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  1. Article ; Online: Vitamin D: a cardioprotective agent?

    Liss, Yaakov / Frishman, William H

    Cardiology in review

    2012  Volume 20, Issue 1, Page(s) 38–44

    Abstract: Vitamin D is a fat-soluble vitamin that is naturally found in very few foods, is added to others, and is available as a dietary supplement. It is produced endogenously when ultraviolet light strikes the skin. Recent epidemiologic and experimental ... ...

    Abstract Vitamin D is a fat-soluble vitamin that is naturally found in very few foods, is added to others, and is available as a dietary supplement. It is produced endogenously when ultraviolet light strikes the skin. Recent epidemiologic and experimental evidence has suggested that low vitamin D levels may play a role in various cardiovascular conditions, including coronary artery disease, congestive heart failure, valvular calcification, stroke, hypertension, and cognitive decline. Low vitamin D may lead to vascular smooth muscle cell proliferation, endothelial cell dysfunction, vascular and myocardial cell calcification, and increased inflammation. However, the data supporting a cardioprotective effect of vitamin D supplementation are very weak, and the large, controlled clinical trials now in progress should resolve this issue.
    MeSH term(s) Cardiovascular Agents/administration & dosage ; Cardiovascular Diseases/etiology ; Cardiovascular Diseases/prevention & control ; Dietary Supplements ; Humans ; Randomized Controlled Trials as Topic ; Risk Factors ; Secondary Prevention ; Vitamin D/administration & dosage ; Vitamin D Deficiency/complications ; Vitamin D Deficiency/diet therapy ; Vitamins/administration & dosage
    Chemical Substances Cardiovascular Agents ; Vitamins ; Vitamin D (1406-16-2)
    Language English
    Publishing date 2012-01
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1294965-6
    ISSN 1538-4683 ; 1061-5377
    ISSN (online) 1538-4683
    ISSN 1061-5377
    DOI 10.1097/CRD.0b013e31822c5380
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 4491: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  2. Article ; Online: Pathological characteristics of light chain crystalline podocytopathy.

    Nasr, Samih H / Kudose, Satoru / Javaugue, Vincent / Harel, Stéphanie / Said, Samar M / Pascal, Virginie / Stokes, M Barry / Vrana, Julie A / Dasari, Surendra / Theis, Jason D / Osuchukwu, George A / Sathick, Insara Jaffer / Das, Arjun / Kashkouli, Ali / Suchin, Elliot J / Liss, Yaakov / Suldan, Zalman / Verine, Jerome / Arnulf, Bertrand /
    Talbot, Alexis / Sethi, Sanjeev / Zaidan, Mohamad / Goujon, Jean-Michel / Valeri, Anthony M / Mcphail, Ellen D / Sirac, Christophe / Leung, Nelson / Bridoux, Frank / D'Agati, Vivette D

    Kidney international

    2022  Volume 103, Issue 3, Page(s) 616–626

    Abstract: Monoclonal immunoglobulin light chain (LC) crystalline inclusions within podocytes are rare, poorly characterized entities. To provide more insight, we now present the first clinicopathologic series of LC crystalline podocytopathy (LCCP) encompassing 25 ... ...

