Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Transcatheter arterial chemoembolization (TAE) and hepatic arterial infusion using totally implantable reservoir were performed for the treatment of liver metastasis of colo-rectal cancers, and their therapeutic effects, side effects and complications were evaluated. Eleven cases of H1 (metastasis in one lobe only), 7 cases of H2 (a few scattered metastases in both lobes), 12 cases of H3 (numerous metastases in both lobes) were entered into the study and underwent TAE 45 times. Gel foam, Ivaron and Lipiodol were used as embolic materials in combination with chemotherapeutic agents such as mitomycin C and adriamycin. Serum CEA level was decreased less than 50% of pre-TAE level 20 out of 32 (61%). The tumor size was regressed in 25% of TAE cases which were evaluated on the basis of CT scan. Abdominal symptoms including abdominal pain, nausea and vomiting and fever, leukocytosis, elevated GOT, LDH and bilirubin level were seen after TAE therapy. Median survival of H1, H2 and H3 cases were 21 months, 8 months and 4.5 months, respectively. Another 21 cases (H1, 5 cases: H2, 3 cases: H3, 13 cases) of liver metastasis of colo-rectal cancers were treated with selective hepatic arterial infusion therapy using totally implantable reservoir. Reservoir catheters were implanted into hepatic artery via gastroduodenal artery under direct vision at laparotomy. Mitomycin C, adriamycin and fluorouracil (5-FU) were used as chemotherapeutic agents. No particular side effect such as leukopenia or liver dysfunction was noted. Median survival of H1, H2 and H3 cases treated with arterial infusion were 4 months, 9 months and 9 months, respectively. Median survival of TAE cases and arterial infusion cases was 10 and 6 months, respectively. Thus, the survival rate of cases treated with TAE was better than that of cases treated with arterial infusion.
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PMID:[Transcatheter arterial chemoembolization and selective hepatic arterial infusion using totally implantable reservoir]. 341 58

An outbreak of typhoid fever occurred among 54 hospital nurses after a picnic. The salient features were fever (100%), nausea and vomiting (46%), loose motions and abdominal pain (13%), and palpable splenomegaly (63%). None of the patients had any major complications. Blood cultures for Salmonella typhi were positive in 81%, blood Widal was positive (1:320 or more) in 43% and suggestive (1:160) in 25% of the blood culture positive patients. A comparable number of patients were administered chloramphenicol or co-trimoxazole and no differences in response were observed. Bacteriological examination of samples of water from the likely sources revealed it to be unfit for human consumption due to gross faecal contamination.
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PMID:An outbreak of typhoid fever in Chandigarh, North India. 348 47

Many patients with gastrointestinal (GI) tumors develop extensive peritoneal and serosal metastasis and/or malignant ascites which respond poorly to available treatments. Twelve patients with tumors confined primarily to the intraabdominal cavity were treated with intraperitoneal (IP) 5-fluorouracil (5-FU) in escalating concentrations (2 to 4 mmol/L) in combination with leucovorin (dl-5-formyltetrahydrofolic acid or folinic acid; dl-CF) in a 2-L volume, either by eight consecutive four-hour dwells or once daily for five days. CF dose was 20.8 or 104 mumol/L. Nine of the patients had pancreatic carcinoma, one had stomach carcinoma, and two had hepatobiliary neoplasms. Median age was 62.5 years and median Eastern Cooperative Oncology Group (ECOG) performance status was 3. Toxicity included mucositis, diarrhea, nausea and vomiting, leucopenia, skin rash, and abdominal pain, and was similar to that previously reported for IP 5-FU used as a single agent. Four episodes of peritonitis occurred, but all patients responded to antibiotics. At the 20.8 mumol/L dose, dl-CF concentration in the peritoneal fluid declined from 10.4 +/- 3.0 3.0 mumol/L at one hour to 4.9 +/- 2.2 mumol/L at four hours, corresponding to a mean absorption half-life of 127 +/- 49 minutes and a mean peritoneal clearance of 13.0 +/- 4.5 mL/min. Decline was biphasic in all but five of the 19 exchanges evaluated. The levels of l-CF (biologically active isomer of dl-CF) were 2.8 +/- 2.5 mumol/L after 60 minutes and 1.2 +/- 0.7 mumol/L after four hours. The peritoneal area under the concentration v time curve (AUC) for 5-FU increased proportionally with dose. For example, the AUC at 2.0 and 3.5 mmol/L was 129 +/- 25 and 201 +/- 23 mmol/L X minute, respectively. However, the maximal peritoneal to plasma AUC ratio was 461 at the 2 mmol/L dose, but decreased with increasing doses as systemic clearance decreased. This regimen was well tolerated in patients with advanced cancer, but must be evaluated further to determine its clinical efficacy.
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PMID:Phase I and pharmacologic studies of intraperitoneal leucovorin and 5-fluorouracil in patients with advanced cancer. 348 19

