JoVE Visualize What is visualize?
Stop Reading. Start Watching.
Advanced Search
Stop Reading. Start Watching.
Regular Search
Find video protocols related to scientific articles indexed in Pubmed.
Hepatitis associated aplastic anemia: case report and discussion.
Conn Med
PUBLISHED: 10-16-2014
Show Abstract
Hide Abstract
Aplastic anemia (AA) is thought to represent an autoimmune disorder leading to generation of activated CD8+ T-cells that target the bone marrow precursors. Hepatitis associated aplastic anemia (HAAA) is a subtype of aplastic anemia that develops within several months ofan episode of acute hepatitis. Etiologic agents include hepatitis viruses (A-E and G), Epstein-Bar virus, cytomegalovirus, HIV, parvovirus B19, and echoviruses amongst others. However, most HAAA cases are labeled "idiopathic" as the inciting agent cannot be identified. Drugs and/or toxins are rarely causal factors. We describe herein a unique case of HAAA linked with the anabolic steroid methasterone that caused a transient cholestatic hepatitis and, subsequently, a severe aplastic anemia in a young man.
Related JoVE Video
Autoimmune disorders in patients with hairy cell leukemia: are they more common than previously thought?
Curr Med Res Opin
PUBLISHED: 09-30-2014
Show Abstract
Hide Abstract
Abstract Background: For a number of decades, hairy cell leukemia (HCL) has been linked with polyarthritis, vasculitis, symptomatic cytopenias and thrombosis in the medical literature. Notwithstanding, the significance of these associations has not been well understood. Therefore, we have decided to analyze them further. Methods: We provide herein a comprehensive literature review of the prevalence of autoimmune disorders in patients with HCL. Most relevant publications were identified through searching the PubMed/Medline database for articles published from inception to February 2014. Findings: Perhaps due to the rarity of HCL, scientific literature on autoimmune conditions in patients with HCL consists mainly of published case series and isolated reports. Our analysis identified increased prevalence of various autoimmune conditions in patients with HCL, including various vasculitides, immune cytopenias and antiphospholipid antibody syndrome (APS) among others. Conclusions: Presence of certain autoimmune disorders should increase the suspicion of HCL in an appropriate clinico-laboratory context. Conversely, the diagnosis of HCL should prompt early recognition of certain autoimmune disorders if clinical suspicion exists. While some of these autoimmune diseases are thought to be secondary to the dysfunctional immune response associated with underlying malignant process, others could be primary and might even play a role in the HCL pathogenesis. The autoimmune complications can pose important clinical problems for the HCL patients. Therefore, a catalogue of these problems is important for alerting physicians to watch for them and diagnose them promptly.
Related JoVE Video
Operated bronchial carcinoids: clinical outcomes and long-term follow-up of a single institution series of 30 patients.
Conn Med
PUBLISHED: 09-09-2014
Show Abstract
Hide Abstract
Bronchial carcinoids (BCs) are infrequent neoplasms that account for only 1% to 2% of all lung tumors. We reviewed the outcomes and long-term follow-up data of all patients diagnosed with BC and treated surgically at our institution between the years 2002-2009.
Related JoVE Video
Posterior reversible encephalopathy syndrome due to targeted agents: vemurafinib among suspects!
J Oncol Pharm Pract
PUBLISHED: 07-12-2014
Show Abstract
Hide Abstract
Posterior reversible encephalopathy syndrome features reversible cortical neurologic dysfunction and characteristic findings on brain imaging studies. This syndrome can be caused by several agents including traditional chemotherapy and immunosuppressive drugs. Targeted therapies such as agents binding vascular endothelial growth factor/VEGFR, CD20 and cytotoxic T-cell lymphocyte antigen 4 (CTLA-4) antigens are also among the culprits. Vemurafenib is a BRAF gene inhibitor that has not been previously linked with posterior reversible encephalopathy syndrome. We report herein the first such case and believe that further studies confirming this association are warranted. We further review the existing posterior reversible encephalopathy syndrome cases associated with targeted therapies in the scientific literature.
Related JoVE Video
Retroperitoneal fibrosis due to B-cell non-Hodgkin lymphoma: Responding to rituximab!
J Oncol Pharm Pract
PUBLISHED: 07-12-2014
Show Abstract
Hide Abstract
Retroperitoneal fibrosis is a rare disease manifesting as chronic soft tissue fibrosis in the retroperitoneum, with potential anatomic and/or functional compromise of adjacent organs. It can be primary (idiopathic) or secondary to other conditions such as cancers, autoimmune disorders, or drugs. We report herein a 66-year-old patient with symptomatic retroperitoneal fibrosis leading to bilateral hydronephrosis and renal failure, in whom, after a complex diagnostic work-up and protracted clinical course, a B-cell non-Hodgkin lymphoma in the retroperitoneal space and several vertebral bodies was identified. The patient was treated with radiation therapy and weekly rituximab infusions, with resolution of hydronephrosis and lower back pain. We include a thorough literature review on etiopathogenesis, diagnosis, therapy, and prognosis of retroperitoneal fibrosis. A meticulous search for malignancy is necessary in this rare condition that, if positive, may have significant therapeutic and prognostic implications.
Related JoVE Video
Pyoderma gangrenosum due to lenalidomide use for multiple myeloma.
J Oncol Pharm Pract
PUBLISHED: 07-03-2014
Show Abstract
Hide Abstract
Pyoderma gangrenosum has been described in association with multiple myeloma and usually affects patients with active/untreated disease. This dermatologic condition was shown to resolve after successful anti-myeloma therapy. We report herein occurrence of pyoderma gangrenosum involving bilateral knees in a patient with multiple myeloma responding to lenalidomide therapy. Previous papers claimed usefulness of thalidomide and its newer derivatives for the therapy of this neutrophilic dermatosis. Occurrence of pyoderma gangrenosum in a myeloma patient responding to lenalidomide would argue against its effectiveness in treating this skin condition. Moreover, the clinical setting suggested that lenalidomide either induced or contributed to the occurrence of pyoderma gangrenosum in our patient. If our hypothesis is correct, we expect more reports of pyoderma gangrenosum with the use of this class of pharmaceuticals.
Related JoVE Video
Adenocarcinoma of the ampulla of Vater: What treatment options are available?
J Oncol Pharm Pract
PUBLISHED: 06-08-2014
Show Abstract
Hide Abstract
The scientific literature on adenocarcinoma of the ampulla (papilla) of Vater suggests that it either represents a distinct entity or is more closely related to small bowel adenocarcinoma than to the biliary malignancies. The ambiguity surrounding this rare cancer has kindled research exploring its immunohistochemistry aspects and gene expression profiling. While the basis of management for resectable disease remains surgical intervention, the role of adjuvant chemotherapy is not clear. A recent large phase 3 clinical trial conducted in patients with resected ampulla of Vater adenocarcinoma favored adjuvant chemotherapy over observation alone. The standards of therapy for the advanced small bowel adenocarcinoma and biliary cancer are fluoropyrimidine derivatives and gemcitabine-based combinations, respectively. In addition, new biologic and targeted agents may enhance clinical results seen in this cancer type. Therefore, diligently designed clinical trials are necessary to establish its optimal treatment strategies. We describe herein a patient with ampulla of Vater adenocarcinoma who had an exceptional response to fluoropyrimidine-based chemotherapy. We further include a discussion reviewing the clinicopathologic aspects of this neoplasm as well as focus on currently available and future therapeutic options.
