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)

The ideal extent of colic excision in the curative treatment of left colic cancers has not yet been defined. The aim of this study is to compare the survival rates following left hemicolectomy and segmental colectomy. Over a period of 5 years from 1980 to 1985, 270 consecutive patients with cancer of the left colon without visceral metastases nor invasion of neighboring organs were included in the study. Survival at 5 years was the main criterion of assessment, with mortality and morbidity being the secondary criteria. 10 patients were excluded a posteriori. Out of the remaining 260 patients, 131 were operated with left hemicolectomy and 129 with segmental colectomy. Both groups were comparable as regards age; sex, risk factors (diabetes, renal failure), radiation therapy, antimitotics, procedure of anastomosis (hand or machine), protective colostomy, size of the tumor, and Dukes' stage. Only the length of the colon resected proximel to the tumor was greater in left hemicolectomy. 16% of the patients had a Dukes A adenocarcinoma. Postoperative mortality was higher after left hemicolectomy (6.1%) than after segmental colectomy (2.3%), but not significantly. Morbidity was similar. The survival rate at 5 years, including immediate deaths, was 64.8% after left hemicolectomy and 65.8% after segmental colectomy. Both survival charts could be strictly superimposed without significant differences. Left hemicolectomy therefore produced results that were comparable to those of segmental colectomy.
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PMID:[Extend of colonic excision in the curative treatment of cancers of the left colon. Left or segmental hemicolectomy? A controlled prospective multicenter study]. 209 43

After an acute episode of pancreatitis, a 63-year-old man was found to have a pancreatic glucagonoma. The tumor was resected without evidence of metastases. Three years later he had symptoms of uncontrolled diabetes, no skin lesions, and diarrhea and was found to have a pancreatic pseudocyst and multiple hepatic metastases. Glucagon concentrations were raised but were suppressible by glucose and somatostatin and responded to arginine stimulation. He was treated for 6 months with octreotide (Sandostatin), which reduced his symptoms; the pseudocyst resolved, but liver metastases continued to grow. Although spontaneous resolution of the pseudocyst is possible, this case appears to illustrate differences in sensitivity of endocrine and exocrine tissues to suppression by Sandostatin.
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PMID:Somatostatin analogue in treatment of coexisting glucagonoma and pancreatic pseudocyst: dissociation of responses. 216 87

Between Nov. 1981 and Nov. 1987 103 patients preselected for chemotherapy combined with surgery, therefore with local extension within homolateral mediastinal lymph nodes, with no signs of remote metastases, PS greater than or equal to 70, with no contraindication for resectional surgery including pneumonectomy, no diabetes, no prior treatment underwent first staging. Staging included: case history, physical examination, full blood count, biochemical tests (alkaline phosphatase, SGOT, GGTP, LDH), CEA, X-ray assessment including CT scan of the chest, bronchoscopy, peritoneoscopy, liver scan (US was not routinely used at the beginning), bilateral bone marrow trephine biopsy, and bone scan. Staging was discontinued when secondaries were detected in one, the more so as in two organs or systems (25 pts), and/or bronchoscopic contraindication for thoracotomy (11 pts), and this group of patients was out of the study. To 67 patients chemotherapy was given and after 3 courses these patients were reevaluated. In 21 patients PD, NC or CR was found. Forty six patients with PR underwent supplementary staging procedures: CT of the brain, CT of the upper retroperitoneal space and liver. Metastatic sites were found in 7 patients. Limited disease was identified in 39 patients. Limited-stage disease can be determined only after exclusion of extensive disease on the ground of: case history, physical assessment, X-ray of the chest (PA + lateral) + CT chest scan, bronchoscopy with biopsy or cytology, and outside the chest: 1. bone marrow trephbine biopsy and bone scan--bone marrow and skeleton, 2. CT head scan--brain, 3. CT abdominal scan--upper retroperitoneal space and liver.
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PMID:[Identification of a limited form of small cell lung cancer among 103 patients pre-selected for chemotherapy combined with surgery]. 217 35

