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Query: UMLS:C0027651 (tumor)
 685,946 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Better, noninvasive, diagnostics, better knowledge of anatomy and of surgical techniques have been responsible for a considerable development of liver surgery during recent years. Primary malignant liver tumours can only be cured by resection. The decision for resectional surgery should be based on different tumor characteristics, of whom the nature of the liver tissue (normal or cirrhotic) in which the tumor develops in of utmost importance. A malignant tumor should be resected with save, tumor-free margins, leaving behind as much normal functional parenchyma as possible. The role of complementary therapies as e.g. chemotherapy, chemo-embolisation and arterial ischemia must be further developed. Liver transplantation will probably play a more important role in the future development of liver cancer treatment. Surgery for benign liver tumors can be restricted most of the time to a limited resection; extended hepatectomies are rarely necessary. The more deliberate use of intraoperative ultrasound and hepatic vascular exclusion as well as the more frequent use of ultrasound dissectors will allow safer liver surgery; this applies especially for the excision of benign solid liver tumors. Because of their degenerative risks, liver adenomas should be excised. Focal nodular hyperplasia and haemangioma remain rare indications for surgery. The low morbidity and mortality of elective liver resections should favour a more widespread use of surgery for the treatment of malignant as well benign liver tumors.
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PMID:[Surgery of benign and malignant primary liver tumors]. 217 70

The authors have measured the magnetic field dependence of 1/T1 (nuclear magnetic relaxation dispersion, or NMRD profiles) of water protons of histologically characterized samples of astrocytomas, meningiomas, and lymphomas. The goal was to elucidate the determinants of 1/T1 of brain tumors at the cellular level and, in particular, to search for a possible correlation of the profiles with neoplastic properties, including degree of malignancy. Because of the recently demonstrated contribution of myelin to 1/T1 of white matter, careful histologic analyses were performed to correct for its presence. The range of magnitude of the profiles of differing types and grades of tumors correlates with the range of water content of these tumors; the correlation of water content with cellularity (density of cell nuclei in a histologic preparation), in turn, produces correlations of 1/T1 with tumor type. For all the tumors studied, 1/T1 is proportional to solids content; the constant of proportionality is relatively insensitive to tumor type and, for astrocytomas, grade of malignancy; and is about the same as that of normal gray matter. For low- and intermediate-grade astrocytomas that contain myelin, the myelin-specific contribution to 1/T1 has to be considered to make manifest the underlying correlations, which are best demonstrated at low fields, where the background contribution of water and dissolved oxygen is minimal. At high fields, where most imaging is done, a change in oxygen partial pressure, as for example from ischemia in very malignant tumors, is sufficient to alter 1/T1 significantly, reducing the intrinsic correlation between histology and 1/T1.
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PMID:Magnetic field dependence of 1/T1 of human brain tumors. Correlations with histology. 217 37

The most common cause of nail bed deformity is trauma, but other causes are infection, tumor, ischemia, or congenital anomalies. This article includes discussions of nonadherence, split nail, reconstruction of the eponychium, crooked and hooked nail, bony irregularity, pachyonychia, ischemic deformities, and absence of the nail. New problems are encountered daily and other deformities have no method of correction recorded in the literature. For these cases, we provide suggested treatments based on the anatomy and physiology of the nail.
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PMID:Reconstruction of a functional and esthetic nail. 217 37

Neurologic sequelae of Paget's disease of bone include involvement of the spinal cord or cauda equina due to mechanical compression by enlarged vertebrae, ischemia caused by a spinal artery, steal syndrome or neoplasm. We describe a patient with Paget's disease of bone who presented with acute cauda equina syndrome due to a spinal epidural hematoma. Clinicians need to recognize this entity since surgical intervention may result in a favorable outcome.
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PMID:An unusual manifestation of Paget's disease of bone: spinal epidural hematoma presenting as acute cauda equina syndrome. 221 67

Fourteen children aged 1 week to 16 years, with a variety of large or superficial brain tumors, underwent localized in vivo 31P magnetic resonance spectroscopy of their tumor. Quantitative spectral analysis was performed by measuring the area under individual peaks using a computer algorithm. In eight patients with histologically benign tumors the spectra were considered to be qualitatively indistinguishable from normal brain. The phosphocreatine/inorganic phosphate ratio (PCr/Pi) averaged 2.0. Five patients had histologically malignant tumors; qualitatively, four of these were considered to have abnormal spectra, showing a decrease in the PCr peak. The PCr/Pi ratio for this group averaged 0.85, which was significantly lower than that seen in the benign tumor group (p less than 0.05). No difference between the two groups was seen in adenosine triphosphate or phosphomonoesters. It is concluded that a specific metabolic "fingerprint" for childhood brain tumors may not exist, but that some malignant tumors show a pattern suggestive of ischemia.
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PMID:Localized 31P magnetic resonance spectroscopy of large pediatric brain tumors. 229 87

With the use of positron emission tomography, regional cerebral blood flow, oxygen utilization, and glucose utilization were measured in the peritumoral low-density areas on x-ray computed tomographic images in 23 patients with supratentorial brain tumors: 7 meningiomas, 11 malignant gliomas, and 5 metastatic brain tumors. Findings on positron emission tomography in these areas revealed characteristic patterns associated with the types of tumor and the degree of mass effect. It is likely that two different types of pathophysiological states exist in "peritumoral edema": 1) primary ischemia caused by mechanical compression by the tumor mass in meningiomas; and 2) primary metabolic suppression (mainly in oxygen metabolism) in malignant brain tumors.
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PMID:Metabolic and hemodynamic aspects of peritumoral low-density areas in human brain tumor. 233 83

