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

Thirty-one children with mediastinal abnormalities--14 malignant lymphomas, 4 other primary malignancies, one metastatic and 12 benign lesions--were examined one or several times using CT, which proved to be effective especially for cysts (5 patients), ductus arteriosus aneurysm (2 patients), and intrathoracic liver (one patient). It also supplied important diagnostic information regarding the extent of disease in malignant thymoma (one patient), in neurinoma (one patient), and in Hodgkin's lymphoma (5 patients). It was found to be useful in the monitoring of treatment of patients with lymphomas, in which a small residue, probably a fibrotic remnant, was invariably seen after completion of chemotherapy and irradiation. It was concluded that when the residue was enlarged, the possibility of relapse and even thymic hyperplasia should be considered. However, if CT was performed under general anaesthesia pseudo-widening of the anterior mediastinum could simulate recurrence. Surgical biopsy was found to be necessary in these cases because fine-needle aspiration biopsy was unsuccessful.
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PMID:Computed tomography in the diagnosis and treatment of mediastinal abnormalities in children. 296 32

A 24-year-old man had a large anterior mediastinal mass and a nonproductive cough of 6 weeks' duration. With the patient under general anesthesia, a diagnostic mediastinoscopy was performed with endotracheal intubation. During the procedure, acute respiratory failure developed as a result of tracheal obstruction. Fiberoptic bronchoscopic examination of the patient in the supine position revealed almost total extrinsic compression of the trachea and no evidence of intraluminal disease. Reexamination of the trachea with the patient in sitting and semiprone positions showed resolution of the extrinsic compression and respiratory distress. Flow-volume curves obtained before treatment of the mediastinal mass (histologically diagnosed as Hodgkin's lymphoma) disclosed major airway compression with the patient in the supine position; the abnormality disappeared after chemotherapy. The mechanisms responsible for tracheal compression by mediastinal masses during general anesthesia may include the following: (1) the effect of anesthesia on pulmonary mechanics, (2) the supine body position, (3) the elimination of glottic regulation of airflow by endotracheal intubation, (4) changes related to the surgical manipulation of the tumor itself, (5) the size and location of the mediastinal mass, (6) the young age of the patient, and (7) preexisting airways disease. Anticipation and prevention of potential respiratory complications and preparedness to treat them appropriately are important aspects of the management of these patients.
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PMID:Mediastinal mass and tracheal obstruction during general anesthesia. 317 49

1. The effects of general anesthesia on passive and active membrane properties of trigeminal root ganglion neurons of decerebrate guinea pigs have been determined using frequency-domain analyses of small-amplitude perturbations of membrane voltage. Quantification of the effects was accomplished by fitting the complex impedance locus diagrams computed from the neuronal responses with a membrane model based on linearized Hodgkin-Huxley-like equations. 2. Endotracheal administrations of isoflurane (2-3% for periods of 30-180 s), the most extensively studied of five general anesthetics, did not elicit large changes in membrane potential or in electrical properties in 26 of the 38 neurons. In this relatively unresponsive group, application of isoflurane in higher concentrations (3-4%) tended to evoke small but significant changes (less than 20%) in membrane properties without altering membrane potential by greater than 5 mV. These changes consisted of increases in the effective input capacitance and input conductance. 3. The impedance magnitude functions were reduced in amplitude consistently in 12 of the 38 neurons during induction of general anesthesia with isoflurane (2-4%) or, in several cases, with halothane (2%). Such applications evoked depolarizations of 8-32 mV, which also were observed in several instances of anesthesia with enflurane and cyclopropane. Quantification of these effects on electrical properties by curve fitting with the linearized Hodgkin-Huxley model revealed increases in the effective input capacitance, in the time-invariant resting conductance, Gr, and in the voltage- and time-dependent conductance, GL. Sometimes, an initial decrease preceded the increase of Gr, and the relaxation time constant associated with GL usually was reduced by the anesthetic agent in the 12 neurons. 4. In 10 neurons, membrane resonance behavior (which was apparent as a large hump at low frequencies of the impedance magnitude functions) was reduced in amplitude, as well as broadened in bandwidth, when peak changes in membrane properties were evident, i.e., during surgical or deep anesthesia. These actions of isoflurane or halothane were correlated to a reduction in spike electrogenesis and they may account for the reduced tendency of neurons to fire repetitive action potentials during anesthesia with isoflurane or halothane.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Modifications in membrane properties of trigeminal sensory neurons during general anesthesia. 349 36

This is the first report of a case-control epidemiological study on lymphomas and leukaemias occurring in Yorkshire during 1979-84. This paper deals with the results of the Hodgkin's disease analysis comprising 248 cases and 489 controls. The results indicate support for previous work with respect to small family size and past history of infectious mononucleosis. Positive observations made in a previous pilot study are also confirmed and extended with respect to associations with certain chronic skin lesions, dental anaesthesia and familial factors. Negative associations are described with respect to X-ray exposures and cigarette smoking. It is proposed that these results fit into a general hypothesis that these conditions are the result of interaction between infectious agents and altered immunity in those persons genetically predisposed.
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PMID:Hodgkin's disease: case control epidemiological study in Yorkshire. 381 82

