laboratory for nosocomial infection surveillance].

We developed an algorism to identify microbial subtypes automatically from daily antibiotic susceptibility data in clinical microbiology laboratory. The susceptibility pattern was expressed as a string of digits, each consisting of 0(resistant), 1(intermediate) or 2(susceptible) to respective antibiotics. Any two patterns were regarded identical and combined if the difference at each digit never exceeds 1. The combined pattern was expressed as an array of digit-by-digit weighted averages of the two. The second combination was based on a degree of similarity among the numerical patterns using a formula, which was designed to emphasize differences in highly variable elements. This subgrouping procedure was done every three months. Identity of the detected subtypes between the intervals was determined using the same algorism as for the second combination. The algorism was applied to data of clinical isolates of MRSA, Pseudomonas aeruginosa (PA), Klebsiella pneumoniae (KP), Enterococcus faecalis (EF), Streptococcus pneumoniae (SP), Escherichia coli (EC) that were obtained over a period of 4 years. Three major subtypes of MRSA, KP and EF were consistently detected with shifting mutual frequencies. Most of EC isolates belonged to two consistent subtypes. Although PA and SP had one or two consistent subtypes, there were multiple minor subtypes of varying frequencies. This analysis is regarded as an "infotyping", in contrast to serotype or genotype, of clinical microbial isolates, which is useful for nosocomial infection surveillance.

Algorithms↗

PubMed2001

[Standardization of statistical procedures and evaluation scheme in external quality-control survey].

Numerous external quality assessment surveys are being conducted by variety of organizations throughout Japan, but the statistical processing and evaluation scheme are not compatible. Standardization of the procedures is essential to make comparison of results among surveys possible. A coding system is available only for names of analytes and analytical equipments. Systematic coding for analytical principles, manufacturers and standard materials is necessary. Regarding computation of peer-group statistics, the mean and SD are often biased when there are many, or wildly, outlying values. Therefore it is recommended to use an iterative method. The methodology removes a relatively large proportion of the population in the tails of the distribution and re-inflates the SD to compensate for the trimming, thus reaching an unbiased mean and SD by iteration. It is also useful to compute between-method CV and within method-CV by one-way analysis of variance. They represent overall levels of standardization and reproducibility of the analyte, respectively. The evaluation of results is usually based on the peer-group mean and SD. The scheme is unfair for those belonging to a peer-group with a narrow SD. It is recommended to use so-called "common CV evaluation scheme", which is based on a within-method CV computed from overall test results after excluding those peer-groups with large CVs. The common CV is applied to the unbiased peer-group mean to get the evaluation SD. For standardized data processing and statistical analysis, it is crucial to develop a unified, generalized soft ware. We developed its prototype named SurveyMaster I & II and herein introduce their potentials.

Clinical Laboratory Techniques↗

PubMed2000

Radical scavenging properties of novel benzopyran derivatives, TA248 and TA276, and effects of the compounds on ischemic/reperfused myocardium in dogs.

Characteristics of novel benzopyran derivatives, TA248 and TA276, and their effects on myocardial contraction in ischemic/reperfused hearts in dogs were examined. TA248 and TA276 inhibited NADPH-dependent lipid peroxidation induced by Fe(3+) in the rat brain homogenate. Both compounds reduced *O(2-) produced by xanthine-xanthine oxidase system in a dose-dependent manner. TA276 scavenged.OH generated by Fenton reaction in a dose-dependent manner. TA248 also inhibited the.OH production, but the effect was neither complete nor dose dependent. Myocardial contraction was assessed as segment shortening of the left ventricular wall in pentobarbital-anesthetized open-chest dogs. The segment shortening was decreased by the left anterior descending coronary artery ligation (ischemia) and returned by release of the ligated artery (reperfusion). The segment shortening did not recover fully during reperfusion. Either TA248 or TA276 injected 10 min before ischemia improved the recovery of myocardial contraction during reperfusion. Both compounds preserved the level of ATP in the 60-min reperfused myocardium. However, the level of lipid peroxides was not changed by TA248 and TA276. TA248 and TA276 may protect myocardium against ischemic/reperfusion insult, partly because of their free radical scavenging activity, but no significant change in myocardial lipid peroxide level was observed.

