Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0024623 (gastric cancer)
 36,219 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

AIMS: A valid measure of quality of life (QL) that is sensitive to clinically significant changes in health is important for the assessment of patients with gastric cancer. The aims of this study were to examine whether the EORTC (European Organisation for Research and Treatment of Cancer) QLQ-C30 core questionnaire alone could distinguish between two clinically different groups of patients and to design a module, which included relevant patient-defined gastric cancer-specific variables. METHODS: The QLQ-C30 was completed by patients with potentially curable disease and those undergoing palliative treatment, and the results were compared between the two groups. A disease-specific module was then developed in four distinct phases according to EORTC guidelines. Relevant issues were identified from a literature search and structured interviews with patients and healthcare professionals, and worded into a provisional questionnaire which was pretested to determine any problems in its content, before formal validation. RESULTS: All of the subscales and single items within the QLQ-C30 were scored similarly by 144 patients, 86 with operable disease and 58 having palliative treatment, except constipation (P = 0.001). On the basis of interviews with 58 patients and 24 professionals, from the UK, France, Germany and Spain, 43 issues were reduced to produce a provisional questionnaire consisting of 24 items and pretested in 114 patients undergoing radical gastrectomy, palliative resection or other supportive measures. The resulting questionnaire, containing 22 items divided into five scales (dysphagia, pain, reflux, dietary restrictions and specific emotional problems related to gastric cancer and its treatment) and four single items, is undergoing validation. CONCLUSIONS: The EORTC QLQ-C30 is a valid generic instrument, but does not address all factors constituting QL in patients with gastric cancer. A specific module has been developed, which includes issues volunteered by patients to increase sensitivity and improve the evaluation of treatments for a disease where QL is important.
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PMID:Development of an EORTC module to improve quality of life assessment in patients with gastric cancer 1071 72

The impressive breakthrough in laparoscopic surgery has pushed surgeons to perform gastric resection through such an approach. Laparoscopy reduces the surgical stress and the postoperative pain and has a positive impact on the rehabilitation time, the hospital stay, and return to work and social activities. Laparoscopic partial gastrectomy for benign diseases and for palliation has been accepted as an effective surgical option: they are reproducible operations performed worldwide at a more and more rapid pace. Laparoscopic gastric resections and laparoscopically assisted gastric resections for malignancy deserve a word of caution. Nevertheless, the investigators report their series of laparoscopic subtotal and distal gastrectomies for cancer with medium and long-term results comparable with those of open surgery. Furthermore, new and less invasive surgical options have been recently introduced. Full and partial thickness local resections may be accomplished through intragastric procedures, for treatment of small benign tumors and early stage gastric cancer.
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PMID:Laparoscopic gastric resections. 1073 15

The prognosis of patients with Stage IVb gastric cancer remains poor, and therapy for these patients is not easy. Recently, neoadjuvant chemotherapy is thought to be one of the better strategies for such patients. In this paper, we report a 48-year-old female patient with advanced gastric cancer whose serum CA 19-9 level decreased remarkably after 2 courses of F/P therapy. We also operated on this patient with staging laparoscopy, a new and more useful technique for the patients such as the present one. The advantages of staging laparoscopy are as follows: 1. The entire intraabdominal space can be observed from a small wound, and the clinical stage of the patient can be diagnosed more correctly. 2. It is easy to obtain cells from small amounts of ascites or tissues of small nodules in the abdominal wall and lymph node involvements. 3. Patients suffer less pain and movement of the body is not as limited after operation. 4. Administering drugs into the intra abdominal space is easy using this technique. Staging laparoscopy might therefore be one of the better surgical strategies for the patients with advanced patients when selecting a suitable therapy.
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PMID:[Staging laparoscopy for a patient with advanced gastric cancer whose serum CA 19-9 level decreased remarkably after 2 courses of F/P therapy]. 1074 Jun 42

