Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0001430 (adenoma)
 21,222 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Methods for bio-assay of secretin-like humoral agents in both cat and dog are described. Bio-assay of tumour extracts and of plasma from patients with the pancreatic choleraic syndrome are described. The first patient was found to have choleretic and secretinlike activity in an extract of her pancreatic islet cell tumour and gastrin-like activity in her plasma. The second patient was found to have both secretin and gastrin-like activity in her plasma, as well as choleretic activity. It is concluded that at least part of the profuse, watery electrolyte diarrhoea of the ;pancreatic cholera' syndrome associated with peptide-secreting adenoma of the pancreas is likely to be a reflection of the excessive production of secretin, as well as of gastrin, and possibly also of a choleretic agent.
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PMID:Bio-assay evidence of abnormal secretin-like and gastrin-like activity in tumour and blood in cases of "choleraic diarrhoea". 431 73

The study was designed to determine the prevalence of large bowel symptoms in an adult working population and to assess their value in screening for large bowel neoplasms. A symptom questionnaire was sent to workers in two large organizations and the results were compared with faecal occult blood testing in the same individuals using Haemoccult (Eaton Laboratories). Completed symptom questionnaires and Haemoccult test kits were returned by 916 out of a total of 1805 employees over the age of 40 (compliance 50.7 per cent). Twenty-eight (3.1 per cent) were Haemoccult positive and 114 (12.4 per cent) had one or more symptoms. All positives (129 persons) were examined by flexible sigmoidoscopy and barium enema. No cancer was found but 7 patients with adenomas greater than 10 mm diameter were discovered. Each of the 7 patients reported at least one symptom (dark red bleeding in 4, bright red bleeding in 2 and diarrhoea in 1) and 6 were Haemoccult positive. There was no individual with a Haemoccult positive adenoma without symptoms. Predictive values for adenomas over 10 mm for Haemoccult positive tests (21 per cent), self-reported dark bleeding (16 per cent) and diarrhoea (17 per cent), were significantly higher than for other symptoms. The predictive value rose significantly to 46 per cent for Haemoccult-positive patients who in addition had at least one symptom (P less than 0.05) and to 57 per cent for Haemoccult positive with dark bleeding. These combinations of Haemoccult- and symptom-positive results increased the specificity of 97.6 per cent for Haemoccult alone to values over 99 per cent without reducing sensitivity.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Self-reported dark red bleeding as a marker comparable with occult blood testing in screening for large bowel neoplasms. 660 79

Trilostane is a competitive inhibitor of the 3 beta-hydroxysteroid dehydrogenase enzyme system localized in the adrenal cortex and in the gonads. This inhibitor reduces the production of cortisol, aldosterone and androstendione. Trilostane was used for the treatment of 3 male and 2 female patients with primary aldosteronism, two of whom had an adenoma of the adrenal cortex and three bilateral adrenal hyperplasia. After a 12 weeks' treatment with trilostane (average dosage 288 mg/day) normalization of plasma aldosterone (from 368 to 35.1 pg/ml) was achieved. Average blood pressure had almost normalized (147/98 mm Hg) after the treatment period. However, in one patient no, or only a minor, reduction in blood pressure was observed during trilostane and even during captopril and minoxidil administration. Except slight diarrhea in 2 cases, which did not require cessation of trilostane medication, there were no further side effects. After 12 weeks' treatment the average serum cortisol was in the lower normal range. It is concluded from these results that trilostane is an effective therapeutic agent in primary aldosteronism, especially where there is no indication for surgery.
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PMID:[Therapy of primary aldosteronism with trilostane]. 665 19

