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)

Germanium compounds are marketed as nonprescription drugs in Europe and are recommended by the suppliers for AIDS and metastatic cancer disease. We observed a patient with nonmetastatic breast cancer who died because of severe lactic acidosis (plasma lactate concentration = 27 mmol/l) after ingestion of 25 g of elemental germanium over a 2-months period. Renal failure and hepatotoxicity had newly developed during germanium intake. Postmortem examination revealed severe hydropic vacuolation of tubule cells and the presence of inclusion bodies predominantly in straight proximal tubule cells with normal appearance of renal interstitium and glomeruli. The liver showed panlobular steatosis. Urine, blood and tissue (kidney, liver, muscle, pancreas) levels of germanium were high. Lactic acidosis may have been caused by the combined, germanium-induced renal and hepatic failure (underutilization), but it remains to be seen whether germanium can affect lactate production and/or metabolism directly.
Nephron 1992
PMID:Abuse of germanium associated with fatal lactic acidosis. 143 51

Lupus anticoagulant was present in this case of paraneoplastic scleroderma revealed by hemolytic-uremic syndrome, suggesting that the autoantibody played a significant role in the sequence of events leading to anuria. Reviewing the literature we found several observations of paraneoplastic scleroderma, and in other series cases of scleroderma-linked (and in rare instances cancer-linked) antiphospholipid autoantibodies. Search for antiphospholipid antibodies should be considered in patients with systemic scleroderma as well as in patients with metastatic cancer. Presence of such procoagulant autoantibodies might predict future complications and should influence treatment strategy.
Nephron 1991
PMID:Hemolytic-uremic syndrome with anticardiolipin antibodies revealing paraneoplastic systemic scleroderma. 175 45

A questionnaire study was performed among 23,209 dialysis patients in 589 institutions together with a retrospective study at Keio University Hospital to determine the risk of malignancy and factors affecting the risk ratio in dialysis patients. The incidence and mortality were 1.4-fold and 1.9-fold higher in dialysis patients than the expected rates in the general population. Incidence and mortality were 1.9-fold and 2.6-fold higher in males than in females. The risk ratios were remarkably high in university hospitals, followed by public hospitals. However, there was no significant difference between those in private hospitals and in the general population. The incidence was very high during the first 6 months of dialysis treatment and rather low in the 7th-10th year. The risk ratio of malignancy was higher in younger patients. Beyond the age of 60, the influence of age was greater than that of renal failure. Malignancies of the digestive organs were frequent and constituted 56% of all malignancies. Frequencies of malignancy in the liver, colon, rectum, bladder and kidney were higher than expected, whereas in the pancreas the frequency was lower than expected. Metastasis of malignancy was observed in 30% of the cases. Our study demonstrated a slight to moderate overall increase in the risk of malignancy and a widely differing risk ratio of malignancy by organ involved, sex, age, hospital group, epidemiological index and length of dialysis treatment in a large single racial population of maintenance dialysis patients.
Nephron 1991
PMID:Incidence and mortality patterns of malignancy and factors affecting the risk of malignancy in dialysis patients. 176 1

Males on long-term dialysis tend to develop more severe forms of acquired cystic disease of the kidney than females. The severity of the disease is unaffected by therapeutic modality, either hemodialysis or CAPD, however, cystic transformation becomes less extensive after successful renal transplantation. The fundamental pathological change characteristic of acquired cystic disease is epithelial hyperplasia, with the uremic milieu and duration of uremia being the most important factors in its development. Renal cell carcinoma, the most important complication of acquired renal cystic disease, has a high prevalence and incidence, usually remains symptomless and sometimes reveals metastases. Therefore, many clinicians and investigators, but not all, accept the need for regular screening of all dialysis patients for the development of renal cell carcinoma. Major complications of acquired renal cystic disease, malignancy and retroperitoneal bleeding, will become increasingly important because of the growing number of patients on long-term dialysis.
Nephron 1991
PMID:Uremic acquired renal cystic disease. Natural history and complications. 189 90

Urinary excretion of alpha-glucosidase (AGL), gamma-glutamyltransferase (GGT) and ribonuclease (RNase), and serum amylase and immunoreactive trypsin (IRT) were determined in 38 control subjects, 48 patients with pancreatic cancer, 77 with chronic pancreatitis and 47 with extrapancreatic diseases in order to ascertain the presence of a renal tubular damage and to investigate its etiology. A significantly increased frequency of pathological results for all urinary enzymes was documented in the various groups of patients as compared to controls. Significant correlations were detected among AGL, GGT and RNase. Considering the subjects as a whole, GGT and RNase excretions correlated with serum IRT and amylase; the two urinary enzymes were found to be higher when jaundice was present. In chronic pancreatic disease enzymuria was related to increased serum pancreatic enzymes; in extrapancreatic diseases it was associated to hyperbilirubinemia. The vast majority of patients with pancreatic cancer and elevated urinary enzymes presented hepatic metastases and/or jaundice. We can conclude that an anatomical and functional tubular impairment is detectable in some patients with chronic pancreatic and extrapancreatic diseases. Tubular damage seems to least in part to be related to pancreatic inflammation and necrosis in chronic pancreatic disease, while jaundice may be found to play an important role in diseases of the hepatobiliary tract. In pancreatic cancer, liver dysfunction (presence of liver metastases and/or extrahepatic cholestasis) also appears to be involved in altering tubular cells.
Nephron 1989
PMID:Renal tubular dysfunction in pancreatic cancer and chronic pancreatitis. 256 74

