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

Between January 1973 and October 1977, 166 patients who died of breast cancer were autopsied. The examination revealed consistently more tumor involvement than had been clinically suspected. Unsuspected areas of tumor involvement included the endocrine organs (40%), lungs (28%), cardiovascular system (21%), and the genitourinary system (21%). The error in diagnosis was smaller with metastasis to the bones (10%) and central nervous system (14%). The major causes of death included pulmonary insufficiency (26%), infection (24%), cardiac disease (15%), hepatic insufficiency (14%), hemorrhage (9%), central nervous system disease (9%), and hypercalcemia (3%). The most common cause of death was metastatic disease to various organs, accounting for 42% of all deaths. Infection was the second most common cause of death; however, only 27% of the patients with infection had significant neutropenia. In patients dying of hemorrhage, only 9% were thrombocytopenic. In conclusion, although many clinicians have expressed concern that chemotherapy would add to early mortality in cancer, our study shows that this is not the case for patients with breast cancer. Deaths due to chemotherapy were rare and the rise in the infection rate did not correlate with the advent of chemotherapy.
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PMID:Causes of death in breast cancer: a clinicopathologic study. 738 58

The effect of initiating leishmanial infection in guinea-pigs with organisms contained within macrophages has been examined. Infection of animals in this way resulted in the development of metastatic disease with inocula 2 logs lower than required when free parasites were injected. The macrophage localization was found to protect the parasite from innate resistance, and, at certain times, from mechanisms of acquired immunity. Despite this, initiation of infection with parasites secluded in macrophages did result in the development of specific cell-mediated and humoral immunity. The results indicate that protection of the parasite by the macrophage contributes to the development of metastatic disease. Furthermore, it was revealed that metastatic disease can devlop in the face of acquired mechanisms of resistance. The possibility that non-healing diffuse leishmaniasis is the cause rather than the result of the suppressed immunological reactivity associated with this disease is discussed.
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PMID:Mechanisms of immunity to leishmaniasis. II. Significance of the intramacrophage localization of the parasite. 738 16

Infection with the varicella zoster virus can include pulmonary complications. These may cause such minor symptomatology as to go unrecognized and unimaged. We describe a case of active chickenpox pneumonia that mimicked pulmonary metastases and was detected incidentally by means of computed tomography in a man with a past history of testicular teratoma.
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PMID:Case report: the pulmonary lesions of chickenpox pneumonia--revisited. 806 4

Infections due to Actinomycosis species are located in the cervico-facial region in 50 to 65 percent of the cases. Extra-cervical cutaneous lesions are exceptional. The most frequently encountered germ is Actinomyces israeli, observed in 85 percent of the cases. We report the case of an Actinomyces meyeri infection which presented as a leg abscess and a pulmonary lesion. There was no cervico-facial localization. There was however a chronic parodontitis. A second germ, Capnocytophaga sp. was isolated from the abscess. This case is of particular interest because of the extracervical localization and the rare species isolated (17 other cases of Actinomyces meyeri infection have been reported). The mechanism of the infection can be better understood in light of pulmonary lesions in the lower right lobe due to inhalation and the coexistence of a buccodental germ in the culture of the leg abscess: buccodental origin of the germ, pulmonary lesion secondary to inhalation, septicaemic dissemination with cutaneous metastases.
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PMID:[Actinomyces meyeri cutaneous actinomycosis with pulmonary localization]. 807 51

