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)

Data was collected from results of injection and dissection of 100 autopsy specimens; the examination of 34 case-reports of cancer patients; the injection of lymphatics in 14 live dogs; and the reconstruction of the mesodorsal region of the pancreas from a 30 mm embryo using Born's technique. Anatomy of the pancreas and lymph vessels shows that the "primary mesodorsal region" of the pancreas is two-fold; a right part for the right side of pancreas: the retroportal process (RPP); a left part for the left side of pancreas, a formation not previously described: the left lateroportal process (LLPP). Whereas lymphatic drainage visible on the anterior surface of the pancreas is apparently as described, posterior drainage, which collects lymph from posterior and anterior vessels, is quite atypical. The right portion drains into the RPP and the left into the LLPP. Terminal collecting vessels of pancreatic lymphatics have only a short distance to travel before emptying into the thoracic duct. The study of lymph node metastases from pancreatic cancer appears to confirm these cadaver anatomic results but the series is too small for valid exploitation. The very rapid passage into the thoracic duct probably greatly diminishes the value of widely extended surgery, justification for the latter being exclusively to remove lymph nodes insofar as adjuvant therapy has currently failed to demonstrate absolute efficacy. Precise knowledge of the anatomy of the pancreatic lymphatics should allow development of experimental models to study lymph circulation changes during acute pancreatitis. Pancreatic edema, an enzyme-rich fluid, is an essentially "lymphatic" edema. The interstitial and lymphatic shunt pathways due to increased duct pressure were evident during the dog study. The lymphatic system acts as a "buffer system" or "safety valve" against progression to necrosis. Ligature of very proximal pancreatic lymphatic efferents (included in the bands) was followed by a fatal necrotic pancreatitis on both occasions when this was performed. Development and study of a lymphagogue drug for the treatment of acute pancreatitis is a justifiable project. A protocol is proposed which combines lymphagogue treatment with anti-enzymes, the former assists use of the enzymes by the lymphatic system. The anti-proteases prevent the onset of fatal shock caused by the outpouring of enzymes into the lymphatic system and the general circulation.
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PMID:[Clinical and surgical anatomy of the lymphatic circulation of pancreas]. 651 23

The diagnostic accuracies of measurement of carcinoembryonic antigen (CEA) and analysis of the cytologic characters of pure pancreatic juice were assessed in 16 control subjects, 20 patients with pancreatitis and 22 patients with pancreatic cancer. Pure pancreatic juice was collected from the pancreatic duct by endoscopic cannulation using a duodenofiberscope after intravenous administration of secretin. The pancreatic fluid was centrifuged and the supernatant was used for CEA assay, while the cell pellet was examined cytologically. Abnormally high CEA levels in the pure pancreatic juice were significantly more frequent in patients with pancreatic cancer; an increased CEA concentration in the pancreatic juice was found in 68.2% of the patients. The location of the cancer had no influence on the CEA level of the pancreatic juice, but the level tended to be high when the tumor had distant metastases. Positive cytologic findings were obtained in specimens of pure pancreatic juice of 68.2% of the patients with pancreatic cancer. Positive cytologic results were more frequent in patients with carcinoma of the head of the pancreas than in those with carcinoma of the body or tail, and those with localized tumors had the lowest yield of positive cytologic results. For sensitive tests, it was necessary to collect pure pancreatic juice containing no contrast medium. High CEA levels and positive cytological results were significantly more frequent in pancreatic juice obtained 10 to 20 minutes after secretin stimulation than in those collected immediately after stimulation. Correct diagnosis of malignancy was made by CEA assay alone or by cytological examination alone in 68.2% of the patients examined, while a combination of these methods raised the diagnostic rate to 86.4%.
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PMID:Significance of carcinoembryonic antigen levels and cytology of pure pancreatic juice in diagnosis of pancreatic cancer. 662 6

Two hundred sixty-seven laparotomized patients with pancreatic cancer during the period 1947 to 1980 were retrospectively analyzed. In 199 histologically confirmed cases of pancreatic carcinoma the tumor was only local with no invasion to neighboring tissues or distant metastases in 15% of the cases at the primary laparotomy and diagnosis stages, and the survival rates after 1, 3, and 5 years were 22%, 3% and 1%, respectively. The prognosis was a little better if a patient was over 70 years old, duration of symptoms was more than one year, the reason for laparotomy was cholecystopathy, the tumor was stage I, the treatment was a combination therapy of pancreatic resection and postoperative irradiation (with a depth dose of greater than or equal to 4,000 rad). We concluded that, excluding the extremely rare cases of pancreatic carcinoma which are cured with pancreatic resection, the survival of patients after primary operation is correlated nearly in the same way with the given treatment and the stage of the disease. It seems that at present the only possibility of improving the results of treatment in pancreatic carcinoma is to develop the combined treatment of surgery, irradiation, and chemotherapy.
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PMID:Operative finding, treatment, and prognosis of carcinoma of the pancreas: an analysis of 267 cases. 686 34

