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Multiple Myeloma: a Retrospective Analysis of 61 Patients from a Tertiary Care Center

  • Sultan, Sadia;Irfan, Syed Mohammed;Parveen, Saira;Ali, Hamza;Basharat, Maria
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.1833-1835
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    • 2016
  • Background: Multiple myeloma (MM) is an acquired clonal B-cell malignancy which primarily affects elderly individuals with an annual incidence of approximately 1% of all malignancies. Our aim is to study demographic and clinicopathological features of adult Pakistani MM patients at presentation. Materials and Methods: This single centre retrospective study extended from January 2010 to December 2014. Data were retrieved from the patients' maintained records on predetermined performa. Results: Overall, 61 patients were diagnosed at our institution with MM during the study period. There were 43 males and 18 females. Age ranged between 34 and 81 years with a mean of $56.1{\pm}12.8$ and a median of 57 years. The male to female ratio was ~2:1. Common presenting complaints included fatigue (81.9%), backache (80.3%) and bone pain (67.2%). Physical findings revealed pallor (44.2%) as a presenting clinical feature. The mean hemoglobin value was $8.9{\pm}1.7g/dl$ with a mean MCV of $85.3{\pm}11.0fl$. Severe anemia with hemoglobin <8.5 gm/dl was seen in 40.9%. The mean total leukocyte count was $8.9{\pm}8.2{\times}10^9/l$, the ANC was $5.0{\pm}3.1{\times}10^9/l$ and the mean platelet count was $188.4{\pm}150.6{\times}10^9/l$. Conclusions: MM in Pakistani patients is seen in a relatively young population with male preponderance. The majority of patients present with symptomatic anemia and backache to seek medical attention. However, clinico-pathological features appear comparable to the published literature.

Influence of Residential Environment and Lifestyle on Multiple Primary Malignancies in Taiwan

  • Chang, Chih-Chun;Chung, Yi-Hua;Liou, Ching-Biau;Lee, Yi-Chen;Weng, Wei-Ling;Yu, Yun-Chieh;Yen, Tzung-Hai;Wu, Jiann-Ming
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.8
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    • pp.3533-3538
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    • 2015
  • Background: Multiple primary malignancies (MPM) have become increasingly prevalent worldwide. This investigation was aimed at establishing the clinicopathological characteristics of MPM patients and evaluating the impact of the living environment on MPM in the Taiwanese population. Materials and Methods: From January 2009 to December 2013, a total of 8,268 cancer patients were identified in our institutional center. Of these, 125 were diagnosed as MPM and thus enrolled. Data for clinicopathological features and treatment approaches for these MPM patients living in urban or suburb zone were obtained. Findings for the air pollution status in Taiwan were also collected. Results: The most common cancer match of MPM was esophageal cancer with hypopharyngeal cancer (12.8%), followed by colorectal cancer with gastric cancer (6.4%) and colorectal cancer with breast cancer (5.6%). The air quality was significantly worse in the urban than in the suburban zone and there was a remarkably higher portion of MPM patients in the urban zone suffering from grade III and IV post-chemotherapeutic neutropenia (30.8% vs 15.1%, P=0.036). Conclusions: The tumor frequency and site distribution should be taken into the clinical evaluation because there is a relatively high risk of developing MPM. This study also highlighted the potential influence of environmental factors on post-chemotherapeutic neutropenia for patients with MPM.

Outcome after Simultaneous Resection of Gastric Primary Tumour and Synchronous Liver Metastases: Survival Analysis of a Single-center Experience in China