Nasopharyngeal carcinomas (NPCs) are malignant tumors which exhibit a wide disparity in their age, racial, and geographic incidence. In parts of Africa NPCs account for 10% to 20% of childhood malignancies. In USA and Europe, the NCP is an uncommon tumor (0.2% of all malignancies) and amounts to only 1% to 2% of childhood malignancies. Etiology and pathogenesis are closely related to an infection with Epstein-Barr Virus (EBV) and the EBV genome was detected in tumor tissues. Children with NPC differ from their adult counterparts in having a closer association with Epstein-Barr-Virus-Infections. The classical lymphoepithelial carcinomas (Cologne type II-type III) have been found in young patients. Clinically, the disease is aggressive, characterised by frequent metastases in bone and lung. These carcinomas are associated with significantly elevated anti-EBV-titers. The prognosis of children with advanced NPC is poor with a 5-year survival rate between 20-30%. Radiotherapy is the treatment of choice in NPC which has provided an improvement in local tumor control in recent years. Human fibroblast interferon is an active agent in recurrent NPC. Seven children have been treated with IFN-beta, (6 with human und 1 with recombinant IFN-beta) as an adjuvant therapy in doses of 10(5) U/kg body weight three times a week for half a year. All patients received radiotherapy to primary site and had advanced stages (III-IV) at presentation. The patients' age ranged from 14-19 years at diagnosis. Six are still in CR (RFS are 10, 8, 8, 7, 6 and 1.5 years) and one patient relapsed after 18 months.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Combined treatment of nasopharyngeal cancer in children and adolescents--concept of a study]. 839 21

The vast majority of pulmonary masses in children are nonmalignant. Most pediatric nodular disease is granulomatous in origin. Infections and congenital lesions outnumber neoplastic lesions. Pulmonary metastatic disease most often results from Wilms' tumor and is followed in frequency by the sarcomas. Primary pulmonary malignancy is rare in the child.
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PMID:Nodules, masses, and pseudomasses in the pediatric lung. 849 96

Numerous studies have demonstrated the importance of urokinase plasminogen activator (uPA) and its receptor, uPAR, in the processes of tumor progression and metastasis. Thus, the uPA/uPAR interaction may represent an important target for inhibiting metastatic disease. The baculovirus expression system was used to produce high levels of a secreted uPA-Immunoglobulin G fusion protein (uPA-IgG) which could then be used for displacing uPA from the surface of tumor cells. The recombinant uPA-IgG fusion protein was placed under the control of either the viral polyhedrin promoter or a copy of the viral basic protein promoter. Recombinant viruses were then used to infect Sf9 and BTI-Tn-5B1-4 cells. Infection of both cell types resulted in the production of secreted uPA-IgG. The molecular mass of the secreted protein as determined by SDS-PAGE was approximately 40 kDa. The highest level of secreted uPA-IgG, 444 microg/ml, was found in the culture medium of BTI-Tn-5B1-4 cells 72 h post-infection with the basic protein promoter-uPA-IgG virus. In the case of Sf9 cells, the highest level of secreted protein was 195 microg/ml. The amount of cell-associated uPA-IgG in infected BTI-Tn-5B1-4 cells was significantly less than that of infected Sf9 cells, reflecting the superior secretory capability of the BTI-Tn-5B1-4 cells. The uPA-IgG was readily purified using a combination of zinc chelate and sephacryl S-100 column chromatography. Routinely, greater than 100 mg of greater than 95% pure protein could be obtained per liter of culture medium collected at 72 h post-infection of BTI-Tn-5B1-4 cells with the basic protein promoter virus. BIAcore analysis and competition binding assays using LOX human malignant melanoma cells expressing uPAR indicated that the purified recombinant protein possessed similar ligand binding characteristics to that of human uPA.
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PMID:Production of a urokinase plasminogen activator-IgG fusion protein (uPA-IgG) in the baculovirus expression system. 918 59

