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)

We report herein the clinicopathological, immunohistochemical and ultrastructural studies on 13 female patients and one male patient with papillary cystic tumors of the pancreas. Their ages ranged from 12 to 60 (mean 25) years. Most patients complained of abdominal mass or abdominal pain. Following complete resection of the tumor, all have remained well for between 3 months and 19 years (maen 5 years). In one patient the tumor was malignant and, 10 years after the initial partial resection, there was a recurrence with involvement of the colon, metastasis to the lymph nodes and venous invasion. Immunohistochemically, most tumor cells were positive for neuron specific enolase, synaptophysin, alpha-1-antitrypsin and vimentin and sometimes for the estrogen receptor related antigen, ER-D5, and the oncogen product of c-Ha-ras, c-Ha-ras P21. Ultrastructurally there were zymogen-like intracytoplasmic granules, intercellular junctions and intercellular spaces. These results support the hypothesis that the tumor originates from undifferentiated cells capable of differentiation toward acinar, endocrine or ductular cells. Estrogen and the c-Ha-ras oncogene presumably are linked to the development.
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PMID:Papillary cystic tumor of the pancreas: an immunohistochemical and ultrastructural study of 14 patients. 273 63

Although ischemic colitis is often considered a condition of elderly persons or persons with vascular disease, it also occurs in healthy adults under age 60. While some patients may have gangrenous forms of ischemic colitis, others may have a benign, self-limited form of the disorder. In these cases, the condition is termed "transient ischemic colitis." This disorder should be included in the differential diagnosis in patients presenting with abdominal pain and hematochezia or bloody diarrhea. Estrogen or oral contraceptive therapy is associated with transient ischemic colitis, so its use should further raise suspicion. The effectiveness of discontinuation of estrogen therapy is controversial, but this measure should be considered. Conservative management includes repeated careful assessment, pain management and fluid replacement. Complications are rare and the prognosis is excellent. Occasionally, patients have recurrences.
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PMID:Transient ischemic colitis in young adults. 931 62

The goal of this study was to determine whether use of postmenopausal estrogen (Premarin, Wyeth-Ayerst, Philadelphia, PA) in women with autosomal dominant polycystic kidney disease (ADPKD) increases liver, hepatic cyst, or kidney volume. We also determined whether clinical symptoms correlated with the volume of either the liver or kidneys. Eight women off estrogen (control, C) and 11 others on estrogen (Premarin, E) were studied basally and after 1 year. The two groups were similar in age, weight, age at menarche, and gravida. Volumes of total liver, hepatic cysts, hepatic parenchyma, and total kidney were measured by a validated computed tomography (CT) technique. Estrogen treatment was associated with a selective increase in total liver volume (E vs. C: delta = 7% +/- 12% vs. -2% +/- 8%, P < .03) and no change in kidney volume (E vs. C: delta = 0% +/- 6% vs. -2% +/- 6%, P = NS). Symptoms were common, regardless of estrogen treatment (abdominal pain 60%, shortness of breath 40%, or both 35%). Patients with symptoms of abdominal pain and shortness of breath had significantly increased hepatic volumes (P < .03) but similar kidney volume compared with patients without symptoms. We conclude that estrogen treatment of postmenopausal ADPKD women is associated with selective liver enlargement and that abdominal symptoms in ADPKD patients may be because of extensive hepatic cystic disease.
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PMID:Postmenopausal estrogen therapy selectively stimulates hepatic enlargement in women with autosomal dominant polycystic kidney disease. 936 73