Related JoVE Video
An unusual presentation of Kikuchi-Fujimoto disease.
Conn Med
PUBLISHED: 05-17-2014
Show Abstract
Hide Abstract
Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis, is a rare, self-limited disease of unknown etiology. This condition is most commonly encountered in Asian and Caucasian females of childbearing age who usually present with cervical lymphadenopathy and fever. Though rarely, KFD has been described in younger African-American females as well. It often mimics more serious conditions such as lymphoma, metastatic solid malignancy, HIV infection, tuberculosis, sarcoidosis, or systemic lupus erythematosus. Although its etiopathogenesis has not been fully elucidated, literature suggests viral or possibly autoimmune components to play a role. We describe a 34-year-old African-American female who presented with constitutional symptoms and polyadenopathy on clinical examination and imaging, of which the portacaval and portahepatis lymph nodes were most prominent. An extensive workup was otherwise unremarkable, and biopsy showed histiocytic necrotizing lymphadenitis. Initially, her clinical condition improved spontaneously, and she required only a short course of oral steroids. Three months later, she relapsed with bilateral cervical adenopathy and constitutional symptoms and was successfully managed again with steroids. Our case is unique with respect to (a) portahepatis and portacaval node enlargement as the dominant adenopathy and (b) her underlying conditions of fibromyalgia and chronic fatigue syndrome.
Related JoVE Video
CD5 negative mantle cell lymphoma: a different clinical entity?
Conn Med
PUBLISHED: 05-17-2014
Show Abstract
Hide Abstract
We report herein a 77-year-old patient with CD5 negative mantle cell lymphoma (MCL). We further review the existing literature on clinicolaboratory features of this rare MCL subtype. Although most of the patients in the literature (including ours) had advanced stage at diagnosis, splenomegaly, and bone marrow involvement, they displayed prompt and durable responses to conventional treatment. We postulate that CD5 surface antigen expression could have prognostic implications in MCL. Further research and a larger number of patients are necessary in order to validate these findings.
Related JoVE Video
Association between HBsAg positivity and pancreatic cancer: a meta-analysis.
J Gastrointest Cancer
PUBLISHED: 05-03-2014
Show Abstract
Hide Abstract
Several studies have proposed an association between hepatitis B and pancreatic cancer. Although the spectrum of serological tests varied between studies, hepatitis B virus (HBV) surface antigen (HBsAg) test results were consistently reported. This meta-analysis evaluates the association between HBsAg positivity and pancreatic cancer.
Related JoVE Video
Autoimmune Manifestations in Patients With Waldenström Macroglobulinemia.
Clin Lymphoma Myeloma Leuk
PUBLISHED: 04-30-2014
Show Abstract
Hide Abstract
Waldenström macroglobulinemia represents a lymphoplasmacytic lymphoma with an indolent clinical course. The existing literature associates this hematologic malignancy with various autoimmune disorders. Notwithstanding, these autoimmune conditions have not been comprehensively characterized or systematized to date. As a result, their clinical implications remain largely unknown. The authors offer a comprehensive review of the existing literature on various hematologic and nonhematologic autoimmune disorders documented in the course of Waldenström macroglobulinemia. Whereas some of them are thought to be secondary to a dysfunctional immune response associated with an underlying malignant process, others might be primary and might even play a role in its pathogenesis. Moreover, the observations that personal history and family history of certain autoimmune diseases were associated with an increased risk of subsequent Waldenström macroglobulinemia strengthen further the hypothesis that shared susceptibility genes and chronic antigenic stimulation might predispose individuals to both conditions.
Related JoVE Video
Respiratory failure due to lung involvement with adult T-cell leukemia/lymphoma: case report and review of literature.
Conn Med
PUBLISHED: 04-30-2014
Show Abstract
Hide Abstract
Acute adult T-cellleukemia/lymphoma (ATLL) is a hematologic malignancy that usually entails a poor prognosis; median survival is only six months. Significant immunosuppression is commonly seen in these patients. Lung involvement in ATLL is usually documented either radiographically or as an autopsy finding. Few proven cases of ante mortem extensive lung infiltration have been described in the scientific literature. We present a fatal case of acute respiratory failure as a result of histologically proven lung infiltration by malignant lymphocytes in a patientwith acuteATLL. Although the most common cause of death i n patients with ATLL is respiratory failure in the setting of an infectious process, it should be kept in mind that patients with ATLL with acute respiratory failure may have malignant lung infiltration as a potential cause.
Related JoVE Video
Recurrent pseudocellulitis due to gemcitabine: Underrecognized and underreported?
J Oncol Pharm Pract
PUBLISHED: 04-29-2014
Show Abstract
Hide Abstract
Pseudocellulitis has been previously described with the use of chemotherapy agent gemcitabine. This condition is thought to occur due to vascular toxicity and increased localized permeability of the skin capillaries. We report herein a case of recurrent pseudocellulitis due to gemcitabine in a patient with metastatic pancreatic cancer. We believe this condition is underreported and underrecognized. Furthermore, it may be misdiagnosed as cellulitis and inappropriately treated with systemic antibiotics. As the diagnosis is clinical and the condition is self-limited, referral to other specialists is usually not required. Awareness of gemcitabine-induced pseudocellulitis is important in order to reassure the patients, their families, and non-oncology providers and to avoid unnecessary (and often costly) diagnostic work-up.
Related JoVE Video
Western variant of brain intravascular lymphoma displaying three distinct evolutive radiologic stages.
Conn Med
PUBLISHED: 04-19-2014
Show Abstract
Hide Abstract
Intravascular lymphoma is a rare type of extranodal diffuse large B-cell lymphoma characterized by proliferation of clonal lymphocytes within small- and medium-sized blood vessels and a relative sparing of surrounding tissues. It commonly affects the central nervous system (CNS), but its atypical presentation often leads to a delayed diagnosis. We report a unique case of a 53-year-old man presenting with confusion and ataxic gait. The initial magnetic resonance imaging (MRI) of the brain showed multifocal plaque-like CNS lesions suggestive of multiple sclerosis. His condition worsened rapidly, accompanied by persistent low-grade fever and further alteration in mental status. Follow-up MRI studies suggested new parenchymal brain lesions consistent with multiple evolving embolic strokes and subsequently with brain infarcts. Biopsy showed intravascular lymphomatous brain involvement. His condition continued to deteriorate, resulting in multiorgan failure and demise. To the best of our knowledge, these clear-cut MRI stages of brain intravascular lymphoma have not been previously reported in the scientific literature. Our findings are important as the diagnosis intravascular lymphoma is commonly made postmortem, given its rapidly progressive course and lack of typical symptomatology.
Related JoVE Video
Intravenous ascorbic acid as an adjuvant to interleukin-2 immunotherapy.
