Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

About 15% of patients with cancer have cerebrovascular lesions, resulting from 4 kinds of disorders sometimes intermingled in advanced disseminated cancer: coagulation disorders, direct effects of the tumor, infections and therapeutic measures. Infarction, hardly less frequent than hemorrhage, mostly complicates lymphoma and carcinoma. Hypercoagulation states, such as chronic disseminated intravascular coagulation, nonbacterial thrombotic endocarditis, and nonmetastatic cerebral venous thrombosis account for about 50% of cases. Tumor emboli, as seen in intravascular malignant lymphomatosis, arteritis related to aspergillus, granulomatous angiitis with or without herpes zoster and radiation-induced atherosclerosis are rarer. Cerebral hemorrhages, excluding bleeding from the metastases of choriocarcinoma and melanoma are mainly associated with leukemia by acute disseminated intravascular coagulation as in promyelocytic leukemia, by leukostasis or by pancytopenia. Both infarction and hemorrhage rarely reveal the neoplasia. Lesions are often small and disseminated, and therefore produce a picture of diffuse acute or subacute encephalopathy rather than acute focal deficits. Finally, there may be no relationship between the cerebrovascular event and the neoplasia, and atherosclerosis or traumatic subdural hematoma may well be the causal factor.
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PMID:[Cerebrovascular complications of cancers]. 130 55

Two patients who developed frank arterial bleeding after combined microwave-induced hyperthermia and radiotherapy are described. One patient received re-irradiation and hyperthermia for recurrent metastatic neck nodes of a mesopharyngeal carcinoma. Full course radiotherapy had been given 6 years previously and a right-sided radical neck node dissection had been performed 4 months earlier because of recurrent neck node metastases. Six weeks after the combined therapy for a second recurrence, which achieved complete remission, a fatal rupture of the carotid artery occurred. The other patient received re-irradiation and hyperthermia for a chest wall recurrence of a breast carcinoma, treated 5.5 years previously by sector resection and tangential beam radiotherapy, and treated again 2 years earlier with extensive surgery for a local recurrence. A frank arterial bleeding from the treated region was seen after 7 months, but could be arrested with surgery. This important complication in combined hyperthermia and radiotherapy does not seem to have been recognized before. Different explanations are discussed, such as the previous local treatment as well as high temperature and atherosclerosis per se.
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PMID:Arterial rupture after microwave-induced hyperthermia and radiotherapy. With reference to two patients treated for recurrence in previously operated and irradiated areas. 216 9

Examinations have been carried out on 83 cancer patients (aged 34-72), 24 patients with atherosclerosis (aged 38-68) and 34 healthy persons (aged 20-69). The cAMP concentration decrease with age in lymphocytes of healthy persons is confirmed. This index in patients with lung carcinoma, breast carcinoma in remission and in patients with atherosclerosis was identical with that of healthy persons, but in patients with breast and corpus uteri carcinomas without metastases it was higher than in healthy persons of the similar age. The amount of cAMP in lymphocytes is compared with the magnitude of the blast transformation and with the amount of cholesterol in blood and lymphocytes in examined persons. The cAMP level in lymphocytes is observed to increase in the process of hyperlipidemia disappearance in cancer patients and in those with atherosclerosis.
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PMID:[Cyclic adenosine monophosphate content in the lymphocytes of cancer patients]. 299 25

The relationships between habitual physical activity and fitness parameters and fasting serum high density lipoprotein cholesterol (HDL-C), total cholesterol (TC), and triglycerides (TG) were assessed in 357 men aged 30-59 years (mean 44, SD 5). A progressive submaximal power output test (PWC150), a 1-min sit-up test, and a 3-day activity energy expenditure record were obtained for each subject. HDL-C, TG, and HDL-C/TC were significantly associated with the fitness indices (PWC150 and sit-ups), but not with the mean daily energy expenditure computed from a 3-day activity record. However, when the subjects were stratified according to the maximal level of intensity reported in the work and leisure energy expenditure record, a relationship between maximal exercise or work intensity and the concentration of HDL-C and TG, and the ratio HDL-C/TC was found. When adjusted by multiple regression procedures for age, alcohol consumption, cigarette smoking, socio-economic status, fatness level, and TC, or TG, or HDL-C, as appropriate, these relationships became nonsignificant, with the exception of TG and PWC150. These results suggest that habitual physical activity of light intensities is not a major determinant of HDL-C, TC, and HDL-C/TC; it could, however, have a small but significant role in TG. In addition, data suggest that periods of exercise of higher intensity, i.e. with an energy cost of about 6 mets and more, could be a sensible mean to influence serum blood lipid levels.
Atherosclerosis 1985 Oct
PMID:High density lipoprotein cholesterol, habitual physical activity and physical fitness. 407 63