The prevalence and significance of colorectal symptoms within a group of 1533 individuals was assessed using a self-completion questionnaire and results compared with faecal occult blood screening. One hundred and twenty eight individuals listed one or more symptoms, while only 12 had a positive blood occult test. Of the subjects studied, 6.6% had noticed bleeding from the rectum in the last six months, 8.7% diarrhoea, and 12.3% a change in bowel habit. Examination of these individuals revealed one (0.8%) to have an adenoma of the colon. By comparison, occult blood testing identified two patients with carcinoma and four with adenoma. Both of the patients with carcinoma and three out of the four with adenoma had replied negative to the questionnaire suggesting the self-completion questionnaire to be of little value in the early detection of colorectal neoplasia.
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PMID:Colorectal screening by a self-completion questionnaire. 671 86

Medullary cancer of the thyroid is rare but of unusual biologic interest. It originates in the thyroid parafollicular or C cells that are of neural crest origin and that secrete calcitonin. Calcitonin measurements, particularly after pentagastrim administration, are useful in detecting the tumor and following its progression. Ninety percent of medullary cancers are sporadic and 10% are familial; the latter may be associated with pheochromocytoma and parathyroid hyperplasia-adenoma. Initial symptoms of both the sporadic and familial varieties include thyroid mass, diarrhea, and less often, flushing. Uninvolved members of kindreds with the disease should be followed up by repeated measurements of calcitonin after pentagastrim and calcium infusion and should be treated when a positive test result is obtained. Therapy involves total thyroidectomy plus node dissection if indicated. In addition, postoperative radiation may reduce the recurrence rate.
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PMID:Medullary carcinoma of the thyroid. 684 63

A case of vasoactive intestinal peptide-producing adenoma of the tail of the pancreas (VIP) successfully managed by surgical resection is presented. Peripheral venous VIP levels correlated with the severity of the diarrhea. Intraoperatively, the VIP levels in the splenic and portal veins were 485 and 100 pg./ml., respectively. These data suggest that preoperative selective transhepatic venous catheterization for VIP sampling might be used to establish the site of VIP production and, thereby, direct surgical management. This technic requires further evaluation regarding its role in this clinical setting.
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PMID:Localization of a vasoactive intestinal peptide-producing tumor with selective venous sampling. 746 68

Technetium-99m sestamibi is known to localize in primary malignant and metastatic tumors. Specifically, brain, breast, thyroid, parathyroid, lung, and kidney tumors have been imaged. The Verner Morrison syndrome, which is caused by excessive vasoactive intestinal peptide (VIP), consists of watery diarrhea, hypokalemia, and achlorhydria. This condition is rarely associated with multiple endocrine neoplasia. The authors present a case of multiple endocrine neoplasia type I with visualization of a pancreatic VIPoma and parathyroid adenoma with Tc-99m MIBI.
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PMID:Tc-99m sestamibi imaging of a pancreatic VIPoma and parathyroid adenoma in a patient with multiple type I endocrine neoplasia. 791 44

The clinical evolution of type I multiple endocrine neoplasia (MEN I) was studied in 45 patients among a consecutive series of 172 with Zollinger-Ellison syndrome (ZES). These 172 patients were seen in our hospital between 1959 and 1989. Diarrhea was half as frequent in ZES-MEN I as in sporadic ZES cases. At diagnosis, mean basal acid output and serum gastrin levels in MEN I patients (28.8 +/- 6.6 mmol/h and 587 +/- 487 pg/ml, respectively) were not different from those observed in the others with sporadic ZES. Laparotomy was performed in all 36 patients with no diffuse liver involvement to attempt the removal of gastrinomas. Twenty-nine patients had adenomas, located in the pancreas in 21, in the duodenal wall in 3, and in both in 5. Adenomas were multiple in 23 cases (78%). No tumor was found in seven patients. Twenty-nine of the 36 operated patients were tumor-free after surgery; 7 died in the postoperative period between 1959 and 1970. Median follow-up of the 38 other patients was 95 months (range 17-278 months). Among the 24 patients without residual tumor at discharge (group I), biological and/or morphological evidence of a persistent or recurrent source of gastrin was obtained in 22. Among the 14 patients with residual tumor (group II), an increase in tumor size was seen in 5 after a median of 27 months (range 9-36 months), while no change occurred in 9 after 54 months (3-100 months). Actuarial survival curves were not different, either in group I versus group II patients (67 and 72% at 5-year follow-up, respectively) or in MEN I versus sporadic ZES patients. Apparently, complete resection of primary tumor did not reduce the incidence of subsequent liver metastases. In all, 21 of the 45 patients had malignant gastrinomas (47%), consisting of liver metastases in 14 (31%), metastatic lymph nodes in 11 (24%), and lung metastases in 2 (4%). Monitoring of fundic argyrophil cells disclosed hyperplasia in 13 of the 14 MEN I patients (92%), and 5 had invasive carcinoid tumors. Taken together, these results prompt us to recommend that in ZES-MEN I patients, surgery should be avoided and oxyntic mucosa regularly monitored.
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PMID:Clinical, anatomical, and evolutive features of patients with the Zollinger-Ellison syndrome combined with type I multiple endocrine neoplasia. 809 74

