Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0025202 (melanoma)
 69,561 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Isolated regional perfusion for the treatment of malignant melanoma is an accepted method of treatment. No standard of anaesthetic practice has been established for those individuals. Perioperative records of patients undergoing isolated limb perfusion were studied to determine adequate blood replacement. Records were examined and compared for (1) age, (2) ASA physical status, (3) presence of associated disease, (4) anaesthetic technique, (5) the amount of blood and fluid replacement, (6) preoperative haemoglobin (hgb) and haematocrit (hct) and postoperative serial complete blood counts. Fifteen patients were studied (mean age 53 +/- 16 yrs). Mean blood and fluid replacement was: packed red blood cells; 2.28 +/- 0.82 units, 722 +/- 17 ml of 5 per cent albumin, 1747 +/- 21 ml crystalloid. There were twelve Physical Status Class I or II and three Class III patients. All patients received general anaesthesia. There was a statistically significant difference in the preoperative and postoperative values for haemoglobin and haematocrit (p less than 0.01) with no difference between the postoperative and discharge values. Adequate blood replacement was determined by the equation: (Formula: see text) Extensive invasive monitoring is not routinely required for adequate blood replacement or the detection of leaks between the systemic and isolated circulation.
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PMID:Isolated regional perfusion; anaesthetic technique, monitoring and blood replacement. 649 70

A CW YAG laser was used to coagulate retina and to produce an optical iridotomy in a human eye that was to be enucleated for malignant melanoma at the optic nerve head. Moderate coagulation with the CW YAG laser produced a deep choroidal reaction involving the outer portion of the retina. The inner structure of the fovea remained relatively unaffected. The nerve fiber over the coagulated vessels was unchanged. An optical iridotomy also was produced with the CW YAG. At least ten times more energy was needed to produce retinal photocoagulation with the CW YAG than is generally needed with the argon laser. Retrobulbar anesthesia should be used to prevent pain if extensive coagulation is done.
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PMID:Effects of the CW YAG laser on the human iris and retina. 654 70

Whole body hyperthermia was produced in 14 patients with conventionally incurable malignant disease. The technique consisted of arteriovenous shunting involving extracorporeal circulation with heat exchange during general anaesthesia. A temperature of 41.8 degrees C was maintained for periods of 6 hours. After achieving hyperthermic temperatures treatment was enlarged by administration of 5-fluorouracil (1000 mg) in patients with colorectal carcinoma and by dacarazine (200 mg/m2) in patients with malignant melanoma. In 5 out 6 patients with stage IV colorectal carcinoma stabilisation of the disease was seen for an average of 10 months. In contrast, progression of the disease was seen in patients with malignant melanoma and mean survival was only 5 months. These preliminary results in a small number of patients indicate that 1. induction and maintenance of whole body hyperthermia is clinically possible, 2. technical requirements are considerable, however feasible, 3. different tumours react differently to treatment.
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PMID:[Extracorporeally induced whole-body hyperthermia in conventionally incurable malignant tumor patients]. 683 25

The outflow system was studied by light microscopy in nine human eyes that were treated with topical timolol maleate (0.5%) prior to enucleation for malignant melanoma of the choroid. The frequency of "giant vacuoles" in the lining endothelium of Schlemm's canal and the diameter of these structures was the same in a control group of eyes as in the timolol-treated series. There was no qualitative difference between the architecture of the meshwork in the control and treated groups. These morphologic findings suggested that timolol had no direct action on the outflow apparatus and did not reflect the intraocular pressure (IOP) lowering effect of the drug. The effects of anesthesia, surgical manipulations, and fixation by immersion may have masked any subtle drug effects.
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PMID:Giant vacuoles in the lining endothelium of the human Schlemm's canal after topical timolol maleate. 683 9

Six cases of malignant choroidal melanoma were treated by microsurgical excision under hypotensive anaesthesia with follow-up periods varying from four months to four years. This paper presents the case for local excision of malignant choroidal melanoma in the light of the current controversy surrounding the management and natural history of choroidal melanoma. The indications for surgery, techniques, and results are described. Vision was preserved best in tumours with diameters of less than 10 mm. No deaths and no evidence of extraocular recurrence occurred.
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PMID:Microsurgery of choroidal melanoma--surgical techniques of local excision. 687 Jun 78

