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

We report three children with benign paroxysmal torticollis (BPT) and review the literature. BPT represents a self-limited disorder that occurs mainly in infancy and in females. The condition is characterized by recurrent spells of torticollis which may, or may not, be accompanied by other symptoms such as vomiting, pallor, ataxia, irritability and drowsiness. The diagnosis of BPT should be established clinically, although, in some cases, it is necessary to rule out conditions such as posterior fossa tumor, cervical dislocation, ocular palsy, dystonia due to side effects of drugs, or Sandifer's syndrome. The etiology of the syndrome remains unknown and, at present, there is no effective therapy.
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PMID:[Benign infantile paroxysmal torticollis. Apropos of 3 cases]. 305 50

Etoposide (VP-16-213) has been used in the treatment of many solid tumors and hematologic malignancies. When used in high doses and in conjunction with autologous bone marrow transplantation, this agent has activity against several treatment-resistant cancers including malignant glioma. In six of eight patients (75%) who we treated for recurrent or resistant glioma, sudden severe neurologic deterioration occurred. This developed a median of 9 days after initiation of high-dose etoposide therapy. Significant clinical manifestations have included confusion, papilledema, somnolence, exacerbation of motor deficits, and sharp increase in seizure activity. These abnormalities resolved rapidly after initiation of high-dose intravenous dexamethasone therapy. In all patients, computerized tomographic (CT) brain scans demonstrated stability in tumor size and peritumor edema when compared with pretransplant scans. This complication appears to represent a significant new toxicity of high-dose etoposide therapy for malignant glioma.
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PMID:Acute neurologic dysfunction after high-dose etoposide therapy for malignant glioma. 328 26

The clinical development of the recombinant alpha interferons has provided a prototype for the clinical development of biological compounds. With over 5,000 patients now treated with these compounds, some general principles have emerged that have wider implications for phase I-II strategies for testing other biologicals. There is a suggestion of dose-response relationships and a clearer picture of schedule dependence. The extent of tumor burden and identification of sensitive subtypes of patients also appear to be critical factors in evaluating the true potential activity of biological compounds. The toxicity profile of the alpha interferons is unusual. Fever and flu-like symptoms occur in all doses and schedules and are usually dose limiting. Somnolence and other CNS effects occur in a small percentage of patients. Hematologic toxicity occurs but is minimal at lower doses and is noncumulative and rapidly reversible at all doses. Gastrointestinal toxicity is mild. No other unusual or unexpected toxicities have been reported, and early reports of cardiovascular toxicity have not been confirmed in large trials. The use of these pioneer recombinant DNA products raised concerns about the potential development of antibodies and serum-neutralizing factors. Reports with small patient numbers confirmed the occasional development of serum-neutralizing activity to some alpha interferons. The significance of this neutralizing activity and the reasons for an apparent higher incidence of this phenomenon with some alpha interferon preparations remain to be determined. The full role of alpha interferon by itself or in combination with other available therapies will be resolved in coming years. This review presents current safety, efficacy, and neutralizing antibody data.
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PMID:The alpha interferons: clinical overview. 329 10

Crisnatol is a novel lipophilic arylmethylaminopropanediol with significant antineoplastic activity in a variety of murine and human tumor models which functions as a DNA intercalator. In this Phase I trial, a 6-h infusion of the drug was administered i.v. in 700 to 1500 ml of 5% dextrose in water every 28 days. Eighty-five courses at doses of 7.5 to 516 mg/m2 were administered to 43 patients with refractory solid tumors. Reversible neurological toxicity was dose limiting at 516 mg/m2 and was manifested as somnolence, dizziness, blurred vision, unsteady gait, and alpha-slowing on electroencephalogram at the end of infusion. All neurological signs and symptoms were reversible. No hematological toxicity was observed. Other toxicities included phlebitis, mild to moderate nausea and vomiting, reversible sinus node arrest in one patient, and hypertension. Crisnatol plasma concentrations were determined by high-pressure liquid chromatography. After infusion, plasma concentrations declined biexponentially with a terminal t1/2 of 2.9 h. Using a two-compartment model, the mean apparent volume of distribution at steady state and total-body clearance were 58.8 liters/m2 and 18.3 liters/h/m2, respectively, indicative of extensive tissue distribution and rapid hepatic clearance. Peak plasma levels occurred at the end of infusion and correlated with the onset of neurological toxicity. The recommended Phase II dose for this schedule is 388 mg/m2.
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PMID:Phase I and clinical pharmacology trial of crisnatol (BWA770U mesylate) using a monthly single-dose schedule. 339 16

