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Query: UMLS:C0012739 (disseminated intravascular coagulation)
 8,673 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Experiments were made to evaluate the potential role played by thrombogenic factors on the hematogenous arrest of circulating tumor cells in mice with demonstrable coagulopathies associated with the presence of a primary tumor, by administration of "therapeutic" doses of anticoagulants. The effects of warfarin, aspirin and heparin administration on the early arrest patterns of 125IdUrd-labelled TA3 carcinoma and Gardner lymphosarcoma cells injected intravenously into tumor-bearing mice were examined. Several hematologic parameters of carcinoma- and lymphosarcoma-bearing animals were measured prior to anticoagulation experiments and the results indicated that mice had coagulopathies similar to those found in cancer patients with disseminated intravascular coagulation syndrome, i.e., thrombocytopenia and elevated fibrinogen levels. Despite the presence of coagulation abnormalities and effective anticoagulation in recipient animals, all three agents were without effect on localization patterns of both tumor types. It was concluded that the proposed involvement of thrombogenesis in metastasis was probably not due to any role played by those clotting factors inhibited by aspirin, warfarin and heparin in early intravascular tumor cell arrest.
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PMID:Initial tumor cell arrest in animals of defined coagulative status. 58 Sep 32

Although the value of surgical decompression and stabilization for solitary spinal metastasis is well documented, indication for surgery for advanced multiple metastatic tumors of the spine is controversial. In this study, the clinical effect of posterior decompression and stabilization was investigated in 11 patients with advanced multiple spinal metastases with unfavorable conditions. Mean blood loss during surgery was 3000 g. Disseminated intravascular coagulation occurred in three patients. Neurologic improvement was observed in nine patients. There was no neurologic deterioration due to surgery in any patients. A measure of pain relief was obtained in all patients. However, the postoperative longevity was short and the patients died 2.5 months (on average) after operation, except in cases of breast cancer. The effect of the posterior surgery on multiple spinal metastases depended on primary diseases. In cases of short life expectancy, the effect of the surgery was limited only to the short duration of neurologic improvement, pain relief, and ease of nursing care while confronted with grave surgical morbidity. In cases of long life expectancy with tumors like breast cancer, however, posterior decompression and stabilization were expected to exert long-term therapeutic effect. Therefore, the posterior surgery for multiple spinal metastases is cautiously indicated considering the nature of the primary tumor.
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PMID:Posterior decompression and stabilization for multiple metastatic tumors of the spine. 128 41

Peritoneovenous shunts of the Denver type were inserted into 36 patients to control malignant ascites. The Denver system features a compressible pump chamber bearing a pressure sensitive valve. Initially, all the shunts functioned well. The shunt remained open until death in 21 patients, and at the beginning of the analysis, another two patients were still alive with an open shunt. Blockage of the shunt occurred in 13 patients before death. The cumulative survival time for patients after shunt insertion was 129 months and the cumulative shunt functioning time was 92 months. The over-all median survival time after shunt installation was 13 weeks, and calculated actuarially, the median shunt functioning time for long term survivors was 14 weeks. The cytologic state of the ascitic fluid did not make a statistically significant difference to the blockage-free interval (p = 0.99), neither did the type of primary tumor (p = 0.37). Complications were of a minor type. There was no laboratory or clinical evidence of disseminated intravascular coagulation. Tumor spread through the tubing was seen in one of the three autopsies performed. Denver type peritoneovenous shunting appears to provide effective palliation in the majority of patients. It should, however, only be performed as a last resort.
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PMID:The Denver type for peritoneovenous shunting of malignant ascites. 242 17

Malignant ascites is often refractory to therapy and rapidly deteriorating the nutritional and physical state of the cancer patient. Nevertheless, ascites does not always implicate preterminal state of the cancer process (e.g. ovarian carcinoma). A short review is made of the pathophysiology of ascites in cirrhosis and in malignancy, and different modes of treatment are discussed. The results of medical therapy of malignant ascites (salt and water restriction, diuretics, intraperitoneal cytostatics or radiocolloids) are not convincing. The immunotherapy with OK-432, as worked out by Katano (16-46) has to prove its value. The best and most hopeful results in cases of massive previously resistant ascites, are obtained with a peritoneojugular shunt, improving immediately the nutritional status and life condition, providing excellent palliation. The superiority of the Denver shunt versus the Le Veen shunt has been assessed recently, especially for malignant ascites. Some technical and perioperative details merit more attention, to limit the high risk ratio. Control of the intrathoracic position of the catheter tip, the maintenance of the bloodflow in the jugular vein, the intramuscular tunnelisation of the peritoneal catheter, the discard of 3 or 5 liters ascitic fluid and the substitution of part of it by physiological fluid, perioperative prophylactic antibiotics and heparinisation, flow-rate control in the postoperative period by changing patients position, respiratory exercises, daily flushing, all those measures limit the risk of fibrinolysis (DIC), shunt occlusion, fluid overload and infection. The fear of metastasis by shunt is unfounded, since the survival of the primary tumor is mostly too short (41). The postoperative follow up in an intensive care unit is necessary during 24-72 hours.
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PMID:[The Denver shunt in malignant ascites]. 258 Apr 8