J Transl Med
PUBLISHED: 03-10-2014
Show Abstract
Hide Abstract
Interleukin-2 (IL-2) therapy has been demonstrated to induce responses in 10-20% of advanced melanoma and renal cell carcinoma patients, which translates into durable remissions in up to half of the responsers. Unfortunately the use of IL-2 has been associated with severe toxicity and death. It has been previously observed and reported that IL-2 therapy causes a major drop in circulating levels of ascorbic acid (AA). The IL-2 induced toxicity shares many features with sepsis such as capillary leakage, systemic complement activation, and a relatively non-specific rise in inflammatory mediators such as TNF-alpha, C-reactive protein, and in advanced cases organ failure. Animal models and clinical studies have shown rapid depletion of AA in conditions of sepsis and amelioration associated with administration of AA (JTM 9:1-7, 2011). In contrast to other approaches to dealing with IL-2 toxicity, which may also interfere with therapeutic effects, AA possesses the added advantage of having direct antitumor activity through cytotoxic mechanisms and suppression of angiogenesis. Here we present a scientific rationale to support the assessment of intravenous AA as an adjuvant to decrease IL-2 mediated toxicity and possibly increase treatment efficacy.
Related JoVE Video
Skin necrosis: a rare complication of protein S deficiency.
Conn Med
PUBLISHED: 03-08-2014
Show Abstract
Hide Abstract
Hereditary protein S deficiency is an autosomal dominant disorder leading to recurrent venous thrombosis and, less commonly, to arterial thrombosis. Cases of skin necrosis have been documented in patients with protein C or S deficiency while being treated with warfarin. We describe herein a patient with protein S deficiency who developed significant skin necrosis without being exposed to warfarin. She had a protracted clinical course resulting in gangrene and transmetatarsal amputation. Recognition of this rare complication and an earlyhematology referral may prevent dismal outcomes in patients with protein S deficiency.
Related JoVE Video
What are the latest pharmacotherapy options for small bowel adenocarcinoma?
Expert Opin Pharmacother
PUBLISHED: 03-04-2014
Show Abstract
Hide Abstract
Incidence of small bowel adenocarcinoma is slowly but steadily increasing. As we gain more knowledge of the molecular basis of this disease, we may be able to approach it via using novel biologic or targeted therapies with or without traditional chemotherapy agents. In the meantime, early diagnosis is still best as it prompts early surgical resection and offers potential cure. The role of adjuvant and neoadjuvant therapy is currently being explored in clinical trials. Several clinical trials have suggested that first-line chemotherapy for patients with metastatic disease should consist of either 5-fluorouracil-leucovorin-oxalipatin or capecitabine-oxaliplatin, while 5-fluorouracil-leucovorin-irinotecan can be reserved for second-line treatment. However, we realize the limitations of these studies, given their small sample size and/or retrospective nature. Single-agent 5-fluorouracil/capecitabine should be considered in patients who are either intolerant to or experience significant side effects with oxaliplatin or irinotecan. We believe that cancers originating in the ampulla of Vater probably deserve a prospective randomized trial of cisplatin-gemcitabine, the current standard of therapy for advanced biliary malignancies.
Related JoVE Video
Updates on immunotherapy in non-small cell lung cancer.
Expert Opin Biol Ther
PUBLISHED: 02-10-2014
Show Abstract
Hide Abstract
Immunotherapy has made significant progress in patients with non-small cell lung cancer (NSCLC) in the last years. Early tumor vaccine studies showed trends toward better clinical outcomes, and larger trial results are currently being awaited. Immune checkpoint inhibitors are promising therapeutic agents in advanced NSCLC. While ipilimumab, a cytotoxic T-lymphocyte antigen 4 inhibitor, has clearly improved outcomes in metastatic malignant melanoma, its safety and efficacy in NSCLC are not yet known. Programmed death-1 (PD-1) and PD-1 ligand inhibitors such as nivolumab, MK3475 and MPDL3280 have demonstrated clinical efficacy in patients with advanced/metastatic NSCLC in early clinical trials. Their validation in larger Phase III trials is anxiously being awaited. Furthermore, exploring efficacy of these molecules in patients with early stages of lung cancer is also necessary.
Related JoVE Video
Second primary pancreatic adenocarcinoma three years after successfully treated index esophageal cancer.
JOP
PUBLISHED: 01-14-2014
Show Abstract
Hide Abstract
Development of a second primary malignancy after an index esophageal cancer is a rare event, primarily due to short survival of patients with esophageal cancer. However, the number of long-term esophageal cancer survivors has been increasing due to advances in early detection and therapy.
Related JoVE Video
Hematology consult: high-sensitivity warfarin genotype.
Conn Med
PUBLISHED: 12-26-2013
Show Abstract
Hide Abstract
Warfarin sensitivity genotyping should be considered in patients who require multiple dosing adjustments to maintain a therapeutic international normalized ratio (INR)--patients with a history of bleeding/thrombosis when taking warfarin or patients who are being started on warfarin therapy for the first time. Studies showed that individuals with genetic variants require a longer time to achieve stable dosing, have more INR measurements that are above therapeutic range, and experience more frequent bleeding events than individuals with normal genotypes. This information prompted development of dosing algorithms based on genotypes in an attempt to more accurately predict warfarin dose and avoid such complications. We report herein a patient with an exaggerated response to warfarin, who was subsequently diagnosed with a high-sensitivitywarfarin genotype. Genetic testing for warfarin sensitivity polymorphisms is currently available, and may decrease event rates for bleeding and/orthromboembolismwhen used to guide dosing. Notwithstanding, randomized controlled trials are awaited to determine the true impact of this testing on clinical outcomes and its cost-effectiveness.
Related JoVE Video
Aleukemic leukemia presenting with paranoid psychosis.
Conn Med
PUBLISHED: 11-26-2013
Show Abstract
Hide Abstract
Mast cells not only synthesize and release serotonin, but also express and are activated through multiple serotonin receptors. Low blood serotonin level might define a specific subset of patients with systemic mastocytosis (SM) who are more likely to present with neurologic and gastrointestinal complaints. Mast cell leukemia (MCL) is a rare and aggressive type of systemic mastocytosis, and psychiatric manifestations in its course have not been well-characterized. We describe herein a unique patient with a KIT D816V mutation positive a leukemic leukemia variant of systemic mastocytosis with gastrointestinal involvement, presenting with a severe and sustained paranoid delusional illness. While diarrhea improved with the use of histamine H1 and H2 receptor antagonists, the psychosis did not, and the disease followed a dramatic course with a rapidly fatal outcome. As there is paucity of literature, diagnosis of MCL presenting with psychiatric symptoms remains a diagnostic challenge and warrants clinicians to be alert of this rare possibility.
Related JoVE Video
Gastrointestinal stromal tumor of small intestine and synchronous bilateral papillary renal cell carcinoma.
