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)

Solitary plasmacytoma of the bone is believed to be manifestation of the spectrum of diseases presented by the term plasma cell neoplasms and the lesion rarely involves the jaws. A case of solitary plasmacytoma of the mandible is presented, the diagnostic problem is posed and the method of treatment by peripheral osteotomy and radiotherapy discussed.
Hell Period Stomat Gnathopathoprosopike Cheir 1989 Dec
PMID:[Solitary plasmacytoma of the mandible]. 270 Dec 32

Normal human immunoglobulin G (IgG) was treated with radioactive N-ethylmaleimide in the absence of a reducing agent but in the presence of a denaturing solvent. The sites of reaction were determined by isolation of the radioactive peptides from thermolytic digests of the heavy and light chains. Six radioactive peptides were purified from the digest of the light chain and ten from that of the heavy chain. When sequenced, all the peptides were identical with peptides that would be predicted for the half-cystine residues involved in disulphide bonds. The specific radioactivity of the peptides indicated that the proportion of the half-cystine residues in the reduced form varied from 0.57 to 2.54%. These results indicate that the disulphide bonds of IgG are not completely oxidized. The estimate of 0.2mol of SH group/mol of IgG (Cecil & Stevenson, 1965; Luks & Connell, 1968) can be accounted for if 0.8% of every half-cystine residue of the intrachain bonds was in the reduced form. Variable cysteine residues as have been described in several myeloma proteins must occur extremely infrequently among the immunoglobulins.
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PMID:Thiol groups of normal human immunoglobulin G. 482 11

Two apparently homogeneous electrophoretic bands were found in the serum of a patient (DA) with multiple myeloma. These M-components were identified as IgA-lambda and IgG-kappa paraproteins bearing different idiotypic determinants. Further analysis of the L chains showed that the lambda-chain was homogeneous but the kappa-chain could be separated by SDS-polyacrylamide gel electrophoresis into two different bands. Both of them were associated with gamma-chains but one (termed kappa n) had normal m.w. (24,500) whereas the other (termed kappa h) was larger (m.w. 30,000). Sugar content of the two DA IgG, as determined by anthrone reaction, was similar in DA IgG kappa n (0.73%) and in DA IgG kappa h (1.1%), clearly demonstrating that the difference in m.w. was not due to a large sugar chain. Furthermore, the peptide map of the kappa h chain included nine peptides absent in those of four other control kappa-chains. Sequence analysis showed that the first 25 N-terminal amino acids of the kappa n differed from those of the kappa h chain at positions 4, 5, 15, 18, and 21. Thus the two kappa-chains had different framework regions.
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PMID:Three M-components IgA lambda + IgG kappa n + IgG kappa h in one patient (DA): lack of shared idiotypic determinants between IgA and IgG, and the presence of an unusual kappa h chain of 30,000 M.W. 676 97

Human sera from myeloma patients were subjected to two-dimensional electrophoresis. Heterogeneity in molecular weight and in isoelectric point of the myeloma proteins were demonstrated on the protein map. The patterns of five major immunoglobulin classes differed from each other, implying that the five classes of myeloma immu,oglobulin can be distinguished by examining the two-dimensional electrophoretic patterns. Sugar content analysis suggested that differences in sialic acid content may be one of the origins of the heterogeneity of myeloma proteins observed in isoelectric focusing.
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PMID:Two-dimensional electrophoresis of immunoglobulin myeloma proteins in the absence of denaturing agents. 735 48

We have studied rapid and simple sugar mapping using liquid chromatography/electrospray ionization mass spectrometry (LC/MS) equipped with a graphitized carbon column. The oligosaccharide mixture was separated on the basis of the sequence, branching structure, and linkage, and each oligosaccharide was characterized based on its molecular mass. In this study we demonstrated the usefulness of capillary LC/MS (CapLC/MS) and capillary liquid chromatography/tandem mass spectrometry (CapLC/MS/MS) as sensitive means for accomplishing the structural analysis of oligosaccharides in a low-abundance glycoprotein. The carbohydrate heterogeneity and molecular mass information of each oligosaccharide can be readily obtained from CapLC/MS of a small amount of glycoprotein. CapLC/MS/MS provided b-ion series, which is informative with regard to monosaccharide sequence. Exoglycosidase digestion followed by CapLC/MS elucidated a carbohydrate residue linkage. Using this method, we characterized N-linked oligosaccharides in hepatocyte growth factor produced in mouse myeloma NS0 cells as the complex-type bi-, tri-, and tetraantennary terminated with N-glycolylneuraminic acids and alpha-linked galactose residues. Sugar mapping with CapLC/MS and CapLC/MS/MS is useful for monitoring glycosylation patterns and for structural analysis of carbohydrates in a low-abundance glycoprotein and thus will become a powerful tool in biological, pharmaceutical, and clinical studies.
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PMID:Microanalysis of N-linked oligosaccharides in a glycoprotein by capillary liquid chromatography/mass spectrometry and liquid chromatography/tandem mass spectrometry. 1269 22

