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[PMID]: 23668209 [Au] Autor: Fan JL; Fu WJ; Shi HT; Zhou F; Yuan ZG; Zhang CY; Wei W; Ye F; Zhang H; Hou J [Ad] Address: Department of Hematology, Changzheng Hospital, Second Military Medical University, Military Myeloma and Lymphoma Center, Shanghai 200003, China. [Ti] Title: [Clinical and laboratory features of four cases with IgM multiple myeloma]. [So] Source: Zhonghua Xue Ye Xue Za Zhi;34(4):341-4, 2013 Apr. [Is] ISSN: 0253-2727 [Cp] Country of publication: China [La] Language: chi [Ab] Abstract: Objective To improve the understanding of the clinical and laboratory features of the IgM multiple myeloma (MM). Methods The clinical data of four cases of IgM MM patients were collected, their clinical and laboratory features were summarized and analyzed. Results Four patients met the criteria of IgM MM. They were all male. The age at the diagnosis ranged from 54 to 69 years. The primary symptoms included bone pain, hyperviscosity and bleeding. Three cases had κ-chain and only one case had λ-chain. They were all staged â…¢A according to the Durie-Salmon staging system (DSS). One case staged â… and three cases staged â…¡ according to the international staging system (ISS). The average value of IgM, hemoglobin, serum calcium, creatinine and the proportion of bone marrow plasma cells were 83.6 (52.9-111.0) g/L, 79.5 (61.0-105.0) g/L, 3.20(2.11-6.00) mmol/L, 104.3 (56.0-171.0) µmol/L and 0.558 (0.290-0.775), respectively. Bone destruction was found in 3 cases. Immunophenotypes of bone marrow plasma cells were analyzed in 3 patients. Results showed that these cells expressed CD38 and CD138, and did not express CD19, CD20 and CD117. Chromosome and fluorescence in situ hybridization (FISH) analysis were carried out in 4 cases and found that all of them had IgH translocations and 1q21 amplification, 2 cases had 13q and 17p deletion, and 3 cases had t(11;14). Three patients received bortezomib-based regimens as induction therapy and reached partial response (PR) - very good partial response (VGPR). Followed up to November 30, 2012, the median progress-free survival (PFS) and overall survival (OS) of the 4 cases were only 6.0 (2.5-7.0) months and 17.5 (2.5-27.0) months, respectively. Conclusions IgM MM is very rare and is no more than 0.5% in all types of MM. IgM MM have frequent t(11;14) and amp(1q21). Bortezomib-based regimens are effective for it, however, the disease progresses rapidly and has poor prognosis. [Pt] Publication type: ENGLISH ABSTRACT; JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review [do] DOI: 10.3760/cma.j.issn.0253-2727.2013.04.020

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[PMID]: 23668203 [Au] Autor: Zhang CY; Fu WJ; Xi H; Zhou LL; Jiang H; Du J; Fan JL; Li R; Jin LN; Zeng TM; Hou J [Ad] Address: Myeloma & Lymphoma Center, Department of Hematology, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China. [Ti] Title: [Busulfan, cyclophosphamide and etoposide as conditioning for autologous stem cell transplantation in multiple myeloma]. [So] Source: Zhonghua Xue Ye Xue Za Zhi;34(4):313-6, 2013 Apr. [Is] ISSN: 0253-2727 [Cp] Country of publication: China [La] Language: chi [Ab] Abstract: Objective To evaluate the efficacy and safety of dose-reduced intravenous busulfan, cyclophosphamide and etoposide (BCV) as conditioning for autologous stem cell transplantation (ASCT) in multiple myeloma (MM). Methods From September 2007 to September 2010, thirty-two ASCT-eligible patients with MM received high dose melphalan (HDM) as conditioning in our center. Median age was 53.5 (30-63) years. From October 2010 to October 2012, thirty-eight patients conditioned by BCV regimen (intravenous busulfan, total doses 9.6 mg/kg), whose median age was 54(35-64) years. Results There were no statistical differences in clinical characteristics between the two groups, including myeloma isotype, Durie-Salmon staging, international staging system(ISS), and patients received the first line, second line or more than third line therapy. The median time to neutrophil and platelet engraftment were 10.5 vs 11 days (P=0.057) and 11 vs 12 days (P=0.100) in the BCV and HDM groups, respectively. The toxicity of two conditioning regimens had no significant difference. None of hepatic veno-occlusive disease and early transplant related mortality was observed. Although overall response rates showed no significant difference between two groups (P>0.05), the CR rates increased from 44.74% pre-ASCT to 63.18% post-ASCT in the BCV group, while 37.50% to 59.38% in the HDM group. During the median follow-up of 16 months (range 2-27) in BCV group, ten patients (26.32%) developed progressive disease and PFS at 12 months were 71.37%. Conclusions In this study, the dose-reduced intravenous busulfan, cyclophosphamide and etoposide (BCV) conditioning was demonstrated an effective and safety regimen for ASCT-eligible patients with MM. However, the long term observation is needed. [Pt] Publication type: ENGLISH ABSTRACT; JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review [do] DOI: 10.3760/cma.j.issn.0253-2727.2013.04.014