From 1986 to 1995, 97 patients older than 65 years of age underwent hepatic resection at the Department of General Surgery, Hospital Lainz, Vienna. The population consisted of 39 men and 58 women with a mean age of 74 +/- 5.5 years. Primary neoplasia was the cause of resection in 35 patients, gallbladder cancer in 16 patients, and metastatic disease to the liver in 40 patients. Six patients underwent hepatic resection because of benign disease. The overall rate of major resections (> or = 3 liver segments) was 73% and the overall mortality was 13.5%. Sixty-five postoperative complications were recorded in 42 patients, and infection was the leading problem in nearly all of these patients (95%). The histologic type of tumor rather than the magnitude of resection had an influence on clinical mortality and morbidity. All complications occurred in patients with malignant disease (P = 0.03). Adverse effects on postoperative morbidity were observed in adenocarcinoma of the hepatic ducts, gallbladder carcinoma, and cholangiocellular carcinoma (P = 0.003). Intraabdominal infections were found in 25% of our patients and were due to biliary leakage in 58%, but had no significant impact on survival. Pneumonia was the leading complication in association with patient survival. All patients who developed pneumonia as a late complication during a complicated course died postoperatively (P = 0.0001). All of these patients had a reduced grade of mobilization. Severe preoperative liver dysfunction carried a significantly higher risk for postoperative morbidity and mortality (P = 0.003 and 0.01), which showed an incremental risk with age > 80 (P = 0.002 and 0.0004). Right lobectomies and extended right lobectomies carried a significantly increased risk for postoperative morbidity (P = 0.004). Infection is associated with nearly every complication recorded after hepatic resection in the elderly. Pneumonia as a late complication poses a worse prognosis in elderly patients who underwent hepatic resection. Patients older than 65 years of age and especially those older than 80 years of age are more liable to succumb to complications that are predominantly infectious. Better local drainage procedures may reduce intra-abdominal infectious complications and early mobilization of the patients may improve the rate of systemic infectious complications and final outcome.
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PMID:[Infections after liver resections in the elderly]. 944 65

Infection with the human immunodeficiency virus (HIV) is associated with a high incidence of cancers. This relationship does not appear to be due to a direct effect of the virus, and may be mediated by neuroimmune interactions since the HIV glycoprotein, gp120, enters the brain soon after infection with HIV, and intracerebroventricular (i.c.v.) infusion of gp120 suppresses aspects of cellular and tumor immunity. It has been speculated that this suppression may be attributed to the release of interleukin-1 (IL-1) in the brain induced by gp120. Using an in vivo tumor model, we examined the effect of centrally administered gp120 on tumor metastasis and lung clearance of mammary adenocarcinoma (MADB106) tumor cells in rats, and the role played by brain IL-1 in mediating these effects. We demonstrate that central administration of gp120 (4 microg) significantly (p<0.05) increased the retention of tumor cells in the lungs and significantly (p<0.02) enhanced the development of tumor metastases. Central administration of IL-1beta (10 ng) also significantly (p<0.05) increased retention of tumor cells in the lungs. The effect of gp120 on lung retention of tumor cells was blocked by co-administration of alpha-melanocyte stimulating hormone (alpha-MSH, 20 ng), a hormone that blocks many of the biological effects of IL-1, or the IL-1 receptor antagonist (50 microg). Given that systemic administration of gp120 or IL-1beta had no effect on the retention of tumor cells in the lungs, these findings indicate that gp120-induced secretion of IL-1 within the brain most likely mediates the effects of gp120 on tumor metastasis. These findings suggest a possible neuroimmune mechanism to account for the increased incidence and aggressiveness of tumors in HIV-infected patients.
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PMID:Intracerebral HIV glycoprotein (gp120) enhances tumor metastasis via centrally released interleukin-1. 950 52

Fotemustine was investigated in 17 patients with progressive hepatic metastases from colorectal carcinoma to define the maximally tolerated dose for a daily hepatic intra-arterial infusion (HAI) schedule. Haematotoxicity was delayed, dose-dependent and related to pretreatment, with thrombo- and leucocytopenia being dose-limiting. Local side-effects at the liver were mild. Infection (WHO grade III) occurred in 1 patient due to neutropenia. Other side-effects, particularly renal, pulmonal, neurological or cardiac toxicity, mucositis and diarrhoea, hair loss or allergic reactions did not occur. Pharmacokinetic analysis indicated a short plasma half-life (t1/2 = 25.8 +/- 11.5 min) and a high body clearance (CL = 2193 +/- 870 ml/min) with large inter- and intra-individual variations. Of 15 evaluable patients, one complete and three partial responses were observed (ORR = 27%; CI95% [4.5-49.5%]). All tumour remissions appeared at higher dose levels in previously untreated patients. Considering the absence of mucosal side-effects, such as mucositis/diarrhoea and of hepatic toxicity, this agent was well tolerated. The recommended intra-arterial dose for consecutive phase II trials is 125 mg/m2/day1-3.
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PMID:Phase I pharmacological study of intra-arterially infused fotemustine for colorectal liver metastases. 962 43


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