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)

A 69-year-old man with respiratory disease sustained multiple rib fractures during resuscitation for respiratory arrest. Death occurred after the second attempt. Autopsy findings included carcinoma of the lung with widespread metastases, multiple pulmonary marrow emboli, and a marrow embolus to the posterior ciliary vessel.
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PMID:Marrow embolus to posterior ciliary vessel. 239 14

Fifty heavily pretreated postmenopausal patients with advanced breast cancer were treated with oral medroxyprogesterone acetate (1 g) daily for 1-18 months. Eight patients (16%) responded to treatment for periods up to 18 months and in an additional eight patients (16%) the disease stabilized for up to 10 months. Thirty-two patients (64%) developed adverse effects and eight (16%), all of whom had extensive pulmonary metastases, died a respiratory-related death thought possibly to have been brought on or accelerated by treatment. Only eight patients (16%) experienced increased appetite, weight gain, feeling of wellbeing, or improved performance status. We conclude that medroxyprogesterone acetate is useful in patients with advanced metastatic disease but should be restricted to carefully selected patients and used only with extreme caution in patients with underlying cardiovascular or respiratory disease. Its major application probably lies in the benefit it confers earlier in the disease.
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PMID:High-dose oral medroxyprogesterone acetate in heavily pretreated patients with metastatic breast cancer. 294 46

A mixed differentiated thyroid carcinoma was found in a small asymptomatic nodule in a 44-yr-old woman with recurrent chest infections and bronchiectasis. After total thyroidectomy and 162 mCi (6 GBq) radioiodine ablation there was uptake in the thyroid remnant and in both lungs, interpreted as lung metastases. In 2 years she received further three 162 mCi (6 GBq) doses of 131I, as scans showed very similar lung activity. Another scan, during thyroxin suppression, showed again activity in the lungs. A 47-yr-old male patient with similar respiratory disease and no history of thyroid disorder volunteered to undergo radioiodine scan while on triiodothyronine suppression. His scan, too, showed concentration in the lungs. The female patient died 7 years after the diagnosis of lung thyroid metastases was made. No metastasis was found at autopsy. Radioiodine lung uptake may occur in patients with chronic inflammatory lung disease, presenting a potential diagnostic pitfall in patients with differentiated thyroid carcinoma.
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PMID:Iodine-131 uptake in inflammatory lung disease: a potential pitfall in treatment of thyroid carcinoma. 337 6

The International Staging System for Lung Cancer provides for classification of six levels of disease extent in five stage groups that relate to patient management and prognosis. Stage 0 is reserved for patients with carcinoma in situ. The Stage I and II definitions provide for classification of two levels of disease extent completely contained within the lung that have different prognostic and therapeutic implications. Definitive resection is the first choice of therapy for patients with non-small cell lung cancer in these stage groups. The Stage II category takes into account the erosion of survival expectations in the optimum group of T1 and T2 patients as a consequence of intrapulmonary lymph node involvement. Although small cell carcinoma is infrequently encountered as Stage I and Stage II disease, these classifications may be useful in the structure of investigational programs involving adjuvant surgery. The exclusion of distant metastases and the division of Stage III into two levels of extrapulmonary disease allow for selection of patients for specific treatment plans. Patients with non-small cell tumors with Stage IIIa disease usually are candidates for definitive surgical treatment. The specificity of the T and N definitions in the Stage IIIa and IIIb categories identifies patients for whom particular radiotherapy treatment plans are structured and protocol assignments are made. It is consistent with patient management concepts that all those with distant metastases are classified as having Stage IV disease. Implications of the system for selection of surgical, radiotherapeutic, and chemotherapeutic regimens are rational for all cell types. The classification meets the requirement for simplicity and can be readily applied in a broad spectrum of clinical and teaching environments. It is, however, sufficiently specific to be useful for reporting results of investigational therapies. Prospective use of the classification should encourage precision in clinical evaluations that exploit full use of refinements in imaging technologies. The cooperative efforts of the Task Force on Lung of the AJCC and the TNM Committees of the UICC to bring this classification system to fruition and international acceptance have been described. It has been adopted by these groups and others, including the International Association for the Study of Lung Cancer, the Japanese Cancer Committee, and the Spanish Society of Respiratory Disease, as their official recommendation for staging lung cancer.
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PMID:The new International Staging System for Lung Cancer. 362 29