The purpose of this study was to detect possible factors related to the occurrence of DIC in carcinoma patients. I) We studied 20 carcinoma cases accompanied with DIC. Results; The carcinomas most frequently accompanied with DIC were cancers of the biliary system, gastric, hepatic and pancreatic cancer, especially those with distant metastases. Pneumonia, UTI and biliary tract infections seemed to be the most important triggers of DIC. No significant relationship was found between anti-cancer chemotherapy and the DIC incidence. Endotoxemia was more frequently detected in patients having received anti-cancer drugs than in those who not. II) The effects of anti-cancer chemotherapy on the incidence of endotoxemia was examined in rats. A higher incidence of endotoxemia was noted in the groups treated with high doses of 5-FU or Cyclophosphamide. The incidence of endotoxemia seemed to run parallel with the incidence of diarrhea and of weight loss in each animal group.
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PMID:[Clinical and experimental studies on DIC found in carcinoma; correlation between anti-cancer drug administration and endotoxemia]. 687 46

Forty patients with inoperable pancreatic cancer were included in a prospective, randomised, controlled trial of multiple chemotherapy. The survival of 19 untreated control patients was compared with that of 21 patients who received an initiation course of intravenous fluorouracil, cyclophosphamide, methotrexate, and vincristine given over five days followed by intravenous fluorouracil and mitomycin given over three or five days at six-week intervals thereafter. Median survival in treated patients was 44 weeks, which was significantly longer than the nine weeks seen in controls. In patients without metastases median survival was 48 weeks in the treated group and 12 weeks in controls. In patients with metastases it was 30 weeks in treated patients and seven weeks in controls. The treatment was well tolerated and seemed to confer a significant prolongation of survival, comparing favourably with previous reports of chemotherapy with or without radiotherapy. If the results are confirmed this regimen may be useful in district general hospital practice.
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PMID:Chemotherapy in pancreatic cancer: results of a controlled, prospective, randomised, multicentre trial. 700 59

A thorough histologic examination of the pancreas was performed on autopsy material from 83 military veterans aged 35-88 years. Hyperplastic, preneoplastic and neoplastic alterations were recorded by severity, multiplicity, location and age. From this material, two patients had clinically known primary, and three had secondary (metastatic), pancreatic cancer. The following occult malignant lesions were found: two early cancers (one adenocarcinoma and one adenosquamous cell carcinoma), one ductal carcinoma in situ and seven ductular carcinomas in situ. Among patients with ductular carcinoma in situ, three had pancreatic caner and the remaining four had cancers of other sites (ethmoid, ear, colon, prostate). One patient who was clinically diagnosed as having lung cancer with selective metastases to the pancreas was found to have pancreatic adenosquamous cell carcinoma with lung metastases. Hence, the incidence of neoplastic exocrine lesions was around 10%. In addition, hyperplasia of the ductal and ductular epithelium (in 57% and 39% of the patients, respectively), squamous cell metaplasia of the ductules (in 48% of the cases), as well as endocrine tumors (islet cell adenoma, 10%; mixed ductular-insular adenoma, 3%) were found. Most lesions occurred in the pancreatic head, a few in the tail. These data and other reports led to the conclusion that, first, the overall incidence of pancreatic cancer appears to be higher than previously reported. Malignant lesions seem to remain clinically occult, either because patients die of other diseases or because of the significantly long latency between premalignant lesions and clinically recognizable invasive cancer. Second, the ductular cells appear to be the progenitor cells of a variety of tumor types, including squamous cell cancer and islet cell tumors, as in the authors' experimental model.
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PMID:Hyperplastic, preneoplastic and neoplastic lesions found in 83 human pancreases. 703 98

