Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0027651 (tumor)
 685,946 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Acute pancreatitis is observed in patients with the acquired immunodeficiency syndrome (AIDS) (4-22%), and is reported with increasing frequency as a complication of therapy in human immunodeficiency virus-spectrum disease. The cause is multifactorial (virus, neoplasm, drugs), and the natural history generally mild and uncomplicated. 2',3'-Dideoxyinosine (ddI) is an experimental antiretroviral agent implicated as a cause of acute pancreatitis in a small number (0.9-2%) of patients. To better define this relationship, we conducted a retrospective analysis of a prospective clinical trial involving 51 homosexual males with AIDS treated with ddI (10-12 mg/kg/day) and reported on the incidence and natural history of pancreatitis. Clinical pancreatitis (symptoms, elevated serum amylase, and lipase and, in most cases, abnormal radiographic studies of the pancreas) was observed in 12 patients (23.5%). Asymptomatic elevations of amylase and lipase were identified in 10 additional patients (39.2%). The onset of pancreatitis was consistently delayed in both groups (overall mean 14.1 +/- 1.2 wk, 98% confidence interval). Ten of 12 symptomatic patients required hospitalization (mean length of stay, 9.4 days); two of 12 progressed to fulminant pancreatitis and died. Two patients with asymptomatic pancreatitis which occurred after starting ddI were rechallenged; severe symptomatic pancreatitis developed shortly after drug reinstitution. In each case, complete recovery followed discontinuation of the drug. We conclude that 1) The incidence (62.7%) and severity of pancreatitis in patients with AIDS receiving ddI therapy are significantly greater than expected, 2) the onset is predictably delayed about 14 wk, 3) ddI should be added to the list of drugs that cause acute pancreatitis, and 4) careful sequential monitoring of pancreatic function and early identification of potential "risk factors" for pancreatitis in AIDS patients treated with ddI may be essential in avoiding this serious complication.
 ...
PMID:Acute pancreatitis as a common complication of 2',3'-dideoxyinosine therapy in the acquired immunodeficiency syndrome. 843 64

The mortality rate of nonmelanoma skin cancer is higher than generally considered. An actual nonmelanoma skin cancer is a risk factor not only for other skin cancers but also for cancers in other organs. The recurrence rate can, according to the method of calculation, yield surprisingly diverging results. Statistical mapping of subclinical tumor growth in basal cell carcinoma supplies the margins for tumor-free excision. An even better but more expensive tool for therapy planning is tumor imaging with magnetic resonance imaging. Psoralen plus ultraviolet light of the A wavelength-treated patients run a dose-dependent risk of developing squamous cell carcinoma of the skin but also cancers in other organs. Human papilloma virus-16 seems not to be associated with squamous cell carcinoma of the skin except for the anogenital region and possibly the finger. The finding of retroviruslike particles in endemic non-acquired immunodeficiency syndrome Kaposi's sarcoma strongly suggests that a virus other than human immunodeficiency virus may play a role in the pathogenesis of this disease.
 ...
PMID:Basal cell and squamous cell carcinoma and Kaposi's sarcoma. 159 11

Despite the generally salutary experience in recent years of managing suppurative pleuropulmonary disease, empyemas and lung abscesses have persisted and increased in incidence in hospitals such as Queens Hospital Center that serve large numbers of the socioeconomically disadvantaged. This study documents the etiology, clinical presentation, treatment, and treatment results of suppurative pleuropulmonary disease at Queens Hospital Center, which serves a large segment of the urban poor, many of whom are black. Results indicate that contributory or antecedent etiologic factors include a history of prior disease (specifically pneumonia, lung abscess, obstructive lung disease, pulmonary neoplasia, and tuberculosis); a predisposition to constitutional or immunologic deficiencies (specifically, alcoholism, anemia/malnutrition, drug abuse, and acquired immunodeficiency syndrome [AIDS]); conditions contributing to tracheobronchial aspiration (specifically, alcoholism and seizure disorders); and a miscellaneous group such as prior surgery, cardiovascular disease, and sepsis syndrome. The patients in this study were young with maximal incidence occurring in the third to fifth decades of life. Patients were predominantly male (75%) and black (66%). There were 18 deaths (23%), with sepsis being the cause in 10 (56%). Most surgical interventions were conservative, ie, bronchoscopies (48), thoracenteses (43), and tube thoracotomies (39). Thirty-one open thoracotomies were performed for drainage, decortication, or pulmonary resection. The surgical mortality was three cases or 5% of the patients who underwent surgery. The designated incidence of proven AIDS in this series (29%) was low, undoubtedly because many patients refused testing, and the multiple gram-positive and gram-negative infections that were seen did not conform to the Centers for Disease Control criteria for diagnosis and case reporting for AIDS.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:The role of surgery in treating pleuropulmonary suppurative disease--review of 77 cases managed at Queens Hospital Center between 1986 and 1989. 160 13