Animals↗

PubMed2000

Excitatory amino acid release in the locus coeruleus during naloxone-precipitated morphine withdrawal in adjuvant arthritic rats.

OBJECTIVE AND DESIGN: Excitatory amino acid levels in the locus coeruleus (LC) and the behavioral signs during naloxone-precipitated withdrawal in arthritic rats treated with chronic morphine were investigated by in vivo microdialysis. METHODS: Increases in glutamate (Glu) and aspartate (Asp) were noted after naloxone (48 nmol/5 microl, LC)-precipitated withdrawal from normal and adjuvant arthritic rats which had been intracerebroventricularly infused for 3 days with morphine (26 nmol/l microl/h). RESULTS: The increases in Glu and Asp levels on morphine withdrawal in normal rats were attenuated following naloxone challenge in the morphine-dependent arthritic rats. Moreover, behavioral signs during morphine withdrawal were detected following the naloxone challenge in both the morphine-dependent normal and adjuvant arthritic rats, but not in the saline-infused controls. CONCLUSIONS: These results show that the attenuation of Glu and Asp release from the LC in the adjuvant arthritic rats might explain the anti-inflammatory and analgesic effects of mu-opioids in adjuvant arthritic rats.

Animals↗

PubMed2000

The prognostic value of quality-of-life scores: preliminary results of an analysis of patients with breast cancer.

This study was conducted to elucidate the prognostic value of patient-assessed quality-of-life (QL) scores in cancer patients. QL was assessed in 47 consecutive patients with advanced or end-stage breast cancer using the Quality of Life Questionnaire for Cancer Patients Treated with Anticancer Drugs (QOL-ACD). The data collected from 19 of the 47 patients, who completed QL questionnaires more than twice before dying of cancer, were analyzed. The relationships between the QL scores and subsequent survival were examined at two assessment points, being the first and last assessment points of each of the 19 patients; corresponding respectively to median survival times of 14 and 4 months. The prognostic significance of the changes in QL scores that occurred over 3 months before the last assessment point was also examined. At the last assessment point, the scores of the physical aspects of QL were significantly related to survival. The change in scores of both overall QL and the physical aspects of QL were also significant predictors of survival. On the other hand, neither the scores nor the change in scores of the psychological and social aspects of QL was significant. This study indicates that both QL scores and changes in QL scores are promising prognostic predictors.

Adult↗

PubMed2000

Fatty acid-specific, regiospecific, and stereospecific hydroxylation by cytochrome P450 (CYP152B1) from Sphingomonas paucimobilis: substrate structure required for alpha-hydroxylation.

Fatty acid alpha-hydroxylase from Sphingomonas paucimobilis is an unusual cytochrome P450 enzyme that hydroxylates the alpha-carbon of fatty acids in the presence of H2O2. Herein, we describe our investigation concerning the utilization of various substrates and the optical configuration of the alpha-hydroxyl product using a recombinant form of this enzyme. This enzyme can metabolize saturated fatty acids with carbon chain lengths of more than 10. The Km value for pentadecanoic acid (C15) was the smallest among the saturated fatty acids tested (C10-C18) and that for myristic acid (C14) showed similar enzyme kinetics to those seen for C15. As shorter or longer carbon chain lengths were used, Km values increased. The turnover numbers for fatty acids with carbon chain lengths of more than 11 were of the same order of magnitude (10(3) min(-1)), but the turnover number for undecanoic acid (C11) was less. Dicarboxylic fatty acids and methyl myristate were not metabolized, but monomethyl hexadecanedioate and omega-hydroxypalmitic acid were metabolized, though with lower turnover values. Arachidonic acid was a good substrate, comparable to C14 or C15. The metabolite of arachidonic acid was only alpha-hydroxyarachidonic acid. Alkanes, fatty alcohols, and fatty aldehydes were not utilized as substrates. Analysis of the optical configurations of the alpha-hydroxylated products demonstrated that the products were S-enantiomers (more than 98% enantiomerically pure). These results suggested that this P450 enzyme is strictly responsible for fatty acids and catalyzes highly stereo- and regioselective hydroxylation, where structure of omega-carbon and carboxyl carbon as well as carbon chain length of fatty acids are important for substrate-enzyme interaction.