    Abstract Monoclonal immunoglobulin light chain (LC) crystalline inclusions within podocytes are rare, poorly characterized entities. To provide more insight, we now present the first clinicopathologic series of LC crystalline podocytopathy (LCCP) encompassing 25 patients (68% male, median age 56 years). Most (80%) patients presented with proteinuria and chronic kidney disease, with nephrotic syndrome in 28%. Crystalline keratopathy and Fanconi syndrome were present in 22% and 10%, respectively. The hematologic condition was monoclonal gammopathy of renal significance (MGRS) in 55% and multiple myeloma in 45%. The serum monoclonal immunoglobulin was IgG κappa in 86%. Histologically, 60% exhibited focal segmental glomerulosclerosis (FSGS), often collapsing. Ultrastructurally, podocyte LC crystals were numerous with variable effacement of foot processes. Crystals were also present in proximal tubular cells as light chain proximal tubulopathy (LCPT) in 80% and in interstitial histiocytes in 36%. Significantly, frozen-section immunofluorescence failed to reveal the LC composition of crystals in 88%, requiring paraffin-immunofluorescence or immunohistochemistry, with identification of kappa LC in 87%. The LC variable region gene segment, determined by mass spectrometry of glomeruli or bone marrow plasma cell sequencing, was IGKV1-33 in four and IGKV3-20 in one. Among 21 patients who received anti-plasma cell-directed chemotherapy, 50% achieved a kidney response, which depended on a deep hematologic response. After a median follow-up of 36 months, 26% progressed to kidney failure and 17% died. The mean kidney failure-free survival was 57.6 months and was worse in those with FSGS. In sum, LCCP is rare, mostly associates with IgG κappa MGRS, and frequently has concurrent LCPT, although Fanconi syndrome is uncommon. Paraffin-immunofluorescence and electron microscopy are essential to prevent misdiagnosis as primary FSGS since kidney survival depends on early diagnosis and subsequent clone-directed therapy.
    MeSH term(s) Humans ; Male ; Middle Aged ; Female ; Glomerulosclerosis, Focal Segmental/pathology ; Fanconi Syndrome/pathology ; Paraffin ; Kidney/pathology ; Kidney Diseases/pathology ; Renal Insufficiency/pathology ; Immunoglobulin G
    Chemical Substances Paraffin (8002-74-2) ; Immunoglobulin G
    Language English
    Publishing date 2022-12-26
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 120573-0
    ISSN 1523-1755 ; 0085-2538
    ISSN (online) 1523-1755
    ISSN 0085-2538
    DOI 10.1016/j.kint.2022.11.026
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 797: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  3. Article: Multifocal neoplasia and nodal metastases in T1 esophageal carcinoma: implications for endoscopic treatment.

    Altorki, Nasser K / Lee, Paul C / Liss, Yaakov / Meherally, Danish / Korst, Robert J / Christos, Paul / Mazumdar, Madhu / Port, Jeffrey L

    Annals of surgery

    2008  Volume 247, Issue 3, Page(s) 434–439

    Abstract: Objective: There has been an increase in interest in endoscopic therapy (ET) for intramucosal (T1a) or submucosal (T1b) esophageal carcinoma. The objective of the present study was to determine the prevalence of nodal metastases, lymphatic vascular ... ...

    Abstract Objective: There has been an increase in interest in endoscopic therapy (ET) for intramucosal (T1a) or submucosal (T1b) esophageal carcinoma. The objective of the present study was to determine the prevalence of nodal metastases, lymphatic vascular invasion, and multifocal neoplasia in patients with pT1 esophageal carcinoma who underwent esophagectomy without preoperative therapy and assess their potential implication for ET.
    Methods: We retrospectively reviewed the records of all patients who underwent esophagectomy without preoperative therapy for pT1 esophageal cancer. A detailed review of all pathology reports was performed to identify relevant pathologic criteria including depth of invasion (T1a or T1b), cell type (adenocarcinoma/squamous), tumor differentiation (poor vs. well/moderate), extent of Barrett esophagus (short segment [SSBE] and long segment [LSBE]), nodal status, lymphovascular invasion (LVI), and the presence of multifocal neoplasia (MFN) (high-grade dysplasia or invasive carcinoma). Overall survival and disease-specific survival were determined by the Kaplan-Meier method.
    Results: There were 75 consecutive patients (58 men, 17 women) between January 1994 and September 2006. Median age was 68 years. Hospital mortality was 2.6% (2 of 75). Thirty patients had T1a and 45 had T1b. Sixty patients had adenocarcinoma. Nodal metastases were present in 2 of 30 (6%) T1a and 8 of 45 (17.5%) T1b tumors. MFN was present in 30% (9 of 30) of T1a tumors and 29% (13 of 45) of T1b tumors. All 9 patients with LVI had T1b tumors. Collectively, 10 of 30 (33.3%) patients with T1a and 25 of 45 (58%) with T1b had MFN, LVI, or nodal metastases. Forty-nine patients had adenocarcinoma with associated BE (23 SSBE, 26 LSBE). There was no difference between patients with SSBE and those with LSBE in the incidence of nodal disease (2 of 23 vs. 2 of 26) but a significant difference in the incidence of MFN (3 of 23 vs. 13 of 26, P = 0.006). Four patients with squamous carcinoma had nodal metastases and 5 had MFN. Overall 5-year survival was 78% (T1a:90% T1b: 71%, P = 0.07). Five-year disease-specific survival was 86.5% (T1a: 96.7%, T1b: 79.6%, P = 0.06).
    Conclusion: The combined high incidence of MFN, LVI, and occult nodal metastases does not support the use of ET in patients with T1 esophageal cancer regardless of depth of invasion, cell type, differentiation or extent of BE. ET may be of value in patients in whom surgical risk is considered prohibitive.
    MeSH term(s) Adenocarcinoma/mortality ; Adenocarcinoma/pathology ; Adenocarcinoma/surgery ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell/mortality ; Carcinoma, Squamous Cell/pathology ; Carcinoma, Squamous Cell/surgery ; Esophageal Neoplasms/mortality ; Esophageal Neoplasms/pathology ; Esophageal Neoplasms/surgery ; Esophagectomy ; Esophagoscopy ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging ; Retrospective Studies
    Language English
    Publishing date 2008-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 340-2
    ISSN 1528-1140 ; 0003-4932
    ISSN (online) 1528-1140
    ISSN 0003-4932
    DOI 10.1097/SLA.0b013e318163a2ff
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Uk I Zs.35/1: Show issues Location:
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    ab Jg. 2022: Lesesaal (EG)