GH and IGF-I levels are elevated in patients with acromegaly. At the time of diagnosis patients present with macroadenomas with a high surgical failure rate or microadenomas. Administration of octreotide (100 micrograms, three times daily) suppressed GH secretion during 8 h to < 5 micrograms/l in 47% and to < 2 micrograms/l in 26% of acromegalic patients after two weeks. IGF-I levels were normalized in up to 70% of patients. Increasing the dose of octreotide to 250 micrograms three times daily did not further improve results. Tumour shrinkage occurred in 37% after six months of treatment, while symptoms improved in 70%. Transient diarrhoea and nausea were noted in 88%, but after six months only 10% reported these symptoms. Gallbladder sludge and gallstones were noted in 19% of patients. IGF-I levels were normalized in 82% of patients with microadenoma and in 50% with macroadenoma. Well-defined pituitary adenomas are usually surgically removed. Invasive tumours are difficult to remove surgically but preoperative octreotide may shrink adenomas and improve response. Octreotide therapy, unlike surgery and irradiation, does not compromise pituitary function. This study suggests that octreotide therapy could be a viable primary management of small discreet adenomas. Where surgery and octreotide fail, other treatments of adenoma include bromocriptine and radiotherapy.
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PMID:Medical management of acromegaly--what and when? 837 5

During a seven year period 18 benign small intestinal tumors were histologically documented in patients referred to us for a small bowel study, using a barium infusion technique. These included seven leiomyomas, five adenomatous polyps, two Peutz-Jeghers hamartomas, one myoepithelial hamartoma, one lipoma, one Brunner's gland adenoma and one neurilemmoma. Ten of the patients were women and eight were men, with their ages ranging from 20 to 75 years (mean age 45 years). Presenting symptoms were gastrointestinal bleeding in 12, anemia in 9, abdominal pain in 4, partial intestinal obstruction in 3 and bloody diarrhea in one. The time elapsed from onset of symptoms to radiological diagnosis ranged between one month and seven years (mean time 16 months). Multiple lesions were encountered in four cases and solitary in fourteen. The site of involvement was the duodenum in 3 patients, the jejunum in 8 and the ileum in 7 of them. Main radiological appearances included solitary or multiple intraluminal filling defects, mass effect on neighbouring loops and dilation of intestinal loops proximally to the lesion. The primary tumor, in the form of a mass or other abnormality of the small intestine was identified in all study cases. Correlation with surgical or endoscopic findings showed that radiology depicted all single lesions, whereas multiple lesions were underestimated in one case. The individual morphological changes shown on examination of the resected specimens resembled the appearances on the barium study in all cases. However, enteroclysis missed four out of seven ulcers and a stalk in one of the five pedunculated lesions. A specific tumor-type diagnosis was reached preoperatively in eleven patients, it was suggestive in five and mistaken in two of them. Our experience indicates that enteroclysis is an effective means in evaluating patients with suspected benign small bowel tumors, preoperatively.
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PMID:Benign tumors of the small intestine: preoperative evaluation with a barium infusion technique. 846 75


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