Calcium Treatment Research Articles

Retrospective Analysis of Febril Convulsion Patients Aged Between 5 Months-5 Years Old

Objective: The purpose of this study was to determine the demographic characteristics of patients admitted to emergency unit with febrile convulsions, and the mistakes during diagnosis so as to evaluate various treatment modalities. Methods: The study was conducted with 326 patients (aged 5 months to 5 years) admitted to emergency unit because of febrile convulsions. Patients with congenital anomalies, history of head trauma and mental retardation were excluded from the study. Patients were evaluated as for age, gender, temperature, sodium and calcium levels, C-reactive protein, leucocyte count, serum glucose, family history, treatment and hospitalization. SPSS for Windows 13.0 software programme was used for statistical analysis. This study was approved by the ethics committee of the Bakırköy Dr. Sadi Konuk Hospital. Results: Mean age of the cases was 25.0±15.3 months, while 147 (45.1 %) of them were female and 179 (54.9 %) of them were male, and 29 (8.9 %) patients had familial history of febrile convulsions. Body temperature levels changed between 36.8 Co and 41°C and mean temperature was 38.49±0.64. Upper respiratory tract infections were found to be the most common causes of the febrile convulsions with a rate of 75.8 %. Paracetamol use was significantly higher in simple convulsions, however midazolam use was significantly higher in complicated convulsions (p<0.01). Hospitalization rate was found to be significantly higher in complicated convulsions than the simple ones (p<0.01). Conclusion: Febrile convulsions have good prognosis, but follow up is important because of high recurrence rate and higher epilepsy risk than normal population.

The Effect of Calcium Treatment on the Corrosion Resistance of Manganese Steels

The metallurgy quality of the steel was improved greatly by calcium treatment which was a technique developed for a long time. The Mn steels treated with calcium, carbon-manganese steels and nickel-chromium steels were collected and their corrosion behaviors were investigated. The results showed that the corrosion resistance of the Mn steel is lower than that of the Ni-Cr steel. The shape of the inclusions can be modified and quality of the steels can be enhanced by the calcium treatment, and the corrosion resistance of the steel treated with calcium is higher than that of the common carbon-Mn steel, and near to that of the NiCr steel.

Physiological and molecular responses to calcium supplementation in Microcystis aeruginosa (Cyanobacteria)

Calcium is an important element in water bodies that plays a pivotal role in numerous biological processes; however, its effects on bloom-forming cyanobacteria have been studied only rarely. In the present study, the effects of calcium on Microcystis aeruginosa, a major bloom-forming cyanobacterium, were investigated. Significant decreases in growth, chlorophyll a and maximum electron transport rate were shown when calcium was absent, while similar reductions in these parameters were also found at high concentrations of calcium (240 mg/l). The expression of psbA, grpE and recA was up-regulated significantly for 0 and 240 mg/l calcium treatments. The activity of catalase (CAT) also increased remarkably under these two treatments, suggesting that Microcystis suffered from stress under both calcium absence and under high calcium concentrations. Additionally, the polysaccharide synthesis gene, epsL, was up-regulated at high concentrations of calcium. These data suggest that calcium plays an important role in the growth of Microcystis, and that enhancement in polysaccharide synthesis in response to increases in calcium concentration might be responsible for bloom formation.

Different uptake of gentamicin through TRPV1 and TRPV4 channels determines cochlear hair cell vulnerability

Hair cells at the base of the cochlea appear to be more susceptible to damage by the aminoglycoside gentamicin than those at the apex. However, the mechanism of base-to-apex gradient ototoxicity by gentamicin remains to be elucidated. We report here that gentamicin caused rodent cochlear hair cell damages in a time- and dose-dependent manner. Hair cells at the basal turn were more vulnerable to gentamicin than those at the apical turn. Gentamicin-conjugated Texas Red (GTTR) uptake was predominant in basal turn hair cells in neonatal rats. Transient receptor potential vanilloid 1 (TRPV1) and 4 (TRPV4) expression was confirmed in the cuticular plate, stereocilia and hair cell body of inner hair cells and outer hair cells. The involvement of TRPV1 and TRPV4 in gentamicin trafficking of hair cells was confirmed by exogenous calcium treatment and TRPV inhibitors, including gadolinium and ruthenium red, which resulted in markedly inhibited GTTR uptake and gentamicin-induced hair cell damage in rodent and zebrafish ototoxic model systems. These results indicate that the cytotoxic vulnerability of cochlear hair cells in the basal turn to gentamicin may depend on effective uptake of the drug, which was, in part, mediated by the TRPV1 and TRPV4 proteins.

