Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Immunological response to surgical trauma may be protected during laparoscopic surgery. A less surgical trauma, in comparison with conventional surgery, may explained these important advantages. Plasma and macrophages studies have demonstrated that laparoscopic cholecystectomy causes less depression of cell mediated immunity than open cholecystectomy. What will be the impact of this immunological protection in laparoscopic advanced and oncological surgery? Experimental studies have showed that laparoscopic techniques in advanced and oncological surgery may have important advantages concerning the "preservation of the immune status" of the patient. That will imply in the future a lower percentage of infections, local recurrence and even a lower percentage of distant metastases. On the other hand, the appearance of tumor implants in the port sites after laparoscopic resection for cancer is a significant drawback of this procedure. Proper investigations have to be carried out in order to find the cause and the solution of this dilemma.
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PMID:Immunological response in laparoscopic surgery. 908 26

When macrometastases are delineated clearly using current radiographic techniques and/or physical examination and can be shown to concentrate 131I, the therapeutic activity to be administered may be determined quantitatively. Administrations of 131I that will deliver 30,000 rad to residual thyroid tissue or 10,000 +/- 2,000 rad to lymph node metastases will ablate them successfully 80% of the time, and bone marrow depression that is severe enough to require specialized treatment will be avoided if the whole blood dose from a single administration does not exceed 200 rad. When micrometastases are detected only by diagnostic radioiodine imaging and/or elevations of serum thyroglobulin levels, and when a clinical decision is made to treat them with radioiodine, then 131I may not be the isotope choice. With small lesions < 0.05 mm in diameter, the lower energy emissions of 125I therapy may be more suitable. With the advent of alternative methods of patient preparation for radioiodine therapy, empiric approaches that were derived from experience with endogenously hypothyroid patients will require full re-evaluation. Approaches based on quantitative radiodosimetric calculations will continue to be valid because they already consider individual differences in radioiodine kinetics.
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PMID:Dosimetric considerations in the radioiodine treatment of macrometastases and micrometastases from differentiated thyroid cancer. 913 81

Port site metastases could be due to mechanical reasons or impairment of host defenses. As it is known that carbon dioxide is toxic for lymphocytes in vitro we decided to investigate lymphocyte stress during laparoscopy. Blood samples and peritoneal fluids were obtained before and after pneumoperitoneum from 16 patients undergoing laparoscopic cholecystectomy. Lymphocyte subsets were determined by flow cytometry. Propidium iodide was used as a lymphocyte vitality test. Cytokines were measured by an ELISA system. Significant falls in the absolute lymphocyte count and T3 and T4 lymphocytes occurred on postoperative day 1 with a quick return to the preoperative value on day 2. T8, natural killer cells, T4/T8, and T4+/T8+ counts were stable. Interleukins 1 beta and 6 and tumor necrosis factor-alpha were depressed during the two postoperative days. Peritoneal lymphocytes were not destroyed by pneumoperitoneum as demonstrated by the propidium test, nor were they locally impaired by carbon dioxide. The circulating lymphocyte subpopulation decrease favors moderate, brief immunodepression. The origin of port site metastases is not immunologic depression but, rather, facilitated implantation of malignant cells by hyperpressure into raw tissues.
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PMID:Influence of CO2 pneumoperitoneum on systemic and peritoneal cell-mediated immunity. 914 63