Palliative endoscopic treatment of esophagogastric cancer is now possible using expandable metal stents. The properties, advantages, and drawbacks of these stents have been extensively analyzed, and there is no doubt that they are now easy and safe to introduce, without serious morbidity. However, the frequency of persistent thoracic pain and delayed complications, as well as the high rate of repeat interventions required, justify limited use of the procedure. The major indication for the procedure is dysphagia due to cancer in the esophagus or at the cardia. Enteral stents have been used in the treatment of malignant duodenal or jejunal stenoses, but the results are poor. A promising new area is the treatment of benign stenoses using expandable and biodegradable stents. It may be possible to use this technique for surgical anastomoses after tumor resection. Careful endoscopic analysis of the mucosal surface is necessary to establish the strict indications for endoscopic mucosal resection for mucosal malignancy. Biopsy evidence of the relation between lesion diameter, a depressed surface pattern and the depth of invasion into the submucosa, as well as the extent of regional or distant lymphatic invasion, provides the best guidelines for safe curative mucosectomy in gastric cancer. Endoscopic therapy is always safe in lesions less than 1cm in diameter; for other lesions, resection is safe when the depth of submucosal invasions is less than 300 microm. In other situations, surgery is preferable in patients who are otherwise in good health. In Japan, the results of the National Survey of Gastric Cancer, with cases detected by screening, confirmed the benefits of adherence to these guidelines; most patients were treated surgically, and only 7% with endoscopic therapy.
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PMID:Treatment of esophagogastric tumors. 1077 74

For the purpose of prevention of postgastrectomy syndrome and a less invasive and yet curative oncological resection, a purely laparoscopic pylorus-preserving gastrectomy with extraperigastric lymphadenectomy was performed for a patient with early gastric cancer located in the middle third of the stomach. The patient's postoperative course was uneventful. During his postoperative recovery, the patient experienced very little pain and used analgesic medication only one time. This operation appeared to be oncologically adequate. As of the seventh postoperative month, the patient never experienced dumping syndrome or alkaline reflux gastritis. This procedure is technically feasible and an excellent option because of its reduced surgical invasiveness and better postoperative quality of life.
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PMID:Purely laparoscopic pylorus-preserving gastrectomy with extraperigastric lymphadenectomy for early gastric cancer: a case and technical report. 1087 26

We characterized anticancer effects of opioid analgesics that are clinically used for cancer patients for pain relief. Treatment with 100 microM buprenorphine, a representative analgesic, induced cell death of human carcinomas, such as A549 (squamous epithelial cell of lung cancer), MCF-7 (breast cancer) and N417 (small cell of lung cancer), but not in KATO III (gastric cancer) cells as evaluated by alamar blue assay. Among 18 clinically utilized and related analgesics, buprenorphine and loperamide showed potent inhibition of cell viability. However, these anti-cancer effects were not affected by opioid receptor antagonists nor by pertussis toxin. Buprenorphine-induced cell death occurred as early as 1 h after the addition, and its T1/2 of cell viability inhibition was 3 h. The cell death manifested the characteristics of apoptosis, such as DNA-laddering and nuclear fragmentation, which were sensitive to a caspase inhibitor, Z-Asp-CH2-DCB. The nuclear fragmentation was independent of cell cycle phase specificity. The activity of caspase-3-like protease which is known to be closely related to apoptotic DNA laddering was markedly enhanced by buprenorphine. However, the inhibition of cell viability by buprenorphine was not affected by the caspase inhibitor. These findings suggest that some opioid analgesics induce typical apoptotic features sensitive to the caspase inhibitor, while also inhibition of cell viability insensitive to the inhibitor.
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PMID:Opioid analgesic-induced apoptosis and caspase-independent cell death in human lung carcinoma A549 cells. 1093 99

Upper GI tract endoscopy remains a key investigation in dyspepsia. Nevertheless, since the development of non-invasive techniques for Helicobacter pylori (Hp) infection detection and the current trend for immediate prescription of anti secretary drugs in "endoscopy negative gastro-oesophageal reflux disease" (NORD), accurate indications for endoscopy must be reconsidered. Careful recording of the medical history of the patient is crucial. Personal antecedents (diseases and drugs), familial history (especially gastric cancer) must be evidenced and three symptomatic groups must be identified: patients with alarm symptom(s), typical ulcer pain and GORD. Beside those three categories, most patients must be classified in "non specific dyspepsia". Immediate endoscopy is highly recommended in all patients with either alarm symptom(s) or typical ulcer pain (except in suspected relapse of a well documented duodenal ulcer disease). Age is a key determinant in GORD: endoscopy is not necessary in patients under 45 years of age. In case of "non specific dyspepsia" in patients under 45 years, a non-invasive test for Hp infection will favour when positive endoscopic investigation ("test and scope" policy). Nevertheless, in all patients above 45 years and in all patients with either a personal history of gastric ulcer, or a familial history of gastric cancer (whatever the age), endoscopy with biopsies remains the first recommended investigation.
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PMID:[Dyspepsia in general medicine: current diagnostic approach]. 1106 85

