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)

Conventional approaches to therapy for cancer, such as chemotherapy, operative therapy and radiation therapy, can produce profound changes in host immunity. The effects of chemotherapy upon immune responses are related both to the dosage and duration of therapy and are readily reversible. Operative therapy likewise suppresses both humoral and cell-mediated immunity for two to three weeks, as manifested by in vitro and in vivo tests of these functions. Radiation therapy, however, seems to decrease host immune responses for more prolonged periods of time, up to ten years. Nutritional status may also affect both limbs of the immune system, and malnutrition is being recognized with increasing frequency as a clinical problem in patients with advanced primary malignant or metastatic disease, especially during antineoplastic therapy. Intravenous hyperalimentation is a safe and effective method for correcting nutritional deficits in patients with cancer; moreover, immunocompetence may be enhanced during adequate nutritional rehabilitation.
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PMID:The effects of nutrition and treatment of cancer on host immunocompetence. 36 3

The study included 873 rectal examinations carried out in children where inspection, rectal examination and endoscopy were performed in each case. Most examinations were done in children complaining of gastroenterocolitis. Inspection of gluteal, perianal and sacrococcygeal areas was normal in most cases: however, ammoniacal erythema was frequently found (44.2%). Rectal examination showed hypotonicity of the external sphincter in 146 cases which was linked to prolonged diarrhea and malnutrition. At the endoscopy, the rectal mucosa showed ulcerations, congestion, friability, edema and bleeding; however, it was considered normal in 274 occasions. In 540 patients, the endoscopic diagnosis was colitis of different types. In 54 cases, the endoscopic examination, plus the examination of fecal mucus taken directly from the rectal mucosa led to the diagnosis of amebic colitis. In opposition with adults, neoplastic lesions were uncommon and usually corresponded to leukemic infiltration or tumoral metastases. There were no complications attributable to the process.
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PMID:[Proctologic examination in pediatrics]. 62 45

Forty-seven cancer patients were selected for study based on their candidacy for hyperalimentation. Each patient received selected skin test antigens intradermally in the forearm prior to the initiation of hyperalimentation, and at 7-day intervals throughout treatment with either chemotherapy, radiation therapy or surgery. Of 23 patients who received chemotherapy, 17 initially had negative skin tests. Thirteen of these patients had positive skin tests after an average of 11.4 +/- 5.5 days of hyperalimentation. Response to chemotherapy occurred only in hyperalimentation. Response to chemotherapy occurred only in those patients whose skin tests were positive, and conversion of skin test reactivity to positive occurred before clinical regression of metastatic disease. No patient who received radiation therapy developed or retained positive skin test reactivity, although nutritional repletion was considered satisfactory in each patient. Surgical patients whose skin tests converted to positive or remained positive preoperatively had an uncomplicated postoperative recovery, whereas 2 of 4 patients whose skin tests remained negative expired postoperatively. Absence of established delayed hypersensitivity in the cancer patient who is treated with chemotherapy or surgery is probably secondary to generalized malnutrition, and established cell-mediated immunity can be restored by proper nutritional repletion.
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PMID:Effect of intravenous hyperalimentation on established delayed hypersensitivity in the cancer patient. 82 Feb 90

Many studies have assessed the benefits of nutrition support in cancer patients. Except for studies directed at the treatment of severe malnutrition, most clinical trials have failed. Although prospective randomized controlled clinical trials (Phase III) remain the most reliable means of evaluating the efficacy of therapy, the available literature reports only results from small trials (Phase II to III), most of which appear to be contradictory and none of which conclusively answer the question being considered. To address this gap in knowledge, tools such as meta-analysis have been adapted from the field of statistics. Meta-analysis involves pooling results across several studies and provides a more precise estimate of treatment effect than can each individual study. However, clinical trials selected for meta-analysis, although broadly similar, can differ significantly in terms of therapies used and clinical populations studied. Major cancer types with differing effects on food intake and malnutrition (eg, the mechanical obstruction in head and neck cancer vs the cytokine-induced metastases associated with lung, ovarian, colon, and breast cancer) cannot be subject to the same analytic criteria. In this paper, the current state of clinical outcome trials in nutrition and cancer is examined, and the desired design for future studies is proposed. Research priorities include the conduct of Phase II clinical trials that use as outcome measures quality of life, performance status, and survival to identify optimal cancer-specific and patient-specific nutrition support. The next round of Phase III efficacy studies should establish the appropriate use of nutrition support in cancer therapy.
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PMID:Optimal design of clinical outcome studies in nutrition and cancer: future directions. 128 22