  • Liu, Qian;Bi, Jian-Jun;Tian, Yan-Tao;Feng, Qiang;Zheng, Zhao-Xu;Wang, Zheng
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.4
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    • pp.1665-1669
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    • 2015
  • Background: The optimal surgical strategy for the treatment of synchronous resectable gastric cancer liver metastases remains controversial. The aims of this study were to analyze the outcome and overall survival of patients presenting with gastric cancer and liver metastases treated by simultaneous resection. Materials and Methods: Between January 1990 and June 2009, 35 patients diagnosed with synchronous hepatic metastases from gastric carcinoma received simultaneous resection of both primary gastric cancer and synchronous hepatic metastases. The clinicopathologic features and the surgical results of the 35 patients were retrospectively analyzed. Results: The 5-year overall survival rate after surgery was 14.3%. Five patients survived for more than 5 years after surgery. No mortality has occurred within 30 days after resection, although two patients (5.7%) developed complications during the peri-operative course. Univariate analysis revealed that patients with the presence of lymphovascular invasion of the primary tumor, bilateral liver metastasis and multiple liver metastases suffered poor survival. Lymphovascular invasion by the primary lesion and multiple liver metastases were significant prognostic factors that influenced survival in the multivariate analysis (p=0.02, p=0.001, respectively). Conclusions: The presence of lymphovascular invasion of the primary tumor and multiple liver metastases are significant prognostic determinants of survival. Gastric cancer patients without lymphovascular invasion and with a solitary synchronous liver metastasis may be good candidates for hepatic resection. Simultaneous resection of both primary gastric cancer and synchronous hepatic metastases may effectively prolong survival in strictly selected patients.

Efficacy of Multiple Low-dose Photodynamic TMPYP4 Therapy on Cervical Cancer Tumour Growth in Nude Mice

  • Liu, Ai-Hong;Sun, Xuan;Wei, Xiao-Qiang;Zhang, You-Zhong
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5371-5374
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    • 2013
  • Objective: Photodynamic therapy (PDT) is an emerging therapeutic procedure suitable for the treatment of cervical cancer. However, the side effects of PDT are severe, including skin ulceration, so we designed an experiment to examine the effects of multiple low-dose photodynamic therapy of 5, 10, 15, 20-tetrakis(1-methylpyridinium-4-yl) porphyrin (Tmpyp4) on tumour growth by utilizing a model in nude mice implanted with Hela cervical cancer cells. Materials and Methods: Female BALB/c nude mice (aged 5-6 weeks, weighing 18-20 g) were used. Hela cervical cancer cells were injected subcutaneously ($1{\times}10^7cells/200{\mu}L$). Ten days after injection, the mice were divided into three groups (n=6), the A group of controls without any treatment, the B group receiving a single-treatment with Tmpyp4 (10 mg/kg, intratumor injection) and irradiation (blue laser, $108J/cm^2$), and the C group given three-treatments with Tmpyp4 (10 mg/kg, intratumor injection) and irradiation at intervals of two days. After starting treatment, tumours were measured every two days, to assess growth. At 2 weeks after the last treatment of C group, tumour tissue and organs were collected from each mouse to evaluate tumor histology and organ damage. Results: Tumour growth in C group was significantly inhibited compared with A and B groups (P<0.05), without any injury to the skin and internal organs. Conclusion: Our novel findings demonstrated that multiple low-dose photodynamic therapy of Tmpyp4 could inhibit cervical cancer growth significantly with no apparent side effects.

Surgical Treatment of the Fifth Metatarsal Base Fracture Using Multiple Kirschner Wires (다발성 Kirschner 강선을 이용한 제 5중족골 기저부 골절의 수술적 치료)

  • Kim, Jihyeung;Kim, Jang Woo;Lee, Jeong Ik;Kim, Sang Kil;Rhee, Seung Hwan
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.1
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    • pp.24-28
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    • 2014
  • Purpose: The purpose of this study is to evaluate the clinical and radiographic results of internal fixation using multiple Kirschner wires (K-wires) for the fifth metatarsal base fracture. Materials and Methods: We retrospectively reviewed 14 patients with a displaced fifth metatarsal base fracture. We measured the distance of fracture displacement on the foot oblique radiograph pre- and post-operatively. We evaluated the clinical results using the visual analog pain scale at six weeks and three months postoperatively and the American Orthopaedic Foot and Ankle Society (AOFAS) mid-foot score at six months postoperatively. Results: In our series, 10 cases were zone I fracture and four cases were zone II fracture. We achieved anatomical reduction and bony union in all of our cases. The average time to bone union was 43 days. The degree of pain around the fifth metatarsal base was significantly decreased after surgery. The average AOFAS score was 95 at six months postoperatively. Conclusion: Multiple K-wire fixation is a relatively simple fixation method for displaced fifth metatarsal base fractures. If we place a K-wire into the medial cortex of the fifth metatarsal, we could prevent proximal migration of the K-wire.