Significance of zoledronic acid on survival in patients with bone metastases from renal cell carcinoma.

374 Background: It remains unclear whether zoledronic acid (ZOL) improves overall survival (OS) for renal cell carcinoma (RCC) patients with bone metastases. We retrospectively investigated the clinical benefit of ZOL for OS in RCC patients with bone metastases. Methods: Between 1978 and 2010, 77 patients who had RCC metastatic to bone were treated in our hospital. Of them, 36 were treated with ZOL and their OS was significantly better than that of the other 41 patients (1- and 3-year survival, 84% and 73% vs. 49% and 27%, respectively, p < 0.001). OS rates were clearly discriminated according to MSKCC model stratification: 3-year survival rates in the favorable, intermediate and poor risk groups were 83% (n = 12), 49% (n = 45), and 19% (n = 20), respectively (p=0.0033). To match characteristics in our retrospective study, we selected 45 patients conforming to MSKCC intermediate risk group criterion. In this cohort, 23 patients received ZOL (ZOL-treated group) whereas the other 22 did not (non-ZOL-treated group). The primary endpoint was OS and the secondary endpoint was the skeletal-related event (SRE) rate defined as the total number of SREs divided by the total years on study. Results: For the cohort of 45 patients, the median OS from diagnosis of bone metastases was 27.2 months. Multivariate analysis showed that low serum calcium (hazard ratio [HR]: 2.58, 95% confidence interval [CI]: 1.31 to 4.69; p = 0.0083) and ZOL treatment (HR: 1.89, 95% CI: 1.27 to 2.96; p = 0.0013) were independent factors predicting longer survival. The ZOL-treated group had significantly longer OS (1-year survival: 80.8%) than the non-ZOL-treated group (1-year survival: 59.1%, p = 0.0034). A difference in OS between the two groups still was present (p = 0.012) when the duration of molecular-targeted therapy was excluded from the OS period. Patients in the ZOL-treated group experienced a lower SRE rate (0.87/year) than patients in the non-ZOL-treated group (1.82/year, p = 0.0453). In particular, none of the patients in the ZOL-treated group developed spinal compression whereas 6 (28%) in the non-ZOL-treated group did (p = 0.0479). Conclusions: The current study indicates that ZOL not only reduces SREs but possibly improves OS in these patients.

Experimental Study to Improve the Castability of Aluminum Killed Cold Heading Steel

AbstractExperimental study on the LF refining of aluminum killed cold heading steel shows that calcium content in the molten steel increased to about 0.0010% at the end of refining, and the aluminum deoxized products were transformed from Al2O3 to the complex inclusions CaO–MgO–Al2O3 with lower melting point by the high basicity, high Al2O3, and strong deoxidizing slag. The inclusions are in liquid state and can be easily floated up during LF refining and continuous casting. The total oxygen content of the steel falls to about 0.0020%. The experimental technology uses only 50 m calcium wire to the 80‐t heat or even without calcium treatment. As compared to the traditional technology with higher amount of calcium for treatment, which forms CaS and CaO–MgO–Al2O3 inclusions with high melting point, the experimental technology improves the castability and reduces the manufacturing cost.

Thermodynamics for Precipitation of CaS Bearing Inclusion and Their Deformation During Rolling Process for Al‐Killed Ca‐Treated Steel

AbstractThermodynamics for CaS bearing inclusions precipitation and their deformative behaviors during compact strip production (CSP) rolling process for Al‐killed calcium treatment steel were researched using scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS) combined with the results of industrial trials. In addition, thermodynamic software FactSage was applied to calculate component activities of an inclusion and to analyze properties of sulfide‐oxide duplex inclusions. It is possible for CaS bearing inclusion precipitation during secondary refining and continuous casting in two manners: the first is that Ca and S react directly after calcium treatment; the other is as the well modified calcium aluminates react with dissolved sulfur and aluminum in liquid steel. Correspondingly, two types of sulfide‐oxide duplex inclusion were observed in casting slab. For the first type duplex inclusion, nearly no chemical reactions occur between outer CaS layer and solid inclusion core, thus the outer CaS rich layer is easily separated even taken off from the inner core during rolling process, and a crack may be generated correspondingly. The later one performs a better deformation during rolling process.