Twenty-five patients with advanced measurable gastric carcinoma were treated with D,L-leucovorin (CF) (500 mg/m2) administered as a 2-hour infusion and FUra (600 mg/m2) iv push midinfusion. Patients were treated weekly for 6 weeks followed by a 2-week rest. Median age was 57 (range 32 to 82). Median Eastern Cooperative Oncology Group (ECOG) performance status was 2 (range 0 to 4). Thirteen patients had progressed on previous combination chemotherapy that included FUra. At the time of this report, 19 patients were evaluable for response: 3 patients had partial responses, 8 had stable disease, and 8 progressed (but 3 of these received only 3 or fewer treatments before early disease-related death). Two of the responders were previously treated with FUra. Four patients were too early to evaluate. Measurable responses of greater than 50% were seen in bone, liver, lung, and an abdominal mass. Diarrhea occurred in 9 patients and FUra dose reduction was necessary in 8 of them. Other toxicities included lacrimation, rash, nausea, and mucositis. One toxic death occurred. Nine patients with gastrointestinal tumors confined primarily to the intra-abdominal space were treated with ip FUra in escalating doses (2 mM to 4 mM) in combination with D,L-CF in a 2-liter volume, either by 8 consecutive 4-hour dwells (7 patients) or once daily for 5 days (2 patients). The D,L-CF dose was 20.8 microM except for the first day of the 5-day schedule when it was 104 microM. Toxicity included leukopenia, mucositis, nausea and vomiting, skin rash, and abdominal pain. Three episodes of peritonitis resolved with antibiotics.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A phase II trial of 5-fluorouracil and high-dose leucovorin in gastric carcinoma and a phase I trial of intraperitoneal 5-fluorouracil and leucovorin. 350 44

Four cases of childhood Menetrier's disease are presented and their clinical and laboratory findings are compared with the other childhood cases reported in the literature. Children with Menetrier's disease usually present with abdominal pain or nausea and vomiting associated with peripheral edema, ascites, or pleural effusion; these symptoms are due to gastrointestinal protein loss and resultant hypoproteinemia. There is no evidence of urinary protein loss. The favorable clinical course as well as distinctive laboratory and roentgenologic findings distinguish this entity from other causes of these symptoms. Supportive therapy is normally all that is required since the symptoms resolve spontaneously in weeks to months. Surgery may be needed in rare cases of active gastrointestinal hemorrhage.
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PMID:Childhood Menetrier's disease: four new cases and discussion of the literature. 351 52

The records of 43 patients with 32 malignant and 11 benign neoplasms of the small intestine were reviewed in order to improve early diagnosis. The malignant tumours comprised of 14 carcinoids, 10 carcinomas and 8 sarcomas. The benign tumours constituted 7 different histological types. An increasing frequency of malignant tumours through the bowel was found. Thirty-three per cent of all patients had a sudden onset of symptoms leading to acute explorative laparotomy, whereas the remaining 67 per cent were characterized by a long history. The predominant symptoms were abdominal pain, nausea and vomiting, weight loss and a palpable abdominal mass. An exact preoperative diagnosis was made in 41 per cent of the cases. Upper gastrointestinal X-ray contrast examination with small bowel follow through and ultrasonography gave the greatest sensitivity. A diagnostic strategy was difficult to recommend considering the rarity of these tumours and the low sensitivity of the employed diagnostic modalities. Recently developed Japanese enteroscopes capable of exploring the entire small bowel seem to offer the most promising diagnostic method for the future.
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PMID:Primary tumours of the small intestine--the diagnostic problem. 351 90