Liver adenomatosis is defined by the presence of multiple hepatic adenomas (more than three lesions). The natural history and treatment of liver adenomatosis are not yet well defined. The Mayo Clinic (Rochester, MN) experience with liver adenomatosis in the past 11 years was reviewed and a rational treatment approach is presented. Records from patients with liver adenomatosis and hepatic adenoma seen at the Mayo Clinic from January 1986 to June 1997 were reviewed. Estrogen- and progesterone-receptor status was assessed by immunohistochemistry. Eight women with liver adenomatosis were identified. All patients had undergone surgical treatment. Abdominal pain was the presenting symptom in 87.5% of the patients with adenomatosis and in 42.1% of the patients with hepatic adenoma. Tumor bleeding was present in 62.5% of the patients with adenomatosis and in 26.3% of the patients with hepatic adenomas. Bleeding occurred predominantly in lesions greater than 4 cm. All patients with liver adenomatosis reported improvement of symptoms after surgery, and the mean bleeding-free period after resection in 5 patients was 52.6 +/- 23.6 months. In 6 patients, estrogen receptor-positive and estrogen receptor-negative tumors were identified in the same liver. Based on the good outcome after resection in symptomatic patients with liver adenomatosis, we recommend resection of large (>/=5 cm) or symptomatic lesions with observation of smaller lesions (</=3 cm). Lack of estrogen receptors in many lesions suggests that estrogen does not play a dominant role in the pathogenesis of liver adenomatosis.
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PMID:Management of liver adenomatosis: results with a conservative surgical approach. 972 76

Endometriosis is an important clinical problem in routine practice. Besides the problems of dysmenorrhea, dyspareunia and chronic abdominal pain, women with endometriosis are often infertile. We performed a systematic literature review on two issues: firstly, we clarified which medical treatment options have been investigated in prospective, randomized studies. Secondly, potential future treatments, still being preclinically investigated, were examined. A meta-analysis was not possible as the studies varied too much in their protocols and inclusion and exclusion criteria, as well as in the drugs and doses administered. Gonadotropin-releasing hormone (GnRH) agonists, progestins and oral contraceptives all appear to offer certain advantages for endometriosis patients. GnRH agonists appear to be the most effective but they are expensive and long-term treatment is not possible because of loss of bone mineral density. Estrogen add-back may offer some benefit for the clinical complaints of patients, but it may reduce the efficacy of GnRH agonists. Progestins have the best clinical profile and a good cost-effectiveness balance; however, most studies found that they were not as effective as GnRH agonists. Oral contraceptives are only effective during treatment and have a high relapse rate after therapy is completed. Future options may include the use of GnRH agonists, selective estrogen receptor modulators (SERMs) and anti-estrogens, as well as immunomodulators.
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PMID:Medical management of endometriosis: a systematic review. 1515 7

In its extraovarian form, co-existence of carcinoma and endometriosis is a sufficient argument used in favour of the malignant transformation of endometric lesions. Estrogen as well as the loss of 5q chromosome heterozygosity are considerate as initiators of that type of carcinogenesis. Endometrioid histological type is the most frequent and is revealed usually by abdominal pain. The incidence of carcinoma arising in endometriosis is about 0.8% and 5-year survival rate of pelvic endometrioid form is about a 100% after surgery and radiotherapy.
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PMID:[Malignant tumours arising in extraovarian endometriosis: three case reports and review of the literature]. 1529 30

Although a few cases of vaginal clear cell adenocarcinoma (CCAC) have been reported in the ages under 14, they have presented in a much more aggressive form than the CCAC cases in higher ages and parenchymal pulmonary metastasis are known to occur following the primary tumor. This is a case report of a primary vaginal CCAC in an 8.6-year-old girl with no history of DES exposure who presented with vaginal bleeding and abdominal pain and the imaging signs of pulmonary metastasis at the presentation. Diagnostic imaging modalities should be considered for any child complaining of vaginal bleeding, due to limitation of vaginal examination. Chest X-ray is recommended at the time of diagnosis of CCAC and at follow-up sessions for early diagnosis of pulmonary metastasis.
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PMID:Vaginal clear cell adenocarcinoma with early pulmonary metastasis in a child. 1885 Apr 81