The antiemetic efficacy of a combination of high-dose metoclopramide, methylprednisolone and flunitrazepam was tested in an open pilot study in 30 tumor patients undergoing strongly emetic chemotherapy. 26 of 30 patients (87%) were partially or completely protected from nausea and vomiting. In 11 of 12 patients receiving the strongly emetogenic cytostatic agent cisplatin in a dose of greater than or equal to 50 mg/m2, the gastrointestinal side effects were partially or completely abolished. The antiemetic efficacy of the combination was maintained during subsequent courses of chemotherapy. All patients experienced somnolence after administration of flunitrazepam. Only 2 of 30 patients had a shortlived extrapyramidal reaction. The combination of high-dose metoclopramide, methylprednisolone and flunitrazepam is an effective antiemetic treatment and should be considered as first-line antiemetic treatment in patients receiving strongly emetic cancer chemotherapy.
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PMID:[Metoclopramide, methylprednisolone and flunitrazepam in cytostatic-induced vomiting]. 343 92

Sensitizing and neurotoxic effect of ornidazole, was tested in a double-blind randomized study in patients with carcinoma of the cervix and larynx. Ornidazole or placebo were given orally, two times weekly, for 3 weeks. Dose was 2.5 g/m2 for each administration. Total dose given was 15 g/m2. Radiation therapy was given 3 h after the drug administration. Ornidazole was well tolerated in the majority of the patients. No neurotoxic side effects, such as peripheral neuropathy or convulsion, were observed with a total dose of up to 30 g. Dizziness, somnolence and nausea were the prominent acute side effects, seen mostly (70%) in women. In the placebo group this rate was 17% (p less than 0.01). No important side effect was observed in men receiving ornidazole. Serum concentration of ornidazole reached the maximum level in 2-4 h after oral administration and ranged (23 patients) from 65.1 to 139.8 micrograms/ml. Mean half-life was 15.6 +/- 2.8 h. Peak concentration in tumour tissue was achieved 1-3 h after the administration, ranging from 13.0 to 78.0 micrograms/g. Tumour concentration of ornidazole ranged from 14 to 93% of the serum concentration at the time of irradiation.
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PMID:Use of ornidazole in fractionated radiotherapy: dose tolerance, serum and tumour tissue concentration. 352 36

The clinical development of the recombinant alpha interferons represents a prototype for the clinical development of biological compounds. Their testing raises fundamental questions concerning phase I objectives and strategies for biologicals, eg, study design in an immune model v a cytotoxic model. However, with over 5,000 patients treated with these compounds, some general principles have emerged. There is a suggestion of dose-response relationships, and a clearer picture of schedule dependence. The extent of tumor burden and identification of sensitive subtypes of patients also appear to be critical factors in evaluating the true potential activity of biological compounds. The toxicity profile of the alpha interferons is unusual. Fever and flu-like symptoms occur almost universally in all doses and schedules, and are usually dose-limiting. Somnolence and other CNS effects occur in a small percentage of patients. Hematologic toxicity occurs but is minimal at lower doses and is noncumulative and rapidly reversible at all doses. Gastrointestinal toxicity is mild. No other unusual or unexpected toxicities have been reported, and early reports of cardiovascular toxicity have not been confirmed in large trials. The use of these pioneer recombinant DNA products raised concerns about the potential production of antibodies and serum-neutralizing factors. Reports with small patient numbers confirmed the occasional development of serum-neutralizing activity to some alpha interferons, which may coincide with a loss of detectable serum interferon and loss of clinical activity. A large study with interferon alfa-2b (Intron A) has reported a low overall incidence of neutralizing activity (2.5%) and no association with loss of clinical activity. The significance of the neutralizing activity and the reasons for an apparently higher incidence of this phenomenon with other alpha interferon preparations remain to be determined. The full role of alpha interferon by itself or in combination with other available therapies will be resolved in coming years. Efficacy data available to date and phase I combination studies are reviewed.
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PMID:Intron A (interferon alfa-2b): clinical overview and future directions. 353 38

