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)

The purpose of this study was to determine the influence of different fasting periods on the in vivo P-31-MR spectroscopy of the healthy liver and patients with liver metastases. Image-guided localized P-31-MRS was performed in 24 patients with liver metastases and in 20 healthy volunteers. The spectra were obtained with a whole body scanner operating at 1.5 T using a surface coil. The P-31-MRS was performed after a fasting period of 3-5 h (group 1) and after overnight fasting (group 2). The PME/beta-NTP, PDE/beta-NTP and Pi/beta-NTP were calculated from P-31-MR spectra and were compared in relation to the nutrition status of the volunteers and patients. The PME/beta-NTP and PDE/beta-NTP were significantly increased in spectra of patients with metastases. There were no significant changes in the ratios of phosphorus metabolites in healthy liver tissue or in liver metastases after a fasting period of 3-5 h as compared with overnight fasting.
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PMID:Influence of different fasting periods on P-31-MR-spectroscopy of the liver in normals and patients with liver metastases. 879 52

Mucoepidermoid carcinomas are malignant neoplasms that rarely involve the skin. Composed of both mucus-secreting cells and epidermoid-type cells in various proportions, mucoepidermoid carcinomas occur most commonly in salivary glands. In this case report, we describe a high-grade mucoepidermoid carcinoma with cutaneous involvement. Although this patient was referred for Mohs' micrographic surgery, further evaluation showed either direct or metastatic extension from the parotid gland to skin and distant metastases to the lung and bone. Despite extensive bone involvement, serum levels of ionized calcium, phosphorus, and lactate dehydrogenase remained normal. In view of the widespread metastases, the treatment plan was altered to radiotherapy and chemotherapy instead of surgery. Instructive lessons from this case include the recognition by dermatologists of this rare entity, the importance of a detailed history and complete evaluation of the patient before determining appropriate therapy, and the necessity of individualizing diagnostic tests to a particular patient.
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PMID:Mucoepidermoid carcinoma with cutaneous presentation. 927 May 43

This is a preliminary report of five patients diagnosed with locally advanced nonresectable pancreatic cancer who achieved improved quality of life, delay of local progression, and reduction of biomarker CA 19-9 after infusion of colloidal phosphorus 32 (32P) and administration of combined chemoradiotherapy. A phase II trial using intratumoral colloidal 32P delivery for nonresectable pancreatic cancer without metastases is in progress. Patients initially were given infusions of decadron followed by macroaggregated albumin and 30 mCi colloidal 32P to the interstitial space of the tumor by two infusions 1 week apart. Through this method, doses ranging from 750,000 to 1,800,000 cGy were delivered. After administration of colloidal 32P, external radiation to a dose of 6000 cGy minimum tumor dose, including regional lymph nodes, was given concomitantly with four intravenous infusions of 500 mg bolus 5-fluorouracil on alternating days within the first 2 weeks after initiation of external radiation. All five of these patients demonstrated cessation of local tumor growth or regression of disease on serial computed tomography scans for a minimum of 10 months from completion of therapy. Three of these patients have survived without local disease progression over 24 months from initiation of therapy, with one patient approaching 36 months. CA 19-9 values for all patients declined within weeks after completion of therapy. This new method of isotope delivery has resulted in reduction of tumor volume, normalization of the biomarker CA 19-9, and improved performance status in those patients who have localized nonresectable disease without dissemination.
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PMID:Complete remission of nonresectable pancreatic cancer after infusional colloidal phosphorus-32 brachytherapy, external beam radiation therapy, and 5-fluorouracil: a preliminary report. 1044 Jan 89

