Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0007097 (carcinoma)
 152,788 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One hundred eighty-nine patients received a four-drug combination consisting of cyclophosphamide, Oncovin (vincristine), methyl CCNU, and bleomycin (COMB), according to three different drug regimens, performed sequentially. Of the 189, 62 had a partial response (33%) including 11/33 with squamous lung cancer, 11/32 with squamous carcinoma of the head and neck, 13/15 with oat cell carcinoma of the lung, and 7/41 with malignant melanoma. The response rate for patients with squamous lung or head and neck cancer appeared to be higher at weekly bleomycin doses of 30 and 60 mg (15/33 = 45%), compared to a weekly bleomycin dose of 15 mg (7/32 = 25%). A median survival from treatment of 30 weeks was observed in oat cell carcinoma, which represents considerable prolongation over that expected from supportive care alone or single-agent chemotherapy. Toxicity included: 1) myelosuppression, resulting in hospitalization for antibiotics in 20% of patients; 2) probable bleomycin lung damage in 4% of patients; and 3) dose-limiting vincristine neuropathy in 11%. The combination of twice-weekly vincristine and bleomycin for more than 6 weeks produced a disturbing "debilitation syndrome," characterized by weakness, anorexia, weight loss, and apathy. The encouraging response rate suggests a future role for these drugs in combination, especially for vincristine and bleomycin, with other agents showing activity in squamous and oat cell carcinoma. Toxicity precludes recommendation of this combination, in the regimens tested, for broader Phase III studies.
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PMID:COMB (cyclophosphamide, oncovin, methyl-CCNU, and bleomycin): a four-drug combination in solid tumors. 5 Aug 70

The clinical and pathologic features of 43 primary adenacarcinomas of the small intestine (32 jejunal and 11 ileal) are reported. Seventy-four percent of the patients presented with partial or complete small bowel obstruction, 56% complained of abdominal pain, 37% had symptoms of anemia (weakness, easy fatigability), and 35% had lost weight. Anemic hemoglobin levels occurred in 69%, and a palpable abdominal mass in 25%. Treatment consisted of a "curative" or "palliative" resection, or a bypass procedure. Seventy-nine percent of the tumors showed an annular, constricting pattern, while the remaining 21% had a predominantly fungating or polypoid appearance. Three individuals currently free of clinical recurrence have been followed less than 5 years. Of the remaining 40 patients, a 5-year cure was achieved in 11 (28%), including 6 (15%) who at present have no recurrence and 5 (13%) who subsequently died of other causes. Within 5 years, 28 of these 40 patients (70%) were known or presumed dead tumor, and 1 had succumbed to other causes (2%). Various pathologic features were correlated with the clinical course. Documented lymph node metastasis proved to be the most valuable prognostic finding, 88% of these individuals dying of tumor, as contrasted to 45% of those with tumor-free nodes. A few cases of superficially invasive carcinoma found in an otherwise benign adenomatous lesion had a good prognosis when symptoms were produced mainly by the adenoma, the carcinoma being a relatively minor component.
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PMID:Primary adenocarcinoma of the jejunum and ileum. A clinicopathologic study. 5 95

A study is presented of 14 patients with hyperparathyroid crisis treated at the Massachusetts General Hospital between 1964 and 1978. These patients showed diverse clinical manifestations that were indistinguishable from those in patients with pseudohyperparathyroidism. Their symptoms varied from progressive fatigue, malaise, and weakness to those related to the gastrointestinal and urinary tracts. The one biochemical alteration commonly found among these patients was the rapid increase in the serum calcium. There was a concomitant rise in the BUN in 50% of the patients and in the creatinine in 80%. The diagnosis was established by an elevated immunoreactive parathyroid hormone (PTH) level in all eight patients (100%) who had the radioimmunoassay; by the presence of subperiosteal resorption of the phalanges in six of the eight patients (75%); and in three of four patients (75%) by the loss of the lamina dura of the teeth. The 12 patients who had surgery all survived; the two who did not died. Thirteen patients (93%) had a neoplasm--an adenoma in 12 and a carcinoma in one. One patient had hyperplasia (7%). Nine patients (64%) received hypocalcemic drug therapy. The serum calcium temporarily fell to 12 mg/100 ml in five patients (56%) but failed to budge in four (44%). Simultaneous treatment with saline infusion, furosemide and with hypocalcemic drugs over a prolonged period compounded the difficulty at operation by increasing interstitial edema. Our findings from this study show prompt surgical intervention as the ideal treatment for hyperparathyroid crisis, preferably, within 72 hours of the acute onset of symptoms.
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PMID:Hyperparathyroid crisis: clinical and pathologic studies of 14 patients. 51 79

Some degree of bladder instability is common in elderly people because aging changes in the portion of the frontal cortex concerned with micturition allow uninhibited bladder contractions. Although this in itself is not a cause of urinary incontinence, it may be an important predisposing factor and must be differentiated from all other causes. Stress incontinence occurs when the bladder outlet becomes incompetent because of weakness of the supporting pelvic muscles. Incontinence also can be a symptom of atrophic urethritis, acute cystitis, chronic bacteriuria, or bladder carcinoma. Overflow incontinence results from retention of urine, which can be caused by impacted feces, prostatic enlargement, autonomic neuropathy, or anticholinergic drugs. A complete history and thorough physical examination, with special attention to neurologic signs, vulval appearance, and rectal examination often will reveal the cause of urinary incontinence. If the cause is not readily apparent, cystometrography is indicated, and if the bladder is normal, cystoscopy should be done immediately. A more limited examination is acceptable only in demented patients who may not be able to cooperate in the examination and subsequent treatment.
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PMID:Differential diagnosis of urinary incontinence. 63 64