Reconstruction of Mandible Defect after Tumor Ablation Surgery : Versatility of Fibular Free Flap Design (광범위 종양절제술 후 발생한 하악 결손의 재건 : 결손부위에 따른 비골 유리 피판의 다양한 디자인)

  • Seul Chul-Hwan;Lee Young-Dae;Tark Kwan-Chul;Lew Dae-Hyun
    • Korean Journal of Head & Neck Oncology
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    • v.21 no.2
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    • pp.190-195
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    • 2005
  • Background and Objectives: Fibula is the flap of choice for reconstruction of wide mandible defects after tumor ablation surgery. In mandible reconstruction, restoring the mandible frame to provide mandibular contour and dental arch while restoring masticatory function are important. Even though vascularized fibula can be osteotomized freely, proper design and flap insetting is not easy because of its three dimensional structure and difference in design according to the defect sites. We reviewed patients who underwent mandible reconstruction with fibular flaps according to the defect sites and suggest proper modification methods of fibular flap according to the various defects sites after tumor ablation surgery. Materials and Methods: Twelve consecutive mandible reconstruction with fibular free flaps were performed for defects after tumor ablation surgery. Patients were classified into 4 groups according to the type of mandibular defect(Group 1 : defect on central segment including symphysis, Group 2 : defect on lateral segment(with or without central segment) confined to body, Group 3 : defect on body and ascending ramus that does not include the condyle, Group 4 : defect including the condyle). Results: We suggest different modification methods of fibular free flap for each patient group. Group 1, 3 ; contour by using multiple closing wedge osteotomy. Group 2 ; single or double barrel reconstruction without wedge osteotomy. Group 4 ; contour using single or multiple wedge osteotomy and condylar reconstruction with costochondral graft. Conclusion: Fibular free flaps can be contoured to any desired shape after multiple osteotomies to restore various mandibular defects. It is a reliable and versatile method for reconstruction of mandibular defects after tumor ablation surgery.

Multiple Regression Analysis for Piercing Punch Profile Optimization to Prevent Tearing During Tee Pipe Burring (다중 회귀 분석을 활용한 Tee-Pipe 버링 공정에서 찢어짐 방지를 위한 피어싱 펀치 형상 최적 설계)

  • Lee, Y.S.;Kim, J.Y.;Kang, J.S.;Hong, S.
    • Transactions of Materials Processing
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    • v.26 no.5
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    • pp.271-276
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    • 2017
  • A tee is the most common pipefitting used to combine or divide fluid flow. Tees can connect pipes of different diameters or change the direction of a pipe run. To manufacture tee type of stainless steel pipe, combinations of punch piercing and burr forming have been widely used in the industry. However, such method is considerably time consuming with regard to performing empirical work necessary to attain process conditions to prevent upper end tearing of the tee product and meet target tee height. Numerous experiments have shown that the piercing profile is the main cause of defects mentioned above. Furthermore, the mold design is formed through trial and error according to pipe diameters and changes in requirements. Thus, the objective of this study was to perform piercing and burring process analysis via finite element analysis using DYNAFORM to resolve problems mentioned above. An optimization design method was used to determine the piercing punch profile. Three radii of the piercing punch (i.e., large, small, and joined radii) were selected as design variables to minimize thinning of a tee pipe. Based on results of correlation and multiple regression analyses, we developed a predictive approximation model to satisfy requirements for both thickness reduction and target height. The new piercing punch profile was then applied to actual tee forming using the developed prediction equation. Model results were found to be in good agreement with experimental results.

