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)

In a multicenter, randomized controlled trial involving 126 patients with endocrine-resistant advanced prostate cancer, all of whom received external beam radiotherapy, additional treatment with a single injected dose of 400 MBq strontium-89 (Metastron) significantly improved overall pain control. Adjuvant therapy with strontium-89 also significantly reduced analgesia requirements compared with placebo and delayed disease progression, as indicated by the requirement for further external beam radiotherapy. On certain measures, patients receiving strontium-89 also showed enhanced quality of life. Accompanying these changes, levels of prostate tumor markers were significantly reduced by strontium-89 treatment. The benefits resulting from adjuvant strontium therapy were associated with tolerable hematologic toxicity. The addition of strontium-89 to external beam radiation had no effect on survival. However, it has clear implications for improved palliation in advanced prostate cancer and may also impact positively on treatment costs.
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PMID:Strontium-89 as an adjuvant to external beam radiation improves pain relief and delays disease progression in advanced prostate cancer: results of a randomized controlled trial. 768 65

The purpose of this study was to assess whether xenogeneic tumor cells secreting beta-endorphin and immunologically isolated in polymer capsules could survive and continue to reduce pain when transplanted into the spinal cerebro-spinal fluid (CSF) space of rats. Also, a silicone container for polymer capsules was designed for the clinical application of this method of cell therapy. The mouse tumor cell lines, proopiomelanocortin gene transfected Neuro2A which secrete beta-endorphin, were enclosed in polymer capsules at a density of 5 x 10(6)/mL, and transplanted into the spinal CSF space from the occipito-atlantal junction of male Sprague-Dawley rats. Three analgesiometric tests--the tail pinch test, the hot plate test, and electrical stimulation test--showed that the rats with encapsulated Neuro2A (n = 6) were significantly less sensitive to pain after transplantation than control animals (n = 8). The analgesia induced by the encapsulated cells secreting beta-endorphin was attenuated by the opiate antagonist naloxone. Morphological study revealed that the encapsulated cells survived for 1 mo after transplantation into the CSF space. An in vitro experiment on cultured capsules (3 cm long) with a silicone container (Kaneka Medics Co) showed that the encapsulated Neuro2A (5 x 10(6) mL) could secrete peptides for 1 mo. The results of this study indicate that immunologically isolated xenogeneic tumor cells can secrete opiate in the CSF space, and that a silicone container may help the application of this method to the treatment of cancer pain.
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PMID:Cell therapy with encapsulated xenogeneic tumor cells secreting beta-endorphin for treatment of peripheral pain. 779 96

We reviewed cases to determine whether suspected or confirmed epidural infection was associated with epidural analgesia for 1620 infants, children, and adolescents treated over a 6-yr period at Children's Hospital, Boston. Postoperative patients (1458/1620) received epidural infusions for a median of 2 days (range, 0-8 days). No postoperative patient had an epidural abscess. One 10-yr-old with terminal malignancy received thoracic epidural analgesia via two successive catheters over a 4-wk period. She had Candida colonization of the epidural space along with necrotic epidural tumor. A second oncology patient and two patients with reflex sympathetic dystrophy were evaluated for epidural abscess, but none was found. We conclude that the risk of epidural infection is quite low in pediatric postoperative patients receiving short-term catheterization. Use of prolonged epidural analgesia in the management of chronic pain in children requires careful monitoring of warning signs of infection.
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PMID:The risk of infection from epidural analgesia in children: a review of 1620 cases. 781 6

The rate of postoperative recovery is determined by pain, stress-induced organ dysfunction, and limitations in conventional postoperative care. We attempted to provide "stress-free" colonic resection for neoplastic disease in eight elderly high-risk patients by a combination of laparoscopically assisted surgery, epidural analgesia, and early oral nutrition and mobilisation. Effective pain relief allowed early mobilisation, and hospital stay was reduced to 2 days without nausea, vomiting, or ileus. Postoperative fatigue and impairment in functional activity were avoided. Major advances in postoperative recovery can be achieved by early aggressive perioperative care in elderly high-risk patients undergoing colonic surgery.
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PMID:Recovery after laparoscopic colonic surgery with epidural analgesia, and early oral nutrition and mobilisation. 789 89