In patients with midgut carcinoid tumors a curative, radical tumor removal should be attempted when possible. As these tumors are generally malignant, irrespective of size, the radical surgery implies that intestinal resection for excision of a primary tumor should be combined with an extended mesenteric resection. When the patients present with the carcinoid syndrome the disease is, with few exceptions, too advanced for curative surgery. However, surgery often has to be performed also in patients with the advanced carcinoids. Patients with more extensive disease may thus benefit from surgical debulking of large mesenteric or hepatic metastases. Moreover, when the patients present with abdominal symptoms it is important to exclude a threatening major abdominal complication, such as intestinal obstruction or ischemia. As these complications may cause malnutrition and deterioration, it is important to treat them properly, sometimes by repeated surgery.
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PMID:Abdominal surgery in patients with midgut carcinoid tumors. 185 12

Our current ability to favorably influence the adverse consequences of malnutrition in adult patients with established cancer is quite limited. Nutrient provision alone has not been successful in this regard. In fact, the approach of managing cancer patients with weight loss by solely providing calories is almost entirely extrapolated from clinical situations in which the presence of cancer is not a confounding problem and, therefore, may well be seriously flawed. These conclusions may not apply to situations in which special considerations hold, such as childhood malignancies and bone marrow transplantation. Current clinical management strategies for the cancer patient with weight loss require appropriate attention to the potential influence of the selected intervention on more than one parameter. As illustrated in Figure 1, nutritional support, whether by nutrient provision, pharmacologic administration, or a combination approach, differentially influences several parameters including nutritional status, abnormal host metabolism, gastrointestinal symptoms, and/or tumor growth. Changes in these parameters will influence the true end points with clinical relevance, which are patient survival and quality of life. Increased survival of patients with metastatic cancer has been difficult to achieve, even using chemotherapeutic regimens targeted directly at cancer growth. Similarly, nutritional support for patients with advanced cancer has not demonstrated improvement in this refractory parameter. Therefore, at the present time, clinicians must judge whether a nutritional support modality will favorably or unfavorably influence patient quality of life. This end point is of emerging importance in studies of nutritional support in cancer populations. Potential interrelationships among parameters influenced by nutritional support and their effect on clinically relevant end points are conceptually outlined in Figure 1. It is likely that concurrent attention to both optimal provision of nutrients and reversal of abnormal metabolism will be required if successful nutritional support approaches are to be described. Currently emerging clinical results provide some optimism for the future, but they do not unequivocally support the present routine application of any one particular nutrition support strategy for the medical patient with cancer.
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PMID:Nutritional support of the medical oncology patient. 190 28

This review delineates the subcellular distribution, biochemical characteristics, and metabolic functions of 5'-nucleotidase (5'NT), summarizes the analytical biochemistry of 5'NT, and assesses the clinical significance of 5'NT determinations in body fluids, cells, and tissues. Salient aspects of the clinical biochemistry of 5'NT, discussed herein, are as follows: (A) Serum 5'NT activity is generally elevated in hepatobiliary diseases, especially with intrahepatic obstruction, but, unlike serum alkaline phosphatase, serum 5'NT activity is not increased in infancy, childhood, pregnancy, or osteoblastic disorders. (B) In cancer patients, elevated serum 5'NT activity does not always indicate hepatobiliary involvement; in some cases, 5'NT may be released into serum from the primary tumor or local metastases. (C) Genetic deficiency of erythrocyte pyrimidine 5'NT activity is a common cause of hereditary non-spherocytic hemolytic anemia. (D) Acquired deficiency of erythrocyte pyrimidine 5'NT activity occurs in patients with beta-thalassemia and lead poisoning. (E) 5'NT activity is low in circulating monocytes, increases markedly upon their differentiation to tissue macrophages, and subsequently diminishes during macrophage activation. (F) Lymphocyte ecto-5'NT activity, a plasma membrane marker of cell maturation, is generally low in immunodeficiency states, and undergoes characteristic changes in patients with certain lymphomas and leukemias.
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PMID:The clinical biochemistry of 5'-nucleotidase. 218 4

