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)

This study was instituted to determine the mechanism of enhanced natural killer (NK) lymphocyte activity during surgery. Natural cytotoxicity of whole blood to K562 target cells was assayed before anesthesia and during anesthesia and surgery in patients with benign and malignant gastrointestinal disease. Those patients with benign conditions and localized primary tumors showed enhanced NK lymphocyte cytotoxicity during surgery (p less than 0.025 and p less than 0.0025, respectively) but not patients with disseminated tumors. In patients with localized tumors, enhancement of NK lymphocyte cytotoxicity was an interferon-independent phenomenon but appeared to be related to a significant rise in the percentage of cells bearing the Leu 7 monoclonal antibody marker for NK cells (p less than 0.02). Exogenous leukocyte interferon caused further enhancement of NK cytotoxicity in patients with benign disease and some cancer patients. Enhancement of NK lymphocyte activity during surgery may be of significance in reducing tumor metastases by stimulation of natural cytotoxic mechanisms to circulating tumor emboli.
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PMID:The nature of enhanced natural killer lymphocyte cytotoxicity during anesthesia and surgery in patients with benign disease and cancer. 621 65

Laparoscopy is highly effective in diagnosing malignant liver disease, with overall accuracy in the 90% range. Up to 80% of the liver surface can be inspected, and biopsies can be directed with precision. A major advantage over scan guided percutaneous techniques is the ability to detect and biopsy lesions only a few millimeters in size on the liver surface. Laparoscopy is useful in staging the liver for metastatic disease during evaluation for treatment of primary cancers. Small peritoneal metastases may also be discovered and biopsied. Primary liver cancers and isolated metastatic deposits can be assessed for resectability, and diagnostic laparotomy can often be avoided. Laparoscopy is safely performed under local anesthesia and mild sedation.
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PMID:Laparoscopy and biopsy in malignant liver disease. 621 80

Pulmonary metastases were counted 10 days after female rats received tail-vein injections of Walker-256 carcinosarcoma cells. Previous observations that halothane anesthesia plus hind-limb amputation increases the number of metastases were confirmed. Amputation under the analgesia of electrical stimulation of the midbrain was found to increase metastatic activity. However, the stimulus-produced analgesia alone also increased the number of metastases. Systemically administered naloxone blocked the analgesic effect of midbrain stimulation but did not block the increase in the number of pulmonary metastases.
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PMID:Electrical stimulation of the midbrain mediates metastatic tumor growth. 625 Feb 20

Five lung tumors in four patients were treated with electrolysis. One of the tumors was probably primary, while the others were metastases. Under local anesthesia, two or three platinum electrodes (diameter 3 mm) were introduced through the thoracic wall into the lung tumor using biplane fluoroscopy. The patient was sedated before the procedure and a chest tube was inserted into the pleural cavity. Between anode and cathode a direct current of 80 mA and 10 V was passed during 2-4 h, creating substantial electrolytic destruction mainly through chlorine liberation. Observations at autopsy, surgery, chest X-ray, and CT showed that 60%-80% of the tumor mass was destroyed. No tumor was completely destroyed. The patients tolerated the procedure well.
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PMID:Percutaneous treatment of pulmonary tumors by electrolysis. 630 8

About 80 per cent of patients with breast cancer ultimately die of metastatic disease in the following twenty years. Distant metastases are more important as cause of death than loco-regional relapses, it is why adjuvant chemotherapy is necessary, especially in young patients and in those with extensive disease. Initial chemotherapy preceding any locoregional treatment is justified on the basis that both surgery and anesthesia lead to immuno-depression. Further, the value of initial chemotherapy has been demonstrated in many experimental and clinical trials of Nissen-Meyer, Bonadonna and Cooper. We have treated 145 patients, including 67 with inflammatory breast cancer (IBC), with 4 to 6 weeks of Velbe, Thiotepa, Methotrexate Fluorouracil and Prednisone with Adriblastine added for those patients with IBC or T greater than 7 cm, or N2 N3. Because of tumor regression of more than 50 per cent observed in 80 per cent of the patients, the majority (123 patients) then received radiotherapy alone (cobalt + iridium) and are in a complete remission in all these cases after curietherapy. Maintenance treatment with the same drugs was prescribed for 6 to 18 months depending on the initial staging. Tumor regression appears to be an important prognostic factor. Median follow-up is only 17 months, the longest one being 42 months. The overall survival at 2 years for IBC, is 90 per cent with a disease-free survival of 80 per cent. Cosmetic results are excellent. While these results are encouraging, longer follow-up is needed to confirm this improvement.
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PMID:[Breast cancer: chemotherapy preceding locoregional treatment with extension of the indications for conservative treatment]. 643 62

Peritoneoscopy is a simple and effective means of diagnosing or excluding intra-abdominal disease. It is currently underutilized and merits increased recognition particularly by general surgeons. The first 77 peritoneoscopic examinations performed by a general surgeon in a large hospital associated with a cancer agency are reviewed. An exact diagnosis was made in 78% of 58 patients in whom the primary diagnosis was in doubt and in 93% of that group management was influenced. Surgical exploration of the abdomen was avoided in 29 patients. The major indications for using the method were: to search for metastases, to evaluate the acute abdomen and to stage lymphoma. Local anesthesia and nitrous oxide insufflation were used almost exclusively. Biopsy was performed in 36 patients and there was one death directly attributable to liver biopsy. In two patients peritoneoscopy was unsuccessful.
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PMID:Peritoneoscopy in general surgery. 645 2