Conn Med
PUBLISHED: 11-08-2013
Show Abstract
Hide Abstract
Association of gastrointestinal stromal tumors (GISTs) with other primary malignant neoplasms has previously been reported. In addition, coexistence of unilateral renal cell cancer and a GIST of the stomach has been documented in the literature. We report herein a unique case of a GIST of the small intestine and bilateral papillary renal cell carcinomas in a patient presenting with melena and dizziness. Literature shows that GIST arising from the small intestine is the most common location of GIST accompanied by a second primary neoplasm. However, a unique feature in our GIST patient is the presence of synchronous (bilateral) papillary renal cell carcinomas.
Related JoVE Video
Mediastinal choriocarcinoma presenting with syncope.
Conn Med
PUBLISHED: 10-26-2013
Show Abstract
Hide Abstract
Mediastinal choriocarcinomas are rare germ-cell tumors that occur almost exclusively in young males. These tumors grow rapidly, causing compression of mediastinal structures, and are usually associated with a poor prognosis. We report herein a unique case documenting syncope as initial clinical presentation of a mediastinal choriocarcinoma causing a superior vena cava (SVC) syndrome. The patient was treated with a standard chemotherapy triplet, with normalization of the tumor markers after the first chemotherapy cycle. He remains with no evidence of disease relapse 18 months later. Clinicians should consider the diagnosis of a mediastinal germ-cell tumor in a younger male patient presenting with a syncopal episode.
Related JoVE Video
A curious case of oxaliplatin-induced neurotoxicity: Recurrent, self-limiting dysarthria.
J Oncol Pharm Pract
PUBLISHED: 10-08-2013
Show Abstract
Hide Abstract
This report presents a unique case of oxaliplatin-induced neurotoxicity featuring acute, recurrent, self-limiting dysarthria following multiple subsequent infusions of oxaliplatin. A 65-year-old man started chemotherapy for metastatic pancreatic adenocarcinoma with oxaliplatin-irinotecan-leucovorin-5-fluorouracil (FOLFIRINOX). During the first and subsequent infusions of oxaliplatin, the patient developed episodes of dysarthria that lasted between 2 and 4?h after oxaliplatin infusions, followed by their complete and uneventful resolution. A thorough neurological examination showed no new neurologic deficits except for very fine tongue fasciculations. Recognizing this self-limiting toxic effect of oxaliplatin is important in order to avoid dose reductions that may affect clinical outcomes.
Related JoVE Video
Immune alterations in malignant melanoma and current immunotherapy concepts.
Expert Opin Biol Ther
PUBLISHED: 08-10-2013
Show Abstract
Hide Abstract
Malignant melanoma is a highly aggressive, immunogenic tumor that has the ability to modulate the immune system to its own advantage. Patients with melanoma present numerous cellular immune defects and cytokine abnormalities, all leading to suppression of the host anti-tumor immune response. Innovative treatment strategies can be achieved through employing our knowledge of the melanoma-induced immune alterations.
Related JoVE Video
Smoking-induced monoclonal B-lymphocytosis in two female smokers: what are the odds?
Conn Med
PUBLISHED: 08-08-2013
Show Abstract
Hide Abstract
Persistentpolyclonal B-cell lympho-cytosis (PPBL) is awell-known entity, characterized by a persistent lymphocytosis with circulating atypical lymphocytes. Affecting mainly younger females, this condition has been linked with chronic tobacco use. Reports have shown atypical lymphocytes in smoking-related B-lymphocytosis to display some genetic and molecular features normally seen only in hematologic malignancies. In addition, a large study has associated chronic lymphocytic leukemia (CLL) with chronic smoking. We describe herein two unique patients with chronic smoking history, persistent neutrophilia and incidentally discovered monoclonal B-lymphocytosis (MBL). The MBL inthe firstpatient was preceded by a PPBL. Clinical scenarios in our patients suggest that the MBL might have been caused by chronic cigarette smoking. We further postulate that tobacco-induced B-lymphocytic proliferation may become neoplastic.
Related JoVE Video
Incidence of second primary malignancies in patients with esophageal cancer: a comprehensive review.
Curr Med Res Opin
PUBLISHED: 07-09-2013
Show Abstract
Hide Abstract
Development of a second primary malignancy (SPM) after an index esophageal cancer is fairly rare, primarily due to decreased survival in patients with esophageal cancer. However, with advances in early detection and therapy, the number of long-term survivors is increasing, as is the incidence of SPMs in this population.
Related JoVE Video
Malignant melanoma in pigmented skin: does the current interventional model fit a different clinical, histologic, and molecular entity?
Dermatol Surg
PUBLISHED: 06-24-2013
Show Abstract
Hide Abstract
Although the incidence of malignant melanoma in African Americans is considerably lower than in Caucasians, African Americans have a less-favorable prognosis related to later presentation and more deeply invasive lesions at diagnosis.
Related JoVE Video
Immune alterations and immunotherapy prospects in head and neck cancer.
Expert Opin Biol Ther
PUBLISHED: 06-24-2013
Show Abstract
Hide Abstract
Several literature sources have suggested that subjects with head and neck squamous cell carcinoma (HNSCC) display significant abnormalities of immunocompetent cells and cytokine secretion. Serious side effects and only a limited success with traditional therapies in HNSCC dictate the need for newer therapies.
Related JoVE Video
Management of advanced and/or metastatic carcinoid tumors: historical perspectives and emerging therapies.
Expert Opin Pharmacother
PUBLISHED: 06-08-2013
Show Abstract
Hide Abstract
Carcinoid tumors are uncommon neoplasms that offer unique therapeutic challenges to practicing physicians. Several chemotherapy combinations and IFN-? have been used for the treatment of unresectable carcinoid tumors over the last decades, but they have shown variable clinical results. Given the heterogeneity of these tumors, there is no clear therapeutic agent or combination that confers a significant advantage over others.
Related JoVE Video
Methotrexate therapy leading to a rapid progression of a previously indolent prostate cancer: Is immunosuppression to blame?
J Oncol Pharm Pract
PUBLISHED: 05-15-2013
Show Abstract
Hide Abstract
Methotrexate therapy has been associated with occurrence and/or accelerated progression of malignancies. We describe a patient who developed widespread bone metastases of a previously confined to the prostate gland prostate cancer shortly after starting methotrexate therapy for rheumatoid arthritis and large granular lymphocyte leukemia. We believe an immunosuppressive milieu brought on by the methotrexate use in this case is responsible for the rapid progression of prostate cancer leading to the patients demise. To the best of our knowledge, no association has been made to date between the therapy with methotrexate and a fulminant course of a previously indolent prostate cancer. Given its utilization in a variety of benign and malignant conditions and the ageing population, caution is advised with the use of this agent, especially in the presence of an underlying malignancy.
Related JoVE Video
Vitamin B12 deficiency in patients undergoing bariatric surgery: Preventive strategies and key recommendations.
Surg Obes Relat Dis
PUBLISHED: 04-18-2013
Show Abstract
Hide Abstract
Advances in bariatric surgery have brought about a paradigm shift in the management of obesity, with benefits extending beyond weight loss. However, nutritional deficiencies are an inherent problem in the postoperative period and often require lifelong supplementation. Vitamin B12, also referred to as cobalamin, is one of the most common micronutrient deficiencies affecting this population. This review explores the pathophysiology of cobalamin deficiency in patients undergoing bariatric surgery and provides an overview of the effectiveness of various available vitamin B12 formulations.