Coincident with medical antitumor treatment of 138 patients suffering from mid-gut carcinoid tumors, 51 patients were subjected to surgery with the principal aims of removing primary tumors and debulking mesenteric or liver metastases. Sixteen patients had previously been operated with intestinal resection or, when the tumors had been considered inexcisable, with intestinal bypass or laparotomy alone. Apart from exhibiting symptoms related to the carcinoid syndrome, the majority (approximately 60%) of the 51 patients had generally intermittent, subileus-like abdominal pain and weight loss. In 18 patients, these symptoms were pronounced and associated with intestinal obstruction or severe malnutrition. Computed tomography and arteriography efficiently demonstrated mesenteric and liver metastases. At laparotomy, the primary intestinal tumors were small, mainly less than 1 cm in diameter, and they were multiple in 39% of the patients. Mesenteric metastases measuring up to 12 cm in diameter were present in 86% of the patients. These metastases were frequently associated with a pronounced mesenteric and retroperitoneal fibrosis causing fixation, angulation, and obstruction of the bowel as well as incipient intestinal gangrene in 8 patients. In all but 6 patients, the primary tumors could be removed by comparatively limited intestinal resections although bulky mesenteric metastases were often dissected from the mesenteric vessels. Liver metastases, found in 49% of the patients, were generally bilateral and multiple, and major hepatic metastases were resected in 6 patients. The results support a role for surgery also in the more compromised patients with mid-gut carcinoid tumors and that such intervention may be associated with considerable symptomatic relief and substantial periods of survival.
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PMID:Surgical treatment of mid-gut carcinoid tumors. 236 41

We have established a colon cancer-prone substrain in WF strain rats strictly bred by sister x brother mating for more than 20 years. Colon carcinomas were located only in the ascending colon with no remote metastases. Each incidence of colon carcinoma varied from 30 to 40% in the respective investigation. There was no apparent sex difference. Approximately 9% of colon carcinomas were associated with gastric carcinoma in the prepyloric region and they died within four months of age due to malnutrition and intestinal bleeding. There were a few cases of carcinomas of the terminal ileum and the rectum. All of these carcinomas from three different portions showed histologically well differentiated tubular adenocarcinoma. It was found that about 40% of colon carcinomas showed spontaneous regression in the period from four to twelve months old. We have also succeeded in establishing two lines of the transplantable colon carcinoma (C1 and C2) and the transplantable gastric carcinoma (S1 and S3) from those of spontaneous colon carcinomas and gastric carcinomas. Then recipient female rats inoculated intraperitoneally with these transplantable carcinomas newly developed adenocarcinomas of the corpus uteri, which had never been found in the rats of this strain. In addition, the transplantable tumor line of adenocarcinoma of the corpus uteri was also established (U2). When transplanted these tumors intraperitoneally (S1, S3, C1, C2 and U2), male and female recipient rats extremely increased in the incidence of carcinomas of the stomach and the colon. As far as female recipient rats were concerned, a large number of carcinomas of the corpus uteri were also found regardless of the derivation of tumors. We believe that the established colon cancer-prone rat strain (WF-Osaka) as well as those of transplantable tumor lines will open a further research fields and will be available as an animal model of colon cancer for human beings.
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PMID:A study on colon cancer-prone rats of WF-Osaka strain. 248 90

Human breast cancer cells secrete and have membrane receptors for insulin-like growth factor I (IGF-I), a growth hormone-dependent peptide that stimulates cell replication. However, little is known about plasma concentrations of IGF-I in breast cancer patients. Plasma IGF-I levels are decreased in malnutrition, decline with advancing age, and are influenced by estrogen. We evaluated the effect of the antiestrogen agent tamoxifen on plasma IGF-I in 32 ambulatory breast cancer patients. Treatment with tamoxifen was associated with lower concentrations of plasma IGF-I (0.48 +/- 0.3 unit/ml in treated versus 1.03 +/- 0.6 units/ml in nontreated patients, P less than 0.01). However, patients treated with tamoxifen did not differ from nontreated patients in age, menopause, duration since diagnosis, metastatic disease, recent weight loss, or measures of nutritional status. We conclude that tamoxifen therapy results in a reduction of plasma IGF-I concentration. We speculate that the antitumor action of tamoxifen in breast cancer is due in part to suppression of IGF-I.
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PMID:Effect of tamoxifen on plasma insulin-like growth factor I in patients with breast cancer. 292 27


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