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

Some unfortunate patients suffer disorders which in one way or another, usually neurologically, severely restrict the larynx in its role as a protector of the lower airway. Aspiration ensues, and unless it can be successfully managed, repeated episodes of a violent pneumonitis may lead to terminal chest problems. In some patients, even the cuffed tracheostomy tubes of new and improved design do not adequately prevent aspiration over an extended time intervel, as evidenced by repeated bouts of aspiration pneumonia despite these cuffed tubes and despite optimal intensive care. For these patients with intractable aspiration, and in whom recovery is expected only after a prolonged period of time, we have suggested a diverting procedure which employs a tracheo-esophageal anastomosis, as an effective yet reversible solution. Such an anastomosis with concomitant tracheostomy allows aspiration of saliva and even food to occur through the malfunctioning larynx but diverts it back into the esophagus through the tracheo-esophageal anastomosis. In normal mongrel dogs we demonstrated that an end-to-side tracheo-esophageal anastomosis is well tolerated and can be performed without damage to the intrinsic larynx or recurrent laryngeal nerves. The tracheo-esophageal lumen remained patent and the anastomosis intact for as long as these animals were observed prior to reconstruction. The reversibility of the tracheo-esophageal anastomosis was demonstrated in these dogs by excising the anastomosis, repairing the esophageal defect, and restoring the continuity of the trachea by end-to-end anastomosis. Vocal cord motion remained intact, the dogs ate normally, and barked once again. A tracheo-esophageal anastomosis was performed in a 60-year-old white female who had suffered lower cranial nerve damage as a result of a large acoustic tumor and the excision thereof. Despite every effort to control aspiration, pneumonitis occurred and became fulminant. The diverting tracheo-esophageal anastomosis was performed with relative ease and was well tolerated by the patient. Aspiration was totally and dependably controlled, and no further chest complications occurred. Her nasogastric feeding tube was removed, and she ate a regular diet with very little difficulty. She gained in strength, became much more alert mentally, and is now taking care of herself in a nursing home. We are following her progress by indirect laryngoscopy and barium swallow examinations and at five months post anastomosis, we are possibly seeing the first signs of lower cranial nerve recovery. We hope that reconstruction and restoration of function will soon be possible.
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PMID:Diverting the paralyzed larynx: a reversible procedure for intractable aspiration. 111 93

Lesions of the ileocecal valve are uncommon and include various inflammatory diseases, submucosal fatty infiltration, edema, and neoplasia. Of the neoplastic lesions, adenomatous polyps are distinctly rare, despite their frequency in the remainder of the colon. Three patients with adenomatous polyps of the ileocecal valve are added to the seven previously reported cases. One had a large pedunculated polyp, another had polyps resulting from familial polyposis, and the third had circumferential adenomatous polypoid hyperplasia and the ileocecal-valve syndrome. Although many lesions of the valve produce the characteristic symptoms, the diagnosis of the ileocecal-valve syndrome is seldom made. Most ileocecal-valve lesions are incidental findings on barium-enema studies and may be carefully followed. The indications for operative intervention are suspicion of malignancy and the presence of troublesome symptoms. If malignancy is likely, a right colectomy should be done. Segmental resection is the procedure of choice for the ileocecal-valve syndrome. Adenomatous polyps may require simple polypectomy, segmental resection, or even subtotal colectomy. Following recognition of these unusual disorders the exact management is individualized.
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PMID:Adenomatous polyps of the ileocecal valve: report of three cases. 112 56

Vesico-intestinal fistulae were observed in 14 patients within a period of 10 years (vesico-colonic: ten; vesico-rectal: two; vesico-ileal and vesico-rectal-ileal: one each). The causes were diverticulitis in five, carcinoma of the sigmoid in two, radiation damage after prostatic or cervical carcinoma in two, and Crohn's disease, abscess of Douglas's pouch after perforated appendicitis, ileal carcinoma, sarcoma of the pelvis, and ovarian carcinoma, one each. Pneumaturia, faecaluria and dysuria were the most frequent symptoms, treatment-resistant cystitis was present in three. Cystoscopy, intravenous pyelogram, retrograde cystogram, barium meal, barium swallow with follow-through, and rectosigmoidoscopy proved to be the best methods of diagnosis. Four patients had multiple operations, three one operation, with a cure in all. In the neoplastic fistulae the underlying carcinoma could not be radically operated on: colostomy or colostomy with palliative resection was performed. In four of these the fistulae then closed, once it remained open. One woman with a vesicorectal fistula due to ovarian carcinoma died of tumor cachexia 16 days after a colostomy had been made.
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PMID:[Vesico-intestinal fistulae]. 114 97

Double pyloric canal produces a recognizable roentgen pattern. A split barium column at the pyloric canal results in an interposed pseudo-defect which must not be confused with tumor mass. The condition is usually caused by a tunnel ulcer extending from the distal stomach to the duodenal bulb and is probably more common than the small number of reported cases would suggest.
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PMID:Tunnel ulcer with double pyloric canal. 115 32