Current therapy for children with cancer includes a variety of invasive procedures many of which require repeated venous access over a considerable period of time. Such procedures are poorly tolerated by children and by their veins. Recently it has become possible to undertake the majority of such procedures by means of permanent indwelling silastic catheters improving the quality of life of the children and their parents and increasing the scope of therapeutic intervention. In the period July '83 - August '84 we have used 46 of these catheters in 45 children with malignant disease, 12 with acute myeloid leukaemia, 12 with neuroblastoma, 7 with B cell leukaemia-lymphoma, 6 with rhabdomyosarcomas, 2 with Ewing's Sarcoma, 2 with Wilms' tumor and 1 case each of Hodgkin's disease, teratocarcinoma, osteosarcoma and juvenile chronic myeloid leukaemia. The children's ages ranged from 2 months to 14 years; 22 were male and 23 female. The catheters were inserted under general anaesthesia (duration 20-40 minutes) usually without difficulty, except for a single patient in whom no suitable vein could be found. No complications connected with the placement of the catheter were observed. Subsequent management of the catheter was initially complicated and time-consuming, but was subsequently simplified so that acceptance by parents, children and nursing staff was eventually excellent. The duration of use of 46 catheters ranges from 7 to 350+ days; 24 catheters are presently in use at 30-350+ days from insertion. Eight children died as a result of disease progression and two of sepsis with the catheter in place.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Advantages of a permanent venous access in children treated for cancer. Preliminary results]. 383 38

Life-threatening airway obstruction from large mediastinal masses in children poses a difficult diagnostic and therapeutic dilemma, requiring the close coordination of a pediatric surgeon, anesthesiologist, radiologist, and oncologist. To focus on this problem, the anesthetic and surgical management of 50 consecutive children with mediastinal masses treated between 1978 and 1984 were reviewed. Thirty children presented with respiratory symptoms; nine had life-threatening respiratory compromise with dyspnea, orthopnea, and stridor. Thirteen of these symptomatic children had marked compression of the trachea and/or mainstem bronchi on radiographic studies. The tracheal cross-sectional area which was measured by computed tomography was decreased by 35% to 93% of the normal tracheal dimensions in these children. Nonresectable malignant neoplasms including lymphoma, Hodgkin's disease, rhabdomyosarcoma, and neuroblastoma were the eventual diagnoses in 10 of these patients. The other 3 patients were less than 4 years old and had benign lesions. General anesthesia was judged to be prohibitively risky in 5 of 13 patients. The diagnosis was established by node or needle biopsy under local anesthesia, and general anesthesia was deferred until the compromised airway was alleviated by radiation and chemotherapy. General anesthesia with endotracheal intubation was administered to 8 patients, 5 of whom developed total airway obstruction. Using a variety of maneuvers, ventilation was reestablished in all 5 patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Life-threatening airway obstruction as a complication to the management of mediastinal masses in children. 408 8

Three cases of asphyxia at the beginning of general anaesthesia for mediastinoscopy or biopsy of adenopathy are described in patients with malignant lymphoma. One of them died in spite of endobronchial intubation, artificial ventilation and steroids. The two others recovered when specific chemotherapy was added to the same symptomatic treatment. The risk of respiratory obstruction seems higher in non-Hodgkin than in Hodgkin lymphomas. This kind of obstruction is not relieved by an antiasthmatic therapy. Pulmonary lymphatic filtration may be hindered in case of mediastinal lymphoma, especially during anaesthetic induction, and pulmonary interstitial congestion may occur impeding gas propagation. Specific chemotherapy according to the histological type of the tumour may relieve the compression and respiratory obstruction in a few hours.
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PMID:[Respiratory obstruction during anesthesia in cases of mediastinal malignant lymphoma]. 665 Sep 35

Tracheobronchial compression was observed in 55% of 20 consecutive newly diagnosed children with Hodgkin lymphoma at Children's Hospital of Philadelphia. In most reports of Hodgkin lymphoma, no mention is made of tracheobronchial compromise. This radiographic finding may explain respiratory symptoms, aid in initial therapy planning, prevent sudden deterioration, and help guide intubations for anesthesia or respiratory support. At times, fluoroscopy and tomography were helpful in confirming the plain film findings.
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PMID:Tracheobronchial compression in Hodgkin lymphoma in children. 698 62

The effects of different kinds of anesthesia on the function of live (evaluated on the basis of activity of enzymes -- aspartate aminotransferase, fructose-I-monophosphate aldelase and glutamate dehydrogenase) were studied in 63 infantile patients with Hodgkin's disease who underwent diagnostic laparotomy with splenectomy. It was found that during the first 6 days after surgery, the rate of activity of these enzymes shows a rise and reaches the upper limits in 77.8% of cases. Halothane anesthesia induced excessive enzymatic activity in 100%, while neuroleptanalgesia -- in 53.8% of cases. Repeated application of halothane produced a higher hepatotoxic effect as manifested by enhanced activity of glutamate dehydrogenase on days 1--2 after operation.
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PMID:[Effect of fluorothane anesthesia on liver function in children suffering from lymphogranulomatosis]. 724 73

Needle aspiration biopsy of hilar and mediastinal masses was attempted in 100 patients and completed in 91. There were no major complications. In the group with completed biopsies, there were 83 patients with malignant neoplasms; a positive diagnosis of malignancy was established in 80 (96%). Two of the three false-negative results occurred in patients with Hodgkin disease. In all 8 patients with benign masses, the biopsy results were correct. Five of the nine incomplete biopsies occurred in patients with aortic aneurysms that simulated lung or mediastinal masses. In the other 4 patients, the needle biopsy was not completed for technical reasons. Needle biopsy can be performed in practically all areas of the mediastinum, does not require general anesthesia or hospitalization, and is well tolerated by the patient. In this series, the use of mediastinal needle biopsy made it possible to avoid surgery and mediastinoscopy in 72 patients with unresectable malignant neoplasms and 5 patients with innocuous benign mediastinal masses. Needle biopsy may be the preferred initial procedure to obtain a tissue diagnosis in patients with mediastinal masses.
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PMID:Percutaneous needle aspiration of hilar and mediastinal masses. 729 53


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