Arachidonic Acid↗

PubMed2000

Cell surface expression of immature H glycoprotein in measles virus-infected cells.

Two forms of hemagglutinin (H) protein, one with an apparent molecular mass of 78 kDa (78K H protein) and the other with that of 74 kDa (74K H protein), are present in cells infected with measles virus (MV). We previously observed that only the mature 78K H protein, a completely glycosylated form of the 74K H protein, was expressed on the cell surface of the infected cells. In the present study, we detected transient expression of the 74K H protein on the cell surface of infected cells by pulse-chase studies, although the level of this expression was much lower than that of the 78K H protein. On the cell surface the 74K H protein was present as dimers and sensitive to endo-beta-N-acetylglucosaminidase H digestion. Treatment with brefeldin A, which blocks the transport of membrane and secretory proteins from the endoplasmic reticulum to the Golgi apparatus, inhibited the cell surface expression of the 78K H protein, but not that of the 74K H protein. These data suggest that a part of the MV 74K H proteins could be transported directly to the cell surface - probably via an alternative pathway - without processing to the complex form in the Golgi apparatus.

Animals↗

PubMed2000

Unique heme environment at the putative distal region of hydrogen peroxide-dependent fatty acid alpha-hydroxylase from Sphingomonas paucimobilis (peroxygenase P450(SPalpha).

Fatty acid alpha-hydroxylase from Sphingomonas paucimobilis is a hydrogen peroxide-dependent cytochrome P450 (P450) enzyme (P450(SPalpha)). In this study, heme-ligand exchange reactions of P450(SPalpha) were investigated using the optical spectroscopic method and compared with those of various P450s. Alkylamines (C >/= 5) induced changes in the spectrum of ferric P450(SPalpha) to one typical of a nitrogenous ligand-bound low-spin form of ferric P450, although their affinities were lower than those for other P450s, and a substrate, laurate, did not interfere with the binding in contrast with in the cases of other P450s. Other compounds having a nitrogen donor atom to the heme iron of P450, including pyridine or 1-methylimidazole, induced no change in the spectrum of P450(SPalpha) in either the ferric or ferrous state. Practically no spectral change was observed on the addition of alkyl isocyanides to ferric P450s. On the other hand, cyanide induced a change in the spectrum of ferric P450(SPalpha) to one characteristic of cyanide-bound form of ferric P450. The affinity of cyanide increased when the substrate was added, in contrast with in the cases of other P450s. Ferrous P450(SPalpha) combined with CO and alkyl isocyanides, and the affinity for CO was of the same order of magnitude as in the cases of other P450s. These findings suggest a unique heme environment of P450(SPalpha), in which most compounds usually acting as external ligands of ferric P450s are prevented from gaining access to the heme iron of P450(SPalpha). The unique properties of the hydroxylase reaction catalyzed by P450(SPalpha), where an oxygen atom of hydrogen peroxide but not of molecular oxygen is utilized and incorporated into a fatty acid at its alpha position, is possibly related with such a specific heme environment of this P450. A possible mechanism for the peroxygenase reaction of P450(SPalpha) is proposed.

Amines↗

PubMed2000

Lipophilic HMG-CoA reductase inhibitors increase myocardial stunning in dogs.

Pretreatment of dogs with simvastatin, a lipophilic 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor, increases myocardial contractile dysfunction during reperfusion after ischemia (stunning), with reduction of tissue adenosine triphosphate (ATP). This was thought to be a consequence of prevention of ubiquinone biosynthesis by the lipophilic inhibitor in the myocardial cell. We examined whether other lipophilic HMG-CoA reductase inhibitors also influence myocardial stunning in dogs. Vehicle, atorvastatin (2 mg/ kg/day), fluvastatin (4 mg/kg/day), or cerivastatin (40 microg/kg/ day) was orally administered for 3 weeks. Hydrophilic pravastatin (4 mg/kg/day) also was given. After 3 weeks, pentobarbital-anesthetized dogs were subjected to 15-min left anterior descending coronary artery occlusion followed by 2-h reperfusion. Myocardial segment function was determined by sonomicrometry. Tissue levels of ATP were determined in 2-h reperfused hearts. All inhibitors significantly decreased serum cholesterol level. The three lipophilic inhibitors resulted in a worsening of segment function in the reperfused myocardium, as compared with the vehicle group. The levels of ATP in the atorvastatin, fluvastatin, and cerivastatin groups were significantly lower than that in the vehicle group. These results confirm that lipophilic HMG-CoA reductase inhibitors enhance myocardial stunning in association with ATP reduction after ischemia and reperfusion.