The influence of diabetes mellitus on the course of breast cancer was investigated retrospectively in 752 patients. Possible unfavourable prognostic factors like overweight, lipid disorders, age and menopausal status were considered as confounders in a Cochran-Mantel-Haensel analysis. There was no difference in primary tumor status and lymph node involvement between patients with diabetes mellitus and nondiabetic patients. Diabetic patients had more often overweight, lipid disorders and were older than nondiabetic patients. Metastatic disease was highly significant correlated with primary tumor status (p less than 10(-6)) lymph node involvement (p less than 10(-10)) and diabetes mellitus (p less than 10(-5)). Overweight, lipid disorders, age and menopausal status were not correlated with metastatic disease. A possible explanation of the correlation between diabetes mellitus and metastatic disease could be hyperinsulinism in type IIB diabetes. A type IIB diabetes in most of the patients included in this study is very plausible because of the correlation between overweight, lipid disorders, old age and diabetes mellitus. This type of diabetes is characterised by a relative resistence to insulin in the target tissues and a prolonged and exceeding insulin secretion. Experimental data demonstrate that insulin stimulates the growth of breast cancer cell in vivo and in vitro.
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PMID:[Diabetes mellitus and breast cancer. A retrospective follow-up study]. 218 18

Primary leiomyosarcoma of the pancreas is a very rare malignant tumor, with only 12 cases reported. A case of primary pancreatic leiomyosarcoma in a 55 year-old female with diabetes mellitus is described. US and CT demonstrated tumor masses in the head and tail of the pancreas. By angiography, abundant tumor vessels corresponding to the pancreatic tumor masses were revealed in the pancreas. The patient underwent surgical resection of the tumor in the tail of the pancreas, and then, microscopically it was diagnosed as leiomyosarcoma. The tumor in the head of the pancreas was not resected on account of the presence of diabetes mellitus and the possibility of poor prognosis. Macroscopically, it seemed to be the same as the tumor in the pancreatic tail. By operative findings, there was invasion from the pancreatic head to the duodenum and there was nothing to justify suspicion of the extra-ductal growing type of primary leiomyosarcoma of the duodenum. There were no metastases noted at the time.
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PMID:[Primary leiomyosarcoma of the pancreas]. 227 65

The authors report two cases of glucagonoma, a rare endocrine tumor of the pancreas, and describe the data currently found in literature. Glucagonoma is a single and usually large tumor, which develops in the alpha cells of the islets of Langerhans and evolves slowly. The combination of characteristic skin lesions, diabetes and weight loss should lead to searching for hyperglucagonemia and for the pancreatic tumor. The diagnosis is usually made rather late, average evolution is five years before diagnosis when it is detected. Imaging, in particular ultrasound and computed tomography (CT), proves to be necessary for the positive diagnosis of glucagonoma as it localizes the pancreatic mass and plays a role in local assessment, thus providing guidance for surgery. The role of imaging is also fundamental for the detection of metastases, which are the only sign of malignancy as no criterion of benignity is found for this tumor.
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PMID:[Diagnosis of glucagonoma. Value of scanning, echography and arteriography. Apropos of 2 cases and a review of the literature]. 255 85

The authors evaluate five-year ultrasonographic material (13,672 examinations) focused on non-cystic liver disease. 8212 examinations (60.1%) were made as part of examinations of the gallbladder, 4919 (36%) as part of examination of the right sub-costal area or other organs and only 541 examinations (3.96%) were focused in the first place on the liver. The total number of examined patients included 7830 women (57.3%) and 5842 men (42.7%). Most frequently the ultrasonographic picture of steatosis was found--in 747 patients (5.46%), cirrhosis of the liver in 45 patients (0.33%), primary carcinoma of the liver was present in 7 patients (0.05%) and tumour metastases in 63 patients (0.46%). The group of women with steatosis comprised 42 diabetic women (32.06%), 78 overweight women (59.5%) and 18 with excessive alcohol intake for several years (13.7%). In the group of men with steatosis there were 48 diabetics (7.79%), 92 overweight (14.9%) and 479 with excessive alcohol intake extending over several years (77.7%). In the group of 34 men with cirrhosis excessive alcohol intake for years was found in 31 (91.2%), in the group of eight women with cirrhosis in five instances (62.5%). In abdominal ultrasonography liver disease must be actively searched for, in particular in patients with long-term alcohol intake, overweight, diabetes and long-term use of various hepatotropic drugs.
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PMID:[Non-cystic diseases of the liver in a 5-year ultrasonographic study]. 266 Apr