Locoregional administration using OK-432 was evaluated in treating malignant effusion. Positive clinical responses were seen in 19 (52%) of 36 gastric cancer patients, and in 9 (90%) of 10 colon cancer patients (p < 0.05), indicating its clinical benefit in treating malignant effusion of colon cancer. Fever elevation was observed in 43 (93%) patients and local pain occurred with 9 (20%) of 46 administrations. Immunological analysis for responder patients with rectal cancer revealed that OK-432 induced autologous tumor-reactive CD 3+ CD 4+ TCRV beta 20+ killer lymphocytes. The TCR gene analysis permitted us to clone a V beta 20 CDR 3 sequence, by which positive bands were shown in 3 (75%) of 4 responders and negative bands in 3 (100%) of 3 non-responders. It is suggested that cross-antigenicity exists between OK-432 and colon cancer, and that genetic analysis using the TCRCDR 3 sequence makes it possible to predict responder patients to OK-432 immunotherapy.
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PMID:[Locoregional immunotherapy of malignant effusions for colorectal cancer using OK-432 and its acting mechanisms--possibility of molecular diagnosis using TCRCDR 3 sequence]. 1108 33

Gastrin is a growth factor for colorectal cancer, and therefore, anti-gastrin hormone therapy has a potential role in treatment of this disease. The gastrin immunogen gastrin-17-diphtheria toxoid (G17-DT; Gastrimmune) produces anti-G17 antibodies that have been shown to be effective in the treatment of colorectal carcinoma in preclinical models. Fifty patients with advanced colorectal cancer were treated with G17-DT in a multicenter, sequential group, open label Phase I/II study. Primary injections with two booster doses were given by i.m. injection. The main aim of the study was to assess the safety and efficacy of the production of antigastrin antibodies. Locally developed and standard WHO toxicity measurements with RIA and Scatchard analysis for antibody assessment were used. One center measured tumor response radiologically. Eighty % of patients produced a measurable antibody response. Antibodies of high affinity (median Kd, 0.295 nM; interquartile range, 0.16-0.41 nM) were detected between 4 and 12 weeks after primary injection. The antigen binding capacity was high at 2.8 x 10(-9) M (interquartile range, 5.1 x 10(-10) to 7.25 x 10(-9) M). The treatment was well tolerated with no systemic side effects seen. Myalgia at the injection site was seen in 46% of patients with severe pain caused by the formation of a sterile abscess seen in 14% of patients. The abscesses were all drained under ultrasound guidance, and the patients recovered fully within 6 weeks. No radiological responses were seen, but two patients had stable disease. G17-DT immunization produces anti-G17 antibodies in patients with advanced colorectal cancer. The antibodies were of an affinity high enough to compete with the cholecystokinin B/gastrin receptor for G17 binding with adequate capacity to neutralize postprandial gastrin surges. Additional dose-ranging studies have been performed in patients with gastric cancer using 100- and 200-microg doses of G17-DT formulated without adjuvant and the emulsifier aluminum monostearate. In addition, the effect of immunizing at different time intervals has been determined.
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PMID:Phase I/II study of G17-DT, an anti-gastrin immunogen, in advanced colorectal cancer. 1115 25

Misoprostol, a prostaglandin E1 analog, is a racemate of four stereoisomers. On administration it rapidly de-esterifies to its active form, misoprostolic acid. Misoprostolic acid is 85% albumin bound and has a half-life of approximately 30 minutes. It is excreted in urine as inactive metabolites. No significant drug interactions have been reported. Besides its gastrointestinal protective and uterotonic activities, misoprostol regulates various immunologic cascades. It inhibits platelet-activating factor and leukocyte adherence, and modulates adhesion molecule expression. It protects against gut irradiation injury, experimental gastric cancer, enteropathy, and constipation. It improves nutrient absorption in cystic fibrosis. Misoprostol has utility in acetaminophen and ethanol hepatotoxicity, hepatitis, and fibrosis. It is effective in asthmatics and aspirin-sensitive asthmatic and allergic patients. It lowers cholesterol and severity of peripheral vascular diseases, prolongs survival of cardiac and kidney transplantation, synergizes cyclosporine, and protects against cyclosporine-induced renal damage. It works against drug-induced renal damage, interstitial cystitis, lupus nephritis, and hepatorenal syndrome. It is useful in periodontal disease and dental repair. Misoprostol enhances glycosoaminoglycan synthesis in cartilage after injury. It prevents ultraviolet-induced cataracts and reduces intraocular pressure in glaucoma and ocular hypertension. It synergizes antiinflammatory and analgesic effects of diclofenac or colchicine and has been administered to treat trigeminal neuralgic pain. It reduces chemotherapy-induced hair loss and recovery time from burn injury, and is effective in treating sepsis, multiple sclerosis, and pancreatitis.
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PMID:Misoprostol therapeutics revisited. 1119 38


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