Characteristics of Inclusions in Low Carbon Al-Killed Steel during Ladle Furnace Refining and Calcium Treatment

A plant trial of the productions of LCAK steel was performed, and characteristics of inclusions during LF refining and calcium treatment were investigated. Besides, thermodynamic diagram among magnesium, aluminum, and oxygen as well as calcium, magnesium, aluminum, and oxygen in the steel melt were studied to understand the fundamentals of inclusion modification by calcium treatment in LCAK steel. Furthermore, the change mechanisms of oxide inclusions and the precipitation of calcium sulfide were discussed. The experimental results showed that oxide inclusions were partly changed along with the path of Al2O3→MgO·Al2O3→(MgO·)CaO·Al2O3, which was a little different from the thermodynamic calculation results due to the limited kinetic conditions. Calcium treatment somehow modified the inclusions, however, many large inclusions were generated, and the modification effect would be dramatically decreased by the formation of large amount of CaS inclusions, which appeared with three main distribution forms. The formation of inclusions after calcium treatment were discussed based on the thermodynamic analysis. In order to reach the target of modification, sulfur concertration in steel should be reduced to a small amount to decrease the formation of CaS.

Preharvest sprays and their effects on the postharvest quality of fruit

Purpose of review: This paper reviews studies on the effects of preharvest spray treatments on the postharvest quality and storage potential of fruits, with the objective of summarising the main effects in each case and identifying major topics requiring further research. Findings: The literature survey shows that most of the studies on preharvest sprays have considered either calcium or growth regulator treatments. Calcium applications are generally reported to delay ripening, decrease postharvest rots and alterations, and extend the keeping period, but their effects are partially dependent on the calcium source and formulation used, and phytotoxicity has also been occasionally observed. Preharvest sprays with growth regulators such as aminoethoxyvinylglycine, gibberellins or polyamines have also been studied and have shown promising potential for delaying ripening and improving storage potential or particular quality traits. Directions for future research: Although some common effects have been identified on fruit physiology for a particular treatment, a certain degree of variability across fruit types or cultivars has been observed in all cases. The suitability and the particular conditions of each treatment should be assessed and adjusted for each fruit type. In addition, because fruit metabolism is complex and strictly regulated, improved keeping potential may be contradicted by detrimental effects on eating quality, meaning that treatment effects should be evaluated as a whole. A third aspect worthy of more intense research efforts involves effects on key quality attributes such as aroma or bioactive compound contents, or on other traits relevant for quality preservation such as fruit cuticles.

A New Double Calcium Treatment Method for Clean Steel Refining

AbstractA new double calcium treatment method was proposed according to industrial experiment. In the new process, the evolution of inclusion was analyzed and the controlling standard of T.[Ca]/T.[O] ratio for calcium treatment was discussed. The results show that good castability with low calcium content about 12 ppm was obtained by this method, and the inclusion grade of D type thin series decreases from 1.5 to 1.0 in final product. CaOMgOAl2O3 system inclusions containing small amount of CaO are mainly presented after LF refining. After the 1st calcium treatment, most inclusions are in the liquid region with low melting point and the MgO content decreases obviously. After the 2nd calcium treatment, the distribution of inclusion composition is more concentrated compared with the 1st calcium treatment, and the MgO content decreases further with the inclusion composition very close to CaOAl2O3 system and almost all in liquid region. In order to get a good calcium treatment result, T.[Ca]/T.[O] ratio should be controlled above 0.91, and the ratio between 0.91 and 1.25 is suitable in present work.