Adenosine Triphosphate↗

PubMed2000

Effects of pimobendan and EGIS 9377, cardiotonic agents, and OG-VI, a nucleoside-nucleotide mixture, administered during reperfusion after ischemia on stunned myocardium in dogs.

BACKGROUND: Pimobendan is a so-called calcium sensitizer that exerts a positive inotropic action. EGIS 9377 is synthesized as a calcium sensitizer. OG-VI is a nucleoside-nucleotide mixture that ameliorates the myocardial dysfunction (myocardial stunning) after ischemia. OBJECTIVE: To determine whether administration of these agents after the onset of reperfusion after ischemia improves the condition of stunned myocardium. METHODS: Dogs anesthetized with pentobarbital were subjected to 20 min ligation of left anterior descending coronary artery and then 60 min reperfusion. The corresponding vehicle, 0.3 and 1 mg/kg pimobendan, or 1 and 3 mg/kg EGIS 9377 was injected intravenously 30 min after the onset of reperfusion. Saline solution or 1.2 mumol/kg per min OG-VI was infused for 30 min, starting 30 min after the reperfusion. Shortening of myocardial segment was measured by sonomicrometry. The tissue levels of energy and carbohydrate metabolites in the 60 min-reperfused hearts were determined. RESULTS: Shortening of myocardial segments significantly decreased during ischemia, and returned toward preischemic level after reperfusion for all groups, although the contractile dysfunction still remained. Injections and infusion of pimobendan, EGIS 9377, and OG-VI after the onset of reperfusion ameliorated the contractile dysfunction. Systemic vascular resistance was decreased by administrations of pimobendan and OG-VI. The levels of high-energy phosphates in 60 min-reperfused heart were not changed by either treatment. CONCLUSION: Administration of pimobendan, EGIS 9377, and OG-VI ameliorate the myocardial contractile dysfunction after ischemia even when these agents are administered after the onset of reperfusion. The increase in contractile function due to these agents did not worsen the myocardial energy balance.

Adenosine Triphosphate↗

PubMed2000

Decision-tree sensitivity analysis for cost-effectiveness of chest 2-fluoro-2-D-[(18)F]fluorodeoxyglucose positron emission tomography in patients with pulmonary nodules (non-small cell lung carcinoma) in Japan.

CONTEXT: Recent studies have demonstrated the potential cost-effectiveness of using 2-fluoro-2-D-[(18)F]fluorodeoxyglucose (FDG) positron emission tomography (PET) in the management of non-small cell lung carcinoma (NSCLC), but because of differences in health-care systems, those findings may not hold true in a Japanese hospital. OBJECTIVE: To assess the cost-effectiveness of the chest CT plus chest FDG-PET strategy in Japan. DESIGN: Decision-tree sensitivity analysis based on the two competing strategies of chest CT-alone vs chest CT plus chest FDG-PET. STUDY SELECTION: A simulation of 1,000 patients in whom NSCLC, stage IIIB or less, was suspected was created using baselines of other relevant variables in regard to sensitivity, specificity, mortality, life expectancy, and cost from published data. METHODS: We surveyed the relevant literature for the choice of variables. MAIN OUTCOME MEASURES: Expected marginal cost and expected life expectancy gain for NSCLC patients. RESULTS: The chest CT plus chest FDG-PET strategy yielded an expected life expectancy gain of 0.607 years (7.3 months) per patient, compared with the alternative strategy of chest CT-alone. Using an FDG-PET examination cost of 1.0 x 10(5) yen (around $700 US) per study, the cost increment was 2.18 x 10(5) yen/yr/patient. CONCLUSIONS: The chest CT plus chest FDG-PET strategy in patients with NSCLC is unlikely to be cost-effective in Japan. However, patient life expectancy gain would increase as a result of improved staging of NSCLC. These preliminary results should be confirmed by further studies for specific environments.