Metastatic spread of malignant tumor appears to correlate with activation of the fibrolytic system. The role of fibrinolysis in growth and metastasis was examined in Lewis lung carcinoma of mice. The inhibition of fibrinolysis or proteases decreased the primary tumor growth and pulmonary metastasis, whereas the activation of fibrinolysis or proteases increased the number of metastatic foci in the lung. Electronmicroscopically, thrombus formation in the primary site prevented tumor invasion and metastasis formation. Plasminogen activator (PA) content of excised tumors was determined by SDS-PAGE, and major PA was found to be urokinase (UK) type. Immunohistochemical study with specific antisera was done. When tumor cells possessed a high level of UK, laminin and type IV collagen, components of the basement membrane, disappeared from tumor tissues. These findings suggest that PA through protease cascade plays a role in tumor invasion and metastasis. Clinically, patients with advanced cancer are usually in a hypercoagulable state with elevated fibrinogen, and fibrin deposition around tumor mass is a serious problem in cancer chemotherapy. UK infusion prior to 5-fluorouracil increased tissue concentration of antitumor agent. However, development of consumption coagulopathy characterized by progression from hypercoagulable state to disseminated intravascular coagulation has also been found in several cases.
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PMID:[Tumor metastasis and the fibrinolytic system]. 273 23

During the period 1975 to 1984, a histopathologic diagnosis of primary cardiac hemangiosarcoma was made in 38 dogs at Angell Memorial Animal Hospital. The diagnosis was confirmed by exploratory thoracotomy in 16 cases and at necropsy in 22 cases. At the time of exploratory thoracotomy, 7 dogs were euthanatized because of nonresectability of the primary tumor and/or gross metastatic disease. In 9 dogs, the tumor was resected by removing part of the right atrium. Complications included atrial and ventricular arrhythmias, anemia, disseminated intravascular coagulation, and pneumonia. Prolonged and multiple hospitalizations were a common feature of the postoperative period. Adjuvant therapy was not utilized in any case. The mean survival time was 4 months (2 days to 8 months).
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PMID:Cardiac hemangiosarcoma in the dog: a review of 38 cases. 405 16

A 21 year old caucasian male, who was admitted to the medicine service for respiratory problems and hematemesis was ultimately diagnosed as having metastatic choriocarcinoma. Plasma samples were analyzed for prothrombin time (PT), activated partial thromboplastin time (APTT), platelets, and clot activation time for fibrinogen (FIB), and coagulation factors II, V, VII, VIII, X and XII. Abnormal clotting parameters included thrombocytopenia, PT, APTT, FIB, factors II, V, VII, and X. The coagulation abnormalities indicate the patient was in a state of consumption coagulopathy possibly induced by hepatic metastasis of the primary tumor.
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PMID:Abnormal hematological indices associated with metastatic choriocarcinoma in a young man. 657 23

A 9-year-old black girl underwent right hepatectomy because of a large primary tumor in the right lobe of the liver. Histopathologic examination revealed the diagnosis of mesenchymal hamartoma, a rare benign tumor occurring mostly in children below the age of 2 years. Preoperatively, the patient had laboratory evidence of mild disseminated intravascular coagulation (DIC) but had no bleeding manifestations. In preparation for the surgery, the patient received whole blood exchange transfusion and platelet transfusion which re-resulted in marked improvement in hemostatic parameters. Despite what appeared to be adequate replacement of blood loss during the surgical procedure, the patient developed sudden cardiac arrest near the end of the procedure and died. The probable cause of death was hypovolemia. This case of mesenchymal hepatic hamartoma illustrates two unusual features: age of the patient and the association with DIC. The latter, to our knowledge, has not been reported before.
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PMID:Mesenchymal hamartoma of the liver in an older child: association with disseminated intravascular coagulation. 670 May 45

From January of 1990 to June of 1993 a diagnosis of microangiopathic hemolytic anemia (MHA) was made in 5 out off 121 new patients with malignant tumor. There were 3 females and 2 males, with a mean age of 57 yr (range: 43-75), and a primary tumor in stomach (n = 2), pancreas (n = 1) and of unknown origin (n = 2). In all cases histologic type was adenocarcinoma and diagnosis was obtained by marrow examination. Four patients developed a disseminated intravascular coagulation syndrome. Intravascular deposits of fibrin, intimal proliferation and tumoral microembolisms were noted in 2 cases. Patients did not received chemotherapy, and the median survival was 7 days (range: 3-61).
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PMID:[Microangiopathic hemolytic anemia associated with neoplasms: an analysis of 5 cases and a review of the literature]. 793 39

A 41-year-old man incidentally found to have a right renal and left large lung tumor in the course of screening for liver dysfunction was admitted to our hospital. Needle biopsy of each tumors revealed histologically renal cell carcinoma and pulmonary blastoma. The renal tumor grew rapidly and soon he died of DIC. Autopsy was performed and the final diagnosis was adult Wilms' tumor and its metastasis to the lung. Histological findings of each large tumors showed different histologic pattern. The renal tumor revealed diffuse nephroblastic subtype and the lung tumor showed epitherial type. This is a rare case of Wilms' tumor in terms of its adult onset and different histologic pattern between the primary tumor and its metastatic lesion.
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PMID:[Adult Wilms's tumor with histologically dissisimilar lung metastasis]. 817 84


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