We examined the number of T-Lymphocytes in 14 malignant melanoma patients using the sheep erythrocyte rosette test and the PHA stimulation test. These investigations were carried out before the operation under general anesthesia was performed as well as 1, 7, 14, 21, and 28 days after the operation. 16 patients with various large surface skin operations in local anesthesia served as a control group. Among them there were also 5 malignant melanoma cases. The tests preoperatively accomplished yielded normal results (T-lymphocytes 65.7 +/- 2.95%, PHA stimulation 79.01 +/- 1.69%) for all 19 melanoma patients. 24 hours after the operation the average portion of T-lymphocytes decreased in relation to the whole lymphocytes and reached only the level of 53.8 +/- 7.8%. After 7 days it amounted to 57.5 +/- 8.5%, after 14 days to 59.5 +/- 7.8%, after 21 days to 62.3 +/- 5.4% and after 28 days to 62.8 +/- 6.1%. The PHA stimulation was significantly diminished only after 24 hours, but not longer after 7 days. A correlation between the diminution of T-lymphocytes observed 14 and more days after the operation and the duration of the general anesthesia may be suggested in single cases. -- Patients operated under local anesthesia showed after 2 and 24 hours a significant diminution of T-lymphocytes. After 7 days the values had returned to normal levels (66.7 +/- 5.9%).
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PMID:[Comparative examinations of the effect of general and local anesthesia upon the T-lymphocytes in melanoma operations (author's transl)]. 697 60

In the past few years a change has been noticed in the behavior of cutaneous malignant melanoma, with higher cure and survival rates. A retrospective review of all cases of primary cutaneous malignant melanoma during the years 1970-1979 in Chaim Sheba Medical Center reveals a possible explanation for this. The microscopic findings were reevaluated, diagnosis confirmed, and thickness of the tumor measured in millimeters. The number of cases diagnosed rose from eight in 1970 to 45 in 1979. A constant rise in number of thin melanomas (less than 0.75 mm in depth) was noticed. The percentage of thin melanoma rose from 11.1% of all melanomas in 1970 to 57.7% in 1979. Greater public and medical awareness of the danger of pigmented cutaneous lesions has probably triggered an earlier diagnosis of melanoma. Each suspected lesion is completely excised with a 1-cm free margin. No further excision is undertaken if a thin melanoma is diagnosed (excluding the more malignant regressing melanoma) on frozen section. Of the patients seen in 1979, 57% were spared wide excision and general anesthesia.
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PMID:The thin malignant melanoma: changing patterns of epidemiology and treatment. 709 18

We report an adult who developed primary malignant melanoma arising in association with residual nevus cells in the pectoralis muscle under an intact skin graft 13 years following the partial excision of a giant congenital nevocellular nevus (GCNN). The case serves to emphasize the malignant potential of GCNN, for which we estimate a lifetime risk of at least 6.3 percent and an approximate 17-fold risk for melanoma when compared with the general population. This case supports previous observations that melanoma may arise in nonepidermal components of a GCNN and suggests the need to consider excision of the GCNN to muscle fascia or deeper if nevus cells extend beyond this anatomic zone. We estimate the risk of death from general anesthesia during the first year of life to be substantially less than the risk of malignant degeneration during the same time period. The decision to excise the GCNN as soon as the problem is recognized should depend on the general health of the infant and the risk of surgical complications.
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PMID:Nonepidermal origin of malignant melanoma associated with a giant congenital nevocellular nevus. 724 80

A LeVeen peritoneo-venous shunt was placed in each of 5 patients under local anesthesia to relieve symptomatic malignant ascites. All patients had marked ascites due to histologically documented intraabdominal carcinomatosis, extensive hepatic neoplasm, or a combination of malignant ascites and severe parenchymal liver disease. Cases included metastatic breast carcinoma, pancreatic carcinoma, melanoma, and primary cholangiocarcinoma. Prompt relief of respiratory distress and discomfort associated with tense ascites was achieved in all patients; however, survival was short (one week to seven months) due to advanced disease. The LeVeen shunt can provide effective palliation of malignant ascites in carefully selected symptomatic patients.
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PMID:Palliation of malignant ascites by the LeVeen peritoneo-venous shunt. 726 Aug 33

Sequential evaluation of lymphocyte blastogenic response (LBR) to PHA was performed in 10 melanoma patients and in 10 gastric cancer patients undergoing radical operations. Preoperative determinations showed a significant depression of LBR in both patient groups as compared to healthy controls. In patients operated for melanoma the average duration of anesthesia was 101 minutes and in patients who underwent gastric resection it was 192 minutes. In both patient groups a further significant depression of LBR was observed in the early postoperative period; however the LBR returned to preoperative levels more promptly in patients who underwent melanoma excision than in those who underwent gastric resection.
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PMID:[Sequential evaluation of lymphocytic blastogenesis in cancer patients after surgical treatment]. 731 75


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