推 strongshort:接下來純西醫的討論在這裡不適合 我回信給你了 請收信 06/15 21:38
※ 引述《strongshort (力量與智慧)》之銘言：
: 非關學術性討論就不回應刪除了
: ※ 引述《Lepputte (純粹)》之銘言：
: 1. 既然你提到 我也提到Harrison 那你應該有看到osteoporosis那章
: 那 為什麼 裡面的risk factor不提到膠質?
: 有幾種可能: 1)目前對collagen瞭解很少 但這點不太可能 見下點說明
: 2)膠質有影響 但對大部分的骨質疏鬆患者來說 膠質比重只佔很小部分
: 3)只有在極少數案例中膠質是有影響的
學長若可以找的到我後面附的論文，有興趣的話，等兩週後我考完試咱們再來討論
: 對於上面舉的第二第三點 倘若你質疑的是我之前過份果斷的語氣
嗯 是沒錯。因為很多事，我們並不能那麼的肯定，
所以才會覺得比較好的態度是提出你所看的參考資料，
根據 xxx 所以我認為 .....
而不是很武斷的以己之見。
: 我承認並收回並道歉 我不該忽略極少數的案例
我後面的論文有提到一些有趣的假設，我覺得頗多啟發。
: 2. 目前已經有非常多研究在探討膠質與osteoporosis的關係
: 甚至事實上也有人確實這麼認為(請參閱期刊 endocrine方面尤佳)
: 病理上很多步驟都似乎有相關的但臨床上目前都沒有太大的成果出來
: 我傾向就目前的證據來講話
: 假設你是想要質疑我不該就尚未建立機制的部分置喙的話
: 我承認並收回並道歉 我不該就仍在進行中的研究說出自己果斷的評論
: 3. 鈣質只是骨質疏鬆那個大表格裡面的一項 甚至是被排到很後面的一項
: 牛奶又只是含鈣質食物中的一項
: 我從沒聽過有論文說過只要補鈣質就可以預防骨質疏鬆 這點說過很多次了
: 我更沒聽過要補鈣質一定要喝牛奶這項
: 所以我不懂這些網路文章是看哪一國的期刊跟研究成果
原post的網路文章有些地方是有問題，不過，我討論的主要是膠質跟鈣質吸附的問題。
: 4. 我誠摯建議既然翻開了Harrison就看完他
現在我還沒修內科學，不過，已經買了Harrison開始在唸，
我想我之後會唸完它的，感謝學長的經驗分享。
: 我是站在一個求學過來人的經驗分享 當然要是你對內科真的沒興趣也不勉強
事實上，我對內科極有興趣。並不排斥各科。
日後蠻想走內科。怕沒人要而已 :)
Osteoporosis, a unitary hypothesis of collagen loss in skin and bone. [Review]
Medical Hypotheses. 65(3):426-32, 2005.
Abstract:
Progress in osteoporosis has been stultified by repetitive,
statistic-driven studies and catechistic reviews; in the absence of
concept and hypothesis research is aimless, and the trivial associations
it continually reveals, has led to the cul-de-sac of multifactorialism.
A return to hypothesis-led research which seeks major causal defects and
the conclusive therapies that arise from them is essential.
The hypothesis proposed evolved from research into the mechanism of senile
purpura. This predicted a causal loss of skin collagen that was contrary
to contemporary opinion, but was confirmed when collagen was expressed
absolutely, instead as a percentage or ratio:
women have less collagen than men and it decreases by 1% a year
in exposed and unexposed skin.
Corticosteroids (which also produce shear purpura) reduce skin collagen
and androgen and virilism increase it; growth hormone produces the
greatest increase, and there is a decrease in hypopituitarism.
All these changes in skin collagen correspond to changes in bone density,
and the circumstances are too various for coincidence.
This led to the hypothesis that the changes found in skin collagen
also occur in bone collagen, leading to the associated changes in bone density
; thus a loss of collagen in skin and bones with aging is the causal
counterpart to loss of bone density in senile osteoporosis.
If this is correct then, as with aging, androgen and virilisation,
corticosteroids, growth hormone and hypopituitarism, changes in bone density
should correspond to systemic changes in skin collagen. This correspondence
is found to occur in osteogenesis imperfecta and Ehlers-Danlos syndrome,
two genetically discrete families of disordered collagen production,
and other situations, e.g., scurvy and homocystinuria. A primary loss of
collagen in osteoporotic bones is an essential prediction of the hypothesis;
in fact this loss is well established but, inexplicably, it has
been assumed to be secondary to the bone loss. Because of the
comparable changes in skin and bones, the hypothesis implies that
skin collagen could be used to predict the state of the bones and
their response to treatment. It also implies androgen should be an
effective treatment of osteoporosis, and growth hormone even more
effective (likewise, of course, skin aging). More importantly, skin
collagen and the production of collagen by skin fibroblasts could be
used for the assay and industrial development
of more potent, if not less toxic treatments and prevention of
loss of bone (and skin) substance
如果有興趣的話可以對對看 Harrison 16 eds p2271 Table 333-2列的
disease associated with an increase risk of generalized osteoporosis
in Adults.
抱歉，在中醫板列英文，不過，我把有趣的地方弄顯目了，應該不用花太多時間看的
。
明天要考期末考，不能多聊，之後有空再來討論。
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我們啊~~ 總是張開著帆
迎著風 一葉小舟
劃過一波又一波 浪的挑戰
向夢和理想的島嶼
前進
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◆ From: 163.25.118.31
※ 編輯: Lepputte 來自: 163.25.118.31 (06/11 23:43)
※ 編輯: Lepputte 來自: 163.25.118.31 (06/11 23:44)