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)

Rhizoxin is a tubulin-binding cytotoxic compound, isolated from the fungus Rhizopus chinensis, with significant antineoplastic activity in several murine and human tumor models. In this Phase I study, the drug was administered by i.v. bolus injection at 3-wk intervals. Twenty-four patients with refractory solid tumors were treated; 60 courses of rhizoxin were given, at doses ranging from 0.8 to 2.6 mg/m2. Grade 3 mucositis, Grade 4 leukopenia, and Grade 3 diarrhea were dose limiting but reversible at 2.6 mg/m2, the maximum tolerated dose for both previously untreated and heavily pretreated patients. Alopecia and moderate discomfort at the injection site occurred at all doses. Other sequelae, including peripheral neuropathy, phlebitis, and nausea and vomiting, were sporadic and mild. Two heavily pretreated patients with recurrent breast cancer had minor responses to rhizoxin, one at 1.6 mg/m2 and the other at 2.6 mg/m2. Plasma concentrations of rhizoxin were measured by high-performance liquid chromatography. The drug was not detectable (less than 5 ng/ml) at doses of 0.8 mg/m2 and 1.6 mg/m2 and was not measurable 10 min after injection at 2.0 mg/m2. At 2.6 mg/m2, there was considerable intersubject variation in the plasma concentration-time profiles; the area under the curve ranged from 0.29 to 0.96 microgram/ml.min. Rhizoxin has shown some clinical activity in this Phase I study, and a dose of 2.0 mg/m2 is recommended for Phase II studies using this schedule.
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PMID:Phase I and pharmacokinetic study of rhizoxin. 158 5

Cavernous hemangiomas are the most common benign tumors of the liver. Twenty-four patients who had hepatic resections for giant symptomatic hepatic hemangiomas during a six year period at a single institute were retrospectively reviewed to analyze indications for surgical treatment and evaluate operative mortality and morbidity. There were 18 women and six men varying in age from 41 to 69 years with an average age of 52.5 years. Moderate to severe pain, discomfort, feeling of fullness, bloating and sensation of an abdominal mass were the most commonly reported symptoms. Ten patients had moderate anemia and two had severe anemia. Tumors were visualized by ultrasonography in all patients and by computed tomography in 18. Angiography was performed in all patients with diagnostic confirmation of a benign hemangioma in all but one patient in whom an angiosarcoma was suspected. The resection was feasible in each patient: 20 minor hepatic resections (three wedge, 11 segmentectomies, six bisegmentectomies) and four right hepatic lobectomies were carried out. There were no surgical deaths. Two patients had postoperative complications: one patient had a pneumonia on the right side and one had wound infection. The benign nature of the tumors was confirmed in all. The lesions varied in size from 5.6 to 26 centimeters in diameter. Symptoms and hematologic disorders were relieved in all patients in the follow-up. The results of our experience confirm that resection for giant symptomatic hepatic hemangioma represents a safe radical curative procedure. Medical treatment is justified in smaller lesions or in asymptomatic patients.
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PMID:Surgical treatment of symptomatic giant hemangiomas of the liver. 159 24

Sarcomas which develop after radiotherapy mainly involve the soft tissue and the bone. Postirradiation angiosarcomas involving the internal organs are exceedingly rare and so far only three cases have been reported. Here, a case of angiosarcoma of the terminal ileum in a 48-year-old female is reported. The tumor developed 39 months after radiotherapy for recurrent squamous cell carcinoma of the uterine cervix. Angiosarcoma recurred locally and metastasized to the liver eight months after initial resection of the primary lesion of the terminal ileum. The patient died from sepsis 23 days after the resection of the recurrent ileal and metastatic hepatic neoplasms. Hence, any patients complaining of new discomfort that occurs in an irradiated field two years or more after radiotherapy should be promptly searched for the presence of the postirradiation neoplasms.
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PMID:Postirradiation angiosarcoma of the terminal ileum. 165 87