Control of MgO·Al2O3 Spinel Inclusions during Protective Gas Electroslag Remelting of Die Steel

The effect of calcium treatment and/or aluminum-based deoxidant addition on the oxygen control and modification of MgO·Al2O3 spinel inclusions during protective gas electroslag remelting (P-ESR) of H13 die steel with low oxygen content was experimentally studied. It is found that all the inclusions in the consumable electrode are MgO·Al2O3 spinels, besides a few MgO·Al2O3 spinels surrounded by an outer (Ti,V)N or MnS layer. After P-ESR refining combined with proper calcium treatment, all the original MgO·Al2O3 spinels in the electrode (except for the original MgO·Al2O3 spinels having been removed in the P-ESR process) were modified to mainly CaO-MgO-Al2O3 and some CaO-Al2O3 inclusions, both of which have a low melting point and homogeneous compositions. In the case of only Al-based deoxidant addition, all the oxide inclusions remaining in ESR ingots are MgO·Al2O3 spinels. The operation of Al-based deoxidant addition and/or calcium treatment during P-ESR of electrode steel containing low oxygen content is invalid to further reduce the oxygen content and oxide inclusions amount compared with remelting only under protective gas atmosphere. All the original sulfide inclusions were removed after the P-ESR process. Most of the inclusions in ESR ingots are about 2 μm in size. The mechanisms of non-metallic inclusions evolution and modification of MgO·Al2O3 spinels by calcium treatment during the P-ESR process were proposed.

The p75 neurotrophin receptor triggers keratinocyte stem-transit amplifying cell transition in normal human epidermis

p75 neurotrophin (NT) receptor (p75NTR) can signal independently from the high affinity receptor Trk and mediates apoptosis in human keratinocytes, upon binding with specific ligands. As p75NTR is predominantly expressed in transit amplifying (TA) cells, we aimed to study the role of p75NTR in keratinocyte differentiation. p75NTR was up-regulated during keratinocyte differentiation in cell culture with both serum and calcium treatment. When p75NTR was silenced, calcium treatment failed to induce differentiation in subconfluent keratinocytes. p75NTR positive (p75NTRpos) human keratinocytes, isolated by cell sorting, were less differentiated, as shown by western blotting and confocal analysis, and proliferated less than p75NTR negative (p75NTRneg) cells. In human skin sections, p75NTR was confined to a MIB-1 negative cell population, while some p75NTR positive cells expressed CK15 and survivin, which preferentially identify keratinocyte stem cells (KSC). Freshly isolated p75NTRpos TA cells expressed more survivin and CK15, while displayed less CK10 than p75NTRneg TA. p75NTRpos TA cells produced more colonies, proliferated to a greater extent, and yielded a higher number of cells than p75NTRneg TA, suggesting that p75NTRpos cells are early TA cells. Moreover, p75NTR retroviral infection of KSC induced a more differentiated phenotype, with the same features of TA cells. Finally, p75NTRpos TA cells generated a skin reconstruct where CK10 was more homogeneously expressed than in skin originated from p75NTRneg TA cells. These results suggest that p75NTRpos keratinocytes represent a subpopulation of TA cells, that just started the differentiation process from KSC. p75NTR may act as a “switch on-off” protein in stem-TA transition, initiating keratinocyte differentiation. JSID AbstractsJournal of Dermatological ScienceVol. 69Issue 2Preview Full-Text PDF

An ErbB receptor mediated AP-1 regulatory network is modulated by STAT3 and c-MYC during calcium dependent keratinocyte differentiation

A calcium gradient in skin epidermis is known to regulate epidermal differentiation. In cultures of human epidermal keratinocytes (NHEK), induction of calcium-dependent differentiation is associated with phosphorylation of ErbB receptors, including the epidermal growth factor receptor (EGFR). The activation of EGFR triggers the induction of activator protein 1 (AP-1) proteins necessary for keratinocyte terminal differentiation. Interestingly, an in vitro long-term calcium treatment revealed the activation of different ErbB receptors with different timings, which is consistent with the differential localization of each receptor in the skin layers in vivo. In the current study, the regulatory relationship between ErbB receptor activation and induction of AP-1 proteins in calcium-dependent keratinocyte differentiation was analysed. For this purpose, we used a mathematical method to predict molecular regulations from time-course proteomic data of 30 target components. The predicted network showed that the ErbB receptor might regulate AP-1 protein expression via two pathways: positive regulation by c-MYC and negative regulation by signal transducer and activator of transcription 3 (STAT3) pathways. Experimental validation analysis revealed that ErbB receptor inhibition resulted in defective induction of AP-1 proteins and suppressed terminal differentiation of keratinocytes. Inhibition of STAT3, however, affected expression of a partial set of AP-1 proteins and resulted in premature differentiation. Studies using RNAi to diminish expression of each ErbB receptor and the AP-1 proteins strongly suggested that STAT3 established a balance that maintains the appropriate set of AP-1 proteins and participates in a complex network for regulating keratinocyte differentiation.