Mycobacterium avium is an intracellular opportunistic pathogen commonly seen in AIDS patients. M. avium-infected monocytes have been recently shown to be lysed by interleukin-2 (IL-2)-activated killer cells. Since some bacterial products can directly augment natural killer activity, we examined the ability of these microorganisms to induce killer cell activity. Coculture of M. avium with large granular lymphocytes (LGL) was found to augment the ability of LGL to lyse both tumor cells and bacterially infected autologous monocytes. The induction of tumoricidal activity by M. avium was only partially neutralized by the presence of anti-IL-2 antibodies, indicating that both IL-2-dependent and IL-2-independent mechanisms are responsible for activation of killer cells. Furthermore, only the direct interaction between bacterium and LGL could induce the expression of both IL-2 receptor alpha protein and mRNA, an effect which was abrogated by the presence of genistein, a tyrosine kinase inhibitor. Thus, M. avium was seen to induce killer cells, an activity that is concomitant with the up-regulation of IL-2 receptor alpha, or Tac antigen, expression and which involves signal transduction mechanisms mediated by tyrosine kinase activity.
 ...
PMID:Mycobacterial induction of activated killer cells: possible role of tyrosine kinase activity in interleukin-2 receptor alpha expression. 161 49

The literature from 1984 to 1991 has been searched for reports of patients who have eliminated human immunodeficiency virus (HIV) from their system. While such reports are scarce, it appears that a small number of HIV-positive patients have reverted to a negative state either spontaneously or following radical immunosuppressive regimens for neoplastic disease. Although no carefully planned animal experiments or clinical trials have been reported, it would appear that bone marrow ablation and replacement may eliminate HIV from healthy, asymptomatic HIV-positive individuals. Although much of the clinical experience to date suggests that radical immunosuppression is not indicated in advanced AIDS patients in whom the virus has likely spread beyond the immune system, such cases do not represent evidence that immunosuppression is not indicated in healthy, HIV-positive individuals.
 ...
PMID:Eliminating human immunodeficiency virus (HIV) from infected individuals and cells: is it possible? 161 55

Chronically immunosuppressed individuals are susceptible to lymphoreticular tumors. Up to 15% of patients with congenital deficiencies such as ataxia=telangiectasia may develop malignancies, mainly high-grade B cell non=Hodgkin's lymphomas (NHLs). AIDS lymphomas are comprised of NHLs including Burkitt's lymphoma (BL) and primary cerebral lymphomas (PCLs). Almost 3% of all AIDS patients (2824 of 97,258 cases) developed NHL. Epstein-Barr virus (EBV) as a co-factor in AIDS lymphomagenesis has been studied: in 12 cases of 24 AIDS lymphomas EBV by DNA in situ hybridization was found. In an analysis of 6 primary cerebral lymphomas, .5 were positive for EBV DNA by Southern blotting. In Burkitt's lymphoma the characteristic genetic alteration affects the c-myc oncogene. In 1/3 of BL p53 mutations were found but none in the 43 NHLs suggesting that p53 mutations and c-myc activation act synergistically in the pathogenesis of these tumors. Cytotoxic agents dideoxyinosine, dideoxycytosine, and zidovudine may cause secondary neoplasia. 8 of 55 AIDS patients under zidovudine treatment developed high-grade lymphoma 23.8 months subsequently; recently doses were reduced. PCL was found in 21 of 90 patients. A 5.2 months survival was associated with combined treatment with cyclophosphamide, Oncovin (vincristine), methotrexate, etoposide, and cytosine arabinoside compared with 11.3 months with chemotherapy. Colony-stimulating factors (CSFs) alleviate drug-induced myelotoxicity and zidovudine-induced neutropenia, however, l8 of 11 patients receiving granulocyte-macrophage CSF developed hematological toxicity. Interleukine-2 produced by T-helper cells enhancing tumor cells cytotoxicity has been used in AIDS-associated cryptosporidial diarrhea and in 4 patients with AIDS lymphoma with modest response, but its stimulation of the HIV-infected substrate may increase viral proliferation.
Int J STD AIDS
PMID:AIDS lymphomas. 161 63

