Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020505 (hyperphagia)
6,116 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Between november 1964 and december 1982, 102 patients were operated upon for the treatment of carcinoma thoracic esophagus. The philosophic objectives were to restore promptly the ability to swallow and to achieve a worthwhile survival period. To fulfill these requirements wide excision of the growth and immediate esophagogastrostomy were performed through a combined abdominal and right thoracic approach. In higher thoracic growths the Authors added a cervical phase. The resectability rate was 74% and the overall hospital mortality rate was 19,6%. Anastomotic leaks occurred in 10 patients (9,8%) with fatal outcome in 6. Pre- and postoperative care (particularly hyperalimentation and intensive respiratory therapy) and use of mechanical devices reduced the operative mortality rate to 8,1% between 1976 and 1982 without deaths in the last 16 patients. Very satisfactory palliation was achieved in 80% of the patients who survived the standard esophagogastrectomy. These patients enjoyed uncomplicated oral alimentation for the remainder of their lives. Despite there has been considerable improvement in operability and resectability rates and in survival of resection as compared to past years, long term results of treatment of carcinoma of the esophagus continue to remain disappointingly low. Overall survival rate at 5 years was 10,2% in this report. The stage of the disease influenced significantly survival: curative as opposed to palliative resections demonstrated a marked difference in 5-year survival (28,2% vs 2,8%). Long-term survival of patients with carcinoma of the esophagus will probably not improve until early diagnosis is possible. Therefore esophagogastrectomy should be the treatment of choice until other forms of therapy prove superior to it both in terms of palliation and long-term survival rate.
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PMID:[Results of the treatment of carcinoma of the thoracic esophagus with one-stage resection and esophagogastrostomy]. 608 66

Seventy-three patients with small bowel obstruction due to metastatic carcinoma were seen in the years 1960 to 1979. Twenty-nine patients were seen in the first decade and 44 patients in the second. The most common primary tumor causing metastatic small bowel obstruction was colonic carcinoma, followed by gastric carcinoma. Plain x-ray examinations supplemented by an upper gastrointestinal series with small bowel follow-through were the most useful diagnostic tests. Seventy per cent (51/73) of these patients were initially treated with intravenous fluids and gastrointestinal decompression using a short (32/51) or long (19/51) tube. In eight of 51 patients, nasogastric decompression relieved the obstruction, but in all but one of these patients symptoms and signs of obstruction recurred promptly after tube removal. At laparotomy, the majority of patients underwent either a bypass procedure or resection. The mean survival for the patients bypassed varied from four to seven months; for those that had resection it varied from five to nine months. The mortality rate was high--41 per cent in the first decade and 25 per cent in the second. Of the last 12 patients, eight received hyperalimentation before and after surgery. The operative mortality rate was 12.5 per cent and the mean survival was eight months. It is concluded that: 1) Colonic carcinoma is the most common primary tumor causing metastatic small bowel obstruction. 2) Tube decompression is rarely effective and surgical relief is necessary in the vast majority of cases. 3) Operative mortality has been reduced, partially because of more vigorous support, i.e., hyperalimentation, but the mean duration of survival has not changed significantly.
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PMID:Surgical palliation of small bowel obstruction due to metastatic carcinoma. 616 83

The coexistence of malignancy and dysphagia makes nutritional deprivation especially serious in patients with carcinoma of the esophagus. Intravenous hyperalimentation (IVH) is often given and should be of particular value in these patients. Sixty-four patients with carcinoma of the esophagus seen between January, 1975, and February, 1982, were studied retrospectively during their first hospitalization for the disease. Thirty-seven patients received IVH, and 27 did not. There were no significant differences at the time of admission to the hospital between the two groups with respect to age, sex, pathological status, and location of the carcinoma. Also, there was no difference in the incidence of hypoalbuminemia (less than 3 gm/dl) or lymphocytopenia (less than 1,500/mm3). More patients in the IVH group underwent surgical resection of the esophagus. Surgical intervention did not significantly influence hospital mortality. The IVH therapy reduced weight loss (p less than 0.05), but was associated with an increased incidence of pulmonary sepsis (p less than 0.05) and longer hospital stay. The incidence of hypoalbuminemia and lymphocytopenia increased between admission and the end of hospitalization, but it did not significantly differ between the groups. Thus, one cannot assume the effectiveness of IVH in this clinical setting, as its value was not demonstrated in this retrospective series. A prospective randomized study is warranted in view of the high cost and the doubtful clinical impact of an IVH regimen in patients with carcinoma of the esophagus.
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PMID:Clinical impact of intravenous hyperalimentation on esophageal carcinoma: is it worthwhile? 643 36