Adult↗

PubMed2000

[Exploratory analysis of elevated C-reactive protein without leukocytosis from the clinical laboratory database].

We studied the characteristics of admitted patients who showed discrepancy between C-reactive protein(CRP) and white blood cell count(WBC). We extracted those patients from our laboratory information system by two criteria: WBC is less than 9500/microliter and either(1) CRP is more than 5.0 mg/dl, or(2) the pair of CRP and WBC is out of 95% confidence ellipse. We found 346 and 90 cases by the two criteria, respectively. They consisted of a variety of diseases, prevalent were such as pneumonia, rheumatoid arthritis, malignant lymphoma, post-operative state and so on by either criterion. There was predominance of elderly patients as a whole. The analysis of individual time courses revealed that WBC did not change in parallel with CRP in patients with rheumatoid arthritis and malignant lymphoma, while they paralleled in those with infectious diseases and post-operation states. The elevation of WBC in some patients might have been overlooked since WBC was not always to be ordered together with CRP. We need a prospective study to closely analyze serial relationship between CRP and WBC for factors leading to the discovery.

Aged↗

PubMed2000

[Nosocomial infection monitoring system featuring detection of local clustering].

We have developed a nosocomial infection surveillance system making use of data from laboratory information system. The system makes cross-reference table of detected bacteria according to either the site of occurrence(hospital wards) or antibiotic sensitivity. It is capable of listing all the patients or serial changes in frequency for any specified bacterium. Furthermore, we have developed an algorism to detect local clustering. For each ward, the system calculates all combinations of distance between beds of patients with specified bacteria. We named the statistics as DC(degree of cluster) and its significance was judged by a confidence interval of DC obtained by a bootstrap method by randomly assigning the same number of patients to the beds in the same wards. Retrospective analysis of the distribution of 4 major bacteria in the wards proved that DC is a sensitive indicator of local clustering.

Algorithms↗

PubMed1999

Translocation of G-protein beta3 subunit from the cytosol pool to the membrane pool by beta1-adrenergic receptor stimulation in perfused rat hearts.

To elucidate the intracellular function and localization of the heterotrimeric G-protein beta3 subunit (Gbeta3) in the heart, we studied the effects of subtype-specific beta-adrenergic receptor (beta-AR) stimulation on Gbeta3 localization using isoform-specific antibodies. The amount of Gbeta3 in the cytosol dramatically decreased in hearts perfused with isoproterenol (ISO) alone or ISO with ICI 118551, a beta2-AR antagonist. Propranolol or CGP 20712A, a beta1-AR antagonist, blocked the ISO-induced decrease in the Gbeta3 content of the cytosol. In contrast, Gbeta3 content of the membrane fraction significantly increased in hearts perfused with ISO alone or ISO with ICI 118551. We conclude that stimulation of the beta1-AR induces isoform-specific translocation of Gbeta3 from the cytosol to the membrane fraction in rat hearts.

Animals↗

PubMed1999

Participation of angiotensin II and bradykinin in contractile function in dog stunned myocardium.

