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)

Uterine carcinosarcoma is a rare and rapidly fatal malignancy. The records of 49 patients with carcinosarcoma were studied; from these studies emerged a symptom complex of vaginal bleeding and abdominal or pelvic pain. Eleven patients had been previously irradiated at an average of 16.4 years before they developed uterine carcinosarcoma. Celiotomies revealed more extensive tumor than could be determined by pelvic examination under anesthesia. The majority of the patients died from local recurrence in the pelvis rather than from distant metastases. The overall 5-year survival was 6%. Celiotomies are recommended to stage carcinosarcomas and guide treatment decisions.
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PMID:Carcinosarcoma of the uterus: a 40-year experience from the state of Missouri. 671 6

Fine needle aspiration (FNA) can be used in place of open breast biopsy in most patients with primary breast cancer. This report summarizes our experience with 398 patients who had FNA of the breast. There was a total of 136 cancers, of which 100 (74%) were diagnosed by FNA. Seventy-one patients had mastectomy without frozen section. Thirteen had an excisional biopsy before mastectomy by preference of the surgeon. These cases occurred early in this series, before the surgeons became confident in the technique. The presence of locally advanced disease was confirmed by FNA in 12 patients and metastases to the breast were confirmed in four. There were no false-positives. Fine needle aspiration was interpreted as "suspicious" but not diagnostic of malignancy in 31 patients and open biopsy was requested. Biopsies demonstrated primary breast carcinoma in 22 patients and metastatic cancer in one. There were 103 patients with FNA negative for cancer who had open biopsy; 102 were confirmed negative, and one was positive for cancer. Fine needle aspiration yielded insufficient material in 38 patients, and 12 of these were found to have carcinoma with open biopsy. Advantages of FNA: It is safe, atraumatic and rapid, and permits definitive discussion about treatment planning at the initial office visit. It obviates the need for frozen section, reducing anesthesia and operative time. Our experience shows that FNA is highly accurate in the diagnosis of breast malignancy if rigorous criteria are used. Although a negative FNA requires biopsy to exclude malignancy, a FNA that is positive for cancer eliminates the need for open biopsy and allows the surgeon to proceed to mastectomy with confidence.
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PMID:Fine needle aspiration cytology in lieu of open biopsy in management of primary breast cancer. 672 6

Natural killer cell-mediated cytotoxicity (NKCC) is one of several possible immune defense mechanisms that may protect against the development of solid-tumor metastases. We have demonstrated that in vitro NKCC can be significantly impaired by both surgical stress and progressive tumor burden. Female C57BL/6 mice received a hindfoot amputation under anesthesia with Nembutal i.p. Twenty-four hr later, amputated and control groups were sacrificed, spleens were harvested, and cytotoxicity assays were performed using 51Cr-labeled Yac-1 lymphoma target cells. In amputated animals, in vitro NKCC was significantly impaired at four effector:target ratios, decreasing by as much as 59%. Nembutal treatment alone caused no significant changes in in vitro NKCC compared to untreated controls. Tumor burden was studied by inoculating the hindfoot pads of C57BL/6 mice with 5 X 10(5) Lewis lung tumor cells. Animal groups were sacrificed 24 hr, 1 week, and 2 weeks after tumor inoculation, and the 51Cr release assay was performed. One day and 1 week of tumor burden mildly stimulated NKCC in vitro; after 2 weeks of tumor burden, when lung metastases were detectable, in vitro NKCC was almost totally suppressed compared with non-tumor-bearing controls. Animals bearing tumor for 1 week and then given amputations showed significantly impaired NKCC in vitro. In vivo, identical animals bearing tumor for 1 week and then given amputations on sacrifice 1 week later were found to have a 71% incidence of lung metastases compared with 38% tumor-bearing unstressed controls. Surgical stress and progressive tumor burden independently and codependently impair NKCC in vitro; this may possibly contribute to the hypermetastatic response observed after surgical stress in this in vivo animal model.
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PMID:Surgical stress-mediated suppression of murine natural killer cell cytotoxicity. 674 5

Fluorocarbons have been used for years as propellants in aerosol sprays. Because of their ability to transport oxygen, perfluorocarbon compounds have been more recently used in artificial fluid respiration. Monobrominated perfluorocarbon compounds are radiopaque and have low enough vapor pressures to be tolerated in biologic systems. Microemulsions of these compounds have been detected in mouse and rat neoplasms and appear to be located within macrophages. In this study of the potential usefulness of these compounds for radiographic contrast enhancement, rabbits with V2 carcinoma thigh implants received either a high-dose (10--12 ml/kg) or a low-dose (2 ml/kg) emulsion of perfluoroctylbromide intravenously. Dense contrast enhancement of some of the V2 carcinomas was demonstrated by both computed tomography and conventional radiography. Four of the five rabbits in the high-dose group died within 9 days but all six rabbits in the low-dose group survived beyond 9 days. Death in the high-dose group was associated with pulmonary consolidation and anesthesia although some animals had extensive V2 metastases. These compounds have some interesting potential applications in imaging, pending further study of their toxicity.
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PMID:Perfluoroctylbromide contrast enhancement of malignant neoplasms: preliminary observations. 678 65