The purpose of this study was to assess whether xenogeneic tumor cells immunologically isolated in polymer capsules could survive and continue to reduce pain when transplanted into the cerebrospinal fluid (CSF) of rats. The mouse tumor cell lines AtT-20 and gene-transfected Neuro2A, which secrete beta-endorphin, were enclosed in polymer capsules at a density of 5 x 10(6) cells/ml and transplanted into the spinal CSF space of the occipitoatlantal junction in male Sprague-Dawley rats. The analgesiometric tests (tail pinch, hot plate, and electrical stimulation) showed that the five rats with encapsulated AtT-20 or Neuro2A (eight rats) were significantly less sensitive to pain after transplantation than the eight control animals (analysis of variance; p < 0.05). The analgesia induced by encapsulated cells secreting beta-endorphin could be attenuated by the opiate antagonist naloxone, which suggested the involvement of opiate in mediating this response. Morphological study revealed that the cells in polymer capsules survived 1 month after transplantation in the CSF space. In vitro experiments with cultured capsules showed that both encapsulated AtT-20 and Neuro2A secrete peptide for 1 month. The results of this study suggest that immunologically isolated xenogeneic tumor cells can secrete opiate in the CSF space, and this method may be applied to the treatment of cancer pain.
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PMID:Analgesia induced by transplantation of encapsulated tumor cells secreting beta-endorphin. 789 26

This report describes the 24-hr time course of the immunomodulatory effects of an acute s.c. injection of morphine in C57BL6 mice, and correlates these effects with the drug's analgesic properties and serum levels. Acute morphine treatment had a biphasic effect on various immune parameters: there was an increase in in vitro phagocytosis and the killing of Candida Albican cells by peritoneal polymorphonuclear leukocytes 20 and 40 min after the injection of morphine, 20 mg/kg, when analgesia and serum morphine concentrations were at their peak. Interestingly, 24 hr after morphine administration (when antinociception and morphine blood levels were no longer detectable) these parameters underwent a marked reduction. Similarly, macrophage-mediated inhibition of tumor cells proliferation was first stimulated (at 20 and 40 min) and then depressed (at 24 hr). Splenic natural killer cell cytotoxicity, determined by standard 51Cr release from YAC-1 target cells, also was evaluated. No differences in natural killer activity was observed at any of the monitored time points. In addition, we evaluated the immunomodulatory effects of an acute injection of methadone (a synthetic narcotic compound) at a dose inducing the same degree of analgesia as morphine. None of the tested immunoparameters were affected by the administration of methadone, which indicates the different drug-sensitivity of immunological correlates in vivo.
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PMID:Effect of morphine and methadone acute treatment on immunological activity in mice: pharmacokinetic and pharmacodynamic correlates. 801 55

Results are presented from a consecutive series of 396 patients referred to hospital in one of the areas of highest incidence in the United Kingdom in a unit that saw all referred cases for assessment and subsequent decision on the most appropriate therapeutic modality. Standard criteria were applied when selecting those patients in whom an attempt at curative resection was justified. Of the 396 patients, only 164 (41%) were considered fit enough to undergo thoracoabdominal resection and to have a tumor that had not invaded contiguous structures or metastasized. The remainder were treated by palliative intubation and more recently by laser photocoagulation. Of the patients who underwent resection, most had an Ivor Lewis esophagogastrectomy and lymphadenectomy, those with proximal lesions undergoing three-stage total esophagectomy. The overall 30-day mortality was 8.3%, falling to 6.7% during the period 1985-1990 when thoracic epidural analgesia was used routinely and fatal respiratory complications were avoided. Overall 5-year survival rate was 23%. However, stratification for tumor staging showed that the 5-year survival for node-negative patients was 47% and for tumors confined within the adventitia 71%. Results of surgical treatment of squamous esophageal carcinoma in the West are considerably more depressing than those in many Eastern series. This difference is largely related to the late presentation in the West, as the relatively low incidence does not justify screening programs. However, results equivalent to those in Eastern series are obtained for the small subset of patients who do present with early disease.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Operable esophageal cancer: current results from the West. 809 76