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[PMID]: 23668196 [Au] Autor: Ma J [Ti] Title: [Prevention and treatment of multiple myeloma bone disease]. [So] Source: Zhonghua Xue Ye Xue Za Zhi;34(4):292-4, 2013 Apr. [Is] ISSN: 0253-2727 [Cp] Country of publication: China [La] Language: chi [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review [do] DOI: 10.3760/cma.j.issn.0253-2727.2013.04.007

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[PMID]: 23671718 [Au] Autor: Pixley JS; Zanjani ED [Ad] Address: John S Pixley, Rheumatology/Immunology Division, Department of Medicine, VA Sierra Health Care System and the University of Nevada School of Medicine, Reno, NV 89557, United States. [Ti] Title: In utero transplantation: Disparate ramifications. [So] Source: World J Stem Cells;5(2):43-52, 2013 Apr 26. [Is] ISSN: 1948-0210 [Cp] Country of publication: China [La] Language: eng [Ab] Abstract: In utero stem cell transplantation, which promises treatment for a host of genetic disorders early in gestation before disease effect stems from Ray Owen's seminal observation that self-tolerance, is acquired during gestation. To date, in utero transplantation (IUT) has proved useful in characterizing the hematopoietic stem cell. Recent observations support its use as an in vivo method to further understanding of self-tolerance. Preclinical development continues for its application as a treatment for childhood hematolymphoid diseases. In addition, IUT may offer therapeutic options in the treatment of diabetes among other diseases. Thus IUT serves as a technique or system important in both a basic and applied format. This review summarizes these findings. [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1305 [St] Status: In-Data-Review [do] DOI: 10.4252/wjsc.v5.i2.43

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[PMID]: 23671754 [Au] Autor: Donkol RH; Nada AM; Boughattas S [Ad] Address: Ragab Hani Donkol, Department of Radiology, Aseer Central Hospital, Abha 61321, Saudi Arabia. [Ti] Title: Role of color Doppler in differentiation of Graves' disease and thyroiditis in thyrotoxicosis. [So] Source: World J Radiol;5(4):178-83, 2013 Apr 28. [Is] ISSN: 1949-8470 [Cp] Country of publication: China [La] Language: eng [Ab] Abstract: AIM: To evaluate the role of thyroid blood flow assessment by color-flow Doppler ultrasonography in the differential diagnosis of thyrotoxicosis and compare it to technetium pertechnetate thyroid scanning. METHODS: Twenty-six patients with thyrotoxicosis were included in the study. Clinical history was taken and physical examination and thyroid function tests were performed for all patients. Thyroid autoantibodies were measured. The thyroid glands of all patients were evaluated by gray scale ultrasonography for size, shape and echotexture. Color-flow Doppler ultrasonography of the thyroid tissue was performed and spectral flow analysis of both inferior thyroid arteries was assessed. Technetium99 pertechnetate scanning of the thyroid gland was done for all patients. According to thyroid scintigraphy, the patients were divided into two groups: 18 cases with Graves' disease and 8 cases with Hashimoto's thyroiditis. All patients had suppressed thyrotropin. The diagnosis of Graves' disease and Hashimoto's thyroiditis was supported by the clinical picture and follow up of patients. RESULTS: Peak systolic velocities of the inferior thyroid arteries were significantly higher in patients with Graves' disease than in patients with thyroiditis (P = 0.004 in the right inferior thyroid artery and P = 0.001 in left inferior thyroid artery). Color-flow Doppler ultrasonography parameters demonstrated a sensitivity of 88.9% and a specificity of 87.5% in the differential diagnosis of thyrotoxicosis. CONCLUSION: Color Doppler flow of the inferior thyroid artery can be used in the differential diagnosis of thyrotoxicosis, especially when there is a contraindication of thyroid scintigraphy by radioactive material in some patients. [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1305 [St] Status: In-Data-Review [do] DOI: 10.4329/wjr.v5.i4.178

