Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0021843 (bowel obstruction)
 9,927 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We reviewed the charts of 1,910 children enrolled in the Third National Wilms' Tumor Study who underwent primary nephrectomy. Four hundred and ninety-five surgical complications occurred in 379 children (19.8 percent). Patients with inoperable tumors, bilateral renal tumors, peroperative therapy and those who refused treatment were excluded from this review. The most common complication was intestinal obstruction, which occurred in 132 patients (6.9 percent). This was followed by extensive intraoperative hemorrhage (112 patients), defined as blood loss exceeding 50 milliliters per kilogram of body weight. Intraoperative injuries to other visceral organs (including intestine, liver and spleen) occurred in 21 children and extensive vascular injuries were reported in 27 patients. There were nine deaths attributed to surgical complications (0.5 percent), only one of which was intraoperative. Survival of patients with complications was similar to patients without complications when stratified by histologic study and stage. Factors associated with the development of surgical complications included advanced local tumor stage at diagnosis, intravascular tumor extension and resection of other visceral organs at the time of nephrectomy. Complete removal of the tumor is important, but not at the expense of radical removal of adjacent structures, because of gross appearances at operation. They are often not invaded by the tumor, but rather are compressed, distorted or adherent without tumor infiltration. Identification of these groups will aid the surgeon in choosing the appropriate management for these patients at high risk. When initial exploration and precise surgical staging indicate that only a formidable operation will achieve total excision, shrinkage of the tumor with selective use of chemotherapy or radiotherapy, or both, may facilitate removal and decrease surgical morbidity. Preoperative therapy may also be the preferred approach for children with extensive intravascular tumor.
 ...
PMID:Surgical complications after nephrectomy for Wilms' tumor. 133 95

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

There were 122 deaths among 803 children registered, randomized, and followed in the second National Wilms' Tumor Study; 17 occurred in children apparently free of disease and were attributable to causes other than tumor progression. Seven deaths were attributed to infection during periods of drug-induced leukopenia; four were due to liver failure; and one each was attributable to radiation pneumonopathy, intestinal obstruction, renal failure, myocardial disease, and encephalopathy. The cause of one death was unexplained. Of particular concern were four (of 47) infants under one year of age with group I or II disease who had toxic deaths. Subsequent to these experiences the doses of all chemotherapeutic agents were reduced by 50% for infants under one year of age. No deaths from toxicity were observed thereafter in infants. An analysis of the therapeutic effect of this dose reduction showed three of 47 relapsed on full dose and five of 54 on half dose. The difference is not statistically significant. This report is a further demonstration of the potentially serious vulnerability of infants to standard doses of anticancer drugs even when they are calculated on a per kilogram basis.
 ...
PMID:Toxic deaths in the Second National Wilms' Tumor Study. 608 9

A case of intestinal obstruction, as a result of radiation injury of the colon, is reported. This child was treated by roentgen therapy in the infant period because of a Wilms' tumour of the left kidney.
 ...
PMID:Instestinal obstruction as a late complication in rotentgen therapy of Wilms' tumor. 625 63

A primary neoplasm of the right adrenal gland in a 4-year-old boy was discovered after the patient developed bowel obstruction following an appendectomy. Until the histologic examination, the tumor was thought to be a neuroblastoma. However, the intra-adrenal tumor was composed of blastematous nodules, primitive tubules, and glomeruloid structures whose overall composition resembled a Wilms' tumor. Other than a single focus of mucinous glands, the tumor lacked the range of somatic tissue types of a teratoma. Approximately 50 cases of putative extrarenal Wilms' tumor have been reported. The retroperitoneum is one of the more common primary sites, yet our case is the first documented example of a neoplasm with features of a Wilms' tumor arising in the adrenal. Based on the embryologic and anatomic relationship between the adrenal gland and kidney, it is somewhat surprising that other instances of similar appearing tumors have not been described before the present case. Our patient was managed on a Wilms' tumor protocol and remains tumor free 15 months after surgery.
 ...
PMID:A unique dysembryonic neoplasm of the adrenal gland composed of nephrogenic rests in a child. 854 Jun 3

A 3-year-old girl underwent left nephrectomy and removal of a tumor thrombus from the inferior vena cava and right atrium in 1978 because of Wilms tumor. Her treatment consisted of tumor bed irradiation (4,000 cGy) and chemotherapy with actinomycin D, vincristine, and doxorubicin. The patient underwent laparotomy 2 months after completion of abdominal irradiation to relieve intestinal obstruction. Fourteen years later, she underwent another laparotomy because of an "acute abdomen" and was found to have perforation of the jejunum in the radiation field. Histopathological examination of resected intestine revealed evidence of severe chronic radiation enteritis, A diagnosis of chronic radiation enteritis should be considered in patients who had received abdominal irradiation and who manifest abdominal pain/vomiting even several years after irradiation.
 ...
PMID:Intestinal perforation 14 years after abdominal irradiation and chemotherapy for Wilms tumor. 884 36