We report a case of limbic encephalopathy clinically characterized by a progressive amnestic syndrome and many EEG seizures mainly localized on the left temporal area. Biological investigations revealed diabetes mellitus and a syndrome of inappropriate antidiuretic hormone secretion (IADH). Haemodynamic and metabolic studies by positron-emission tomography showed an important increase in cerebral blood flow (CBF) and cerebral metabolic rate of oxygen on the left anterior temporal region precisely where the electrical seizures were recorded. Nine months later, severe disorders of memory and a dramatic decrease in CBF and CMRO2 on the same area region were present. At autopsy, a small size oat cell bronchial carcinoma was found with metastases in two small adjacent lymph nodes. Neuropathological examination showed atrophy (neuronal loss, protoplasmic gliosis) in the amygdala; where there was in addition an area of nodular gliosis. The hippocampus and parahippocampal gyrus lesions were severe on the left and moderate on the right side. The authors discuss the nosology of their case in the paraneoplastic syndromes and, with a review of the literature, the role of ADH and cellular hyperactivity in the pathogenesis of specifically localized neuronal alterations.
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PMID:[Paraneoplastic limbic encephalopathy, inappropriate ADH secretion and recurrent subclinical epileptic seizures. Clinical, anatomo-pathological and metabolic correlations by positron emission tomography]. 282 90

Although tumour metastases to the pancreas and peripancreatic lymph nodes are found commonly at necropsy in cases of small cell carcinoma of lung, tumour-induced acute pancreatitis is described rarely. A case of metastasis-associated necrotising pancreatitis with the unusual presentation of epigastric pain followed by diabetes is described here. Patients (particularly cigarette smokers) with none of the conventional risk factors for acute pancreatitis merit chest radiography and if indicated prompt cytotoxic treatment.
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PMID:Necrotising pancreatitis and diabetes associated with disseminated small cell carcinoma of lung. 285 1

SMS 201-995 (Sandostatin) was studied using low doses (50 to 100 micrograms) administered subcutaneously every 12 hours. A single 50-micrograms dose of SMS 201-995 effectively controlled gastric acid and blood gastrin levels for 12 hours in three patients with benign gastrinomas and was useful in their perioperative management. Higher doses of the agent (500 to 800 micrograms per day) had no effect on metastases in one of two patients with metastatic gastrinoma. In the other patient, one tumor shrank but the other continued to grow after three months of treatment while serum gastrin levels did not change. Cultured metastatic tumor tissue from this patient released different forms of gastrin; growth rates varied, independent of uptake of SMS 201-995, and gastrin release increased. A neonate with nesidioblastosis maintained normal blood glucose levels while receiving SMS 201-995 therapy following a 95 percent pancreatic resection. In two elderly patients with organic hypoglycemia--one with a single benign adenoma and one with multiple adenomatosis--the somatostatin analogue did not prolong the hypoglycemia-free interval. In nine patients with carcinoid syndrome, flushing was uniformly controlled with 50 micrograms of SMS 201-995 administered every eight to 12 hours. One of the nine required exocrine pancreatic replacement. After six months of treatment, three of the nine had no change in tumor size and one had remission of symptoms and stopped treatment. In two patients with vipoma, SMS 201-995 controlled diarrhea and reduced levels of vasoactive intestinal peptide; tumor necrosis occurred in one patient. In a patient with diabetic diarrhea unresponsive to all treatments, SMS 201-995 therapy controlled the diarrhea but did not interfere with control of the diabetes.
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PMID:Somatostatin analogue (SMS 201-995) in the management of gastroenteropancreatic tumors and diarrhea syndromes. 287 47


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