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[PMID]: 23671747 [Au] Autor: Le O [Ad] Address: Ott Le, Diagnostic Imaging, University of Texas, MD Anderson Cancer Center, Houston, TX 77030, United States. [Ti] Title: Patterns of peritoneal spread of tumor in the abdomen and pelvis. [So] Source: World J Radiol;5(3):106-12, 2013 Mar 28. [Is] ISSN: 1949-8470 [Cp] Country of publication: China [La] Language: eng [Ab] Abstract: The spread of tumor in the peritoneum can be understood, although it is a complex organ. A study of its embryology, anatomy and function is of clear benefit. It is formed from a network of folds, reflections, and potential spaces produced by the visceral and parietal peritoneum. These folds and reflections begin as a dorsal and ventral mesentery, supporting the primitive gut in early embryologic development. The dorsal mesentery connects the stomach and other organs to the posterior abdominal wall, while the ventral mesentery connects the stomach to the ventral abdominal wall. As the embryo develops, there is further organ growth, elongation, cavitation and rotation. The dorsal and ventral mesentery also develops along with the viscera, forming ligaments, mesenteries, omenta and potential spaces from the resulting reflections and folds. These ligaments, mesenteries, and omenta, support and nurture the organs of the peritoneum, providing a highway for arteries, veins, nerves and lymphatics. The potential spaces created from these folds and reflections of the visceral and parietal peritoneum are also important to realize. For example, the transverse mesocolon divides the peritoneal cavity into a supramesocolic and inframesocolic space in the abdomen and paravesicular spaces within the pelvis. The falciform ligament is well known in the supramesocolic space, dividing it further into a left and right compartment. Knowledge of the peritoneal vascular anatomy is beneficial in locating the spaces and ligaments about the peritoneum. For example, identifying the left gastric artery or vein will lead to the gastrohepatic ligament, which is part of the supramesocolic space. Besides serving a life sustaining role, the multiple compartments, ligaments, mesenteries and omenta within the peritoneum can also facilitate the spread of disease. Tumors can spread directly from one organ to another, seed metastatic deposits in the peritoneal cavity, and travel through the lymphatic or hematogenous route to invade other organs in the peritoneum. [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1305 [St] Status: In-Data-Review [do] DOI: 10.4329/wjr.v5.i3.106

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[PMID]: 23671746 [Au] Autor: Tamm EP; Bhosale PR; Vikram R; de Almeida Marcal LP; Balachandran A [Ad] Address: Eric Peter Tamm, Priya Ranjit Bhosale, Raghu Vikram, Leonardo Pimentel de Almeida Marcal, Aparna Balachandran, Department of Diagnostic Radiology, Division of Diagnostic Imaging, University of Texas, MD Anderson Cancer Center, Houston, TX 77230-1402, United States. [Ti] Title: Imaging of pancreatic ductal adenocarcinoma: State of the art. [So] Source: World J Radiol;5(3):98-105, 2013 Mar 28. [Is] ISSN: 1949-8470 [Cp] Country of publication: China [La] Language: eng [Ab] Abstract: Significant advances in imaging technology have changed the management of pancreatic cancer. In computed tomography (CT), this has included development of multidetector row, rapid, thin-section imaging that has also facilitated the advent of advanced reconstructions, which in turn has offered new perspectives from which to evaluate this disease. In magnetic resonance imaging, advances including higher field strengths, thin-section volumetric acquisitions, diffusion weighted imaging, and liver specific contrast agents have also resulted in new tools for diagnosis and staging. Endoscopic ultrasound has resulted in the ability to provide high-resolution imaging rivaling intraoperative ultrasound, along with the ability to biopsy via real time imaging suspected pancreatic lesions. Positron emission tomography with CT, while still evolving in its role, provides whole body staging as well as the unique imaging characteristic of metabolic activity to aid disease management. This article will review these modalities in the diagnosis and staging of pancreatic cancer. [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1305 [St] Status: In-Data-Review [do] DOI: 10.4329/wjr.v5.i3.98