Directed to the health care professional, this review covers the current concepts of pelvic inflammatory disease (PID) affecting adolescent and young adult women. It defines PID and discusses the magnitude of the problem, risk factors (sexual activity, age, method of contraception, history of previous PID, history of gonococcal of chlamydial lower genital tract infection, and uterine instrumentation), etiologic agents (N. gonorrhea, aerobic and anaerobic bacteria, chlamydia trachomatis, genital mycoplasmas, and other pathogens), pathogenesis, clinical and laboratory features, diagnostic evaluation, differential diagnosis, treatment, and sequelae. The Centers for Disease Control define acute PID as "the acute clinical syndrome (unrelated to pregnancy or surgery) attributed to the ascent of microorganisms from the vagina and endocervix to the endometrium, fallopian tubes, and/or contiguous structures." The true incidence and prevalence of PID in women is uncertain. Recent data show an increase to 267,200 in the average annual number of hospitalizations for PID during the 1975-81 period for women 15-44 years of age. PID occurs rarely in sexually inactive women. The large number of PID cases among adolescents reflects in part the high proportion of sexually active females in that group. The risk of developing PID in sexually active females is inversely related to age; 1/3 of all patients in Westrom's series were 19 years of age or younger at the time of their 1st PID episode, and 69% of all women with PID were younger than 25 years. Women who have had 1 episode of PID have a 20-25% chance of developing subsequent episodes. A large series of PID cases verified by laparoscopy has shown that only a small proportion of patients (3%) present with a severe clinical illness. Low abdominal pain is the most common symptom and may be present for variable periods of time prior to diagnosis. Other common symptoms include vaginal discharge (55%), irregular vaginal bleeding (36%), urinary symptoms (19%), nausea and vomiting (10%), and proctitis symptoms (7%). The major goals of therapy in PID are to prevent infertility and other long-term sequelae. About 15% of patients fail to respond to initial antibiotic therapy, 20% experience recurrences, 20% develop involuntary infertility, and 8% of post-PID patients who conceive have an ectopic pregnancy. Early diagnosis and treatment reduces the risk of residual tubal damage.
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PMID:Acute pelvic inflammatory disease. 360 34

Sixteen evaluable patients with advanced gastric cancer who had no prior therapy were treated intravenously with cisplatin (DDP) 20 mg/m2/day on days 1-5 and with Adriamycin 40 mg/m2 and 5-fluorouracil 600 mg/m2 on day 1 (DAF) every 3 weeks. There were five objective partial responses, giving a response rate of 31%. Five patients had minor responses, and 5 others achieved disease stabilization. The median duration of response for responders was 10 months, and the median time to tumor progression in nonresponders was 6 months. The overall median survival was 12 months (responders 14 months, nonresponders 9 months; NS). Most patients had a subjective improvement, including disappearance of abdominal pain (7/9) and gastrointestinal bleeding (5/7). The drug toxicity was moderate to severe. The primary nonhematologic toxicities were nausea and vomiting (in all patients), severe weakness (44%), and parasthesias (31%). Eight patients (50%) experienced significant bone marrow suppression. The DAF combination appears to have some activity in patients with advanced gastric cancer. However, further efforts in new drug development and other combinations are needed to improve the results of chemotherapy in stomach cancer.
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PMID:Treatment of advanced gastric cancer with DDP (cisplatin), adriamycin, and 5-fluorouracil (DAF). 361 11

A co-operative phase II study of the semisynthetic podophyllotoxin derivative Etoposide (VP-16) was undertaken in patients with genitourinary tumors. A total of 83 out of 115 patients entered into the study were evaluable for response. Antitumor effects were evaluated according to "Standards for the Evaluation of Direct Effects of Chemotherapy in Solid Tumors" (otherwise known as the Koyama-Saito Group Criteria). Objective response was noted in 2 patients (6.3%) out of 32 with testicular cancer, whereas no responders were seen in bladder and renal cancer patients. In patients with prostatic cancer, 1 out of 13 (7.7%) responded. Major clinical side effects were alopecia and gastrointestinal toxicities (anorexia, nausea and vomiting). Mucositis, abdominal pain, diarrhea and general fatigue were also noted. Anomalies in laboratory test findings were mainly myelosuppression-related, with leukopenia being observed in 66.3% of patients.
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PMID:[Phase II study of etoposide (VP-16-213) in genitourinary tumors. VP-16-213 Genitourinary Study Group]. 375 24

A chart review from 1975 to 1985 at the Toronto Western Hospital identified 16 patients (9 women and 7 men, between the ages of 39 and 83 years) with gastrointestinal phytobezoars. Nine had previously undergone vagotomy and drainage procedures. There were two distinct clinical groups, dependent on the location gastric bezoars presented with chronic burning epigastric pain and nausea and vomiting in addition to anorexia and weight loss. Six of seven patients with small-bowel bezoars had acute small-bowel obstruction, manifested by crampy abdominal pain, vomiting and obstipation. In the seventh patient the bezoar was found incidentally in an efferent loop during endoscopy. Gastric bezoars were all diagnosed by endoscopy; patients with small-bowel bezoars had x-ray films compatible with small-bowel obstruction. The obstructing small-bowel bezoars were found at midileum and proximal jejunum. Five patients underwent proximal enterotomy with bezoar removal; in one the bezoar was milked distally into the cecum. One patient also had multiple nonobstructing small-bowel bezoars removed through the single enterotomy and another had a separate gastrotomy for removal of a gastric bezoar. The postoperative courses were uncomplicated except for wound infection in one patient. None of the patients with an isolated gastric bezoar required surgery. Three patients were successfully treated with gastric lavage and the others with clear fluid diet.
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PMID:Gastrointestinal phytobezoars: presentation and management. 377 44


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