From 1992 to 1996, 15 children with an acute small bowel obstruction were treated by laparoscopy. There were 10 boys and 5 girls between 6 to 15 years. They had been formerly operated in the neonatal period (4 cases), for appendectomy (9 cases), or ureteronephrectomy for Wilm's tumor (1 case), and caudal pancreatectomy after a traumatism (1 case). Thirteen times it was the first obstruction and twice the second or more (but never treated by surgery). Conversion in laparotomy was necessary in 4 cases. There were no operative complication. We noted a quick recovery (12 hours), an early discharge (3.5 days), and a good postoperative comfort. Laparoscopic viscerolysis for acute small bowel obstructions seems to be a good treatment in children.
 ...
PMID:[Small bowel obstruction and laparoscopic treatment in children]. 929 14

Intestinal obstruction as a result of postnephrectomy adhesions occurs in up to 7% of children treated for Wilms' tumor. The authors report two children who developed small-bowel volvulus during the treatment of their renal tumor. Both underwent urgent resection of their ischemic bowel with primary anastamosis and are long-term survivors. The risk of this complication may be increased in young children with bulky tumors who receive abdominal radiotherapy.
 ...
PMID:Small-bowel volvulus during treatment for renal tumors. 978 15

Desmoplastic small round cell tumors (DSRCT) are highly aggressive tumors typically involving the serosal surfaces of the peritoneum. Patients often present with abdominal pain, an abdominal mass, ascites or signs of intestinal obstruction. Cytogenetic and molecular studies have identified a characteristic t(11;22)(p13;q12) translocation within the tumor cells. The fused gene product apparently aligns the NH2-terminal domain (NTD) of the EWS gene to the zinc finger DNA-binding domain of the WT1 gene. This product could lead to loss of the tumor suppressor effect of the WT1 gene as well as to an increase in EWS driven expression of growth factors normally repressed by WT1. We investigated this latter possibility by performing immunohistochemical studies on formalin fixed tissue from 10 cases of DSRCT and five Wilms' tumors using-antibodies to insulin-like growth factor (IGF)-II, the latency associated peptide of transforming growth factor (TGF)-beta 1, platelet-derived growth factor (PDGF)-AB chain and PDGF-alpha receptor, respectively. In general, tumor cells were strongly positive for these growth factors in DSRCT, while stromal cells were negative for IGF-II and positive for the other growth factors in parallel with the tumor cells. Wilms' tumor cells were essentially negative for PDGF-AB chains, but positive for IGF-II, and the latency associated peptide of TGF-beta 1 and variably positive for PDGF-alpha receptor. These findings support the proposed molecular mechanism of tumorigenesis for DSRCT and may help explain this tumor's poor prognosis.
 ...
PMID:Intra-abdominal desmoplastic small round cell tumor: immunohistochemical evidence for up-regulation of autocrine and paracrine growth factors. 984 6

Desmoplastic small round cell tumors (DSRCT) are highly aggressive tumors typically involving the serosal surfaces of the peritoneum. Patients often present with abdominal pain, an abdominal mass, ascites or signs of intestinal obstruction. Cytogenetic and molecular studies have identified a characteristic t(11;22)(p13;q12) translocation within the tumor cells. The fused gene product apparently aligns the NH2-terminal domain (NTD) of the EWS gene to the zinc finger DNA-binding domain of the WT1 gene. This product could lead to loss of the tumor suppressor effect of the WT1 gene as well as to an increase in EWS driven expression of growth factors normally repressed by WT1. We investigated this latter possibility by performing immunohistochemical studies on formalin fixed tissue from 10 cases of DSRCT and five Wilms' tumors using antibodies to insulin-like growth factor (IGF)-II, the latency associated peptide of transforming growth factor (TGF)-beta1, platelet-derived growth factor (PDGF)-AB chain and PDGF-alpha receptor, respectively. In general, tumor cells were strongly positive for these growth factors in DSRCT, while stromal cells were negative for IGF-II and positive for the other growth factors in parallel with the tumor cells. Wilms' tumor cells were essentially negative for PDGF-AB chains, but positive for IGF-II, and the latency associated peptide of TGF-beta1 and variably positive for PDGF-alpha receptor. These findings support the proposed molecular mechanism of tumorigenesis for DSRCT and may help explain this tumor's poor prognosis.
 ...
PMID:Intra-abdominal desmoplastic small round cell tumor: immunohistochemical evidence for up-regulation of autocrine and paracrine growth factors. 1007 70


1 2 Next >>