We examined the effects of enalapril and 4'-[(1, 4'-dimethyl-2'-propyl-[2,6'-bi-1H-enzimidazole]-1'-yl)methyl]-[1, 1'-biphenyl]-2-carboxylic acid (BIBR-277), an angiotensin II receptor antagonist, on contractile dysfunction in the stunned myocardium. Dogs were subjected to 20-min ligation of the coronary artery, followed by 60-min reperfusion. Saline, enalapril (1 mg/kg or 3 mg/kg), or BIBR-277 (3 mg/kg) was injected i.v. 10 min before ligation. D-Arginyl-L-arginlyl-L-prolyl-trans-4-hydroxy-L-prolylglycyl -3-(2-thi enyl)-L-alanyl-L-seryl-D-1,2,3, 4-tetrahydro-3-isoquinolinecarbonyl-L-(2alpha, 3beta, 7abeta)-octahydro-1H-indole-2-carbonyl-L-arginine (Hoe-140), a bradykinin B(2) receptor antagonist, at 300 microg/kg was injected i. v. 10 min before drug injection. Contractile function was assessed on the basis of percentage segment shortening (%SS). ATP levels were measured in 60-min reperfused hearts. %SS significantly decreased during ischemia, and recovered during reperfusion, although the %SS was significantly less than the pre-ischemic level. Both enalapril at either dose and BIBR-277 significantly enhanced %SS recovery during reperfusion, an effect which was associated with a tendency toward energy preservation. Hoe-140 completely abolished the effect of enalapril at either dose, while it did not modify that of BIBR-277. Inhibition of angiotensin II formation and bradykinin breakdown may be separately related to the improvement of myocardial stunning.

Adenosine Triphosphate↗

PubMed1999

Characterization of the ybdT gene product of Bacillus subtilis: novel fatty acid beta-hydroxylating cytochrome P450.

We have characterized the gene encoding fatty acid alpha-hydroxylase, a cytochrome P450 (P450) enzyme, from Sphingomonas paucimobilis. A database homology search indicated that the deduced amino acid sequence of this gene product was 44% identical to that of the ybdT gene product that is a 48 kDa protein of unknown function from Bacillus subtilis. In this study, we cloned the ybdT gene and characterized this gene product using a recombinant enzyme to clarify function of the ybdT gene product. The carbon monoxide difference spectrum of the recombinant enzyme showed the characteristic one of P450. In the presence of H2O2, the recombinant ybdT gene product hydroxylated myristic acid to produce beta-hydroxymyristic acid and alpha-hydroxymyristic acid which were determined by high-performance liquid chromatography (HPLC) and gas chromatography-mass spectrometry. The amount of these products increased with increasing reaction period and amount of H2O2 in the reaction mixture. The amount of beta-hydroxyl product was slightly higher than that of alpha-hydroxyl product at all times during the reaction. However, no reaction products were detected at any time or at any concentration of H2O2 when heat-inactivated enzyme was used. HPLC analysis with a chiral column showed that the beta-hydroxyl product was nearly enantiomerically pure R-form. These results suggest that this P450 enzyme is involved in a novel biosynthesis of beta-hydroxy fatty acid.

Amino Acid Sequence↗

PubMed1999

Biochemical markers of bone turnover in breast cancer patients with bone metastases: a preliminary report.

BACKGROUND: Some biochemical markers of bone turnover are expected to reflect the disease activity of metastatic bone tumor. In the present study six biochemical markers were evaluated to determine appropriate markers for the detection of metastatic bone tumors from breast cancer (BC). METHODS: A panel of bone turnover markers was assessed in 11 normocalcemic patients with bone metastases from BC and in 19 BC patients without clinical evidence of bone metastases. Bone formation was investigated by measuring serum bone isoenzyme of alkaline phosphatase (BALP), osteocalcin (OC) and carboxy-terminal propeptide of type I procollagen (PICP): Bone resorption was investigated by measuring serum carboxy-terminal telopeptide of type I collagen (ICTP), fasting urinary pyridinoline (Pyr) and deoxypyridinoline (D-Pyr). RESULTS: PICP was influenced by age and menopausal status. Significant correlations were observed between each of bone turnover markers except between BALP and OC. The mean levels of the six bone turnover markers were higher in patients with bone metastases than in those without them and significance was observed except for OC. The best diagnostic efficiency by receiver-operating characteristic (ROC) analysis was provided by ICTP followed by Pyr or D-Pyr, BALP, PICP and OC and significance was observed between ICTP and OC. Multiple logistic regression analysis adjusted by age revealed that the only significant marker related to bone metastases was ICTP. CONCLUSIONS: Serum ICTP appears to be the leading marker of bone metastases from BC. However, to reveal the clinical usefulness of these markers, further examination will be needed to account for the ease and cost-effectiveness of the measurements.

Adult↗