Certain accidents related to local anaesthesia during bronchial fibroscopy may be due to overdosage of local anesthetic drugs. In view of the various techniques employed, the various doses used and the different serum levels obtained, we decided to study the passage of lidocaine into the systemic circulation during bronchial fibroscopy in order to confirm that the doses required for good anaesthesia are not toxic. We studied the kinetics of lidocaine on 10 occasions in 9 patients. All patients had normal renal, hepatic and cardiac function. The anaesthetic was administered in standardized doses (by pharyngo-laryngeal spray of a 5% solution followed by injection via a laryngeal syringe and finally by the operating lumen of the fibroscope with a 1% solution). The total dose of anaesthetic was administered at the beginning of the examination in order to avoid contamination of the aspirated secretions after connection of the traps. The mean dose administered was 9.2 +/- 0.5 mg/kg (range of 380 to 800 mg). The maximal serum levels never attained toxic levels (9 mcg/ml). The highest levels (7 mcg/ml and 5.7 mcg/ml) were observed in a patient with a bronchial epithelioma, normal biochemistry and normal liver ultrasonography, who died two months later with hepatic metastases. The mean maximal serum levels for this group of patients was 2.8 +/- 0.6 mcg/ml between the 5th and 45th minute, which is equivalent to anti-arrhythmic doses (therapeutic level of 1.2 to 5 mcg/ml). The levels obtained are not negligible, but they achieve very good quality anaesthesia with a good margin of safety, apart from the one case with hepatic metastases.
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PMID:[Plasma concentrations of lidocaine in bronchial fibroscopy]. 652 33

J.W. is a 68-year-old white female who noted an "anal growth" 1 year prior to admission. She also complained of bleeding from her rectum when she was constipated. She attributed these symptoms to hemorrhoids. She noted increasing pain and more bleeding 1 month prior to admission. Locally applied hemorrhoid remedies gave her no relief. She was then admitted to a hospital where a biopsy of the anal mass was performed, and then referred to Rush-Presbyterian-St. Luke's Medical Center. On physical examination the patient was noted to be obese. There was no inguinal lymphadenopathy. There were no abdominal masses or hepatosplenomegaly. Rectal examination revealed a 3 X 4 cm mass protruding from the anus. Examination and protoscopy done under anesthesia revealed this mass to be approximately 4 X 5 cm and arising from the proximal anal canal. The mass was freely moveable and bled spontaneously when manipulated. Pelvic examination revealed a normal uterus and adnexa with no obvious tumor involvement of the vagina. Proctoscopic examination revealed no tumor proximal to the lesion described. Further evaluation included a liver-spleen scan that was negative for metastatic disease and intravenous pyelogram that showed no lesions. A barium enema revealed only diverticula. A gallium scan showed marked uptake at the area of the anal tumor but no other lesions. The chest x-ray was within normal limits. A CT scan of the abdomen and pelvis revealed no masses or lymphadenopathy. The CEA was 1.3 ng/ml. The patient underwent concomitant radiation therapy and chemotherapy. Over a 4-week period the patient received 5000 rads to the anal region. In addition, during the first week of radiation therapy and the fourth week of radiation therapy, the patient received 5-fluorouracil, 800 mg/m2 by continuous infusion for 5 days. In addition, the patient received mitomycin C, 15 mg/m2 on the first day of the first week of chemotherapy and the first day of the last week of chemotherapy. During the treatment period, the patient had mild diarrhea, perineal desquamation, and mild ulceration at the site of the anal tumor. During the third week of treatment, the patient had a white blood cell count nadir of 2800 and a platelet count of 86,000 per cubic millimeter. Her symptoms were managed with local emolients and antidiarrheal medications.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Carcinoma of the anal canal. 663 29

Abdominal CT examination is the method of choice when examining ovarial tumours. Abdominal CT is redundant in the early stages of carcinoma of the collum and if the carcinoma has penetrated into the vagina. In advanced stages of carcinoma of the collum, CT enables accurate staging. CT is at least equal in relevance to gynaecological examination in respect of assessment of parametraneous infiltration. Distant metastases, as well as complications of the efferent urinary tract can be visualized. In view of this, the following procedure appears meaningful in advanced carcinoma of the collum: First of all, gynaecological examination is performed without anaesthesia to confirm the findings in the regions of the portio and vagina; as far as possible, the existence of the central parametraneous infiltrations is confirmed. For the purpose of further staging of the parametraneous infiltration, as well as of the paraaortal lymphomas and possible metastases, as well as for the purpose of excluding hydronephrosis, computed tomography is performed. This avoids burdening the patient with an examination under anaesthesia, and it also avoids invasive examination methods, such as urography and lymphography.
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PMID:[Value of computer tomography in gynecological tumors]. 665 23

Physicians caring for women with diseases of the breast are well aware of the time lost before many patients consult their physicians. Nowhere is this more apparent than when a breast mass is associated with gestation or lactation. Enlargement of the breast tends to obscure parenchymal masses. Those that are found are too readily attributed to normal hypertrophy, abscess, or resolving fibrocystic disease. In this review we have attempted to focus on the earlier diagnosis and treatment of breast masses in pregnancy. Prompt needle aspiration will elucidate the solid or cystic nature of a mass. A simple cyst or a galactocele can be diagnosed by the fluid obtained. Solid lesions can be further investigated by fine-needle aspiration for cytologic study. Cytologically equivocal lesions should be subjected to excisional biopsy using local anesthesia. Cancerous lesions occurring during pregnancy should be treated promptly by mastectomy. The outlook for these patients, if treated before metastases occur, is comparable to that for nonpregnant patients. Pregnancy need not be terminated unless disseminated cancer is present and chemotherapy is necessary on an urgent basis.
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PMID:Surgical diseases of the breast during pregnancy. 666 40


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