A 65 year old man was transferred to our cath lab for primary PCI about two hours after the onset of pain in the context of acute, anterior myocardial infarction. Thrombus aspiration of the proximal LAD and balloon angioplasty with a DES implantation were performed. After a few days, although the patient was under treatment with unfractioned heparin, he sustained a transient ischemic attack. The echocardiographic study revealed a large, mobile, protruding thrombus in the apex. Four days later, the patient complained of mild abdominal pain with a gradual deterioration. Abdominal CT scan revealed embolism of the superior mesenteric artery and urgent embolectomy was scheduled.
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PMID:Sequential thromboembolic events after primary angioplasty in a patient with acute anterior myocardial infarction. 2406 25

Aim: Doxorubicin-eluting beads transarterial chemoembolization (DEB-TACE) is reported to improve survival and tolerability when compared with conventional lipiodol-TACE (cTACE) for the treatment of hepatocellular carcinoma (HCC). The aim of this study was to evaluate tolerability and long-term survival in patients treated with cTACE or DEB-TACE in a real-life setting. Methods: Incidence of adverse events and overall survival in HCC patients treated with either cTACE or DEB-TACE at Karolinska University Hospital 2004-2012 were analyzed retrospectively. Median follow-up was 7.1 years. Patients were censored when transplanted or at the end of follow-up. Patients receiving both cTACE and DEB-TACE, or treated with resection or ablation post-TACE were excluded from the survival analysis. Results: A total of 202 patients (76 cTACE and 126 DEB-TACE) were eligible for analysis of adverse events, and 179 patients (69 cTACE and 110 DEB-TACE) were included in the survival analysis. cTACE patients were younger and had fewer tumors but higher BCLC stage than DEB-TACE. Child-Pugh and ECOG performance status were similar between groups. Adverse events (abdominal pain, nausea and vomiting, fever, fatigue) were significantly less common in the DEB-TACE group. Median survival was 17.1 months in the cTACE group and 19.1 months in the DEB-TACE (NS). In multivariate Cox regression analysis, portal vein thrombosis and tumor size were associated with increased, and sorafenib treatment post-TACE with decreased mortality. Conclusion: In this retrospective real-life analysis, DEB-TACE had better tolerability compared to cTACE, but overall survival did not differ between the two treatments. Portal vein thrombosis, tumor size and sorafenib treatment after TACE influence survival.
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PMID:Comparison of lipiodol infusion and drug-eluting beads transarterial chemoembolization of hepatocellular carcinoma in a real-life setting. 3128 38

Plexiform fibromyxoma (PF) is a unique mesenchymal tumor of the stomach. The molecular characteristics of these tumors remain unclear. Here, we report 10 cases of PF with clinicopathological features and molecular features in detail. The patients ranged in age from 26 to 72 years (mean, 49 y) and most commonly presented with abdominal pain and distension, black stool, and anemia. Eight tumors were located at the antrum while two in the fundus of stomach. Histologically, tumor cells exhibited a plexiform growth pattern with multiple nodules in the muscularis propria of stomach wall and infiltrative borders. Immunohistochemically, all tumors were strongly positive for vimentin and smooth muscle actin (SMA), some were staining for CD10 (5/10), desmin (5/10), H-caldesmon (6/10) and progesterone receptor (PR, 6/10), however, CD34, S-100, Estrogen Receptor (ER), ALK, CD117 and DOG-1 were all negative in our cases. The glioma-associated oncogene homologue 1 (GLI1) gene translocation was detected in eight cases by FISH with three positive and five negative. Mutation analyses of C-KIT and platelet-derived growth factor receptor alpha (PDGFRA) genes were performed on five cases and all of which were wild-type for mutation. Our follow-up indicated that all of the patients made an uneventful recovery at 24 to 95 months after diagnosis. In summary, the distinctively histological features and immunohistochemical positivity of SMA, CD10 and PR can help differentiate PF from other gastrointestinal mesenchymal tumors. GLI1 gene translocation offers an additional molecular instrument for the diagnosis. The expression of PR and the existence of GLI1 gene translocation in PF highlights of our article.
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PMID:Plexiform fibromyxoma of the stomach: a clinicopathological study of 10 cases. 3196 36


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