The role of phosphorus-32 (32P) was evaluated in patients experiencing pain due to skeletal metastases from prostate cancer and refractory to other modes of treatment. Twenty patients received 185 MBq (5 mCi)32P intravenously; 12 patients received a single dose each, five patients were injected twice and three patients three times at 3-month intervals. A blood count and clinical assessment for bone pain, tender sites, mobility and analgesic intake were performed before and 4, 8 and 12 weeks after the administration of 32P. A bone scan was performed before and 12 weeks after therapy. The results showed a significant decrease in pain at 4 weeks and a palliative response persisted for up to 12 weeks. Analgesic medication intake decreased significantly (F = 13.2213, P < 0.0001) and mobility improved after therapy. Quantitative analysis of the bone scans showed a statistically significant reduction in osteoblastic activity in metastatic lesions after therapy (t = -3.80, P < 0.001). Transient myelosuppression after 4 weeks, which was statistically significant for WBC and platelet counts only (F = 3.0226, P = 0.0358; F = 6.2514, P = 0.0009 respectively), returned within normal limits by 8 weeks. We conclude that 32P is an effective and safe therapy for pain palliation.
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PMID:Effective and economical option for pain palliation in prostate cancer with skeletal metastases: 32P therapy revisited. 1045 77

Bone pain from osteoblastic metastases can be ameliorated 40% to 80% of the time. Although we can predict nonresponders, we cannot predict responders; however, patients with a better performance scale may have a better chance of pain relief. Radiopharmaceuticals containing phosphorus 32, strontium 89, samarium 153, rhenium 186, and tin 117m are effective, but we do not know which is the most efficacious and the safest. Toxicity includes the flare phenomenon and mild to moderate pancytopenia, but disseminated intravascular coagulation can cause severe, life-threatening thrombocytopenia. This treatment may be repeated at about 9- to 12-week intervals, perhaps earlier with (153)Sm lexidronam, (186)Re etidronate, and (117m)Sn pentetate, with a success rate approaching that of the initial injection. The duration of action of pain reduction ranges from 2 weeks to many months. Tumorical effects are probably not the only mechanism of pain relief.
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PMID:Systemic radiopharmaceutical therapy of painful osteoblastic metastases. 1103 34

Although bone pain from osteoblastic metastases can be ameliorated 50% to 80% of the time by use of intravenously or orally administered radiopharmaceuticals, we cannot accurately predict who will or will not respond. The radiopharmaceuticals containing phosphorus-32, strontium-89 (Metastron), rhenium-186, samarium-153 lexidronam (Quadramet), and tin-117m are effective, but we do not know which of these is the most efficacious or the safest. Toxicity includes mild-to-moderate pancytopenia and an occasional brief flare of pain, and treatment of patients with disseminated intravascular coagulation must be avoided because it may predispose the patient to severe thrombocytopenia. Treatment may be repeated at approximately 8- to 12-week intervals, depending on the time of return to normal leukocytes and platelet counts. Tumoricidal effects are probably not the sole mechanism of pain relief.
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PMID:Painful osteoblastic metastases: the role of nuclear medicine. 1125 31

Bone pain from metastatic disease is most common in cancers of the breast, prostate, and lung. Despite the World Health organization algorithm for treating such pain, the outcomes are not often satisfactory. In 2005, there will be 3 radiopharmaceuticals available in the United States that can reduce or relieve bone pain caused by osteoblastic metastases with apparently equal efficacy. Phosphorus-32 as sodium phosphate, strontium-89 ( 89Sr) as the chloride, and samarium-153 lexidronam may all be given intravenously (and 32P also orally) in patients where bone scintigraphy demonstrates a metastatic lesion causing the patient's bone pain. Side effects are usually mild and include pancytopenia with leukocyte and platelet nadirs at approximately 50% of baseline, and a mild-to-moderate, but brief, increase in pain ("flare") in approximately 10% of patients. At least 1 of these radiotracers, 89Sr, has the availability to reduce the incidence of new bone metastases as well, but, given alone, none prolong life. In a few studies in which 89Sr has been combined with chemotherapy, prolongation of patient survival has been demonstrated. Many questions remain as to the optimization of use of this group of radiopharmaceuticals, including whether combinations of radiopharmaceuticals with each other, with bisphosphonates or with chemotherapy can improve the therapeutic outcomes even more.
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PMID:Teletherapy and radiopharmaceutical therapy of painful bone metastases. 1576 78