An experience of surgical non-thoracic emergencies in patients admitted for chronic lung disease is herein presented. Fifty-four patients out of 10457 admitted in the four Departments of Pneumology of the Binaghi Hospital (Cagliari) between 1-1-1985 and 31-3-1993, were referred to our Department of General Surgery due to non-thoracic surgical emergencies. There was a considerable delay in the referral (only 25% of patients within 12 hours from the onset of symptoms): indeed predominant respiratory symptoms, hypoxia and hypercapnia made these patients no responsive to symptoms of surgical emergency. Surgical emergencies in causal correlation with respiratory disease (intestinal occlusion due to abdominal metastases of lung carcinoma, complicated peptic ulcer) had the worst prognosis (mortality: 52.9%). Those in chance connection, such as acute limb ischemia and preexisting abdominal disease, had a less adverse outcome. Mortality, however, was 37.5%: this datum outlines the role of chronic lung disease in defining operative risk. The authors call attention to three groups of observed patients: 1) three patients were operated on for intestinal occlusion due to unrecognized abdominal neoplasia, that showed itself in the course of hospitalization in the Department of Pneumology for lung metastases; 2) in 3 cases symptoms and signs of acute abdomen were observed without abdominal disease. The cause of acute pseudoabdomen was diaphragmatic pleural or basal pulmonary inflammation; 3) the eight patients with pulmonary embolism were all admitted in the Department of Pneumology with a wrong diagnosis of bronchopneumonia.
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PMID:[Extrathoracic surgical emergencies in hospitalized patients with bronchopulmonary diseases. Analysis of the operative risk]. 780 66

Oesophageal cancer is one of the most lethal carcinomas, with 5-year survival rates of less than 5%. This is due to a combination of factors including late presentation, associated cardiac and respiratory disease, and the technical difficulties of resectional surgery. The outcome for patients with oesophageal cancer has changed little in recent years, perpetuating a pervading attitude of pessimism in the surgical community. The epidemiology of oesophageal cancer is changing with the increasing incidence of adenocarcinoma. Most of these tumours arise in the setting of Barrett's oesophagus and chronic gastro-oesophageal reflux disease. Survival following surgery for oesophageal cancer is determined by several independent factors, most notably the pathological stage of the disease and the patients physiological status. However, in patients with limited disease, in particular patients with less than five lymph node metastases, the extent of the nodal dissection positively impacts survival. This article reviews the changing epidemiology of oesophageal cancer, focusing on the need for early diagnosis and the selection of patients for surgery. It places emphasis on the importance of integrating surgical therapy in a multidisciplinary team approach to the management of such patients.
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PMID:Carcinoma of the oesophagus: the time for a multidiciplinary approach? 906 63

With the FDA approval of Rituximab in 1998 for the treatment of lymphoma, and Trastuzumab in 1999 for the treatment of breast cancer, monoclonal antibodies were officially added to the therapeutic armamentarium against malignancy. Most of the side effects associated with these agents are due to antigen-antibody interactions on specific cells and tissues. One of the most predictable side effects of these products is a constellation of various systemic effects including flu-like symptoms such as headache, fever, sweats, skin rash, shortness of breath, hypotension, nausea, and asthenia that occurs with the first infusion of such products. Rarely severe hypotension, bronchospasm, and hypoxia and even death have occurred. The pathophysiology of these reactions appears to be secondary to the release of cytokines as the antibodies bind do circulating antigen-expressing cells that are then removed in the reticuloendothelial system of the lungs, spleen and liver. In patients with large numbers of antigen-dense cells that have a high mitotic index, such as prolymphocytic leukemia, mantle cell lymphoma, or lymphosarcoma cell leukemia, there is a risk of true tumor lysis syndrome. One should be particularly cautious when treating patients with high numbers of circulating antigen-expressing cells in the setting of underlying cardiovascular or respiratory disease.
Cancer Metastasis Rev 1999
PMID:Infusion reactions associated with the therapeutic use of monoclonal antibodies in the treatment of malignancy. 1085 89