The Wallstent biliary endoprosthesis is a mesh of stainless steel that is delivered percutaneously over a 7-French catheter but expands to achieve a 1-cm lumen when released across a bile-duct stricture. The small transhepatic track required makes insertion easier, less painful, and probably safer when compared with plastic stents, and the large internal lumen reduces the rate of occlusion by encrusted bile. Wallstent endoprostheses were inserted under local anesthesia in 41 consecutive patients with malignant obstructive jaundice. Biliary drainage was considered the treatment of choice in all of these patients. The diagnosis was based on biopsy results in 32 patients and on radiologic appearances in nine. The patients were followed up in outpatient clinics for 16 months and had repeated radiologic examinations only if they had symptoms suggesting stent occlusion. No cases of hemobilia due to damaged hepatic vessels occurred. Two patients had septicemia treated with antibiotics. Three patients had recurrent jaundice due to growth of tumor below or above the stents. Endoprosthesis migration was not seen. No cases of stent occlusion due to encrustation of bile occurred. The median survival of patients was 105 days (range, 10-545 days). Our experience shows that Wallstent endoprostheses can be inserted with little discomfort for the patient and with relatively few complications. They provide good palliation in patients with malignant obstructive jaundice.
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PMID:Self-expandable stainless steel endoprostheses for treatment of malignant bile duct obstruction. 170 74

A 58-year-old man was seen with obstructive jaundice and discomfort in the upper abdomen. Computed tomographic and ultrasound examinations revealed a soft-tissue mass in the gallbladder. Cholecystectomy and choledochotomy revealed a soft black mass in the gallbladder and a second one in the intrapancreatic portion of the common bile duct. Each was diagnosed as malignant melanoma. Subsequently, a Whipple resection of the pancreas, duodenum, and distal bile duct revealed a melanoma circumferentially invading and obstructing the distal common duct. No lymph node or distant metastasis was identified. Repetitive searches for another primary site have been negative. The tumor apparently originated in the biliary tract. The patient remains almost well 2 years after diagnosis.
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PMID:Malignant melanoma of the biliary tract: a case report. 170 27

Malignant esophageal obstruction in patients with advanced and metastatic carcinoma is unsuitable for surgery. Palliative treatment must provide adequate swallowing with minimum complications in these often seriously ill patients. Twenty consecutive patients underwent endoscopic Nd:YAG contact laser resection and vaporization (ECLRV) and esophageal dilatation (ED) for advanced esophageal carcinoma since August, 1985. Average duration of the disease when first referred was 7.2 months. Tumor cell type was either squamous cell carcinoma (n = 11) or adenocarcinoma (n = 9). Tumor location was distal (n = 14), middle (n = 5), or upper (n = 2). Mean tumor length was 7.5 cm. Mean preoperative luminal diameter was 1 mm, with total obstruction in ten (50%) patients. The operative procedure in all patients was under general anesthesia with endotracheal tube intubation. Rigid and flexible endoscopes were both used as indicated. Mean postoperative luminal diameter was 15 mm. All but four were able to swallow fluids on the first postoperative day, followed by semisolids the next day without discomfort. Minor perforation was noted in three cases and managed in two conservatively. One more patient had difficulty in swallowing due to extra-esophageal compression, in spite of a technically successful laser therapy. Percutaneous endoscopic gastrostomy (PEG) was carried out in eight cases. Eleven patients were retreated successfully for recurrent obstruction and two were treated more than twice, at a mean of six-week intervals. Endoscopic contact laser resectional vaporization with esophageal dilatation was relatively safe and provided an improved quality of life in this preliminary study group, providing a mean survival of 18.5 weeks (range 2-50 weeks).
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PMID:Endoscopic contact Nd:YAG laser resectional vaporization (ECLRV) and esophageal dilatation (ED) in advanced malignant obstruction of the esophagus. 171 2