Technetium-99m methoxy-isobutyl-isonitrile (99mTc-MIBI) has been proposed as an in-vivo marker of various active malignant diseases. The goal of this study was to evaluate the 99mTc-MIBI whole body scintiscan for the early detection of multiple myeloma (MM), active or in remission. We have studied 43 patients with MM, 32 men and 11 women aged 52+/-10 years. Group A patients had active MM disease (29 cases) and Group B patients had MM disease in remission (14 patients). Plasma proteins, serum immuno-electrophoresis, bone marrow biopsy, whole body 99mTc-MIBI scan and serum bio-chemical tests (ESR, and serum alkaline phosphatase) were carried out in each patient for the diagnosis of active or relapsed disease, or remission. Clinical and laboratory evaluation was made by two oncologists. Scintigraphic images were interpreted by three nuclear physicians who were blinded to the patients' clinical condition. The extension scale of the lesions on scintigraphy (E-score) was categorized into E0-E3. The intensity of radiotracer uptake throughout the skeleton (I-score) was also classified from I0-I3 as compared to the intensity of myocardial uptake. All patients were followed for at least one year and reassessed by the end of the year for confirming active-relapsed disease or remission. One-way analysis of variances and Spearman correlation coefficient were used for statistical data analysis. The sensitivity, specificity, positive and negative predictive values and accuracy of the 99mTc-MIBI scan for determining active or relapsed cases were: 69%, 100%, 100%, 61% and 79%, respectively. There were significant differences in scan pattern, intensity, and extension of the lesions in patients with active-relapsed disease versus those in remission (P<0.001). It is concluded that the pattern of extension and intensity of 99mTc-MIBI uptake in MM patients is associated with disease activity. Hence, in addition to the hematological and pathological findings, the 99mTc-MIBI scan may be considered as a relatively accurate non-invasive technique for the differential diagnosis of active-relapsed from in remission MM.
Hell J Nucl Med
PMID:The value of 99mTc-MIBI whole body scintigraphy in active and in remission multiple myeloma. 1639 23

Six hundred years before Christ, Hippocrates said that physicians on exercising their medical duties, should benefit but not harm their patients. Seventy years ago increased medical radiation caused radiologists in the US an excess risk of leukemia, lymphoma and multiple myeloma. Now medical radiation is rather safe for the physician but the question remains if proper prophylactic measures are being taken to make it safe for the subjects examined. Roughly, first trimester of pregnancy radiography has a much greater fatal cancer risk than that of exposures taken later in pregnancy. It is suggested that women should be administered the minimum activity consistent with achieving the desired clinical information, whether or not they are known to be pregnant. The best available risk estimates suggest that pediatric CT diagnostic procedures will induce significantly increased lifetime radiation risk in children. Professor Roger Clarke wrote that there may be a need to reduce or prevent doses of medical radiation up to 3 mSv if there is no benefit to the individual. 30 mSv is described as "a dose which should not be exceeded" and can be approached only if there is a benefit to individuals and the dose is difficult to reduce or prevent. In WHO Category III a) Static brain imaging with technetium-99m pertechnetate, b) Gated cardiac imaging c) Bone imaging with technetium-99m MDP, c) Quantitative haemodynamics with technetium-99m pertechnetate, d) myocardial imaging with thallous-201 chloride and e) abscess imaging with gallium-67 citrate, induce an effective dose equivalent of 5-9 mSv. A CT scan commonly gives 25 mSv to the subject examined. BEIR VI indicated that a 10 mSv single population dose is associated with a lifetime attributable risk for developing a solid cancer or leukemia in 1:1000. Multiple CT examinations have administered to some patients with renal colic a dose of 19.5-153.7 mSv. One may suggest that there should be "justification" and informed written patients' consent for nuclear medicine examinations administering to the patient doses greater than 5 mSv, especially doses around or above 30 mSv / year.
Hell J Nucl Med
PMID:The physician should benefit, not harm the patient. 1689 9