The objective is to investigate the presence of dysphonic symptoms in multiple sclerosis (MS) patients and to compare quantitative acoustic parameters in multiple sclerosis patients and normal individuals. The method of study was an 8-month controlled cross-sectional that was carried out with 106 individuals (30 MS, 76 controls). Both groups included males and females from 20 to 55 years. Exclusion criteria were prior vocal disorder, laryngeal microsurgery, recent endotracheal intubation, tumors, laryngeal, lung or mediastinal metastases, respiratory disease, and other associated neurological diagnoses. For dysphonic symptoms (qualitative variables), associations were assessed using Mantel-Haenszel's chi2 test, with Yates correction or the Fisher exact test when necessary. Statistical significance was set at p< or =0.05. Dysphonia was observed in 70% of MS individuals versus 33% of controls (p=0.01). Association was found between MS and dysphonia (OR: 2.2, CI 95%: 1.13-4.25). Fundamental frequency was higher among MS patients (p=0.01). Fundamental frequency deviation was significantly higher in MS women (but not men) than controls (p=0.00). Jitter was higher in MS men than in all other groups (p=0.00). Results suggest that evaluation and treatment of MS patients should be revised, evaluating voice alterations in relation to other signs. MS seems to intensify gender effect on fundamental frequency deviation, noise, and jitter, with MS women presenting fewer voice variations than men.
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PMID:Acoustic analysis of voice in multiple sclerosis patients. 1533 Nov 6

A 67-year-old man was admitted to our hospital due to esophageal cancer. Cancer existed at the lower esophagus and subtotal esophagectomy and lymphadenectomy was performed. The postoperative course was uneventful. Pathological findings revealed moderately differentiated squamous cell carcinoma that metastasized to the abdominal lymph nodes which include the paraaortic lymph nodes. He complained of anorexia three months after the operation and was found to have multiple liver and mediastinal lymph node metastases. He was admitted for chemotherapy. Before starting chemotherapy, he suddenly died without any sign of hemorrhage or respiratory disorder. Autopsy showed metastatic lesions to the heart and mediastinal lymph nodes, liver, thoracic vertebrae, kidney, adrenal gland and heart. Metastatic nodules in the heart were on the ventricular septum where the conducting system exists. No direct invasion from the pericardium was observed. Blockade of the conducting system of the heart was considered to have caused the severe arrhythmia and sudden cardiac arrest.
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PMID:Sudden death from metastatic esophageal cancer to the ventricular septum. 1609 36

Multiple adenofibromas or adenofibromatosis is characterized by the presence of at least 3 mono- or bilateral adenofibromas increasing significantly in size, causing trophic disorders. We report the case of a 46-year old female patient who had been followed up since she was 30 years old for bilateral adenofibromatosis that required 4 surgical procedures. Patient's medical data were collected in the Department of Respiratory Diseases at the Ibn Rochd University Hospital Center, Casablanca. Basing on preoperative assessment before bilateral mastectomy, the patient underwent chest X-ray that showed opaque right hemithorax exerting compression on the mediastinum. Clinical examination showed effusion syndrome in the right hemithorax and left supraclavicular cervical adenopathy. Pleural puncture biopsy confirmed the presence of poorly differentiated invasive carcinoma in the pleura, supporting breast origin. Bronchoscopy after pleural puncture objectified infiltration of the whole bronchial tree; biopsies confirmed the anatomopathological results. The recommended treatment strategy was based on multidrug chemotherapy. Patient's evolution was marked by the occurrence of hepatic metastases. This study shows that adenofibromas require regular monitoring given the risk of trasformation to breast cancer, which is a frequent cause of pleuropulmonary metastases.
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PMID:[Pleural and lung metastasis from degenerated multiple adenofibromas: about a case]. 2951 33


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