We studied a patient with lung cancer, who exhibited severe systemic derangements of metabolism causing cachexia preceding the appearance of a large bulky tumor. The data described herein left no doubt that lung cancer growing in the patient acted as a powerful hypoglycemic factor, setting in motion widespread metabolic disorders. Inappropriate secretion of insulin may be involved in the manifestation of hypoglycemia. However, no ectopic secretion of insulin, glucagon, ACTH and aldosterone appeared to be associated with the carcinoma in the patient. From the present and previous observations, it is stressed that progressive energy loss from the patient occurs by virtue of a combination of severe anorexia and the establishment of a systemic energy-losing cycle dependent on an interplay of glycolysis in the cancer cells and stimulated gluconeogenesis in the host tissues, which in turn results in derangements of protein, lipid and electrolyte metabolism. Attempts to ameliorate the patient's distress and counterbalance the effect of the tumor by parenteral hyperalimentation were not satisfactory and resulted in only a temporary improvement. This study also demonstrated that marked granulocytosis was the result of production of an excess granulopoietic colony stimulating activity by the cancer cells.
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PMID:Hypoglycemia, hypopotassemia and hyperleukocytosis associated with squamous cell carcinoma of the lung. 697 22

We reviewed the records of 44 consecutive patients with advanced esophageal carcinoma treated at either a Veterans Administration or a city-country hospital. The patients, 38 men and six women, ranged in age from 27 to 72 years and had been referred for operative management. The average duration of dysphagia was 5 months. All patients underwent a one-stage esophagogastrectomy with esophagogastrostomy. The last 34 patients also had a modified fundoplication. Lesions at the gastroesophageal junction were approached via a low left thoracotomy and the others via a simultaneous right thoracotomy and laparotomy. All patients had preoperative enteral or parenteral hyperalimentation. Seven patients died within 30 days after operation (operative mortality 16%). Twenty-six patients lived from 3 to 28 months postoperatively (average 11.5 months). Eleven are alive at present (average 10 months). Postoperative complications were as follows: anastomotic leak, three patients (two died); respiratory failure, four (two died); stricture, three; myocardial infarction, two (two died); cholecystitis, one; and pulmonary embolus, one (patient died). Thirty-four patients had modified fundoplication, and an inconsequential anastomotic leak developed in one. In contrast, two of the 10 patients who did not have modified fundoplication died as a result of anastomotic leak. Preoperative hospital stay ranged from 10 to 28 days (average 18); postoperative stay ranged from 10 to 40 days (average 16). Except for the three patients in whom stricture developed, all patients (92%) had continuous relief of dysphagia. We conclude that one-stage esophagogastrectomy with esophagogastrostomy is applicable in most cases and is associated with both satisfactory long-term palliation and a reasonable period of hospitalization. The addition of a modified fundoplication results in a relatively low rate of anastomotic leak.
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PMID:Carcinoma of the esophagus. An aggressive one-stage palliative approach. 745 20

A 55-year-old patient with hypercalcemic crisis due to gastric carcinoma with bone marrow metastasis was treated with bisphosphonate (pamidronate) and calcitonin. Urinary excretion of parathyroid hormone-related protein (PTHrP) was increased. When normocalcemia had been attained, intravenous hyperalimentation was started, in which 1,000 U vitamin D2 was inadvertently supplemented on days 5-18, On days 15-18, hypercalcemia rapidly recurred, accompanied by markedly increased serum levels of 25-OHD2 (9.1 ng/dl) and 1,25-(OH)2D2 (161 pg/ml). This clinical course suggests that PTHrP, like PTH, stimulated 1 alpha-hydroxylase activity and produced excessive 1,25-(OH)2D2. Vitamin D should not be administered to patients with malignancy-associated hypercalcemia, particularly that due to PTHrP-producing tumors.
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PMID:Increased 1,25-(OH)2D2 concentration in a patient with malignancy-associated hypercalcemia receiving intravenous hyperalimentation inadvertently supplemented with vitamin D2. 801 94

The nutritional status of 24 patients of carcinoma oesophagus was assessed before and after central hyperalimentation with a liquid blenderized diet containing 3000-3500 cal and 100-120 g protein. The overall prevalence of malnutrition was found to be 70.8 per cent before the initiation of therapy. Of the various parameters used for assessment of nutritional status weight loss was the most common finding (91.6%) followed by alteration in midarm circumference, haemoglobin, triceps skin fold thickness, midarm muscle circumference and serum albumin. Enteral hyperalimentation for 10 days improved nutritional status by inducing significant gain in body weight (74.1%), triceps skin fold thickness (50%), midarm circumference (58%), midarm muscle circumference (62.5%) and serum albumin levels (91.6%). There was no significant change in haemoglobin levels.
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PMID:Role of enteral hyperalimentation in patients of carcinoma oesophagus. 826 76