Related JoVE Video
Primary respiratory failure due to inclusion body myositis: think outside the box.
Conn Med
PUBLISHED: 04-18-2013
Show Abstract
Hide Abstract
Inclusion body myositis features a slowly progressive inflammatory myopathy characterized by progressive proximal muscle weakness in the lower extremities, followed by proximal, upper-extremity weakness and later involvement of distal muscles groups. Although the most severely affected muscles are those of the limbs, the disease can also involve the respiratory, cardiovascular and gastrointestinal system muscles as well. We describe a unique patient who presented with acute hypercapnic hypoxic respiratory failure secondary to inclusion body myositis. Our patient required mechanical ventilation but responded to corticosteroid therapy. The diagnosis was delayed in part because of the slowly progressive course of the disease and the fact that an extensive investigation had not disclosed a cause. We postulate that muscle biopsy may be warranted in select patients suffering from a protracted muscle weakness.
Related JoVE Video
Intrinsic immune alterations in renal cell carcinoma and emerging immunotherapeutic approaches.
Expert Opin Biol Ther
PUBLISHED: 04-16-2013
Show Abstract
Hide Abstract
Individuals affected by kidney cancer present a variety of immune abnormalities including cellular immune dysfunction, cytokine alterations and antigen presentation defects. On the other hand, spontaneous remissions are seen in up to 4% of renal cell carcinoma (RCC) patients and they are thought to occur via immune mechanisms.
Related JoVE Video
Collision tumors: pancreatic adenocarcinoma and mantle cell lymphoma.
JOP
PUBLISHED: 04-14-2013
Show Abstract
Hide Abstract
Collision tumors are very rare entities composed of two or more distinct tumor components, each separated by normal tissue. Perhaps due to technical advances in the last decade, the incidence of collision tumors has been on the rise. To the best of our knowledge, collision tumors featuring mantle cell lymphoma and pancreatic adenocarcinoma have not been previously described in the scientific literature.
Related JoVE Video
Normal values of regional and global myocardial wall motion in young and elderly individuals using navigator gated tissue phase mapping.
Age (Dordr)
PUBLISHED: 04-05-2013
Show Abstract
Hide Abstract
The purpose of this study was to evaluate normal values for regional and global myocardial wall motion parameters in young and elderly individuals, as detected by navigator gated high temporal resolution tissue phase mapping. Radial, longitudinal and circumferential ventricular wall motion, as well as ventricular torsion and longitudinal strain rates, were assessed in two age groups of volunteers, 23?±?3 (n?=?14) and 66?±?7 years old (n?=?9), respectively. All subjects were healthy, non-smokers without known cardiac disease. An increased global left ventricular (LV) torsion rate (peak systolic torsion rate 20.6?±?2.0 versus 14.5?±?1.0°/s/cm, peak diastolic torsion rate -25.2?±?1.8 versus -14.1?±?1.3°/s/cm) and a decrease in longitudinal LV motion (peak systolic values at mid-ventricle 5.9?±?0.5 versus 8.5?±?0.8 cm/s, peak diastolic values -10.7?±?0.7 versus -15.2?±?0.9 cm/s) in the older age group were the most prominent findings. Lower peak diastolic radial velocities with a longer time-to-peak values, most pronounced at the apex, are consistent with reduced diastolic function with ageing. Lower peak clockwise and counter-clockwise velocities at all LV levels revealed limitations in resting LV rotational motions in the older group. Significant changes in the undulating pattern of the rotational motions of the left ventricle were also observed. The results demonstrate distinct changes in regional and global myocardial wall motion in elderly individuals. Increased LV torsion rate and reduced LV longitudinal motion were particularly prominent in the older group. These parameters may have a role in the assessment of global LV contractility and help differentiate age-related changes from cardiac disease.
Related JoVE Video
Adult biphasic pulmonary blastoma.
Conn Med
PUBLISHED: 02-23-2013
Show Abstract
Hide Abstract
Pulmonary blastoma is a rare malignant tumor, histologically resembling the fetal lung. Since its first description in 1945, only about 200 cases have been reported worldwide. This tumor predominantly affects children, but has also been reported in adults with a peak incidence in the fourth decade of life. Pulmonary blastoma has a variable clinical course that cannot be determined by its histological appearance. We report a 51-year-old patient with a large biphasic pulmonary blastoma who was treated with surgical excision. The patient remains disease-free eleven months postoperatively. As relapse rates are high in patients with large biphasic (type 2) tumors, the patient is being monitored closely. Although a rare occurrence after the age of 20, pulmonary blastoma should remain in the differential diagnosis of a lung mass in an adult.
Related JoVE Video
Newer developments in the immunotherapy of malignant melanoma.
J Oncol Pharm Pract
PUBLISHED: 02-22-2013
Show Abstract
Hide Abstract
Individuals with malignant melanoma present a variety of immune abnormalities including but not limited to cellular immune dysfunction, antigen presentation deficits, and cytokine production defects. Therefore, enhancing the immune system potential represents an appealing avenue for melanoma therapy. The authors review the immune therapies currently in clinical use as well as the most promising immunotherapy candidates. Ipilimumab, a monoclonal antibody against the CTLA-4, was approved for the therapy of advanced melanoma in 2011. In addition, sizeable anti-melanoma activity has recently been shown with the use of other agents including anti-PD-1/anti-PD-1 ligand antibodies. Consequently, these experimental immunotherapy agents may soon become important items in the anti-melanoma armamentarium.
Related JoVE Video
Pralatrexate : evaluation of clinical efficacy and toxicity in T-cell lymphoma.
Expert Opin Pharmacother
PUBLISHED: 02-14-2013
Show Abstract
Hide Abstract
Pralatrexate is a novel antifolate agent that belongs to the class of 10-deazaaminopterins. Its clinical efficacy as a single agent in relapsed or refractory peripheral T-cell lymphoma (PTCL) has been established in randomized trials. Treatment with this agent is generally safe.
Related JoVE Video
Hepatoid variant of pancreatic cancer: insights from a case and literature review.
JOP
PUBLISHED: 02-13-2013
Show Abstract
Hide Abstract
"Hepatoid" cancer refers to an extrahepatic neoplasm with hepatocellular differentiation. The stomach is the most common site and pancreatic origin is distinctly uncommon.
Related JoVE Video
An unusual presentation of a carcinoid tumor of the common bile duct.
JOP
PUBLISHED: 01-12-2013
Show Abstract
Hide Abstract
Carcinoid tumors arising from the bile ducts account for only a small fraction of biliary tract cancers.
Related JoVE Video
Muehrckes lines (Leukonychia striata) due to transretinoic acid therapy for acute promyelocytic leukemia.
J Oncol Pharm Pract
PUBLISHED: 01-04-2013
Show Abstract
Hide Abstract
Transverse leukonychia (Leukonychia striata or Muehrckes lines) has been described with the use of several drugs in oncology, mainly chemotherapeutic agents. This condition is thought to represent an abnormality of the vascular nail bed. As the diagnosis is clinical and the condition is self-limited, referral to other specialists is usually not required. We report the first case of transverse leukonychia related to the use of transretinoic acid for acute promyelocytic leukemia. Physician awareness of transverse leukonychia is important in order to reassure the patients and avoid unnecessary (and often not inexpensive) diagnostic work-up.