As compared to an above-knee amputation, the knee disarticulation has several marked advantages that are well known and accepted by most surgeons. However, it has not gained popularity because it leaves a double condylar, bulbous, uneven stump, which is difficult to fit into the base of the socket. In ten patients, a modified surgical technique included moderate trimming of the femoral condylar prominences and patellofemoral arthrodesis in the intercondylar notch. This produces a conical stump with a large area for end bearing, and at the same time allows the standard suction-socket fitting without ischial weight bearing. The average age was 33.1 years (range, ten to 75 years). The indication for amputation was trauma in four cases, tumor in three cases, chronic osteomyelitis in one, ischemia of the leg in one, and congenital malformation in one. Average length of follow-up study was four years (range, one to 9.8 years). Complications were stump ulceration in one case and fistula formation in two cases. Nine patients achieved full weight-bearing ambulation with an end-bearing type of prosthesis. The remaining patient was not fitted with a prosthesis prior to his death from a systemic medical illness. Union of the patellofemoral arthrodesis was achieved in all ten cases. This procedure is recommended whenever knee disarticulation is indicated and ambulation expected. Significant improvement over standard knee disarticulation or distal above-knee amputation can be achieved.
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PMID:Knee disarticulation with intercondylar patellofemoral arthrodesis. An improved technique. 236 22

The alteration of the blood flow of the proper hepatic artery (PHA) on occlusion of the common hepatic artery (CHA) was studied intraoperatively using an electromagnetic flowmeter for 18 cases of malignant gastric tumor. PHA blood flow was 280 +/- 225 ml/min before CHA occlusion, and after the occlusion it was 170 +/- 132 ml/min, or 64 +/- 15% of the pre-occlusion flow (n = 16). The pulsation of PHA after CHA occlusion was palpable in all cases, and there were no complications due to ischemia in 17 cases which underwent Appleby's operation. These results suggested that there was fairly good blood flow in PHA maintained by collaterals after CHA occlusion and that, clear pulsation of PHA could be regarded as evidence of sufficient blood flow. Tissue blood flow (TBF) measurement for the liver and gall-bladder by H2 gas clearance method was also done in several cases of Appleby's operation and of other abdominal operations. TBF of the gallbladder was significantly lower in cases of Appleby's operation on the day of operation (p less than 0.02), but the difference between the two operation groups was not recognized 5 days after surgery, suggesting rather quick recovery of circulation. As to hepatic TBF, significant decrease following Appleby's operation could not be proved.
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PMID:[Collateral circulation after division of the common hepatic artery--clinical study concerning Appleby's operation]. 238 26

Computed tomography (CT) findings in eleven patients with symptomatic cerebrospinal fluid (CSF) dissemination from cerebral glioblastoma were analyzed and, in seven cases subsequently autopsied, they were compared with histological observations. Each patient had multiple CT abnormalities including periventricular enhancement (5/11), subarachnoid enhancement (10/11) and progressive hydrocephalus (7/9) by cranial CT, and small filling defects with or without block (5/5) by CT myelography. The areas that showed periventricular or subarachnoid enhancement on CT were confirmed to have macroscopically detectable seeding at autopsy. On the other hand, microscopic deposits were more widely distributed than the enhancement suggested, and were hardly visualized on CT. In association with subarachnoid seeding, we found low-density lesions on CT which had resulted from ischemia or reinvasion of adjacent structures by disseminated glioblastoma and resulting parenchymal edema. By cranial CT, subarachnoid enhancement seems to be a very reliable sign of CSF seeding, whereas periventricular enhancement due to CSF metastases should be carefully distinguished from that due to periventricular tumor infiltration. CT myelography is capable of revealing minute metastatic spinal deposits and may be helpful for ruling out spinal seeding as well as its precise evaluation.
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PMID:Symptomatic cerebrospinal fluid dissemination of cerebral glioblastoma. Computed tomographic findings in 11 cases. 239 40

We describe a patient who developed progressive hepatic failure one year after pancreatoduodenectomy for pancreatic carcinoma and died of gastrointestinal bleeding. He suffered from progressive weight loss after surgery, even though obstruction or stenosis of the gastrointestinal tract was excluded. At autopsy, the liver showed extensive perivenular fibrosis associated with variable loss of hepatocytes, perisinusoidal fibrosis, alcoholic hyalin and a lack of parenchymal regenerative activity, all of which closely resembled severe alcoholic liver disease. Stricture of both the main pancreatic duct and the pancreaticojejunostomy with almost complete loss of exocrine acini was also found, and the recurrent tumor was seen to have caused portal venous obstruction and hepatic arterial stenosis. A combination of these nutritionally unfavorable circumstances and prolonged ischemia appeared to have been responsible for the liver injury in this non-alcoholic patient.
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PMID:Liver injury with perivenular fibrosis and alcoholic hyalin after pancreatoduodenectomy for pancreatic carcinoma. 245 95


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