A large number of reports have dealt with comparative studies of total parenteral nutrition (TPN) and enteral hyperalimentation (EH). However, there have been few reports on comparative studies in which patients were stringently selected for identical observation periods. We divided patients who underwent total gastrectomy for stomach carcinoma into two groups. The two groups were given TPN and EH, respectively, for three weeks to investigate immunological competence and nutritional conditions. There were ten patients in the TPN group and ten in the EH group was IgG, IgA, IgM, and complements (C3 and CH50) selected as the immunological indices. At the same time, TP, Alb, Tf, PA and RBP were used as the nutritional indices. Immunological competence dropped from one to three days after surgery in both groups, but gradually increased thereafter. Up to three weeks after surgery, immunological indices showed preoperative values or above though there were no significant differences between the two groups. The nutritional indices were low from three to four days after surgery but gradually increased thereafter and returned to preoperative levels or above, no significant differences were noted between the two groups. This was probably because malignant tumors were resected, and nutritional was supplemented from three to four days after surgery which led to the improvement of immunological and nutritional indices. Since the patients in both groups experienced uneventful clinical courses without developing any complications, there were no significant differences in these indices between the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Nutrition for total gastrectomy. Especially the usefulness of enteral hyperalimentation]. 833 Nov 51

Pancreatojejunal sutural insufficiency occurring after pancreatoduodenectomy and countermeasures are discussed. In the Department of Surgery at Kurume University School of Medicine, 318 patients underwent pancreatoduodenectomies. The present study includes 15 of these patients, all of whom had pancreatojejunal sutural insufficiency. The frequency of sutural insufficiency was 4.7%. Five patients had bile duct cancer, 5 had cancer of the papilla of Vater, 2 had a carcinoma of the pancreatic head, 1 each had gallbladder cancer, chronic pancreatitis, and papillitis. Six (40%) of the 15 patients died during hospitalization. The presence or absence of sutural insufficiency was confirmed mainly by radiography and determining the properties and amylase levels of the drainage fluid. There was no significant difference due to the method of anastomosis. End-to-side anastomosis had a rate of 5 (5.9%) of 85 patients, while end-to-end had 10 (4.3%) of 233 patients. The sutural insufficiency was manifested as a major leakage in 6 patients and a minor leakage in 9. The degree of lymph node dissection was D0 in 6.1%, D1 in 1.4%, D2 in 4.8% and D3 in 10.8%, with a high incidence of sutural insufficiency in D3 patients. The pancreatic duct diameter was smaller than 4 mm in 10, 5-7 mm in 4 and over 8 mm in 1 patient. The intraoperative pancreatic findings were a soft pancreas in 8, slightly hard in 3, and hard in 4 patients. Fibrosis of the pancreas was normal to slight in 11 and moderate in 4 patients. Drainage by relaparotomy was performed in 4 of the 6 patients with major leakages to control sutural insufficiency, and the other 2 underwent continuous aspiration with an intraperitoneal drain inserted during the operation. The 9 patients with minor leakage underwent conservative treatment including continuous aspiration via an intraperitoneal drain inserted during surgery, fasting, intravenous hyperalimentation, and antibiotic administration. All of the patients with major leakage died from an associated occurrence of hepatic insufficiency, renal insufficiency, intraperitoneal hemorrhage or diffuse peritonitis during hospitalization. However, 8 of the 9 patients with minor leakage had some healing, and the 1 remaining patient developed a pancreatic fistula. The frequency of pancreatojejunal sutural insufficiency was high in patients with minimal pancreatic fibrosis, with soft pancreatic tissue without dilatation of the pancreatic duct, and with relatively good pancreatic function.
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PMID:Pancreatojejunal sutural insufficiency occurring after pancreatoduodenectomy and countermeasures. 866 93

A 28-year-old woman with inoperable gastric carcinoma was given continuous infusion of 5-fluorouracil (5-FU) and low-dose cisplatin (CDDP) for 4 weeks while receiving intravenous hyperalimentation (IVH). Eleven days after her last treatment, she developed acute diplopia, deafness and gait ataxia, followed by severe confusion. She became markedly acidotic and hypotensive with a systolic blood pressure of 60 mmHg, necessitating intubation, dopamine treatment and hemodialysis for 7 h. She was also given thiamine. Thereafter, her blood pressure stabilized, the acidosis improved, and her deafness, diplopia, and confusion were resolved. This case suggests that FP (5-FU/CDDP) therapy toxicity, manifested as acute metabolic acidosis and Wernicke's encephalopathy, may be associated with IVH and thiamine deficiency.
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PMID:Severe acute metabolic acidosis and Wernicke's encephalopathy following chemotherapy with 5-fluorouracil and cisplatin: case report and review of the literature. 876 81


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