We analyzed long-term, 2- to 9-year results and risk factors in 13 patients treated with dialysis and transplantation for hypernephroma. Eight were dialyzed only, 6 died, 4 of them from metastatic disease that occurred in less than 8 months in 3. Five patients were also transplanted. Three died, 1 of metastatic disease. Two are alive, 1 with metastatic disease, 6 years after transplant, 3 years after diagnosis of metastasis. There were no differences in age and sex in those with early metastatic disease when compared to those without, but stage III-IV disease and time of less than 5 years between first and second nephrectomy were more common in those with early metastatic disease. These data indicate that a 7-month waiting time on dialysis is enough to avoid transplanting those with early recurrence, and that patients with stage III-IV and early reappearance of tumor in the second kidney are best treated with conservative management rather than a second total nephrectomy.
Nephron 1986
PMID:Long-term results of dialysis and transplantation in patients with end-stage renal failure from hypernephroma. 353 5

The clinical manifestations of 253 neuroblastoma cases in childhood, treated in Denmark from 1943 to 1980, were reviewed. Most striking was the vagueness of symptoms in the majority of patients, only a few of whom exhibited the symptoms strongly suggestive of a neuroblastoma (i.e. the Horner syndrome, the watery diarrhoea syndrome, the dancing eye syndrome). The vagueness of the symptoms might have led to fatal procrastination of the diagnosis. The diagnostic delay has, however, no independent prognostic significance for survival in our patients (p = 0.09). The maximal tumour spread was recorded for all 253 patients, and the distribution of metastases was in accordance with the "soil-seed" hypothesis. The tumour spreads with equal frequency by local growth, by lymphatic vessels to distant lymph nodes, and by blood to bone. Only in widely disseminated tumours are metastases to the lungs, the meninges, the brain, and the reproductive organs seen to occur. Eighty-five percent of the patients, for whom data were available, excreted VMA above the normal value for their age, and 43% excreted Norepinephrine + Epinephrine (N + E) above normal levels. The excretion of both VMA and N + E was significantly correlated to stage, and thus to prognosis. Neither the level of VMA excretion nor the level of N + E had any bearing on the survival when age and stage were adjusted for. Serial VMA and N + E determinations show that patients with normal values for these parameters had significantly better prognosis than patients with elevated values during the first, second, third and fourth trimesters after the initiation of treatment. Increasing values in the individual patient were associated with a poor prognosis. We found no correlation between the initial leucocyte count and survival when age and stage were adjusted for.
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PMID:Signs, symptoms, metastatic spread and metabolic behavior of neuroblastomas treated in Denmark during the period 1943-1980. 363 7

By means of metabolic products of the AB-56 strain of Bac. mesentericus it was possible to produce specific antitumor vaccines which both in experimental and clinical conditions proved to have prophylactic and therapeutic effects. 60-100% of the animals prophylactically immunized with these vaccines became resistant to a subsequent injection of living virulent cells, the percentage depending on the number of immunizations. The employment of similar autovaccines in the treatment of relapses and metastases in humans resulted in a 56% five-year survival of patients operated on for gastric cancer, in contrast to a 28% five-year survival of those without any vaccination.
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PMID:Experimental and clinical results of application of antitumor vaccines obtained by means of bacterial metabolism. 642 16

The concept of surgical treatment of renal cell carcinoma was discussed by classifying the procedures into four categories: 1) radical nephrectomy; 2) nephron sparing surgery such as partial nephrectomy and enucleation for small renal cancer detected incidentally by ultrasonography and CT; 3) extended surgery for cases having IVC tumor thrombus or with invasion of neighboring organs; and 4) surgery for metastatic disease. Consequently, details of surgical procedure were not presented in this paper. Nephron sparing surgery and laparoscopy will be important steps in the future direction of surgery for renal cell carcinoma.
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PMID:[Surgical treatment of renal cell carcinoma]. 829 11

Several renal cell carcinoma (RCC) prognostic factors show promise, including K1-67, p53/mdm-2, and vascular endothelial growth factor. The combination of increased incidence of RCC and diagnosis during earlier stages has generated interest in local therapeutic options. Nephron-sparing surgery and laparoscopic nephrectomy continue to gain support and may become the standard of care in select patients. Standard therapy for metastatic disease continues to be cytokine-based therapy with little benefit gained from adding granulocyte-macrophage-colony-stimulating factor, retinoic acid, or adoptive immunotherapy. The addition of chemotherapy, such as capecitabine, floxuridine, and vinblastine, may increase the effectiveness of immunotherapy; nonmyeloablative stem cell transplantation has shown early promise in metastatic disease.
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PMID:Renal cell carcinoma. 1130 65


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