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[PMID]: 23671723 [Au] Autor: Satoh D; Yagi T; Nagasaka T; Shinoura S; Umeda Y; Yoshida R; Utsumi M; Tanaka T; Sadamori H; Fujiwara T [Ad] Address: Daisuke Satoh, Takahito Yagi, Takeshi Nagasaka, Susumu Shinoura, Yuzo Umeda, Ryuichi Yoshida, Masashi Utsumi, Hiroshi Sadamori, Toshiyoshi Fujiwara, Department of Gastroenterological Surgery, Transplant, and Surgical Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan. [Ti] Title: CD14 upregulation as a distinct feature of non-alcoholic fatty liver disease after pancreatoduodenectomy. [So] Source: World J Hepatol;5(4):189-95, 2013 Apr 27. [Is] ISSN: 1948-5182 [Cp] Country of publication: China [La] Language: eng [Ab] Abstract: AIM: To investigate the pathogenesis of non-alcoholic fatty liver disease (NAFLD) after pancreatoduodenectomy (PD). METHODS: A cohort of 82 patients who underwent PD at Okayama University Hospital between 2003 and 2009 was enrolled and the clinicopathological features were compared between patients with and without NAFLD after PD. Computed tomography (CT) images were evaluated every 6 mo after PD for follow-up. Hepatic steatosis was diagnosed on CT when hepatic attenuation values were 40 Hounsfield units. Liver biopsy was performed for 4 of 30 patients with NAFLD after PD who consented to undergo biopsies. To compare NAFLD after PD with NAFLD associated with metabolic syndrome, liver samples were obtained from 10 patients with NAFLD associated with metabolic syndrome [fatty liver, n = 5; non-alcoholic steatohepatitis (NASH), n = 5] by percutaneous ultrasonography-guided liver biopsy. Double-fluorescence immunohistochemistry was applied to examine CD14 expression as a marker of lipopolysaccharide (LPS)-sensitized macrophage cells (Kupffer cells) in liver biopsy specimens. RESULTS: The incidence of postoperative NAFLD was 36.6% (30/82). Univariate analysis identified cancer of the pancreatic head, sex, diameter of the main pancreatic duct, and dissection of the nerve plexus as factors associated with the development of NAFLD after PD. Those patients who developed NAFLD after PD demonstrated significantly decreased levels of serum albumin, total protein, cholesterol and triglycerides compared to patients without NAFLD after PD, but no glucose intolerance or insulin resistance. Liver biopsy was performed in four patients with NAFLD after PD. All four patients showed moderate-to-severe steatosis and NASH was diagnosed in two. Numbers of cells positive for CD68 (a marker of Kupffer cells) and CD14 (a marker of LPS-sensitized Kupffer cells) were counted in all biopsy specimens. The number of CD68+ cells in specimens of NAFLD after PD was significantly increased from that in specimens of NAFLD associated with metabolic syndrome specimens, which indicated the presence of significantly more Kupffer cells in NAFLD after PD than in NAFLD associated with metabolic syndrome. Similarly, more CD14+ cells, namely, LPS-sensitized Kupffer cells, were observed in NAFLD after PD than in NAFLD associated with metabolic syndrome. Regarding NASH, more CD68+ cells and CD14+ cells were observed in NASH after PD specimens than in NASH associated with metabolic syndrome. This showed that more Kupffer cells and more LPS-sensitized Kupffer cells were present in NASH after PD than in NASH associated with metabolic syndrome. These observations suggest that after PD, Kupffer cells and LPS-sensitized Kupffer cells were significantly upregulated, not only in NASH, but also in simple fatty liver. CONCLUSION: NAFLD after PD is characterized by both malnutrition and the up-regulation of CD14 on Kupffer cells. Gut-derived endotoxin appears central to the development of NAFLD after PD. [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1305 [St] Status: In-Data-Review [do] DOI: 10.4254/wjh.v5.i4.189