Accelerated graft atherosclerosis is responsible for increased mortality and morbidity among heart transplant recipients. The aim of this in-vivo study was to evaluate coronary atherosclerotic vessel alterations and endothelial function. Seventeen patients (14 males; mean age 49.3 years; range 24 to 69) were studied an average of 11 weeks (range 5 to 21) after heart transplantation because of coronary artery disease (n = 8), dilative cardiomyopathy (n = 7), mitral valve replacement (n = 1) and left atrial metastases of a leiomyosarcoma (n = 1). Mean age of the donor hearts (9 males) was 29 years (range 12 to 55). All recipients underwent biplane ventriculography and coronary angiography. In this study population, a total of 120 coronary segments (main stem, 21; left anterior descending artery, 85; circumflex artery, 14) were analyzed by intravascular ultrasound (20 MHz, 3.5F). In 13 patients, acetylcholine was infused into the proximal left anterior descending artery (10(-8) to 10(-5) M) to evaluate vasomotion within this segment. Regional contraction abnormalities were documented in 2 patients. Nine segments angiographically showed non-critical stenoses (5 patients). Intravascular ultrasound detected 52 cross-sectional areas with a three-layer pattern indicating intimal thickening. Mean circumferential extension of intimal proliferation was 192 degrees, mean intimal thickness 0.35 mm. Only 5 segments of the sonographically pathological cross-sectional areas showed angiographical evidence of atherosclerotic lesions. Intracoronary administration of acetylcholine at doses of 10(-8) and 10(-7) M resulted in vasoconstriction of the examined coronary segment in only 2 patients; the intracoronary application of acetylcholine at doses of 10(-6) and 10(-5) M revealed coronary vasoconstriction in 10 of the total of 13 patients. Using intravascular ultrasound, coronary artery lesions in heart transplant recipients can already be depicted at a very early stage. The abnormal response to acetylcholine in most of the heart recipients is independent of the extent of atherosclerotic vessel abnormalities documented by ultrasound or angiography.
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PMID:Angiographic, intravascular ultrasound and functional findings early after orthotopic heart transplantation. 762 83

In 21 patients with T3, T4 pharyngo-laryngeal cancer circumferential resection with immediate reconstruction using a free revascularized jejunal autograft was performed. In 13 cases the jejunal reconstruction was successful. In patients previously not irradiated the rate of success was 75% and in irradiated ones 37.5%. Five patients survived more than 5 years: one more than 7, two more than 6 and one more than 5. One patient with an unsuccessful jejunal graft and with subsequent skin reconstruction survived more than 6 years. The causes of failure were:-irreversible spasm of the arteries in 2 cases, skinking of the vessels resulting in flap necrosis in flap necrosis in 2 cases, -necrosis due to widespread atherosclerosis of the cervical arteries in 3 cases and of an unknown cause in 1 case. The cause of death was: widespread metastases in 12 cases, C.V.A. in 1 case, road traffic accident in 1 case, complications of the ileus in 1 case and carotid artery haemorrhage in 1 case. One of the successful patients was irradiated postoperatively, because the pathology report stated there was incomplete resection, and survived more than 6 years with no disturbance of swallowing. In general 10 patients died in the first year, 4 in the second, 1 in the third and 1 in the fourth--without any signs of recurrence. The five year survival of 24% in the presented group is relatively high in comparison with the generally accessible data for T3, T4 hypopharyngeal carcinoma treated by any of the usual methods.
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PMID:[The latest results of the advanced hypopharyngeal cancer surgery with immediate reconstruction using the free jejunal autograft]. 797 Jul 59