Background. The aim of our study was to analyze the results of biochemical, densitometic and calcaneous ultrasound examination in children with vertebral fractures. Material and methods. The study involved 19 patients (7 girls, 12 boys) with pathological vertebral fractures diagnosed radiologically. Bone mineral densitometry (DXA method) and ultrasound examinations of the calcaneous bone were performed. The biochemical examinations including serum concentration and diurnal elimination of calcium, phosphorus and magnesium. Concentrations of parathormon (PTH) were assessed by radioimmunometry, and 25OHD by the Elisa method. Results. Fifteen children had back pain complaints; in 5 cases there had been vertebral trauma before diagnosis, and in 12 at least one fracture of a long bone. The most common fractures occurred at Th6-L1 and L4- L5. Fractures of only one vertebra appeared in 3 children. In 10 patients the DXA Z-score was below -2.0, and in 7 from -1.0 to -2.0. In 11 patients at least one of the ultrasound parameters fell below -2.0. Seven patients had a low concentration of 25OHD and PTH, and there were 5 cases of hypomagnesemia. Conclusions. In children with pain complaints from the vertebral region and a significant quantitative decrease of bone mineral density (even without clinical symptoms), lateral X-rays of the lower thoracic and lumbar region are indicated. Pathological vertebral fractures (after exclusion of local changes and metastases) should be an important diagnostic criterion for osteoporosis regardless of quantitative bone examination results.
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PMID:Vertebral fractures in children with osteoporosis. 1760 41

The infamous "phossy jaw" that created an epidemic of exposed bone osteonecrosis exclusively in the jaws began around 1858 and continued until 1906, with only a few cases appearing since that time. This epidemic of osteonecrosis produced pain, swelling, debilitation, and a reported mortality of 20% and was linked to "yellow phosphorous," the key ingredient in "strike-anywhere" matches. In match-making factories, workers called "mixers," "dippers," and "boxers" were exposed to heated fumes containing this compound. Related to the duration of exposure, many of these workers developed painful exposed bone in the mouth, whereas their office-based counterparts did not. The exposed bone and clinical course were eerily similar to what modern day oral and maxillofacial surgeons see due to bisphosphonates used to treat metastatic cancer deposits in bone or osteoporosis. Although yellow phosphorus has a simple chemistry of P(4)O(10), when combined with H(2)O and CO(2) from respiration and with common amino acids, such as lysine, bisphosphonates almost identical to alendronate (Fosamax; Novartis Pharmaceuticals, East Hanover, NJ) and pamidronate (Aredia; Novartis Pharmaceuticals) result. Forensic evidence directly points to conversion of the yellow phosphorus in patients with "phossy jaw" to potent amino bisphosphonates by natural chemical reactions in the human body. Thus, the cause of phossy jaw in the late 1800s was actually bisphosphonate-induced osteonecrosis of the jaws, long before clever modern pharmaceutical chemists synthesized bisphosphonates. Today's bisphosphonate-induced osteonecrosis represents the second epidemic of "phossy jaw." Case closed.
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PMID:Uncovering the cause of "phossy jaw" Circa 1858 to 1906: oral and maxillofacial surgery closed case files-case closed. 1894 May 6

We report a case of acute respiratory failure due to refeeding syndrome caused by hypocaloric enteral tube feeds. A 60-y-old obese man, with a diagnosis of esophageal carcinoma with local metastases, underwent feeding jejunostomy tube insertion. Enteral tube feeding was initiated at small volumes providing 4.4 kcal x kg(-1) x d(-1) and gradually increased over 48 h to 29 kcal x kg(-1) x d(-1) (based on adjusted body weight). The patient then developed acute respiratory distress requiring intubation and ventilatory support. Serum phosphorus (P) level was extremely low at <0.7 mg/dL. Serum potassium (K) and magnesium (Mg) levels were also low. It took >4 d to adequately correct the electrolyte derangements. Successful liberation from mechanical ventilation was then possible. In chronically malnourished patients undergoing nutritional support, even hypocaloric feeding should be considered a risk factor for developing refeeding syndrome leading to severe and acute electrolyte fluid-balance and metabolic abnormalities.
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PMID:Acute respiratory failure due to refeeding syndrome and hypophosphatemia induced by hypocaloric enteral nutrition. 1915 80


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