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[PMID]: 23671720 [Au] Autor: Hatzis G; Ziakas P; Kavantzas N; Triantafyllou A; Sigalas P; Andreadou I; Ioannidis K; Chatzis S; Filis K; Papalampros A; Sigala F [Ad] Address: Gregorios Hatzis, Panayiotis Ziakas, Stamatios Chatzis, Department of Pathophysiology, Athens University School of Medicine, 11527 Athens, Greece. [Ti] Title: Melatonin attenuates high fat diet-induced fatty liver disease in rats. [So] Source: World J Hepatol;5(4):160-9, 2013 Apr 27. [Is] ISSN: 1948-5182 [Cp] Country of publication: China [La] Language: eng [Ab] Abstract: AIM: To investigate melatonin's preventive action in oxidative stress in a rat model with high fat diet-induced non-alcoholic fatty liver disease (NAFLD). METHODS: NAFLD was induced by high fat diet (HFD) in adult, male, Wistar rats, weighing 180-230 g. After acclimatization for one week, they were randomly assigned to 6 experimental groups that comprised animals on regular diet plus 5 or 10 mg/kg melatonin, for 4 or 8 wk; animals on HFD, with or without 5 or 10 mg/kg melatonin, for 4 or 8 wk; and animals on HFD for 8 or 12 wk, with melatonin 10 mg/kg for the last 4 wk. Liver damage was assessed biochemically by the serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and histologically. Lipid peroxidation and oxidative stress were assessed by malondialdehyde and glutathione levels in liver tissue. Lipidemic indices and portal vein pressure were also measured. RESULTS: Compared to rats not receiving melatonin, rats on 5 or 10 mg/kg of melatonin had lower mean liver weight (-5.0 g and -4.9 g) (P < 0.001) and lower liver weight to body weight ratio (-1.0%) (P < 0.001), for the two doses, respectively. All rats fed HFD without melatonin developed severe, grade III, steatosis. Rats on HFD with concurrent use of melatonin showed significantly less steatosis, with grade III steatosis observed in 1 of 29 (3.4%) rats on 10 mg/kg melatonin and in 3 of 27 (11.1%) rats on 5 mg/kg melatonin. Melatonin was ineffective in reversing established steatosis. Melatonin also had no effect on any of the common lipidemic serum markers, the levels of which did not differ significantly among the rats on HFD, irrespective of the use or not of melatonin. Liver cell necrosis was significantly less in rats on HFD receiving melatonin than in those not on melatonin, with the AST levels declining by a mean of 170 U/L (P = 0.01) and 224 U/L (P = 0.001), and the ALT levels declining by a mean of 62.9 U/L (P = 0.01) and 93.4 U/L (P < 0.001), for the 5 and 10 mg/kg melatonin dose, respectively. Melatonin mitigated liver damage due to peroxidation and oxidative stress in liver tissue as indicated by a significant decline in MDA production by 12.7 (P < 0.001) and 12.2 (P < 0.001) µmol/L /mg protein /mg tissue, and a significant increase in glutathione by 20.1 (P = 0.004) and 29.2 (P < 0.001) µmol/L /mg protein /mg tissue, for the 5 and 10 mg/kg melatonin dose, respectively. CONCLUSION: Melatonin can attenuate oxidative stress, lessen liver damage, and improve liver histology in rats with high fat diet-induced NAFLD, when given concurrently with the diet. [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1305 [St] Status: In-Data-Review [do] DOI: 10.4254/wjh.v5.i4.160

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[PMID]: 23671736 [Au] Autor: Ben-Ishay O; Peled Z; Othman A; Brauner E; Kluger Y [Ad] Address: Offir Ben-Ishay, Zvi Peled, Amira Othman, Eran Brauner, Yoram Kluger, Department of General Surgery, Rambam Health Care Campus, Haifa 33271, Israel. [Ti] Title: Clinical presentation predicts the outcome of patients with colon cancer. [So] Source: World J Gastrointest Surg;5(4):104-9, 2013 Apr 27. [Is] ISSN: 1948-9366 [Cp] Country of publication: China [La] Language: eng [Ab] Abstract: AIM: To elucidate the relationship between clinical presentation and outcome. METHODS: A single institution retrospective chart review of patients admitted with the diagnosis of colon cancer. We used univariate and a multivariate analysis to identify symptoms association with mortality. An odds ratio based clinical score was created to evaluate the contribution of the quality of symptoms to outcome. Primary measure of outcome was survival. RESULTS: During the study period, 236 patients met the inclusion criteria. Overall survival was 60.6%, mean follow-up 3.0 years. A bivariate analysis showed that increasing number of symptoms is not associated with mortality. However, a symptom-specific analysis performed using a logistic regression model controlling for age, stage and the duration of complaints revealed that the presence of melena was independently associated with mortality [P = 0.04, odds ratio (OR) 7.4], while rectal bleeding was associated with survival (P = 0.004, OR 3.9). Applying the proposed clinical score to an receiver operating characteristic curve showed that score > 1 had a strong association with mortality. The same logistic regression model was applied. The results showed that a score > 1 was an independent predictor of mortality (P < 0.001) and associated with node-positive disease (P = 0.008). CONCLUSION: The quality of symptoms rather than quantity is correlated with outcome among patients with colon cancer. The proposed clinical scoring system may correctly predict the patient's outcome. [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1305 [St] Status: In-Data-Review [do] DOI: 10.4240/wjgs.v5.i4.104

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