Cleanliness of Low Carbon Aluminum‐Killed Steels during Secondary Refining Processes

AbstractEfficient secondary refining process is necessary for massive and stable production of low carbon aluminum‐killed (LCAK) steels. Plant trials were performed to investigate the cleanliness of steels. Characteristics of composition, cleanliness, and inclusions of LCAK steel during different secondary refining processes, including LF, CAS, RH‐LIT, and RH, were studied and compared. The results showed that CAS, RH‐LIT, and RH processes had better control of low carbon, silicon, and nitrogen than LF process. High cleanliness of LCAK steels could be achieved by all the mentioned refining processes. It was concluded that the total oxygen (T.O.) should be <35 ppm to reduce the amount of inclusions and reach the level of clean steels. The removal rate of inclusions during RH‐LIT and RH processes was much higher than that of LF and CAS. The T.O. content and the amounts of inclusions during CAS, RH‐LIT, and RH could be quickly decreased to a low value within 10 min. The results showed that CAS and RH‐LIT as well as RH refining processes can produce LCAK steels that meet the requirements of high efficient, low cost, clean, and stable production, while LF is more suitable for the heats with poor control of end point of BOF, and for the process with calcium treatment to control sulfur content and lower the clogging of Submerged Entry Nozzle during thin slab continuous casting.

Prevention of Chronic Lead Toxicity on Adult Worker with Calcium Supplement

Lead can cause health disorders in humans, albeit at a lower level than the permitted maximum blood lead level. Therefore, a treatment should be sought that will reduce lead in the blood, especially in adults. Communities who have a high risk for chronic lead poisoning from the ambient air are employees who work on the road. This study aims to analyze the effects of calcium supplementation on blood lead levels in adult workers. This research uses quasi-experimental design with a community trial design for as many as 150 people, the group consisted of 75 control and 75 treated groups which were given calcium supplements at a dose of 500 mg 3 times daily for three months. Measurements of blood lead levels were taken before consuming calcium and three months afterwards by using Spectrofotometer at Clinical Laboratory. Subjects who completed the study on a regular basis totaled 87 people, divided into a control group of 46 people and the treated group of 41 people. The results showed that: (1) the initial blood lead levels in the control group 6.11 μg/dL and 4.16 μg/dL after treatment. Initial blood lead levels in the treated group 10.35 μg/dL and 3.2 8 μg/dL after treatment; (2) calcium treatment with a dose of 3 x 500 mg a day orally for 3 months can reduce blood lead levels significantly. This study found that calcium tablets can be used to reduce blood lead levels in adult workers.

The effect of calcium on auxin depletion-induced tomato ( Lycopersicon esculentum Mill.) pedicel abscission

Indole-3-acetic acid (IAA) and calcium are the most important factors that instigate plant organ abscission. This study aimed to elucidate the mechanisms that underlie the effects of IAA and calcium on delayed abscission in tomato. The results showed a clear trend towards reduced abscission rates with increased concentrations of IAA, and the applications on pedicel proximal or distal side also resulted in a different abscission. IAA combined with calcium significantly improved inhibition in contrast to IAA only, while IAA combined with magnesium exhibited little increased inhibition. 1-NNaphthylphthalamic acid (NPA), a polar auxin transport inhibitor, accelerated the abscission. IAA transported basipetally through an assay with 4 mm long pedicel sections indicated that the average transport intensity of [ 3 H]-IAA applied to the distal pedicel end was 65 Bq h –1 and the average velocity was 5.29 mm h -1 . When the proximal side was incubated in [ 3 H]-IAA, its average transport intensity reduced to 19.53 Bq h –1 and the average velocity was only 1.92 mm h -1 . Calcium treatment enhanced IAA transportation, as shown by significantly enhancing the transport intensity, but it had no effect on velocity. Keywords: Indole-3-acetic acid (IAA), calcium, abscission, tomato

Inclusion Control of Oil Drilling Steel SAE4137

In consideration of inclusion control in smelting drilling steel SAE4137 by convert process, the software FACTSAGE is applied on the deoxidation technology, composition of ladle slag and calcium treatment technology. The tests show that the deoxidation technology is reasonable and the oxygen content of molten steel is not more than 5×10-6 and 3.2×10-6 on average. The inclusion of bar is less and like a ball. The effect of calcium treatment is good. The inclusion is transformed in refining process, the absorbing ability to inclusion of ladle slag is strong. The level of any type of inclusion is not more than 1.5. The mechanical performance of SAE4137 bar meets the requirements, and the inclusion control technology does not influence the mechanical performance of bars.