A huge, intradiploic, right temporoparietal epidermal cyst was known to be present, unchanged in extent, for over 14 years in a 55-year-old man. Although extreme mass effect was demonstrated by computed tomography scans, results of the neurological examination were within normal limits. Treatment of nausea and vomiting after vestibular testing caused somnolence and an acute diencephalic-mesencephalic syndrome of tentorial herniation. However, only moderate amounts of analgesics and sedatives were given. These symptoms disappeared as the pharmacological sedative effect diminished. Thereafter the tumor was resected radically. Neuropathological examination confirmed an epidermal cyst. Results of the postoperative neurological examination were within normal limits.
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PMID:Completely reversible, severe, acute neurological deterioration with an otherwise asymptomatic, huge intradiploic calvarial epidermal cyst. 394 86

Tumors of the posterior fossa presenting orthostatic hypotension are rare and only nine cases have been reported so far. The locations of almost all these tumors were near the fourth ventricle and three of them were hemangioblastoma. A case of a tumor of the fourth ventricle showing autonomic disturbances mainly composed of orthostatic hypotension is reported. A 42-year-old male was admitted to the Department of Neurology of Chiba University Hospital on June 25th, 1981 because of three years' history of autonomic disturbances including orthostatic syncope, impotence, urinary disturbance and bowel dysfunction such as vomiting, diarrhea and constipation. He also complained of weight loss and staggering of gait to the left side. On admission, the patient was emaciated being 50 kg in weight and 172 cm in height. Neurological examination revealed hippus of bilateral pupils in light reflex, saccadic eye movement, slightly hypoactive deep tendon reflexes, mild terminal oscillations in bilateral finger-to-nose test, oscillation in the left heel-to-knee test, staggering tendency of gait to the left, slightly impaired tactile and thermal sensations in distal parts of the legs. Autonomic disturbances were showed by orthostatic hypotension (BP 104-50 in supine and 70-40 in sitting position), impotence, weight loss, anorexia, decrease of sweating, spontaneous yawning and loss of sensation of bladder fullness. About 5 weeks after admission, he began to complain of temporal headache and showed impairment of memory, drowsiness, paroxysmal apnea and papilledema.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Progressive dysautonomia in hemangioblastoma in the region of the fourth ventricle]. 396 90

A rare case was reported in which a brain tumor was associated with a cerebral aneurysm. A 59-year-old woman was admitted with right spastic hemiparesis and motor aphasia. She was in somnolence and complained of headache. She had two attacks of loss of consciousness about 12 years previously. Since then she had right spastic hemiparesis and motor aphasia as sequelae. Preoperative CT scan and carotid angiograms showed a malignant brain tumor in the left temporal region and an anterior communicating artery aneurysm. Operation was performed in one stage. At first the neck of the aneurysm was clipped by right sphenoidal approach and the tumor was partialy removed by left temporal approach. The histological diagnosis was glioblastoma multiforme. The cerebral aneurysm associated with brain tumor should be treated as soon as possible. The operative result in our case was good.
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PMID:[The association of cerebral aneurysm with malignant brain tumor--report of a case (author's transl)]. 625 77


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