(99m)Tc-2-methoxyisobutylisonitrile ((99m)Tc-MIBI) scintigraphy has been suggested in multiple myeloma (MM) patients. According to the International Staging System (ISS), serum b2-microglobulin (Sbeta(2)M) and serum albumin (SA) are dominant predictive factors and different cut-off values of these factors can separate patients into various stages of the disease. The purpose of this study was to assess the relationship between ISS staging, by Sbeta(2)M and SA, and the (99m)Tc-MIBI scan findings. Twenty-five MM patients have been studied. Eighteen patients were at stage I, three at stage II and four at stage III of MM. (99m)Tc-MIBI scans were obtained and scored according to intensity (I) and extent (E) of the radiotracer uptake. A summed score (S) for the (99m)Tc-MIBI scan was calculated for each patient. A statistically significant negative correlation between E, I and S uptake scores versus the SA levels (P=0.004, 0.049 and 0.018 respectively), as well as a statistically significant positive correlation between E and S scores and the Sbeta(2)M levels (P=0.012 and 0.032) were detected. A statistically significant difference between the E and S uptake scores among the MM patients examined for every stage separately was also found (P=0.007 and 0.024 respectively). The gradual increase of the E and S scores across the three stages of MM was also significant (P=0.003 and 0.021 respectively), despite the relatively small number of patients in stages II and III. In seven patients who died at the end of the follow-up period all three scores were significantly increased as compared to the scores of the patients who remained alive at that time. In conclusion, this study provides additional evidence that (99m)Tc-MIBI scan not only reflects myeloma disease activity in bone marrow but it is also well correlated with the Sbeta(2)M and SA levels according to ISS.
Hell J Nucl Med
PMID:Scintigraphy with technetium-99m methoxyisobutylisonitrile in multiple myeloma patients: correlation with the International Staging System. 1716 Jan 59

Nitrogen-containing biphosphonates are a group of medications that are increasingly used in the management of Paget's disease, fibrous dysplasia, osteoporosis, multiple myeloma and metastatic prostate or breast cancer bone disease. On 2004 it was established that nitrogen-containing biphosphonates may induce jaw osteonecrosis and since then, a substantial number of publications has supported this finding. Jaw osteonecrosis may be asymptomatic, lasting for about a year or symptomatic, accompanied with mild or severe pain. Jaw osteonecrosis usually results in patients with poor dental hygiene, or subjected to invasive dental procedures. Its incidence increases with the length of nitrogen-containing biphosphonates treatment and appears to be higher for the Zometa(TM) users. It is important to early recognize this entity, since early intervention can make a significant difference to the outcome of this debilitating side effect. We here report three patients who had a positive technetium-99m methylene diphosphonate ((99m)Tc-MDP) bone scan. One of these patients also had osteomyelitis and was treated aggressively. The other two were treated in a more conservative manner. Detailed dental examination supported the scintigraphic findings. Biopsy was performed only in one patient and also offered specimens for antibiotic cultures. In discussion, jaw biopsy is a debatable procedure in the setting of jaw osteonecrosis and many consider that it should be avoided in most cases, except if it is necessary to establish the diagnosis and suggest antibiotic treatment by obtaining samples for bacterial cultures. Although axial tomography and magnetic resonance imaging are useful in defining the extent of the disease, 3-phase (99m)Tc-MDP bone scan is the most sensitive imaging modality pinpointing the disease at its early stages. In conclusion, a 3-phase (99m)Tc-MDP scan with anterior and lateral views of the skull is indicated in all symptomatic or asymptomatic patients, with a history of long-term nitrogen-containing biphosphonate treatment, since this may lead to an early detection of the disease.
Hell J Nucl Med
PMID:Jaw uptake of technetium-99 methylene diphosphonate in patients on biphosphonates: a word of caution. 1808 61

Multi-drug resistance (MDR) is a major challenge in the treatment of multiple myeloma (MM). There is low sensitivity of technetium-99m methoxy isobutyl isonitrile ((99m)Tc-MIBI) whole body scan (WBS) in the detection of active MM lesions, because (99m)Tc-MIBI is washed out from malignant cells in the presence of P-glycoprotein (PGP). The objective of the present cohort study was to evaluate of (99m)Tc-MIBI WBS in the prediction of MDR in MM patients during a course of one year follow up. Thirty four patients with MM (25 male, 9 female of mean age 54.12+/-11.46 years) entered the study. Thirteen patients had no previous history of treatment and 21 had a history of previous chemo-radiotherapy. The diagnosis and staging of the disease were based upon routine laboratory and clinical criteria like bone marrow plasma cell count, serum M component, calcium, albumin, beta(2)-microglobulin. Measurements of PGP and WBS using (99m)Tc-MIBI were performed before initialization of treatment and the response to treatment was assessed one year later. The baseline (99m)Tc-MIBI WBS were considered positive for the detection of active lesions when at least one area of non-physiologic increased activity was noted. The follow up (99m)Tc-MIBI WBS was positive for MDR when the patient had active disease but normal WBS. Our results showed that for WBS, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy in active state for the diagnosis of MDR were 38.9%, 62.5%, 70%, 31.2% and 46.1%, respectively. Also the above values for the detection of MDR, using PGP values were 50%, 50%, 69.2%, 30.8% and 50%, respectively. The relative risk of resistant to multiple regimens of chemotherapy after one year follow up in patients with negative to patients with positive (99m)Tc-MIBI WBS was 1.02 (0.60-1.72). In conclusion, we found a low sensitivity of WBS and of PGP in the detection of MDR in patients with active MM. However, both WBS and PGP have 70% and 69% positive predictive value for MDR.
Hell J Nucl Med
PMID:99mTc-MIBI whole body scintigraphy and P-glycoprotein for the prediction of multiple drug resistance in multiple myeloma patients. 1993 39


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