Classification of Waterfalls in Jeju Island Based on Properties of a Lava Flow (용암류 특성에 의한 제주도 폭포의 유형화)

  • Kim, Tae-Ho
    • Journal of the Korean association of regional geographers
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    • v.18 no.2
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    • pp.129-140
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    • 2012
  • In order to examine geomorphic characteristics such as form and retreat process of waterfalls in Jeju Island, 26 waterfalls were classified based upon materials forming a fall face. The waterfalls could be categorized into three types such as single unit, multiple units and basal soft-rock based upon the number and type of a lava flow. A block fall, composed of a pile of large blocks, could be added to the typology of waterfalls in Jeju Island. While the single unit fall is distributed in a region of trachyte or trachyandecite, the multiple units fall and basal soft-rock fall are largely developed in a region of basalt or trachybasalt. A retreat process of the single unit fall is an inclination or a replacement, but the basal soft-rock fall shows a parallel retreat. The multiple units fall exhibits three types of a retreat process according to the physical properties of a lava flow. The fall face is generally vertical due to well-developed vertical joints of a lava flow.

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Statistical Homogeneity Tests and Multiple Comparison Analysis for Response Characteristics between Treatments of Bridge Groups (교량 집단의 특성 수준간 통계적 응답 동질성 검정 및 다중 비교 분석)

  • Hwang, Jin-Ha;Kim, Ju-Han;An, Seoung-Su
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.18 no.4
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    • pp.107-117
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    • 2014
  • This study tests homogeneity and performs multiple comparison analysis among treatment levels of each factor group through t-test by materials and analysis of variance by structural type and service period. For that descriptive statistical analysis is performed for static and dynamic response characteristics and their ratios of calculated versus measured values based on a good many safety assessment reports for bridges. Homogeneity and post hoc test based on descriptive statistical analysis provide the measures for homogeneity identification among comparison groups in addition to the statistical reference values such as central tendency, variation and shape. This study is expected to be valuable for structural integrity assessment and design by comparing the measured and calculated values with the reference values for the homogeneous group identified, which can help the engineers review the adequacy of the values and put the group database to practical use.

Impact of multiple firings and resin cement type on shear bond strength between zirconia and resin cements

  • Oguz, Ece Irem;Ozgur, Merve Erdog;Sungur, Sercan;Uctasli, Sadullah
    • The Journal of Advanced Prosthodontics
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    • v.12 no.4
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    • pp.197-203
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    • 2020
  • PURPOSE. The aim of this study was to evaluate the effect of multiple firings on the bond strength between yttriatetragonal zirconia polycrystals (Y-TZP) and 2 types of resin cements. MATERIALS AND METHODS. Sixty 3Y-TZP specimens (LAVA Frame Multi) were divided into 3 groups depending on the following firing procedures: (1) 2-firing cycles, (2) 5-firing cycles, (3) 10-firing cycles. Two samples from each group were investigated by using SEM to determine the morphological changes. All specimens were treated with 125 ㎛ airborne-particle abrasion and the surface roughness of each specimen was measured. The specimens from each firing group were then further divided into 2 subgroups (n = 9) to apply 2 types of resin cement (MDP-free resin cement: RelyX Unicem-RU, and MDP containing resin cement: Panavia F 2.0-PA). The shear bond strength (SBS) test was performed and failure types of all the debonded specimens were classified by using a stereomicroscope as adhesive, cohesive, and mixed. The statistical analysis of surface roughness and SBS data were performed by using 1-way ANOVA and 2-way ANOVA followed by Tukey-HSD tests (α=.05). Failure modes were calculated as a percentage for each group. RESULTS. The bond strength of RU and PA to the specimens obtained with 2 firings were not statistically different from each other (P=.1). However, the SBS values of PA were found to be significantly higher than RU for the specimens obtained with 5 and 10 firing cycles (P=.001 and P=.02, respectively). Surface roughness analysis revealed no statistical difference between groups (P=.2). The SEM analysis of samples fired 5- and 10- times showed irregularities and boundary loss in zirconia grains, and empty spaces between zirconia grains. CONCLUSION. The bond strength of PA cement was higher than that of RU to the zirconia subjected to repeated firings (5 and 10 firing cycles). When zirconia is subjected to multiple firings, using MDP-containing resin cement can be recommended.