The microbial immunostimulant OK-432 has been studied intensively in preclinical systems and has shown promise as an anticancer agent in trials that have been conducted over the past 20 years in Japan. To date, no systematic dose response evaluation of this agent has defined its dose-limiting toxicity or immunobiological activity. A phase IA study has been conducted in 25 patients with metastatic cancer at the University of Pittsburgh Cancer Institute Melanoma Center, establishing 30 KE as the maximal tolerable dosage, on the basis of cutaneous reactions. Subsequently, 48 patients with resected high-risk melanoma participated in a phase IB study of OK-432. This study has evaluated the immunomodulatory activity of OK-432 at five dosages ranging from 1 KE to 20 KE, administered ID twice weekly for 3 months. A formal analysis of the treated population in comparison to the randomized control group has been conducted, and profound immunological effects have been defined in the group of patients treated with OK-432. Patients who participated in this trial had a significant depression of OK-432-inducible cytokine production (interleukin-1 beta, interferon gamma, and tumor necrosis factor alpha) at baseline. Treatment with OK-432 reversed this deficit for interferon gamma (IFN gamma) production in a dose-dependent manner, and mitigated the inhibition for interleukin-1 (IL-1) across all dosage groups. The impact of OK-432 upon other immunological functions of the treated cohorts is more variable, with durable suppression of mononuclear cell superoxide production, and in vitro cytotoxicity to tumor. Immunological characteristics of the entire cohort demonstrate a strong and significant correlation of elevated blood CD16+ cell counts and natural killer activity with early tumor progression and death due to melanoma. Favorable prognosis is associated with monocyte capacity to produce tumor necrosis factor (TNF), and polymorphonuclear leukocyte formylmethionyl-leucylphenylalanine-inducible superoxide release. This study reveals several new immunological correlates of tumor progression and lethal outcome in resected high-risk melanoma. It demonstrates that the depressed IL-1, TNF, and IFN gamma release associated with melanoma may be mitigated by treatment with OK-432. This study has defined treatment and dose response patterns of immunomodulation associated with one of the most complex immunological agents yet evaluated in phase IB trials, in a well-defined population of high-risk patients with resected melanoma.
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PMID:Phase IB trial of picibanil (OK-432) as an immunomodulator in patients with resected high-risk melanoma. 919 73

Unrelieved pain has been cited as an important reason why cancer patients may seek to hasten their deaths. We interviewed 48 patients with painful metastatic cancer to ascertain their interest in various active and passive modes of hastening death. Ninety percent of these patients supported the general right of terminally ill patients to passive modes of hastening death and 80% supported the right to active modes such as assisted suicide and euthanasia. If they developed severe pain that could not be relieved, 80% would instruct their physician write a "do not attempt resuscitation" order, 40%-50% would want to receive suicide information or a lethal prescription from their physician, and 34% would request a lethal injection from their physician. Current pain and depression levels were not associated with interest in hastening death, but current somatic symptom burden was significantly associated with this interest.
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PMID:Pain and the choice to hasten death in patients with painful metastatic cancer. 935 37

Escape from immune surveillance is critical for tumor progression in metastatic melanoma. We assessed the function of melanoma-derived dendritic cells (DCs) in patients presenting simultaneously with responding (rM) or progressing (pM) melanoma metastases. These rare coincidences allowed us to compare syngeneically the function of tumor DCs. CD83+ DCs were purified freshly from large responding (rDCs) or progressing (pDCs) metastases following chemoimmunotherapy. rDCs were 5 times more potent inducers of allogeneic T-cell proliferation than the pDCs that were used as control. Phenotypic analysis showed a marked depression of CD86 expression on pDCs. Culture supernatants from pM showed production of Th2-type cytokines [interleukin-10 (IL-10)], whereas a Th1 pattern [IL-2, interferon-gamma (IFN-gamma), IL-12) predominated in rM. The IL-10 detected in progressing metastases was directly derived from melanoma cells. Culture supernatants from metastases applied to DC-supported allo-MLR assays suppressed T-cell responses by 50-75% in the case of pM, but not rM. Finally, in a co-stimulation-dependent anti-CD3 tolerance assay, pDCs (but not rDCs) induced anergy in syngeneic CD4+ T cells. Anergy could be overcome by addition of IL-12 or IL-2. Our results show that melanoma-derived factors convert DC-antigen presenting cell function to tolerance induction against tumor tissue, changing tumor DCs to "silencers" of anti-tumoral immune responses.
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PMID:Dendritic cells as mediators of tumor-induced tolerance in metastatic melanoma. 935 74

The aim of this study was to investigate the prevalence of anxiety and depression in cancer patients seen at the Norwegian Radium Hospital, using the Hospital Anxiety and Depression Scale (HADS), the EORTC QLQ-C33 and an ad hoc designed questionnaire. In addition, information about the patients' malignant disease and treatment was obtained. The prevalence of anxiety and depression among 716 evaluable patients was 13% and 9% respectively, as assessed with HADS. In hospitalised patients, the risk of psychiatric distress was approximately twice that of patients in the outpatient clinic. Female patients reported significantly more anxiety than men. Patients < 30 or > 70 years old expressed less anxiety than all other patients. Age or gender had no influence on the occurrence of depression. Impaired ability to continue professional work and/or daily life activities, impaired social life and previous psychiatric problems were significantly correlated with anxiety and depression as were impaired physical function, fatigue and pain. The prevalence of depression, but not anxiety, increased in the presence of distant metastases, with less than a month since diagnosis, and with relapse or progression. In the logistic regression analysis, a history of previous psychiatric problems and impaired social life were correlated with both anxiety and depression. Female gender, impaired physical activity and impaired social role function were additional predictive parameters for anxiety, whereas fatigue predicted depression. Careful attention should be paid to cancer patients displaying these problems in order to diagnose and treat depression and anxiety disorders.
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PMID:Prevalence of anxiety and depression in cancer patients seen at the Norwegian Radium Hospital. 938 21