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  4. Article ; Online: Positron emission tomographic scanning predicts survival after induction chemotherapy for esophageal carcinoma.

    Port, Jeffrey L / Lee, Paul C / Korst, Robert J / Liss, Yaakov / Meherally, Danish / Christos, Paul / Mazumdar, Madhu / Altorki, Nasser K

    The Annals of thoracic surgery

    2007  Volume 84, Issue 2, Page(s) 393–400; discussion 400

    Abstract: Background: The ability to accurately predict clinical and pathological response and survival in patients undergoing preoperative chemotherapy may have a significant impact on treatment strategy for esophageal carcinoma. This study assessed the ... ...

    Abstract Background: The ability to accurately predict clinical and pathological response and survival in patients undergoing preoperative chemotherapy may have a significant impact on treatment strategy for esophageal carcinoma. This study assessed the predictive accuracy of clinical response (CR) and positron emission tomography (PET) scanning in determining pathological downstaging and disease free survival (DFS) after chemotherapy.
    Methods: This is a retrospective review of patients who underwent chemotherapy prior to complete surgical resection for esophageal carcinoma between 1999 and 2005. Clinical response was correlated with pathological downstaging and survival. For PET scanning, the percent reduction in maxSUV after induction therapy was determined and we identified the optimal threshold of percent reduction in maxSUV for predicting clinical response and pathological downstaging.
    Results: Sixty-two patients (52 men, median age 62.3) were evaluated. Thirty-nine patients (62.9%) had either a partial (n = 32) or complete clinical response (n = 7) to induction therapy. The sensitivity, specificity, positive, and negative predictive value of an objective clinical response in predicting downstaging in T and (or) N were 85.7%, 55.9%, 61.5%, and 82.6%, respectively. There was no difference in DFS between responders and nonresponders. The PET sensitivity, specificity, positive, and negative predictive values for predicting pathologic downstaging were 77.8%, 52.9%, 56.8%, and 75%, respectively. Thirty-seven patients (59.7%) had a 50% or greater reduction in the maxSUV of their primary tumor and had a significant improvement in DFS compared with patients with a less than 50% reduction in maxSUV (median DFS time: 35.5 months vs 17.9 months, respectively, p = 0.03). Significantly, 11 patients had a 100% reduction in maxSUV despite the presence of residual tumor.
    Conclusions: Complete response and PET appear equivalent in predicting pathological downstaging. However, a 50% reduction in the maxSUV after induction therapy is more significantly associated with improved DFS than CR or pathological downstaging. Additionally, a complete absence of PET signal cannot be equated with a complete pathological response.
    MeSH term(s) Adenocarcinoma/diagnostic imaging ; Adenocarcinoma/drug therapy ; Adenocarcinoma/mortality ; Adenocarcinoma/surgery ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Carcinoma, Squamous Cell/diagnostic imaging ; Carcinoma, Squamous Cell/drug therapy ; Carcinoma, Squamous Cell/mortality ; Carcinoma, Squamous Cell/surgery ; Combined Modality Therapy ; Esophageal Neoplasms/diagnostic imaging ; Esophageal Neoplasms/drug therapy ; Esophageal Neoplasms/mortality ; Esophageal Neoplasms/surgery ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Positron-Emission Tomography ; Predictive Value of Tests ; Retrospective Studies ; Survival Rate ; Tomography, X-Ray Computed
    Language English
    Publishing date 2007-08
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 211007-6
    ISSN 1552-6259 ; 0003-4975
    ISSN (online) 1552-6259
    ISSN 0003-4975
    DOI 10.1016/j.athoracsur.2007.03.094
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 252: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  5. Article ; Online: Risk factors for occult mediastinal metastases in clinical stage I non-small cell lung cancer.