Malignant tumors are known to have a "remote" or nonmetastatic effect on the central and peripheral nervous systems. Eight patients were seen with proximal muscle weakness in association with bronchogenic carcinoma (5), carcinoma of breast (2), and leukemia (1). Electromyography demonstrated small polyphasic motor unit potentials. Muscle biopsy, however, showed evidence of denervation. Electron microscopy revealed morphological abnormalities in the intramuscular segments of axons. This combination of EMG and biopsy findings is presented as evidence for a remote effect of tumor on the intramuscular distal axons.
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PMID:Weakness in malignancy: evidence for a remote effect of tumor on distal axons. 71 40

The authors report a series of 100 consecutive patients with spinal metastases causing cord or cauda equine compression, who were treated with surgical decompression. Of these, 30% (all women) had breast cancer. The most common primary neoplasm in man was prostatic carcinoma. Pain was the earliest and most prominant symptom, followed by weakness. Bladder dysfunction was recorded in 40 patients. The thoracic region was the most common site of cord compression (76 patients). Surgical treatment involved urgent and extensive laminectomy decompression. Concomitant spinal stabilization was required in 10 cases, involving posterior rib graft fusion in seven and Harrington rod instrumentation in three. At last follow-up review, 29 of these patients were living with an average postoperative survival of 2.3 years; 71 patients had died with an average survival of 8.8 months. Surgical decompression produced effective pain relief in 70% of the patients. Postoperatively, 58 patients could walk; of these, 40 were walking and continent of urine 6 months following surgery (including five patients who were totally paraplegic on admission). Positive approach and aggressive management in this problem can achieve results superior to those generally reflected in the literature.
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PMID:The neurosurgical management of spinal metastases causing cord and cauda equina compression. 73

The present study was designed to produce the experimental carcinoma of the biliary tract in dogs. Tube cholecystostomy was constructed in 8 mongrel dogs and 5-10 ml of 0.7-1.0 mg/ml solution of N-ethyl-N'-nitro-N-nitrosoguanidine (ENNG) was administered through the tube every day for the maximum period of 180 days. As the results: The experiment had to be cut off in 7 dogs (5 dogs: The tube was inadvertently pulled out. 2 dogs: died of general weakness). Pathological changes were observed in one dog given ENNG for 180 days and sacrificed at 372 days after the beginning of the experiment. Macroscopically, scattered foci of flat elevation of the mucosa were observed in the entire mucosal surface of common bile duct and a tiny polypoid lesion at the terminal protion. A tiny polypoid projection was adenocarcinoma confined to the mucosa, and areas of flat elevation showed marked hyperplasia of mucosa with partial atypical proliferation. No remarkable findings were noted in other organs.
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PMID:Experimental carcinoma of the biliary tract induced in dogs by N-ethyl-N'-nitro-N-nitrosoguanidine. 89 36

Two patients with maysthenic syndrome apparently not associated with carcinoma were studied in detail with repetitive stimulation of motor nerves, single fibre electromyography and histology. One patient showed signs of widespread autonomic dysfunction and the other patient had multifocal CNS symptoms of unclear etiology. Both cases showed a marked improvement with guanidine treatment which could be documented by the electrophysiological investigations. Due to severe adverse effects of the guanidine treatment on kidney, pancreatic and bone marrow functions the drug had to be withdrawn. Edrophonium given intravenously caused a marked and longlasting improvement of the muscle weakness and of the neurophysiological parameters. The mechanism of action is suggested to be different from that seen in myasthenia gravis. Single fibre electromyography showed a marked increase of neuromuscular jitter and blockings which decreased with increasing innervation frequency. The morphological study showed a selective affection of type II (fast twitch) fibres, a finding which is suggested to be secondary to an impaired neuromuscular transmission in the type II motor units.
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PMID:Clinical, neurophysiological and morphological findings in Eaton Lambert syndrome. 89 16

A 64 year old woman with a past history of panhysterectomy and oophorectomy for carcinoma of the body of the uterus (1950) and partial colectomy for carcinoma of the colon (1971), presented in 1972 with severe weakness of the proximal girdle muscles and histological evidence of polymyositis. A detailed search disclosed no tumor and she was treated with prednisone. Two years later, investigations for iron deficiency anemia revealed two polyps in the colon. Pathological examination of the resected colon disclosed two separate foci of adenocarcinoma and a number of adenomatous polyps. Three months later, further investigations for melena led to the discovery of a gastric carcinoma. Due to the extent of the tumor, she was subjected to gastrectomy. splenectomy, and excision of the tail of the pancreas, but died of postoperative complications. At autopsy, no residual cancer was detected, but a meningioma was found. The association of polymyositis with malignant tumors has been recognized for a long time, but only two previously reported patients have had more than one cancer. Although a causal relationship is difficult to establish, continued vigilance for neoplasms is advocated during the follow-up period.
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PMID:Polymyositis in a patient with multiple neoplasms. 97 62

The authors describe a case of gastric carcinoma coupled with pregnancy, the only such case they encountered in 80,064 deliveries over a period of 30 years. The pregnancy was complicated by pronounced anemia and general weakness. By administering roborants, antianemic therapy, and blood transfusion to improve the patient's general condition, the pregnancy was completed by the birth of a clinically healthy at-term live child, weighing 3150 g. The patient lived only 6 months after delivery.
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PMID:[Cancer of the stomach, pregnancy and labor]. 101 5


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