The anesthetic management of a hemodialyzed patient with a dopamine producing pheochromocytoma is described. A 56-years old man underwent surgical procedure the day after hemodialysis. Prior to intervention adrenal cortex hormones were normal as well as other endocrine variables (T3-T4-TSH-cortisol-ACTH-parathyroid hormone); epinephrine and norepinephrine, were in a normal range while dopamine was elevated (185 pg/ml). Preoperatively the patient was alpha-blocked with oral phenoxybenzamine (20 mg/day). A balanced anesthesia was performed (isoflurane and fentanyl). Plasma catecholamines were determined. During the induction of anesthesia and before tracheal intubation phentolamine and labetalol were injected till 3.4 mg and 50 mg total dose respectively. During surgical manipulation a nitroglycerin infusion was started (1.5 gamma/kg/min) and after tumor resection dopamine was given till 15 gamma/kg/min. Hormonal values increased in presence of unchanged hemodynamic parameters, likely due to alpha and/or beta blockade. In this case report our problem was especially fluid replacement after tumor resection, because of renal failure. On the basis of CVP and PCWP values, fluid treatment and dopamine infusion allowed to achieve an adequate preload. A sufficient level of analgesia and an efficient alpha blockade may assure hemodynamic stability also in a so compromised patient status.
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PMID:Anesthetic management of pheochromocytoma in a long term hemodialysed patient. 820 20

This study analyses 25 cases of spermatic cord blockade for scrotal surgery (hydrocele, spermatocele, tumor of epididymis). The spermatic cord was infiltrated, after identification of the pubic tubercle, with a mean total dose of 17 +/- 3 ml of a 2% lidocaine solution not containing adrenaline. The scrotal skin was infiltrated separately at the site of incision. Analgesia was excellent in 22 patients. The duration of analgesia was 82 +/- 33 min. No adverse effects occurred. It is concluded that the blockade of the spermatic cord is a convenient anaesthesia technique for testicular surgery.
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PMID:[Block of spermatic cord in surgery of the testis]. 827 25

Forty-one ovarian cancer patients with less than 2 cm residual disease after systemic cisplatin-based chemotherapy received 4 courses of an ip regimen including cisplatin (75 mg/m2), mitoxantrone (20 mg/m2), and interferon-alpha 2b (30 mil IU/m2). The most important side effects were abdominal pain and fatigue. Overall 15/41 patients (37%) required narcotic analgesia for severe abdominal pain. In 1 case laparotomy was necessary due to bowel obstruction. Grade 3-4 myelotoxicity was observed in 18/41 patients (28 courses). No treatment-related death occurred. Pathological complete response (pCR) was achieved in 23/37 (62%) evaluable patients. Four-year disease-free survival was 50%, and no relapse occurred after 32 months. The estimated 4-year progression-free survival (PFS) and overall survival were 35 and 60%, respectively. Patients who achieved pCR showed significantly better survival than the others (P < 0.000). At multivariate Cox's analysis pCR achievement was the most important predictor of PFS (P < 0.005) and survival (P < 0.02). Age (< or = 60 vs > 60) and CA-125 serum levels at entry (normal vs increased) also showed independent predictive value. On the basis of multivariate analysis results we created a risk model for survival and PFS based on age and CA-125 at entry. We identified three subgroups of patients with significantly different outcomes. With this new ip combination long-term disease-free survival is achieved in a significant part of ovarian cancer patients with small tumor burden. A longer follow-up is needed to see whether it can cure some of these patients, and further comparisons with other ip or systemic regimens are needed to draw definitive conclusions about its role in these patients.
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PMID:Intraperitoneal (ip) cisplatin-mitoxantrone-interferon-alpha 2b in ovarian cancer patients with minimal residual disease. 834 66


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