Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0026764 (multiple myeloma)
 36,148 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Forty-two unstable, four-part intertrochanteric fractures in forty-one patients (seventy-one to 104 years old) with severe osteoporosis were treated by open reduction and internal fixation (Jewett nail or compression screw-plate) supplemented with methylmethacrylate packed into the curetted medullary space. One patient was lost to follow-up, one died of a myocardial infarction at six weeks, and one was excluded because of an unsuspected myeloma found at the fracture site. All patients were sitting up in a chair the day after operation. Full weight-bearing on the limb was started within three weeks by thirty patients and at an average of 118 days by six who had very comminuted fractures. Three patients, non-ambulatory preoperatively, did not walk after operation. Of the thirty-eight fractures followed for from nine to thirty-seven months, thirty-seven healed with no loss of position. One fracture which had been fixed with the nail and cement not extending far enough into the head and neck displaced, and the operation had to be repeated, this time with a successful result. The fractures healed by periosteal new-bone formation. There was no evidence of avascular necrosis or wound complications.
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PMID:The use of methylmethacrylate as an adjunct in the internal fixation of unstable comminuted intertrochanteric fractures in osteoporotic patients. 115 8

Growth of a plasma cell myeloma (Adj PC-5) was studied in mice made lathyritic by the administration of beta-amino-proprionitrile (BAPN). The number of bones that had their medually cavities filled with tumor cells was notably decreased compared with tumor-bearing mice not treated with BAPN. Other aspects of tumor growth were the same. BAPN caused some retardation of tumor growth in the medullary cavity, but also caused osteoporosis and decreased tensile strength of collagen that allowed expansion of tumor growth outside the bones to proceed as usual. Additionally, the tumor-bearing mice showed some inhibition in their response to BAPN. This agrees with previous work that has shown that the response to BAPN treatment is greatest in animals that otherwise are healthiest.
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PMID:Growth of a plasma cell myeloma in lathyritic mice. 119 Nov 22

Hypocalcemic response following the administration of 160 units of porcine calcitonin was investigated in 14 patients with bone lesions caused by myeloma and in 9 control subjects. Significant decrease in blood serum calcium level was found in 85 per cent of myeloma patients, both in those with osteolytic bone lesions and those with generalized osteoporosis. Moreover, in all the patients a significant positive correlation was found between hypocalcemic response and the initial blood serum calcium concentration. Calcitonin administration did not cause any changes in blood serum phosphate level in myeloma patients.
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PMID:[Calcitonin test in patients with bone changes during the course of myeloma]. 136 10

Twenty-two cases of multiple myeloma were seen in the Department of Internal Medicine, Tikur Anbessa (Black Lion) Hospital, a teaching and referral hospital in Addis Abeba, Ethiopia, from January 1983 to December 1990. The age range was 38 to 76 (mean +/- SD = 51.5 +/- 12.2) years; a third were in the fifth decade. The male:female ratio was 1.75:1. The common clinical findings were bone pain in 20 (91%), bone tenderness in 15 (68%), anaemia in 14 (64%) and spinal cord compression in 8 (36%). The erythrocyte sedimentation rate (ESR) was raised in 21. Serum protein was raised in 17 (77%) and hyperglobulinaemia was seen in 20 (91%). Serum uric acid, blood urea nitrogen (BUN) and calcium were elevated in 10, 8 and 5 patients respectively, Bence-Jones proteinuria and albuminuria were each found in 9 patients. All patients had radiological abnormalities; 9 had a combination of lytic lesions, osteoporosis and pathological fractures (41%). Ten patients presented in clinical stage III. Four patients are being followed after 3-84 (median 40.5) months; eight were lost to follow-up 1-8 (median 2.0) months after diagnosis. Ten patients have died after 1-55 (median 11) months. Multiple myeloma is not uncommon in Ethiopians. Except for a lower age at presentation, the clinical, haematological, biochemical, and radiological findings, and the response to therapy, are similar to those reported elsewhere.
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PMID:Multiple myeloma in Ethiopians: analysis of 22 cases. 139 16

From 1984 to 1990 the authors reviewed the radiologic-clinical charts of 237 patients affected with multiple myeloma (MM). The series included 127 males and 110 females (mean age: 66 years) who had been classified according to Durie and Salmon clinical criteria. All the patients underwent X-rays of the skeleton, as recommended in international literature; moreover, 148 subjects underwent whole-body bone scintigraphy, and 130 bone marrow scintigraphy. A selected group of cases (18 male/female patients) were submitted to bone densitometry employing both quantitative computed tomography (QCT) and dual-energy X-ray absorptiometry (DXA). The results follow: 1) in the first stage of the disease, a high number of patients (29.5%) exhibits no skeletal abnormalities on X-rays; the most common lesion locations include the spine (49%), skull (35%), pelvis (34%), ribs (33%), humeri (22%), femora (13%) and mandible (10%); 2) the most frequent pattern is osteolysis, as a characteristic "punched-out" multiple lesion; the second most frequent lesion is osteopenia (43%), especially in the spine; pathologic fractures are common (54%) in the ribs, vertebral bodies, limbs; typical associations of features and sites are seen on X-ray images, which sometime make diagnosis easier; 3) whole-body scintigraphy, revealing aspecific uptake only in the presence of pathological fractures, is not recommended in the first staging of the disease, but is considered as a valuable technique in the follow-up, when the patients become symptomatic; 4) bone marrow scintigraphy, especially in the "marrow expansion" pattern, might be considered as an attempt made by the body to recover the central space which was destroyed by myelomatous involvement. The prognostic value of this technique is still to be assessed; 5) bone densitometry, by confirming the grade of osteopenia, reveals that osteoporosis is a peculiar pattern of bone disease in MM, which is not related to age only; 6) conventional radiography of the skeleton is the method of choice in the diagnosis of lytic areas of MM, and remains, as yet, irreplaceable. The other diagnostic techniques--i.e., CT and MRI--can be used to evaluate the extent of bone and soft tissue involvement, in the cases with questionable diagnosis, and to assess the degree of marrow involvement.
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PMID:[Bone disease in multiple myeloma. A study of 237 cases]. 163 29