Non-Metallic Inclusions Control for High Strength Anti-HIC X65 Tube Steel

The hot metal fed converter in Panzhihua Steel Company is characterized by high sulfur content of 0.085% and high phosphorus content of 0.133%. Under this condition, some technologies like control of sulfur and T[O] content, ladle slag optimization, calcium treatment and protective casting were used in practice, and the desired result of T[O] as low as 0.0014% and sulfur content of 0.0023%was achieved, which met the cleanness requirements by anti-HIC X65 tube steel. With the help of inclusion control technology, grade of inclusions in as-cast steel was less than 0.5. In addition, total amount of inclusions was only 0.0044% which dispersed in slab in form of small spherical particle.

Investigation of Oxide Inclusions and Primary Carbonitrides in Inconel 718 Superalloy Refined through Electroslag Remelting Process

The effect of remelting atmosphere and calcium treatment during electroslag remelting (ESR) of Inconel 718 superalloy on the oxide inclusions and primary carbonitrides was investigated. The results show that after ESR refining combined with calcium treatment, the original oxide inclusions in the electrode, mainly MgO·Al2O3 spinels and some MgO inclusions, were modified to CaO-Al2O3 system inclusions or the inclusions of MgO·Al2O3 spinel core surrounded by CaO-MgO-Al2O3 system inclusion layer. Without the calcium treatment in ESR process, all the oxide inclusions in superalloy ingots are MgO·Al2O3 spinels. All the oxide inclusions in ESR ingots act as the nucleation site for carbonitride (Nb,Ti)CN with two-layer structure precipitation, except for those with a single (Nb,Ti)CN layer containing a small amount of Ti and N in the ingot refined by a proper amount of calcium addition in ESR process. The carbonitrides (Nb,Ti)CN formed directly on the oxide inclusion have a small amount of Nb and C as well as a relatively fixed atomic ratio of Nb/Ti (about 0.6:1). There is a Nb-rich and C-rich (Nb,Ti)CN layer on the pre-existing (Nb,Ti)CN formed on the oxide inclusion. The size of the observed carbonitrides is in the range of 5 μm to 15 μm. The calcium treatment in the ESR process has a significant effect on the morphology of carbonitrides in superalloy ingot due to modification of oxide inclusions by Ca-treatment resulting in the change of precipitation and growth conditions for carbonitrides. The morphologies of carbonitrides were changed from clustered block or single octahedral to skeleton-like after calcium treatment.

Possible improvement of survival with use of zoledronic acid in patients with bone metastases from renal cell carcinoma

Bisphosphonates play an indisputable role in preventing skeletal-related events (SREs) secondary to bone metastases, and also have a direct effect on tumor cells. However, it remains unclear whether bisphosphonates improve overall survival (OS) for renal cell carcinoma (RCC) patients with bone metastases. Between 1978 and 2010, a total of 45 patients who had RCC metastatic to bone and were classified as intermediate risk according to Memorial Sloan-Kettering Cancer Center criteria were included in this retrospective study. In this cohort, 23 patients received zoledronic acid (ZOL) treatment (ZOL-treated group) whereas the other 22 did not (non-ZOL-treated group). The primary endpoint was OS and the secondary endpoint was the SRE rate defined as the total number of SREs divided by the total years under study. For the cohort of 45 patients, the median OS from diagnosis of bone metastases was 27.2 months. Multivariate analysis showed that lower serum calcium (p = 0.0083) and ZOL treatment (p = 0.0013) were independent factors predicting longer survival. The ZOL-treated group had significantly longer OS than the non-ZOL-treated group (p = 0.0034). Patients in the ZOL-treated group experienced a lower SRE rate than patients in the non-ZOL-treated group (p = 0.0453). In particular, none of the patients in the ZOL-treated group developed spinal compression whereas 6 (28%) in the non-ZOL-treated group did (p = 0.0479). The current study indicates that ZOL not only reduces SREs but possibly improves OS in these patients.