Related JoVE Video
Hodgkin lymphoma as Richter transformation in chronic lymphocytic leukaemia: a retrospective analysis of world literature.
Br. J. Haematol.
PUBLISHED: 10-24-2011
Show Abstract
Hide Abstract
Richter transformation in chronic lymphocytic leukaemia (CLL) represents an entity of considerable genetic, molecular, immunological and clinical heterogeneity. A rare occurrence, Hodgkin variant of Richter syndrome, has not been comprehensively characterized or systematized to date. We conducted a retrospective analysis of the existing cases of Hodgkin lymphoma as Richter syndrome reported in the medical literature in the previous three and a half decades. Our search identified 86 such patients; this entity affects predominantly older men and the most common histological subtype is mixed cellularity. Interval between the diagnosis of CLL and subsequent development of Hodgkin lymphoma is circa 4.3 years. The overall survival of patients was approximately 1.7 years in our analysed cohort. However, our pooled data showed that patients in whom CLL had been treated with fludarabine had a shorter survival after transformation compared to the ones not treated with this agent. The role of immunosuppression and Epstein-Barr virus infection in the aetiopathogenesis of this entity remains to be clarified.
Related JoVE Video
Targeting the HER2 pathway for the therapy of lower esophageal and gastric adenocarcinoma.
Expert Opin Pharmacother
PUBLISHED: 10-04-2011
Show Abstract
Hide Abstract
The mysteries of complex molecular pathways of tumorigenesis are only beginning to be unraveled. Overexpression of HER2 receptors has been associated with adverse outcomes in certain malignant solid tumors.
Related JoVE Video
Refractory DKA as first presentation of acromegaly and a potential role for continuous venovenous hemofiltration in its successful management.
Conn Med
PUBLISHED: 09-13-2011
Show Abstract
Hide Abstract
Diabetic ketoacidosis is rarely encountered in acromegaly. We present a unique patient with refractory diabetic ketoacidosis (DKA) as a first presentation of acromegaly. In addition to an insulin drip and intravenous fluids, our patient was managed with octreotide therapy. As he developed acute renal failure in the context of renal hypoperfusion, continuous venovenous hemofiltration (CVVH) was instituted. After only three days of therapy, the growth hormone (GH) level dropped circa fourfold and insulin growth factor 1 (IGF-1) level dropped ninefold. We postulate a hypothetical role of CVVH in removal of plasma GH and IGF-1, similar to the clearance of other medium size molecules such as brain natriuretic peptide and procalcitonin. If this is confirmed in future studies, CVVH may have therapeutic implications for the above category of patients.
Related JoVE Video
Immune alterations in untreated and treated multiple myeloma.
J Oncol Pharm Pract
PUBLISHED: 08-22-2011
Show Abstract
Hide Abstract
The incidence of second malignancies was shown to be increased in patients with multiple myeloma. Although a shared genetic predisposition or common environmental carcinogens may account for the occurrence of both myeloma and additional cancers, multiple immune defects encountered in myeloma might play an important role in this regard. This review explores the impairments in both cellular and humoral mediated immunity in multiple myeloma, linking them with increased susceptibility to infections and additional cancers. In addition, the recent therapeutic advances transformed myeloma into a chronic entity, with multiple relapses and salvage therapies, which may result in cumulative immunosuppression. Although recent reports have suggested an increased rate of second cancers in myeloma patients treated with lenalidomide, the true impact of this agent and other novel anti-myeloma therapies on the incidence of additional malignancies remains to be clarified.
Related JoVE Video
Details of left ventricular remodeling and the mechanism of paradoxical ventricular septal motion after coronary artery bypass graft surgery.
J Invasive Cardiol
PUBLISHED: 07-05-2011
Show Abstract
Hide Abstract
The purpose of this study was to obtain new details of three-dimensional left ventricular wall motion related to ventricular remodeling in patients undergoing coronary artery bypass graft (CABG) surgery.
Related JoVE Video
Isolated thrombocytopenia: should we routinely screen for antiphospholipid antibodies?
Conn Med
PUBLISHED: 06-18-2011
Show Abstract
Hide Abstract
Antiphospholipid (aPL) antibodies are thought to be present in at least 25% of immune thrombocytopenia patients. Conversely, more than 25% of patients with aPL antibody syndrome (APLAS) present with thrombocytopenia.
Related JoVE Video
Autoimmune phenomena in untreated and treated marginal zone lymphoma.
Expert Opin Pharmacother
PUBLISHED: 06-17-2011
Show Abstract
Hide Abstract
Current literature suggests an association between various autoimmune conditions and marginal zone lymphoma (MZL). However, these autoimmune conditions have not been comprehensively systematized to date. As a result, their clinical implications remain largely unknown.
Related JoVE Video
Chasing the reflected wave back into the heart: a new hypothesis while the jury is still out.
Vasc Health Risk Manag
PUBLISHED: 06-07-2011
Show Abstract
Hide Abstract
Arterial stiffness directly influences cardiac function and is independently associated with cardiovascular risk. However, the influence of the aortic reflected pulse pressure wave on left ventricular function has not been well characterized. The aim of this study was to obtain detailed information on regional ventricular wall motion patterns corresponding to the propagation of the reflected aortic wave on ventricular segments.
Related JoVE Video
Emerging pharmacotherapeutic strategies for cholangiocarcinoma.
Expert Opin Pharmacother
PUBLISHED: 05-17-2011
Show Abstract
Hide Abstract
Although of limited clinical benefit, chemotherapy represents the cornerstone of management for patients with inoperable cholangiocarcinoma. The literature on chemotherapy in advanced cholangiocarcinoma is difficult to interpret because of the heterogeneity of cholangiocarcinoma, the use of various chemotherapeutic agents in different combinations and dosing regimens, and the small size of existing patient cohorts.
Related JoVE Video
Newer developments in adult T-cell leukemia/lymphoma therapeutics.
Expert Opin Pharmacother
PUBLISHED: 04-12-2011
Show Abstract
Hide Abstract
Adult T-cell leukemia/lymphoma (ATL) is a rare disease with a unique geographic distribution. Conducting controlled randomized trials to assess the effective therapeutic strategies has therefore been a significant challenge to date.
Related JoVE Video
Immune alterations in untreated and treated myelodysplastic syndrome.
Expert Opin Drug Saf
PUBLISHED: 03-21-2011
Show Abstract
Hide Abstract
Current literature suggests a variety of immune abnormalities are present in myelodysplastic syndrome (MDS) patients. However, they have not been comprehensively characterized or systematized to date. As a result, their clinical implications remain largely unknown. In addition, an increased incidence of various autoimmune conditions has been documented in MDS patients.
Related JoVE Video
Intravenous ascorbic acid to prevent and treat cancer-associated sepsis?