This case report describes a dog with spontaneous melanoma of the orofacial region which was treated by a synthetic inhibitor of cyclin-dependent kinases, i.e. olomoucine (OC). The drug was applied i.v. in a single dose of 8 mg/kg/day for 7 days in succession. Repeated bioptic examinations of metastatic cervical lymph nodes showed rapid induction of apoptosis in tumor cells as early as on the third day of treatment. Standard clinical and laboratory examinations did not reveal side effects of the therapy. There were no detectable manifestations of myelosuppression, hepatotoxicity, nephrotoxicity or neurotoxicity. However, transient anemia developed following bleeding from a devitalized tumor mass. For this reason, the dog underwent surgery to minimize tumor load as well as to eliminate the source of bleeding. Two kilograms of primary tumor were extirpated in the course of surgery, including cervical node metastases. Unfortunately, the dog died soon after surgery due to respiratory depression. Histological examinations of the tumor tissue showed marked apoptosis of melanoma cells in both the primary tumor and metastases. The induction of programmed cell death of cancer cells by OC resulted in rapid eradication of at least 68% of the tumor cells. The remaining melanoma cells retained at least equally well in vitro sensitivity to OC as to drugs currently used in clinical practice.
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PMID:Induction of apoptosis and regression of spontaneous dog melanoma following in vivo application of synthetic cyclin-dependent kinase inhibitor olomoucine. 943 44

Although fatigue is the most frequent complaint in cancer patients, there is no universally accepted definition. In this book a series of studies are presented whose aims were definition of cancer-specific fatigue and the development of an instrument which had the capacity to discriminate levels of fatigue in different groups of cancer patients. The first study (chapter 2) explored the concept of fatigue by comparing the personal experiences of cancer patients (n = 20) with those of healthy individuals (n = 20). Using grounded theory, themes emerged which classified fatigue into physical, affective and congitive components. Differences were found in the expressions used by the two cohorts, particularly in relation to the physical sensations experienced. The descriptors generated by cancer patients were compared with those used in the currently available fatigue instruments and illustrated considerable differences in content. They were therefore used to develop a new fatigue instrument--the Fatigue Assessment Questionnaire (FAQ). The second study (chapter 4) tested the reliability and feasibility of the FAQ in a non-randomised, prospective, cross-sectional study of cancer patients (n = 77) and healthy individuals (n = 77). It was found to discriminate between fatigue experienced by cancer patients and that experienced by healthy individuals. A tentative step-like theoretical explanation for the production, perception and expression of fatigue proposed at the end of study one was supported by factor analysis. It led to minor adaptations of the instrument. The third study (chapter 5) subjected the FAQ to further validity testing. Four hundred and ninety-nine cancer patients with a variety of tumour types and stages were included in a prospective, non-randomised, cross-sectional study. Factor analysis supported the theoretical framework and led to modifications which resulted in a multi-dimensional, 20-item instrument. The FAQ discriminated significantly different levels of fatigue and the distress that it caused in patients with metastatic cancer, patients with localised cancer and patients whose disease was in remission. High levels of fatigue were mainly associated with advanced stages of cancer, in combination with high levels of depression. The closing chapter represents a synthesis and discusses issues for further research and implications for practice.
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PMID:Fatigue in patients with cancer. Analysis and assessment. 955

The case history is reported of a patient with melanoma and advanced metastases, who died from massive cerebral bleeding. The lethal event was not caused by intracerebral metastasis but by thrombocytopenia. Depression of the bone marrow resulted from tumour infiltration of the skeleton, chemotherapy and vertebral irradiation. An increase of intracranial pressure triggered the cerebral bleeding, caused by haematemesis from a gastric metastasis directly preceding sudden somnolence.
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PMID:Massive lethal cerebral bleeding in a patient with melanoma without intracranial metastasis. 976 84


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