Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0019829 (Hodgkin's disease)
 30,247 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Staging laparotomy was performed at the University of Virginia Medical Center on 111 patients with Hodgkin's disease. The operation included multiple liver and lymph node biopsies and, excepting three patients, splenectomy. The histopathology was reviewed and the 111 patients were classified as follows: nodular sclerosis, 74; mixed cellularity, 28; lymphocyte predominance, 7; and undetermined, 2. There were no deaths. Wound, pulmonary or urinary tract complications occurred in 11 patients. One case of postoperative thrombophlebitis occurred and in another case small bowel obstruction developed, and resolved without reoperation. The pathologic stage (PS) following laparotomy was unchanged from the clinical stage (CS) in 64%, reduced in 20%, and advanced in 16%. The therapy, however, was altered in 38% of the patients. Lymphangiography in 103 patients was interpreted as showing lymph node involvement in 38, equivocal involvement in 11, and no involvement in 54. Among the 92 examinations reported as either positive or negative, 77% were confirmed histopathologically, 21% were falsely positive, and 2% were falsely negative. The spleen was positive for Hodgkin's disease in 39% of cases, and in these patients with positive spleens there was no reason to suspect intra-abdominal involvement preoperatively in 21%.
 ...
PMID:Staging laparotomy in Hodgkin's disease. 64 87

Resort to laparotomy for the staging of Hodgkin's disease has been controversial because of its questionable advantage over nonsurgical staging methods. The recent concern over splenectomy and subsequent overwhelming infection has added to this debate. The author reviews experience with Hodgkin's disease in 34 patients whose ages ranged from 6 to 18 years. Seventeen patients underwent staging laparotomy after their disease had been staged by standard nonoperative methods; the duration of follow-up was from 2 to 7 years. In 7 of these 17 patients the stage of their disease was changed as a result of the laparotomy findings. Complications have been late septicemia resulting in death in one patient and subacute bowel obstruction not requiring reoperation in two patients. In the author's opinion staging laparotomy in children with Hodgkin's disease is a valuable means of deciding on their subsequent therapy.
 ...
PMID:Staging laparotomy for Hodgkin's disease in children. 71 63

Twenty-five cases of hodgkin's Disease (15 males and 10 females) aged 5 to 17 years were studied from April 1970 to July 1976 (75 month period). Histology revealed that 2 had lymphocytic predominance, 12 had nodular sclerosis, and 11 had mixed cellularity. Pathologic staging revealed that 3 were IA, 1 IB, 5 IIA, 4IIB, 6IIIA, and 6 IIIB. Laparotomy altered the staging in 12 patients (9 were staging up and 3 down). All but 2 patients received extended field radiation, and 5 had recurrence of disease and were treated with combination chemotherapy. Twenty-three are alive without evidence of disease (21-75 months), and the 2 deaths were not due to Hodgkin's Disease but to hemobilia (postliver biopsy) and penumococcal septicemia, purpura fulminans, and disseminated intravascular coagulation (14 months postsplenectomy). Other complications included 2 patients with intestinal obstruction, 1 with postoperative subphrenic abscess, and 1 with streptococcal septicemia and polyarthritis. Nineteen patients received continuous penicillin prophylaxis postoperatively and the 2 with serious infections were amongst the 6 who had not received penicillin or whose penicillin had been discontinued at the time of infection. It is concluded that laparotomy and splenectomy in children is essential for accurate staging but carries significant risk, and continuous penicillin prophylaxis is recommended.
 ...
PMID:Staging laparotomy and splenectomy: treatment and complications of Hodgkin's disease in children. 100 54

We reviewed 39 patients with untreated Hodgkin's disease who underwent staging laparotomy and such cases in the English literature over the past two-and-a-half years. In the group of institutions in our compilation, the accuracies of clinically positive and negative judgments of liver involvement were 28 per cent and 95.4 per cent respectively, while in our institution the accuracies were 100 per cent and 95 percent respectively. The accuracies of the clinically positive and negative determinations of splenic involvement were 61.2 per cent and 67.3 per cent respectively after histological examination, whereas we had accuracies of 100 per cent and 74 per cent respectively. The accuracies of the clinically positive and negative determination of lymph nodes were 72.1 per cent and 86.7 per cent respectively, whereas the results were 70.6 per cent and 100 per cent respectively in our 39 cases. The percentage of complications was 10 per cent and the mortality rate was 0.9 per cent among 719 staging laparotomies. The common complications were atelectasis, pneumonia, wound infection and dehiscence, abscess, intestinal obstruction and thrombocytosis. We think more aggressive staging laparotomy should be performed for Hodgkin's disease under one surgeon or one surgical team.
 ...
PMID:Staging laparotomy for Hodgkin's disease. 126 87

The Authors review a case of intestinal non-Hodgkin lymphoma, whose clinical feature was an intestinal obstruction caused by ileoileal intussusception. Some findings which make it unusual are compared with those mentioned in the international literature.
 ...
PMID:[A case of intestinal occlusion caused by malignant ileal lymphoma]. 162 Apr 84