The anatomy of the pelvis makes it difficult to perform local excisions in the rectum when the tumor is some distance from the anal verge. We have, therefore, developed a new minimally invasive technique for tumor resection. A rectoscope with a 40-mm diameter permits tumor resection under stereoscopic control in the gas-dilated rectal cavity. Excisions in full-thickness technique up to segmental resections with end-to-end anastomosis can be performed. In selected cases, local excision of a small rectal cancer can be regarded as appropriate treatment. However, most local resections of carcinomas are performed when removal of an adenoma is planned, and the postoperative histology shows a carcinoma. Since 1983, we have operated on 326 patients, 274 who have been enrolled in a prospective clinical trial. Definitive histologic examination proved that 74 of these tumors were carcinomas. The rate of severe complications in patients with carcinomas was 9%, and the mortality rate was 0%. The advantages of this new technique are: The stereoscopic magnified view in the gas-dilated rectum allows precise surgery in an operative field that is otherwise difficult to reach. During the postoperative period, minimal discomfort and pain result in a short hospitalization.
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PMID:Technique and results of transanal endoscopic microsurgery in early rectal cancer. 173 75

The psychometric characteristics of two indexes used to evaluate the subjective morbidity of chemotherapy regimens were analyzed. Both indexes assessed the duration of discomfort as perceived by the patient throughout therapy. The first index asked patients to state the number of days spent with 'discomfort', and the second index asked them which days they would like to eliminate altogether because of the unbearable symptoms experienced on those days. While the first index gives some idea of the duration of suffering, without defining it, the second highlights a specific time when the quality of her life was unacceptable to the patient. We studied these indexes in the form of a questionnaire completed by 168 women who had entered a cancer clinical trial. This trial evaluated the efficacy of primary chemotherapy in rendering conservative surgery feasible in women with operable breast cancer, but whose tumor size was greater than 3 cm. Four different treatment regimens were used: CMF, FAC, FEC, FNC (C = cyclophosphamide, M = methotrexate, F = fluorouracil, A = adriamycin, E = epirubicin, N = mitoxantrone). Seventy-nine patients were interviewed during chemotherapy and 89 during follow-up visits. Initial assessment of the reliability, discriminant and concurrent validity of the two indexes produced satisfactory results. Finally, we analyzed the responses given by 168 patients for a total of 600 treatment cycles. The average value of 'discomfort' was 3 days, whereas the average value of days 'to be eliminated' was 1. The range of subjective morbidity (for every cycle of treatment: 'discomfort = 0-30 days; 'to be eliminated' = 0-20 days) was very broad.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Two simple indexes used to evaluate the impact of therapy on the quality of life of patients receiving primary chemotherapy for operable breast cancer. 176 28

Primary tumor of the diaphragm is very rare. Furthermore, to our knowledge, no cases of multiple neurilemmoma of the diaphragm have appeared in the literature. A 61-year-old female was admitted to our hospital because of epigastric discomfort. Roentgenologic examination of the chest showed a tumor in the left leaf of the diaphragm. Laparotomy revealed two tumors, one measuring about 5 cm in diameter, and the other about 1 cm in diameter arising from the diaphragm. There was no adhesion to adjacent organs. The two tumors were resected with a part of the left diaphragm. Histological examination revealed benign neurilemmoma of the diaphragm. There has been follow-up on the patient for two and a half years without evidence of recurrence.
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PMID:[Primary multiple neurilemmoma of the diaphragm]. 177 83

In a retrospective study from 1978 to 1990, 143 patients had elective surgery for colonic diverticular disease. Surgical indications were: uncomplicated diverticulitis (128), functional discomfort (6), suspicion of associated neoplasia (6), bleeding (3). The overall mortality is 1/143 (0.6 p. cent). 3 patients (2.2 p. cent) had to be reoperated for anastomotic fistula with peritonitis. Definitive re-establishment of digestive continuity was done in 139 patients (98.6 p. cent). Our results suggest that surgery is to be widely indicated for diverticular disease. Resection must be performed in every patients presenting with an history of two or more acute recurrences, with a fistula, and when clinical and/or radiological abnormalities continue after a first acute crisis.
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PMID:[Elective surgical treatment of colonic diverticulosis]. 185 71


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