A review of the perioperative morbidity and mortality and long-term survival in elderly and high-risk patients with colorectal neoplasia was undertaken. Elderly high-risk patients with localized disease were compared with those with advanced disease. Over a five-year period, 82 high-risk (at least one major organ system disease), or elderly (age > or = 70 years) patients underwent an operation for colorectal neoplasia. Overall, 43 of 82 (52 percent) had advanced disease (obstruction, perforation, hemorrhage, or metastatic disease), while 39 of 82 (48 percent) had localized disease. The mean age of all patients was 78.2 years. Preoperative comorbid diseases included: coronary atherosclerosis, 59 (72 percent); previous myocardial infarction, 17 (21 percent); previous arrhythmia, 10 (12 percent); emphysema, 32 (39 percent); renal failure, 6 (7 percent); and cirrhosis, 3 (4 percent). At the time of surgery, 26 patients (32 percent) had metastatic disease. Six patients (7 percent) died in the perioperative period. The presence of advanced neoplasia did not significantly affect 30-day mortality. There was no difference in major morbidity between patients operated on for localized and for advanced disease. The mean actuarial 18-month survival was less for patients with advanced disease (P < 0.05). Sixty-eight patients (83 percent) are alive at a follow-up of 17.7 +/- 29 months postoperatively. The morbidity and mortality associated with resection of colorectal neoplasia in high-risk elderly patients are acceptable even in the presence of advanced disease. In select patients, resection offers the best palliation and may improve the quality of remaining life.
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PMID:Advanced colorectal neoplasia in the high-risk elderly patient: is surgical resection justified? 842 20

Triglycerides, which are major constituents of dietary fat, contain a mixture of saturated and unsaturated fatty acids. One newly recognized function of unsaturated fatty acids is modulation of cell adhesion to components of the extracellular matrix. Alterations in cell adhesiveness or cell adhesion molecule expression accompany the onset of a number of diseases including arthritis, atherosclerosis, and cancer. Cell adhesion is necessary for the metastatic spread of cancer cells to new organs. Circulating cancer cells adhere to endothelial cells and the underlying subendothelial basement membrane as an initial step in the process of invading target organs during metastasis. Several recent studies have provided convincing evidence that unsaturated fatty acids and their metabolites influence adhesion of cultured human cancer cells to individual components of the basement membrane. These unsaturated fatty acid effects appear to be dependent in some instances on the expression of specific cell surface adhesion molecules. Unsaturated fatty acids influence the development of metastases in animal tumor models by largely unexplored mechanisms; the possibility that cell adhesion is involved in this process has not been thoroughly investigated. Future studies of unsaturated fatty acid effects on cell adhesion molecule expression in breast cancer patients should reveal the clinical relevance of the studies reviewed here.
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PMID:Modulation of breast cancer cell adhesion by unsaturated fatty acids. 897 9

We report a case of a 35-year-old man who died of a brain infarct 20 months after radiotherapy for carcinoma of the tonsil with metastases to the cervical lymph nodes. Histology revealed mild atherosclerosis, necrotizing vasculitis, and occlusive thrombosis of the internal carotid artery. Significant changes were observed in the vasa vasorum: swelling and detachment of the endothelium, subendothelial oedema, hyaline change, fibrinoid necrosis of the vessel walls with mononuclear cellular infiltration, accompanied by focal haemorrhages and chronic inflammation in the periadventitial soft tissue. We believe that these changes of the vasa vasorum and necrotizing vasculitis are causally related and that vasculitis represents focal ischaemic necroses with inflammatory reaction. Our findings support the hypothesis, based on experimental studies, that injury to the vasa vasorum is an important mechanism in the development of radiation-induced vasculopathy of large arteries. They also suggest an evolution of the injury to the vasa vasorum and periadventitial tissue from the early lesions described in our patient, to late stages resulting in dense periadventitial fibrosis as reported previously. We suggest that injury to the vasa vasorum and the consequent ischaemic lesions of the arterial wall are morphological features distinguishing radiation-induced arterial injury from spontaneous atherosclerosis.
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PMID:Contribution to the pathogenesis of radiation-induced injury to large arteries. 942 96

Angiogenesis is the development of new blood vessels from the existing vascular bed. In normal conditions this tightly regulated process occurs only during embryonic development, the female reproductive cycle and wound repair. In contrast, in pathological conditions such as malignant growth, atherosclerosis and diabetic retinopathy, angiogenesis becomes persistent due to an imbalance in the interplay between the positive and negative regulatory signals controlling the process. Thus, the control of tumor neovascularization may lead to new therapeutic approaches. Indeed, several anti-angiogenic drugs are currently undergoing preclinical characterization and/or clinical investigation. Recent achievement has clarified the mechanisms of action leading to pathological angiogenesis and has highlighted the role of hypoxia, growth factors, growth factor-receptors, enzymes and cell adhesion molecules involved in the process. This knowledge has permitted the design of receptor antagonists, adhesion molecule blockers and new targeted vascular approaches including gene therapy.
Clin Exp Metastasis 1999 Feb
PMID:Mechanisms of tumor angiogenesis and therapeutic implications: angiogenesis inhibitors. 1039 Jan 41


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