J Transl Med
PUBLISHED: 03-04-2011
Show Abstract
Hide Abstract
The history of ascorbic acid (AA) and cancer has been marked with controversy. Clinical studies evaluating AA in cancer outcome continue to the present day. However, the wealth of data suggesting that AA may be highly beneficial in addressing cancer-associated inflammation, particularly progression to systemic inflammatory response syndrome (SIRS) and multi organ failure (MOF), has been largely overlooked. Patients with advanced cancer are generally deficient in AA. Once these patients develop septic symptoms, a further decrease in ascorbic acid levels occurs. Given the known role of ascorbate in: a) maintaining endothelial and suppression of inflammatory markers; b) protection from sepsis in animal models; and c) direct antineoplastic effects, we propose the use of ascorbate as an adjuvant to existing modalities in the treatment and prevention of cancer-associated sepsis.
Related JoVE Video
Polycystic ovary syndrome: focus on platelets and prothrombotic risk.
South. Med. J.
PUBLISHED: 02-08-2011
Show Abstract
Hide Abstract
Subjects with polycystic ovary syndrome (PCOS) were shown to carry an increased long-term cardiovascular risk. Systemic inflammation and reactive leukocytosis have also been described in PCOS. Recent research suggests the presence of an increased thrombotic risk in these patients.
Related JoVE Video
On the missing link between inflammation and cancer.
Dermatol. Online J.
PUBLISHED: 01-29-2011
Show Abstract
Hide Abstract
A various array of cutaneous granulomatous disorders have been found to be associated with internal malignancy. Among them, sarcoidosis, granuloma anulare (GA), psoriasis, pyoderma gangrenosum (PG), or other neutrophilic dermatoses such as the Sweet syndrome and subcorneal pustular dermatosis may precede the development of a neoplastic process by months or years. Pathogenic links of inflammation with cancer are discussed, including inflammation, intrinsic immune dysfunction, cytokines and interleukins, angiogenetic factors, and epigenetic changes.
Related JoVE Video
Cutaneous sarcoidosis and malignancy: An association between sarcoidosis with skin manifestations and systemic neoplasia.
Dermatol. Online J.
PUBLISHED: 01-29-2011
Show Abstract
Hide Abstract
Whereas the association between multisystem and pulmonary sarcoidosis and malignancy has been documented, a relationship between cutaneous sarcoidosis and neoplasia has not yet been reported. Because cutaneous manifestations are seen in 20-25 percent of cases of sarcoidosis, this association deserves further investigation.
Related JoVE Video
Newer developments in the therapeutics of the transitional cell carcinoma of renal pelvis.
J Oncol Pharm Pract
PUBLISHED: 01-19-2011
Show Abstract
Hide Abstract
Many of the risk factors and pathogenesis of urothelial carcinoma of the renal pelvis are similar to the ones of the more common urothelial bladder cancer. In addition, two endemic nephropathies and two inherited syndromes have been linked with the development of upper urologic cancer. Multiple synchronous or metachronous lesions throughout urinary tract are rather common and should always be sought in the management of this entity. Surgical resection is the treatment of choice in early-stage tumors. The role of adjuvant radiation and chemoradiation for carcinoma of the renal pelvis remains to be redefined, given the advent of conformal approaches and intensity modulation. In non-surgical candidates, chemotherapy remains the mainstay. Metastatic urothelial renal pelvic cancer is usually treated with combination platinum-based chemotherapy. Definitive radiation therapy should be considered in persons with locally advanced/unresectable disease, multiple comorbidities, and/or severely compromised performance status. Recently, the antifolate agent pemetrexed has demonstrated an overall response rate of circa 30% in urothelial carcinoma. New targeted agents, alone or in combination with cytotoxic drugs, are currently being tested in clinical trials and may lead to new and exciting avenues for the therapy of this disease.
Related JoVE Video
Targeting macrophages in classical Hodgkins lymphoma may seem rational, but is it safe?
J Oncol Pharm Pract
PUBLISHED: 01-19-2011
Show Abstract
Hide Abstract
A few reports have linked increased numbers of tissue macrophages with treatment failure and reduced lifespan in classical Hodgkins lymphoma (HL) patients. Some investigators even suggested to target the macrophages in HL with biologic therapy, thus eliminating them from the tumor microenvironment. This review explores the risk: benefit equation of such approach as well as what the author believes is the driving force behind the great migration of macrophages in HL. This article unravels the inflammatory pathways and immune alterations in classical HL that lead to a complex network consisting of T-cells, numerous cytokines, macrophages, and other cells. Macrophages are thought to play a crucial role in tumor antigen processing and presentation tasks, Reed-Sternberg (RS) cell phagocytosis, and antibody-dependent cellular cytotoxicity, therefore their extinction may be hazardous. The author believes RS cells should be targeted by the biologics, not the macrophages, and links his hopes with the existing investigational anti-CD30 therapies in relapsed/refractory classical HL.
Related JoVE Video
Association between Helicobacter pylori infection and pancreatic cancer. A cumulative meta-analysis.
JOP
PUBLISHED: 01-06-2011
Show Abstract
Hide Abstract
Infection with Helicobacter pylori (H. pylori) has been implicated in the etiopathogenesis of various malignant conditions. Notwithstanding, its etiological association with pancreatic cancer remains inconclusive. Studies focusing on the relationship between H. pylori infection and pancreatic cancer risk have yielded conflicting results.
Related JoVE Video
Alpha-thalassemia genetic testing: an important anemia diagnostic tool in patients of African heritage.
Conn Med
PUBLISHED: 12-31-2010
Show Abstract
Hide Abstract
Inherited alpha-thalassemia genotypes have been shown to have a rather high prevalence in some patient populations of African heritage. These genotypes lead to mild anemia with microcytic indices and a normal hemoglobin electrophoresis. In our outpatient department, we analyzed 54 consecutive patients of African descent with longstanding microcytic anemia, but no evidence of iron deficiency. We detected alpha-thalassemia gene deletions in 94 percent of these patients. Alpha-thalassemia genetic testing appears cost-effective in an otherwise unexplained, longstanding microcytic anemia in patients of African origin.
Related JoVE Video
Congenital combined deficiency of coagulation factors VII and II in a young adult.
Conn Med
PUBLISHED: 12-31-2010
Show Abstract
Hide Abstract
We present herein a case of a young female with congenital combined coagulation factor VII (FVII) and factor II (FII) deficiencies. She was completely asymptomatic and found to have a prolonged prothrombin time during a routine preoperative evaluation. Low levels of plasma FVII and FII in the absence of an inhibitor confirmed the diagnosis in our patient. Congenital combined FVII and FIX deficiency as well as combined FVII and FX deficiency have been previously reported. The congenital combined deficiency of FVII and FII in our patient is exceptional and represents the first such instance in the English literature. Furthermore, we hypothesize that she had not shown any bleeding manifestations because of possible compensation for the missing factors II and VII by enhanced activity of some intrinsic coagulation pathway components or depression of fibrinolysis.
Related JoVE Video
Squamous cell lung cancer presenting with pulmonary lymphangitic carcinomatosis.
