Exploring the Clinicopathological Parameters Affecting the Outcome in Egyptian Patients with Multiple Myeloma.

BACKGROUND: Multiple myeloma (MM) is a plasma-cell neoplasm in which the interplay of several clinical, pathological and genetic parameters affects the patient's prognosis and response to treatment and survival. AIM: The aim of this study was to evaluate the different clinicopathological parameters of MM patients in correlation with response to therapy, progressionfree survival (PFS) and overall survival (OS). METHODS: This retrospective study was performed on 60 MM patients diagnosed at NCI, Cairo University from January 2005 to December 2008. The patients were evaluated for different clinicopathological parameters which were correlated to their response to treatment, OS and PFS. RESULTS: Sixty patients were followed up for a median period of 21 months wherein about 90% received 1st line treatment: 34 VAD, 17 MP and 3 dexamethasone. Six patients (10%) were referred for BSC. CR was achieved by 15%, 11.7% achieved good PR, 6.7% achieved PR, 22.1% have stable disease, 35% experienced disease progression. ECOG PS-I patients have 39 months median survival compared to 12 months for patients with PS ECOG-II (P 0.005). Patients with multiple skeletal lesions (≥3) have median OS of 19 months (P 0.03). Patients who presented with plasmacytoma have better OS than those without (38 months versus 14 months) (P<0.05). Patients <60 years old have a better median OS compared to patients <60 years (37 months versus 12 months) (P 0.001). OS was 39 months in female patients versus 14 months in male patients (P0.025). Median OS was 9 months for patients with comorbidities versus 27 months for those without (P0.01), 39 months for patients with non-detected paraproteinuria versus 18 months for those with paraproteinuria (P 0.045), 18 months for stage II disease versus 12 months for stage III disease (P0.001), 12 months for patients with elevated serum LDH versus 39 months for those with normal levels (P 0.001), 27 months for patients with normal serum creatinine level versus 13 months for those with elevated levels (>1.4 mg/dl) (P 0.005), 27 months for patients with normal serum calcium levels versus 10 months for those with hypercalcemia (P 0.03). CONCLUSION: Besides FISH-guided molecular cytogenetic classification of myeloma abnormality, a specific risk-stratification model based upon the patient's age, sex, performance status, lytic bone lesions, plasma cells labeling index, serum creatinine, calcium, LDH, B2M and paraproteins in serum and urine, can depict the response to treatment, OS and PFS of patients with MM.

Nano Mg(1-x)Ni(x)Al2O4 spinel pigments for advanced applications.

Nano Mg(1-x)Ni(x)Al2O4 spinel pigments were synthesized via polymeric combustion technique upon heat treatment at 210 °C. Citric acid in the presence of ethylene glycol polymer, with mass ratio of 60:40, was successfully used as a host network for the synthesis process. The obtained spinel was calcined at different temperatures; 300-1200°C and investigated by thermal analysis (TG-DTG/DTA), X-ray powder diffraction (XRD), Fourier transform infrared spectroscopy (FT-IR), transmission electron microscopy (TEM), and scanning electron microscopy (SEM). UV-Vis and diffuse reflectance spectroscopy (DRS) using CIE-Lab/parameters methods have been used for color measurements. The addition of colored pigment on different types of glazes was studied. The results revealed that NiMgAl2O4 spinel beside MgNiO phases were crystallized with particle sizes of 9-21 nm at 600 °C and 52-180 nm at 1200 °C. All prepared samples exhibited green to pale green colors due to the inclusion of Ni(2+) inside the spinel structure. The pale green color intensity increased with increasing calcination temperature. The prepared pigment was suitable to convert commercial and opaque glazes to color product to be used in different applications.

Spondylothoracic dysplasia with diaphragmatic defect: a case report with literature review.

Spondylothoracic dysplasia (Jarcho-Levin syndrome) is a syndrome of unknown etiology. We describe a new case with diaphragmatic eventration. Literature review for cases of Jarcho-Levin syndrome with diaphragmatic defects, which were six cases, revealed that renal affection increased when diaphragmatic defects associate the syndrome with pulmonary hypoplasia. Thus, the subgroup of spondylothoracic dysplasia with diaphragmatic defect is a more severe subgroup of the syndrome rather than the other forms of this syndrome. Relating the described anomalies in this case and that of the literature cases to the known embryological basis may point to a pivotal developmental link between lung, kidney and diaphragm, possibly the posterior mesenchyme.

Novel mercury (II) ion-selective polymeric membrane sensor based on ethyl-2-benzoyl-2-phenylcarbamoyl acetate.

Mercury (II) ion-selective PVC membrane sensor based on ethyl-2-benzoyl-2-phenylcarbamoyl acetate (EBPCA) as a novel nitrogen containing sensing material is successfully developed. The sensor exhibits good linear response of 30 mV per decade within the concentration range 10(-6)-10(-3) mol l(-1) Hg(II). The sensor shows good selectivity for mercury (II) ion in comparison with alkali, alkaline earth, transition and heavy metal ions. The EBPCA-based sensor is suitable for use with aqueous solutions of pH 2.0-4.5 and exhibits minimal interference by Ag(I) and Fe(III), which are known to interfere with other previously suggested sensors. The nature and composition of the sensing material and its mercury complex are examined using Fourier-transform infrared analysis, elemental analysis and X-ray fluorescence techniques. The proposed sensor is applied as a sensor for the determination of Hg(II) content in some amalgam alloys. The results show good correlation with data obtained by atomic absorption spectrometric method.

Long-term evaluation of modified lateral anorectal myomectomy for low-segment Hirschsprung disease.

OBJECTIVES: To provide a simple myomectomy technique for low-segment Hirschsprung disease and evaluate the efficacy of the new modification. DESIGN: Case series of 19 patients followed up for 12 to 56 months (mean, 39.1 months). SETTING: Tanta University Hospital, Tanta, Egypt. PARTICIPANTS: Nineteen patients aged 4 months to 10 years complaining of chronic constipation, with radiological and clinical data suggestive of low-segment Hirschsprung disease proven by histological examination. INTERVENTION: Modified lateral anorectal myomectomy. MAIN OUTCOME MEASURES: Clinical and radiological improvement measured by postoperative barium enema, bowel habits, and patient's relief of symptoms. RESULTS: Seventeen of 19 patients improved clinically and 13 showed radiological improvement 3 years postoperatively. There was poor response in 2 patients, who were subjected to further Soave procedures. CONCLUSION: Modified lateral anorectal myomectomy is an effective and technically simple procedure in patients suspected of having low-segment Hirschsprung disease.

Endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy: experience in the Sudan.

Over a 5 year period 626 endoscopic retrograde cholangiopancreatography (ERCP) examinations were attempted in Khartoum, Sudan. The relevant duct was successfully cannulated and visualized in 94% of cases of biliary tract disease and in 73% of cases of pancreatic disease. This was due to the large number of cases with advanced pancreatic cancer. The commonest abnormal finding was stones in the biliary tree in 214 cases (35% of all cases). Cholangiocarcinoma was seen in 18 cases, pancreatic cancer in 64 cases, chronic pancreatitis in 48 cases and periampullary carcinoma in 20 cases. ERCP was considered normal in 100 cases. Endoscopic sphincterotomy (EST) was performed in 48 cases; 44 had common duct stones. ERCP and EST are feasible and useful procedures in a developing country. However they are expensive and should be carried out in referral centres.