    Lee, Paul C / Port, Jeffrey L / Korst, Robert J / Liss, Yaakov / Meherally, Danish N / Altorki, Nasser K

    The Annals of thoracic surgery

    2007  Volume 84, Issue 1, Page(s) 177–181

    Abstract: Background: In patients deemed to have clinical stage I for non-small cell lung cancer (NSCLC) after computerized tomography (CT) and positron emission tomography (PET) scans, the utility of mediastinoscopy to detect occult mediastinal metastases is ... ...

    Abstract Background: In patients deemed to have clinical stage I for non-small cell lung cancer (NSCLC) after computerized tomography (CT) and positron emission tomography (PET) scans, the utility of mediastinoscopy to detect occult mediastinal metastases is unclear. The goal of this study was to analyze the risk factors for occult mediastinal metastases in this subset of patients.
    Methods: We conducted a retrospective review during a 7-year period to identify patients with potentially operable clinical stage I NSCLC screened by CT and PET scans. Medical records were reviewed, and the prevalence of pathologic N2 disease was analyzed according to clinical tumor location, size, histology, and PET uptake of the primary tumor.
    Results: Of 224 patients identified with clinical stage I NSCLC with a CT-negative and PET-negative mediastinum, 16 patients had pathologic N2 disease proven by mediastinoscopy (n = 11) or after resection (n = 5). The overall prevalence of histologically confirmed N2 disease was 6.5% in clinical T1 patients and 8.7% in clinical T2 patients. Central tumors had a higher prevalence of N2 disease compared with peripheral tumors, 21.6% versus 2.9% (p < 0.001). Larger clinical T size predicted a higher prevalence of occult N2 disease (p < 0.001). All 16 patients with occult N2 metastases had adenocarcinoma as the primary tumor cell type. When the PET maximum standardized uptake value (SUV(max)) of the primary tumors was analyzed, patients with occult N2 metastases had a higher median SUV(max) of the primary tumor compared with patients without N2 metastases, 6.0 g/mL versus 3.6 g/mL (p = 0.017).
    Conclusions: For patients deemed at clinical stage I NSCLC by CT and PET, the prevalence of missed N2 metastases increased significantly with larger tumor size and central location. Adenocarcinoma cell type and a high PET SUV(max) of the primary tumor were other risk factors. Mediastinoscopy may have improved yield in the select subset of patients with one or more risk factor.
    MeSH term(s) Aged ; Aged, 80 and over ; Carcinoma, Non-Small-Cell Lung/pathology ; Female ; Fluorodeoxyglucose F18 ; Humans ; Lung Neoplasms/pathology ; Male ; Mediastinal Neoplasms/secondary ; Middle Aged ; Neoplasm Staging ; Positron-Emission Tomography ; Retrospective Studies ; Risk Factors ; Tomography, X-Ray Computed
    Chemical Substances Fluorodeoxyglucose F18 (0Z5B2CJX4D)
    Language English
    Publishing date 2007-07
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 211007-6
    ISSN 1552-6259 ; 0003-4975
    ISSN (online) 1552-6259
    ISSN 0003-4975
    DOI 10.1016/j.athoracsur.2007.03.081
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 252: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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