In 1980, based on experimental and clinical data, a protocol was developed at the Institut Gustave-Roussy (IGR), alternating eight monthly courses of chemotherapy (CHVP) and two, then three, radiotherapy sequences (15 Gy in 6 fractions and 10 days to the initially involved areas), for early stage unfavourable histology non-Hodgkin lymphomas (NHL). The results are updated for 55 selected patients presenting with bulky stage I and II NHL, intermediate and high grade according to the Working Formulation. Five-year overall survival rate was 69% and freedom from progression was 68%. Early haematologic and digestive tolerance was satisfactory, probably because a 10-15-day interval was respected between chemotherapy and radiotherapy and vice versa. No late toxicity was detected in 39 patients who presented with head and neck localizations; xerostomia was found to be only mild and transient. All patients given mediastinal irradiation experienced radiological mediastinitis, but functional impairment was usually moderate. One of the 4 patients who received 3 x 15 Gy radiotherapy courses to part of the abdomen, died of small bowel obstruction and perforation. The study demonstrated the feasibility of an alternated schedule of chemotherapy and radiotherapy, with satisfactory results in terms of long-term survival. However, the few late complications which were detected after irradiation of the abdomen or of the thorax led to an alteration of the initial scheme when these volumes are to be treated.
 ...
PMID:Alternating chemotherapy and radiotherapy combination for bulky stage I and II intermediate and high grade non-Hodgkin lymphoma: an update. 202 Jul 53

Due to it's rare appearance, the intestinal trichobezoar is usually not considered as a differential diagnosis of abdominal masses seen in children. A case of a 10 year old girl with a five month evolved inferior hemi-abdominal mass is cited. The girl appeared severely ill and within 24 hours of her physical examination, showed signs and symptoms of an intestinal obstruction. She was admitted to surgery with the diagnosis of a non Hodgkin lymphoma. Due to its' presentation, we may have even supposed it to be a case of Rapunzel syndrome which grew within the intestine causing obstruction or which may have initially grown in the terminal ileum. The medical literature is reviewed.
 ...
PMID:[Intestinal trichobezoar: differential diagnosis in children with an abdominal mass]. 269 37

Postoperative course is reported in 52 children with malignant tumors (neuroblastoma, Wilms-tumor, non-Hodgkin-lymphoma, osteosarcoma etc.) who were operated on between 1979 and 1987. 26 children received chemotherapy prior to surgery, whereas 26 children were operated on without preceding chemotherapy (control group). Most children were under six years of age. 15 Children (57.7%) with preoperative chemotherapy developed early postoperative complications, such as sepsis, pneumonia, suture dehiscence, woundhealing disturbances and ileus, whereas this was the case in only 5 children (19.2%) without preoperative chemotherapy (P 0.0005). Four of the children with preoperative chemotherapy (15.4%) sustained late complications, such as local recurrence or mechanical bowel obstruction, whereas none of the control children did so. Lethality rate from underlying disease did not differ in both groups during follow-up (5 = 19.2% vs. 5 = 19.2%). This demonstrates that the surgeon must carefully be aware of an increased possibility of early and late complications in children who have to undergo surgery for malignant tumors following preoperative chemotherapy.
 ...
PMID:[Postoperative course in children with malignant tumors following preoperative chemotherapy]. 273 47

Out of 516 patients who entered in the two successive EORTC trials H2 and H5 for supra-diaphragmatic stages I and II Hodgkin's disease (HD), and who received an infra-diaphragmatic irradiation, 36 (7%) developed late radiation injuries of the gastrointestinal tract (GIT). Twenty-five patients presented with ulcers (stomach or duodenum), 2 with severe gastritis, 6 with small bowel obstruction or perforation and 3 patients had both an ulcer and bowel obstruction. A previous laparotomy played an important role. While the complication rate was 2.7% without any previous abdominal surgery, it was 11.5% after laparotomy (p less than 0.001). Fractionation was also found to be of importance in the occurrence of complications: three different weekly schedules were used -5 x 2 Gy, 4 x 2.5 Gy and 3 x 3.3 Gy; the GIT complication rates were 4, 9 and 22%, respectively (p less than 0.001). When combining laparotomy and fractionation, we found that the patients who were treated using 5 weekly fractions of 2 Gy without any prior laparotomy had a very low rate of late digestive complications (1%), whereas the patients who received 3 weekly fractions of 3.3 Gy after laparotomy presented a 39% complication rate. The other subgroups of patients were at an intermediate risk (from 5 to 13%) of late digestive injuries. Since most patients received 40 Gy with only very small variations, the influence of the radiation dose could not be investigated.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Late radiation injuries of the gastrointestinal tract in the H2 and H5 EORTC Hodgkin's disease trials: emphasis on the role of exploratory laparotomy and fractionation. 314 82

Staging laparotomy in patients with Hodgkin's disease continues to be a controversial procedure in their management. Between 1970 and 1986, 67 patients up to 18 years of age were seen with Hodgkin's disease. The results of staging laparotomy performed on 39 of these children are reviewed. The clinical stage was changed as a result of laparotomy in 43.6% of cases, with 12.8% of cases upstaged and 30.8% of cases downstaged. All changes in stage modified the proposed treatment for the patient. In 20.5% of patients the laparotomy was positive, and in all cases the spleen was involved. Preoperative lymphangiography did not accurately identify nodal disease. Of the patients with negative laparotomies, 10% developed relapse in the abdomen. Major complications included three episodes of bacterial sepsis, with one death due to Streptococcal pneumonia and one to Neisseria gonorrhea. All septic events occurred prior to the use of pneumococcal vaccine and prophylactic antibiotics. One patient required reoperation for intestinal obstruction with bowel resection. None of the currently used noninvasive tests accurately identifies intraabdominal disease. Therefore, staging laparotomy continues to play an important role in the early management of Hodgkin's disease.
 ...
PMID:Staging laparotomy for Hodgkin's disease in children. 317 39


1 2 3 4 Next >>