Conventional transcutaneous ultrasound examinations are often compromised by intervening pulmonary or bowel gas and have limited resolution. Ultrasonic probes of frequencies greater than 5 MHz, which enhance resolution, cannot be used successfully on the skin surface, because they do not penetrate deeply enough to view intraabdominal organs in most adults. To overcome these problems, we tested an ultrasonic endoscope which had a 10-MHz, 64-element linear assay, generated real-time images at resolutions of less than 1 mm, and was an integral part of a 35-mm-long and 13-mm-wide endoscopic rigid tip. Thirty-two studies were performed in 15 healthy subjects, 4 patients with pancreatic cancer and 6 patients with chronic pancreatitis, and 1 patient each with a gastric ulcer and a suspected pancreatic abscess. We demonstrated that this procedure is safe, provides high resolution real-time ultrasound visualization of the heart, aorta, spleen, pancreas, liver, gallbladder, kidneys, and gastrointestinal mucosa and can detect moderate-sized pancreatic tumors and hepatic metastases less than 1 cm in diameter. Because endoscopic visualization of gastrointestinal mucosa and ultrasound examination of extraluminal organs can be obtained during a single procedure, rapid differentiation among mucosal and intramural disease of the hollow gut and disease of extraluminal organs should be possible with this diagnostic technique.
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PMID:Human endoscopic ultrasonography. 710 13

The possible role of poly(C)RNase serum activity and CEA serum level for early detection and differentiation of pancreatic carcinoma and its specificity and valuability were critically analyzed: Serum RNase (median, min-max) with polycytidin as substrate was determined in 13 "normal" patients (14.6 E/ml, 4.3--29.8 E/ml), 16 patients with pancreatic cancer (T3 or metastases) (17.6 E/ml, 6--49-9 E/ml), 15 patients with chronic pancreatitis (9.5 E/ml, 4.9--26.5 E/ml), 7 patients with acute pancreatitis (14.2 E/ml, 5.5--67.3 ng/ml), and 13 patients with other types of malignomas (15 E/ml, 4.3--42.5 E/ml). Serum CEA level was evaluated in 18 "normal" patients (1.15 ng/ml, 0--4.3 ng/ml), 12 patients with pancreatic carcinoma (T3 or metastases) (6.5 mg/ml, 2--456.5 ng/ml), 13 patients with chronic pancreatitis (2.3 ng/ml, 0--8.5 ng/ml), 8 patients with acute pancreatitis (2.7 ng/ml, 0.1--4.6 ng/ml) and 5 patients without operative verification of suspected pancreatic carcinoma (0.9 ng/ml, 0--1.7 ng/ml). The serum RNase activity in pancreatic cancer patients did not show any significant increase in comparison to the other groups, and these patients could not be distinguished from those with the other diseases when excluding other factors influencing serum RNase level such as: Renal insufficiency, nutrition, age, sex. Their CEA level was significantly higher in comparison to the other groups (p less than 0.05). Using 2.5 ng/ml as the limit, the sensitivity was found to be 80% (10/12 of pancreatic carcinomas positive) and the specificity being 70.5% (31/44 of other groups without malignant diseases negative). The presented study and data in the literature show that poly (C) RNase measurement is not useful in early detection of pancreatic carcinoma, but the CEA test could be helpful in the differential diagnosis of pancreatic diseases due to its specificity (70.5%) and seems to be valuable in detection of residual and in monitoring for recurrent pancreatic carcinoma in view of its sensitivity and correlation with the stage of cancer.
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PMID:[The value of poly-C-specific serum ribonuclease and CEA in the diagnosis of pancreatic carcinoma (author's transl)]. 731 90

A laryngeal metastasis from pleomorphic carcinoma of the pancreas is described. The patient was a 70-year-old male. The tumour was located on the right margin of the epiglottis. Bilateral neck lymph node metastases were also found. The patient underwent supraglottic laryngectomy, right radical neck dissection and left suprahyoid neck dissection. Following surgery, the patient's general condition deteriorated day by day, and one month after the surgery he died. The autopsy findings demonstrated a big mass of cancer in the pancreatic tail, multiple lymphatic metastases, carcinomatous peritonitis, and possibly a lymphatic spread of the pancreatic cancer to the larynx.
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PMID:Pancreatic cancer with metastasis to the larynx. 743 Jul 80

Computed tomography examinations of the liver, kidneys, and pancreas were conducted in 466 patients over a period of one year, and both adrenals were visualized in 94 p. cent of cases. The adrenals were investigated during examination of the posterior submediastinal space in certain types of cancer, and clinically silent adrenal metastases were demonstrated in 14 patients with bronchial or pancreatic cancer. When computed tomography is employed for specific investigation of the adrenals (22 cases), the technique varies (5 mm thick sections, "angioscan"), and results are comparable with those of early renal tomography, ultrasonography, and scintigraphy. Computed tomography provides clearer evidence of small tumors (less than 2 mm in diameter) and hyperplasia, and can provide images that are perfectly correlated with operative findings, but not always with the histology of the lesions. A method for exploring the adrenals radiologically, including the use of computed tomography, is proposed as a function of the biological nature and size of the tumors.
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PMID:[Contribution of computed tomography to radiological investigation of the adrenals (author's transl)]. 745 34


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