The authors retrospectively reviewed the MR examinations of 46 patients with clinical and laboratory findings of monoclonal gammopathies (MG). All cases had been submitted to radiographic examination which had shown skeletal involvement in 22 cases and osteoporosis in 11, with rupture of the vertebral body in 3 patients. Scintigraphy had been performed on all patients and CT on 12; 36 patients were subsequently submitted to follow-up (at 6, 12 and 24 months). MR examinations were performed with dedicated coils and standard sequences for the subjects with skeletal localizations on X-ray images. The extant cases, with no radiographic evidence of skeletal involvement, were submitted to MRI of the spine, skull and pelvis. In agreement with clinical and laboratory findings and with follow-up results (in 36 patients), MRI diagnosed MG with no skeletal involvement in 13 cases, osteoporosis in 8 (with rupture of the vertebral body in 2), asymptomatic non-progressive myeloma in 4, solitary myeloma in 3, and multiple myeloma in 18 cases. The good identification of bone marrow and its multiplanarity make MRI the method of choice in the study of patients with suspected or known gammopathies. If compared with other modalities, MRI is more sensitive and accurate in depicting the tumor, its size and relationship to periskeletal tissues, and its possible multifocality. Moreover, the technique has proven to be a valid tool during the follow-up, showing tumor response to therapy.
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PMID:[Magnetic resonance in the staging of multiple myeloma]. 163 30

Salmon calcitonin, a polypeptide hormone secreted by the parafollicular C cells of the thyroid gland, lowers serum calcium levels by decreasing bone resorption and renal tubular calcium reabsorption. An analgesic action, possibly mediated via beta-endorphins, is also evident. In the past, parenteral formulations of salmon calcitonin have been used in the management of metabolic bone disorders, but their routine use has been limited by the inconvenience of this route of administration and by poor tolerability. The development of an intranasal preparation of salmon calcitonin will provide a more convenient means of administering the drug. In clinical trials published to date intranasal salmon calcitonin has been effective and well tolerated in small numbers of recently postmenopausal women at risk of developing osteoporosis, and in patients with established osteoporosis, Paget's disease, or osteoporosis secondary to corticosteroid usage, multiple myeloma or ovariectomy. For periods of up to 2 years the drug reduces bone resorption and improves bone architecture, relieves pain and increases functional status. Further research is needed to confirm longer term efficacy (in particular, effects on fracture rate), optimal dosage schedules and the role of intermittent and combination treatment regimens.
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PMID:Intranasal salmon calcitonin. A review of its pharmacological properties and potential utility in metabolic bone disorders associated with aging. 179 28

In secondary osteoporosis, amazing etiologies can be found: We report on two cases of nonsecretory myeloma, which had been diagnosed by investigations for osteoporosis. In this connection the diagnostic value of bone-density evaluation by densitometry and high-resolution tomography is discussed and illustrated.
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PMID:[Can normal peripheral bone density measurements in osteoporotic spinal fractures be diagnostically significant?]. 187 86

Since 1972, 25 cases of multiple myeloma had been diagnosed. Of them, 22 (88%) were over 50 years old. Most of them had bone pain with anemia to different degrees. Marked elevation of ESR was found in 19 cases. Bence-Jones protein was detected in the urine in 15 cases resulting in elevation of blood urea nitrogen and creatinine. Twenty-two of 23 cases were found to have a high peak of abnormal globulin. Increased plasma cells with abnormal features in the bone marrow were observed in 17/21 cases. Multiple osteolytic lesions, compression fracture and osteoporosis on X-ray films were shown in the majority. Of these 25 cases, 10 had advanced myeloma. These 10 patients all died during admission and eight without any chemotherapy. In the other 15 cases treated with chemotherapy, marked response was seen in 1, partial response in 8 and no response in 6. The diagnosis of the disease is discussed in detail.
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PMID:[Clinical analysis of 25 cases of multiple myeloma]. 188 42

Bone densitometry has replaced conventional X-ray imaging in the diagnosis of bone loss. Conventional X-ray techniques however, are still the source of choice in the diagnosis of fractures in patients with osteoporosis and in the differential diagnosis of atraumatic fractures. The differential diagnosis of vertebral fractures includes metastases of solid malignant tumours, such as breast, lung or renal cancer or manifestation of systemic malignant diseases such as myeloma. The differential diagnosis of long bone fractures includes osteolytic metastases as well, and in the younger patients also bone cysts, bone tumours or hereditary skeletal diseases. Objective techniques have been developed, which allow the identification of beginning fractures but also the determination of the extent of vertebral deformation (SDI).
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PMID:[The use of conventional roentgen studies in the diagnosis and therapy of osteoporosis]. 203 67


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