Cancer of the large bowel is an important cause of morbidity and mortality. The barium enema is still the most reliable diagnostic tool, but the selection of the proper candidates for this moderately expensive and time-consuming examination presents a real problem. To wait for significant symptoms of change in bowel habits, such as unexplained anaemia, is hazardous. Testing for occult blood has fallen into disuse in most general practices. This paper discusses some of the available techniques for this procedure which I suggest offer a worthwhile aid to examination of patients with possible alimentary neoplasm.
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PMID:Tests for occult blood. 118 25

A 1011/12-year-old boy with chronic ileocolic intussusception associated with ileocecal lymphosarcoma was decribed. The patient had abdominal pain of 3 months' duration, vomiting, and a firm mass with smooth surface in the right lower abdomen. Barium enema showed intussusception at the distal part of the ascending colon, which was irreducible by hydrostatic pressure. Barium by mouth revealed markedly distended small intestines, which were displaced to the left abdomen. The tumor was inoperable, and the boy died.
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PMID:Chronic intussusception associated with ileocecal lymphosarcoma. 124 86

To further define and determine the usefulness of CEA, 1100 CEA determinations have been made over the past two years at The Ohio State University Hospitals on patients with a variety of malignant and nonmalignant conditions. Correlation of CEA titers with history and clinical course has yielded interesting results not only in cancers of entodermally derived tissues, for which CEA has become an established adjunct in management, but also in certain other neoplasms and inflammatory states. The current total of 225 preoperative CEA determinations in colorectal carcinomas shows an 81% incidence of elevation, with postoperative titers remaining elevated in patients having only palliative surgery but falling to the negative zone after curative procedures. An excellent correlation exists between CEA levels and grade of tumor (more poorly differentiated tumors showing lower titers). Left-side colon lesions show significantly higher titers than right-side lesions. CEA values have been shown to be elevated in 90% of pancreatic carcinomas studied, in 60% of metastatic breast cancers, and in 35% of other tumors (ovary, head and neck, bladder, kidney, and prostate cancers). CEA levels in 35 ulcerative colitis patients show elevation during exacerbations (51%). During remissions titers fall toward normal, although in 31% still remaining greater than 2.5 ng/ml. In the six colectomies performed, CEA levels all fell into the negative zone postoperatively. Forty percent of adenomatous polyps showed elevated CEA titers (range 2.5-10.0) that dropped following polypectomy to the negative zone. Preoperative and postoperative CEA determinations are important in assessing the effectiveness of surgery. Serial CEA determinations are important in the follow-up period and in evaluation of the other modes of therapy (e.g., chemotherapy). These determinations of tumor antigenicity give the physician added prognostic insight into the behavior of the tumor growth. Rectal examination with guaiac determinations, sigmoidoscopy, cytology, barium enema, and a good clinical evaluation remain the primary tools for detecting colorectal disease. However, in the high-risk patient suspicious of developing cancer, CEA determinations as well as colonoscopy are now being used increasingly and provide additional highly valuable tools in the physician's armamentarium.
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PMID:Carcinoembryonic antigen: clinical and historical aspects. 124 68

X-rays of the pancreatic duct can now be obtained by a nonoperative endoscopic approach (endoscopic retrograde cholangiopancreatography-ERCP). After more than 2 years experience we have found that the pancreatic duct can be visualized in 85 to 90% of patients. This test is used to detect pancreatic carcinoma in the symptomatic patient and in searching for an operative pancreatic lesion in a patient with known recurrent or chronic pancreatitis. Many of these patients have pain or a transiently elevated amylase; a few have steatorrhea or abnormalities of the duodenal sweep on barium meal. Stenosis or obstruction of the main pancreatic duct with or without proximal duct dilation are the characteristic abnormalities noted in pancreatic carcinoma. A rare pancreatic tumor which is not in juxtaposition with the duct will have a normal pancreatogram although the common duct may be obstructed by cholangiography as it passes through the head of the pancreas. In patients with chronic pancreatitis it may be difficult to differentiate an inflammatory from a neoplastic stricture by either operative or endoscopic pancreatography. In the future, cytologic and biochemical examination of the pancreatic secretions obtained at ERCP may increase the accuracy of diagnosing carcinoma.
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PMID:Operative and endoscopic pancreatography in the diagnosis of pancreatic cancer. 124 76

Study was made of a kindred with a strong history of carcinoma of the colon. Twenty-three family members were screened for the tumor with carcinoembryonic antigen (CEA) assay, barium enema, and proctoscopy; one occult colon cancer was diagnosed. Identification and surveillance of families at high colon cancer was diagnosed. Identification and surveillance of families at high risk of cancer can provide unusual opportunities for early tumor detection.
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PMID:Familial colon cancer. 125 19

Carcinoma of the cardia of the stomach in patients with sliding hiatal hernia is a disease of poor prognosis, since symptoms nearly always occur late in its course at an already incurable stage. Eleven cases are reviewed from the records of The New York Hospital-Cornell Medical Center from 1932 to 1975. Resectability of tumor appeared related to shorter interval between onset of symptoms and diagnosis. Barium studies combined with esophagoscopy led to correct preoperative diagnosis of malignancy in all cases.
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PMID:Carcinoma of the gastric cardia and hiatal hernia. 126 41


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