J Ark Med Soc
PUBLISHED: 12-27-2010
Show Abstract
Hide Abstract
Pulmonary lymphangitic carcinomatosis (PLC) refers to the infiltration of lung lymphatic channels with metastatic carcinoma and is associated with a dismal prognosis. PLC accompanies circa 7% of all pulmonary metastases and is most commonly caused by various metastatic adenocarcinomas. Only two cases of PLC due to squamous cell lung carcinoma have been reported to date in the English literature. We report herein a unique case of squamous cell lung carcinoma with lymphangitic spread, displaying bilateral and diffuse bronchial tree involvement that might have been a result of invasion from the pulmonary lymphatics into the bronchial lumen.
Related JoVE Video
Tumor fever, paraneoplastic leukocytosis and necrotic liver metastases: a triad worth remembering.
Conn Med
PUBLISHED: 09-02-2010
Show Abstract
Hide Abstract
Arriving at the diagnosis of tumor fever may prove difficult for the clinician and should always be based upon investigations that exclude other potential causes of fever. Timely recognition of this entity is essential for the effective delivery of care to cancer patients. In solid malignancies, tumor fever is commonly associated with rapidly progressive metastatic disease and a limited survival. Liver metastases are present in many of these patients and some of them may display significant systemic inflammation. We report two unique patients with adenocarcinoma of the lung associated with tumor fever, necrotic liver metastases and granulocyte-colony stimulating factor (G-CSF) driven leukocytosis.
Related JoVE Video
Adenosquamous carcinoma of the pancreas: a distinct clinicopathologic entity.
South. Med. J.
PUBLISHED: 08-11-2010
Show Abstract
Hide Abstract
Among exocrine pancreatic tumors, adenosquamous carcinoma (ASC) is a rare, aggressive subtype with a worse prognosis and a higher potential for metastases compared to its more conventional glandular counterpart, adenocarcinoma. The disease distribution shows an approximately 1:1 male/female ratio and a median survival of circa five months. Although such features as central necrosis and hypervascularity are suggestive of pancreatic ASC, more research is necessary to identify other, more specific markers for this tumor subtype. Humoral hypercalcemia of malignancy has also been described with ASC of the pancreas, likely as a result of PTHrP production by the squamous component of the tumor. Similar to the therapeutics of pancreatic adenocarcinoma, adjuvant chemotherapy or chemoradiotherapy is currently indicated for resectable ASC of the pancreas, while gemcitabine or gemcitabine combinations are used for a more advanced disease. Both pathologic and molecular features of pancreatic ASC characterize it as a distinct subtype of pancreatic cancer. As a result, its molecular and genetic makeup could be exploited for both diagnostic and therapeutic quests in the future.
Related JoVE Video
Small cell lung cancer with paraneoplastic lipase production.
South. Med. J.
PUBLISHED: 07-13-2010
Show Abstract
Hide Abstract
Kulchitsky cells represent the cells of origin of small cell lung cancer (SCLC). They display an antigenic makeup characteristic of both the neural crest and epithelium and have been shown to secrete both polypeptide hormones and enzymes. The coexistence of two or more (concomitant or sequential) paraneoplastic endocrine syndromes is possible with SCLC, and paraneoplastic amylase production has also been described with this malignancy. We present here the first patient with an extensive stage SCLC, exhibiting a marked paraneoplastic lipase production and a syndrome of inappropriate antidiuretic hormone (SIADH) secretion. In our patient, the paraneoplastic hyperlipasemia paralleled both the initial SCLC response to chemotherapy and its subsequent clinicoradiological relapse.
Related JoVE Video
Bortezomib: friend or foe of hemolytic anemia?
J Oncol Pharm Pract
PUBLISHED: 06-18-2010
Show Abstract
Hide Abstract
Over the last decade, bortezomib moved in a stepwise fashion from a benchside promise into a bedside reality and is currently an important tool in the treatment of plasma cell disorders. This review focuses on the relationship between bortezomib and hemolytic anemia. In animal models with lupus-like disease, this agent was shown to deplete the auto-reactive plasma cells and serum autoantibody levels. In humans, two isolated reports advocate the efficacy of bortezomib in autoimmune hemolytic anemia, but important concerns remain with data interpretation and length bias. Conversely, bortezomib may be causative of hemolytic anemia, as reported in a cohort of patients with chronic lymphocytic leukemia [corrected]. Concerted efforts of both basic and clinical researchers are necessary to further explore the safety and efficacy of this agent in nonmalignant disorders, including autoimmune disorders and anemias.
Related JoVE Video
Immunotherapy for melanoma: current status and perspectives.
J. Immunother.
PUBLISHED: 06-17-2010
Show Abstract
Hide Abstract
Immunotherapy is an important modality in the therapy of patients with malignant melanoma. As our knowledge about this disease continues to expand, so does the immunotherapeutic armamentarium. Nevertheless, successful preclinical models do not always translate into clinically meaningful results. The authors give a comprehensive analysis of most recent advances in the immune anti-melanoma therapy, including interleukins, interferons, other cytokines, adoptive immunotherapy, biochemotherapy, as well as the use of different vaccines. We also present the fundamental concepts behind various immune enhancement strategies, passive immunotherapy, as well as the use of immune adjuvants. This review brings into discussion the results of newer and older clinical trials, as well as potential limitations and drawbacks seen with the utilization of various immune therapies in malignant melanoma. Development of novel therapeutic approaches, along with optimization of existing therapies, continues to hold a great promise in the field of melanoma therapy research. Use of anti-CTLA4 and anti-PD1 antibodies, realization of the importance of co-stimulatory signals, which translated into the use of agonist CD40 monoclonal antibodies, as well as activation of innate immunity through enhanced expression of co-stimulatory molecules on the surface of dendritic cells by TLR agonists are only a few items on the list of recent advances in the treatment of melanoma. The need to engineer better immune interactions and to boost positive feedback loops appear crucial for the future of melanoma therapy, which ultimately resides in our understanding of the complexity of immune responses in this disease.
Related JoVE Video
Diffuse large B-cell lymphoma with lung involvement in a psoriatic arthritis patient treated with methotrexate.
Dermatol. Online J.
PUBLISHED: 05-25-2010
Show Abstract
Hide Abstract
Non-Hodgkin lymphoma (NHL) occurs in the setting of methotrexate (MTX) therapy for rheumatoid arthritis. However, it has been very rarely reported in subjects with psoriatic arthritis treated with MTX. We report here a case of a 70-year-old woman with psoriatic arthritis who presented with bilateral lung infiltrates, pleural effusion, splenomegaly, and inguinal lymphadenopathy during treatment with MTX. The diagnosis of diffuse large B-cell lymphoma was made by analysis of the pleural fluid via thoracentesis and biopsy of an enlarged inguinal lymph node. Clinicians should consider the possibility of a NHL complicating psoriasis and with MTX therapy in order to prevent treatment delays.
Related JoVE Video

What is Visualize?

JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

How does it work?

We use abstracts found on PubMed and match them to JoVE videos to create a list of 10 to 30 related methods videos.

Video X seems to be unrelated to Abstract Y...

In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.