Pericardial metastases are frequently found and often cause cardiac tamponade which requires emergency treatment. Pericardiocentesis or subxiphoid pericardiotomy and pericardial drainage can be performed; the latter is a safe and effective method for the management of continuous pericardial effusion since it can be done under direct visualization and local anesthesia. We had four patients with neoplastic cardiac tamponade who were treated successfully with subxiphoid pericardiotomy and pericardial drainage. In three of them neoplasms had not been found until cytology of pericardial fluid proved to be malignant when they were attacked by cardiac tamponade. If the patient with malignancy is attacked by cardiac tamponade, subxiphoid pericardiotomy and pericardial drainage should be performed considering neoplastic cardiac tamponade. We have described pathophysiology, diagnosis and treatment of neoplastic cardiac tamponade.
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PMID:[Neoplastic cardiac tamponade]. 688 70

The minimum requirements of the International Union against Cancer (UICC) to assess the TNM-classification of urothelial bladder cancer include since 1978 the clinical examination, urography, cystoscopy, bimanual palpation under anesthesia and biopsy or transurethral resection of the tumor. The single biopsy of the tumor should be supplemented by multiple biopsies of all bladder walls in combination with the resection of the tumor to diagnose multifocal tumor growth. The exfoliative urinary cytology should be included in the routine diagnostic regimen: cytology is helpful in detection of severe dysplasia and controls the histologically determined grade of the tumor. In selected cases computer tomography improves the accuracy of clinical evaluation of the depth of tumor infiltration. In our hands the lymphangiography can not assess the regional lymph node metastases: therefore, the staging operation is recommended before radical cystectomy is performed.
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PMID:[Clinical diagnosis of bladder cancer]. 700 82

Eighteen patients with cardiac tamponade were treated by subxiphoid pericardiotomy performed with the patients under local anesthesia. This group included 9 cases of uremic pericarditis (50%), 5 cases of metastatic cancer (28%), 2 cases of trauma (11%), 1 case of tuberculosis (5.5%), and 1 case of unknown cause. Immediate relief from acute cardiac tamponade was obtained in all 18 cases with only minor and self-limiting postoperative complications, including transient supraventricular arrhythmias (five cases) and fever (five cases). There were no deaths related to either the operative procedure or reaccumulation of the pericardial effusion. The drainage period averaged 9.6 days (range, three to 28 days). Pericardial biopsy was performed in 15 of 18 cases. We conclude that subxiphoid pericardiotomy is a safe and effective method for the management of pericardial effusion of diverse causes. The ability to perform this technique safely using local anesthesia and the capacity to obtain a biopsy specimen under direct visualization make this technique superior to both needle pericardiocentesis and pericardiectomy in the acutely ill patient.
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PMID:Management of acute cardiac tamponade by subxiphoid pericardiotomy. 705 4

The end results of therapy of 346 patients with lung tumors, treated with surgery alone, are compared, depending on the type of general anesthetic agent used. Anesthesia was induced with ether in 220 patients, halothane in 103, and neuroleptanalgesia in 23 cases. All the anesthetic agents were administered in a mixture with nitrous oxide. The basic characteristics of patients, who were divided on the basis of anesthetic agent, were identical. The results show that type of anesthesia during surgical treatment for lung tumor has an effect on the end results of therapy, and the best prognosis is ensured when halothane is used. Further analysis established that the end results of surgery with halothane anesthesia are improved, when partial resection rather than radical pneumonectomy is performed, at stage 2 of malignant disease and when metastases into regional lymph nodes are absent. Such improvement may be explained by stimulation of the hypothalamo-pituitary-adrenal system as well as a relatively lower degree of immunosuppression and development of conditions more adverse for implantation of circulating tumor cells than in the case of ether or neuroleptanalgetic anesthesia.
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PMID:On the end results of surgical treatment of lung cancer patients depending on the type of anesthetic agent. 728 18

A review of ten years' experience of talc pleurodesis applied to the treatment of permanently recurrent carcinomatous pleural effusions. Twenty six patients aged between 35 and 83 years, suffering from metastatic pleural effusions, underwent pleuroscopy with local anaesthesia followed by powdering with talc, then suction drainage. There were 8 failures (30%), including 4 early deaths and 4 survivals of less than 4 months with no reduction in the effusion. Three results proved to be poor because of early extra-thoracic metastases (11.5%). There were 15 useful results, with drying up without return of the effusion and comfortable survival for 3 months to 7 years, including 8 of more than a year. These figures, somewhat unfavourable in comparison with those found in the recent literature (up to 90% useful results) were biased by the inclusion of patients who were in fact beyond help (excessive age, markedly impaired general condition, too advanced pleuro-pulmonary lesions, multiple metastases) which represent classical contraindications to the use of the talc technique. It emphasizes the best indications, based upon a sufficiently long life expectancy, good local pleuro-pulmonary state, the virtual restriction of malignant disease to the pleura, residual therapeutic possibilities-all conditions frequently found in cases of pleural carcinomatosis of mammary origin.
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PMID:[Indications for intrapleural talc under pleuroscopic control in malignant recurrent pleural effusions. Based on 26 cases (author's transl)]. 731 62

Forty three lung scans, obtained in 29 anaesthetized children, were evaluated and compared with 85 scans performed in 52 sedated children. Confluent high absorptive areas in the lower parts of the lungs were found in 35 (81%) of the scans performed in children under general anaesthesia but such areas were not found in the scans performed under sedation.--For general anaesthesia, halothane-N2O-O2 was used in all but one patient. The radiological changes are presumably due to a fall in functional residual capacity with consequent airway closure.--It is important not to misinterpret these anaesthesia-induced pulmonary changes which may obscure or mimic true pathological lesions, such as parenchymal and pleural metastases.
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PMID:Pediatric pulmonary CT-scanning. Anaesthesia-induced changes. 739 68


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