Radionuclide imaging, if applied with an organ system approach, is useful in the diagnosis of the AIDS (acquired immunodeficiency syndrome)-related complex. Specific pathologic processes can be suspected on the basis of uptake patterns. The intensity and pattern of pulmonary uptake and concomitant nonpulmonary uptake of gallium provide guidelines for distinguishing among various opportunistic pulmonary pathogens. Gastrointestinal and extra-gastrointestinal tract uptake of gallium aids distinction among fungal, mycobacterial, and viral infections and neoplasms. Patterns of spleen uptake of technetium-99m sulfur colloid and gallium allow differentiation between neoplasm (Kaposi sarcoma) and infection (with mycobacteria). Skeletal and soft-tissue abnormalities can be characterized and differentiated on the basis of bone scan and other radionuclide scan findings. Thallium uptake in brain tumors (and not in areas of infection) allows brain lesion discrimination. In the proper clinical setting, AIDS nephropathy has a characteristic gallium uptake pattern. Cardiac abnormalities (including functional) can also be assessed with scintigraphy. With knowledge of these organ-specific patterns and with correlative imaging studies, the manifestations of AIDS can be differentiated and appropriate treatment instituted.
 ...
PMID:Diagnostic uses of nuclear medicine in AIDS. 163 36

Anticardiolipin antibodies (ACA) frequently appear in patients with autoimmune disorders such as systemic lupus erythematosus, and have also been detected in infections, neoplasia, the primary antiphospholipid syndrome, in association with certain medications and also in those patients without apparent disease. Recently, anticardiolipin antibodies were described in connection with acquired immunodeficiency syndrome (AIDS). 84 human immunodeficiency virus (HIV)-infected patients were examined in order to assess the influence of risk factors for HIV infection and of the stage of HIV-1 infection on the prevalence of IgG-ACA in HIV-seropositive patients. 2 groups were created -- 1 composed of 38 asymptomatic HIV-infected individuals and the other of 46 AIDS patients. A control group of 42 healthy HIV-negative blood donors was also studied. All those in the control group were IgG-ACA-negative. Of the 84 HIV-positive patients, 50 were IgG-ACA positive (59.5%) and 34 IgG-ACA-negative (40.5%). None of the HIV-positive individuals presented any thromboembolic phenomena. There were no significant differences with respect to sex, risk factors, and stage of disease when the presence of IgG-ACA in HIV-positive patients was ascertained. ACA does not appear to be a prognostic marker in HIV-1 infected patients; the presence of IgG-ACA is probably related to HIV-1 infection itself and is indicative of impaired humoral immunity in this group. (author's modified)
 ...
PMID:Anticardiolipin antibodies and acquired immunodeficiency syndrome: prognostic marker or association with HIV infection? 164 88

The causes of abdominal pain in patients with AIDS are different from those of the general population, and there are no guidelines as to which investigations are optimal. We reviewed our experience of 63 patients who presented with abdominal pain as the main reason for admission to the AIDS unit at St Stephen's and Westminster Hospital between January 1988 and January 1990. All patients were assessed within the same structured diagnostic programme. Thirty-five had upper abdominal pain, predominantly in the right upper quadrant in 27; seven had lower abdominal pain, which was concentrated in the right iliac fossa in three; 21 had diffuse abdominal pain. The causes of pain were determined satisfactorily in the majority of patients using routine gastroenterological investigations. The predominant site of pain had considerable predictive value in the diagnosis. The commonest cause of right upper quadrant pain was sclerosing cholangitis (17 of 27); endoscopic retrograde cholangio-pancreatography was necessary for a confident diagnosis. Diarrhoea was frequently associated (15 of 21) with diffuse abdominal pain; the commonest cause (six of 21) was cytomegalovirus colitis. Neoplasia was the cause of abdominal pain in eight patients. The other causes of abdominal pain and the utility of various investigations are discussed. An investigatory route which may provide maximum information has been suggested.
 ...
PMID:Abdominal pain in HIV infection. 164 62

Association of glioma with AIDS is unusual. Cytomegalovirus (CMV) infection of glioma has not been documented in AIDS or non-AIDS patients. We present the case of a 37-year-old homosexual, HIV positive man who had a history of pneumocystis pneumonia and died of disseminated CMV infection and an anaplastic astrocytoma (5 x 5 x 4 cm) of the left temporal lobe. Part of the tumor was severely infected by CMV as demonstrated by immunohistochemical stain. Intranuclear and intracytoplasmic CMV inclusions were present in the cytomegalic cells whose astrocytic nature was identified by immunostain for GFAP. CMV-bearing cells were scattered throughout the astrocytoma but were rarely seen outside the tumor. CMV-bearing endothelial cells were seen in several capillaries within the tumor. Microglial nodules were scattered within the tumor and some contained CMV-infected cells. Many multinucleated giant cells (MNGC) with circularly arranged small nuclei were present in the infected area of the tumor and some showed fusion with cytomegalic cells. MNGC were absent outside the tumor. CMV ependymitis was not seen. The findings suggest that a) astrocytoma cells are permissive to CMV infection, b) that they may be more susceptible to CMV infection and replication than normal brain tissue, and c) the hyperplastic endothelia and abnormal blood brain barrier of the astrocytoma may facilitate the entry of CMV itno the tumor.
 ...
PMID:Cytomegalovirus infection of cerebral astrocytoma in an AIDS patient. 165 Mar 2


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>