Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of primary mucinous adenocarcinoma of the renal pelvis is reported. A 55-year-old man visited our clinic with lumbar pain. He had a history of left renal stone and had left partial nephrectomy four years previously. Physical examination revealed a hard, child-head-sized, unmovable and uneven tumor in the left side of the abdomen. Intravenous pyelography revealed the non-functioning left kidney with calcification, in which hydronephrosis was detected by computed tomography. In transabdominal sonography a huge mass with mixed echo pattern was observed. Aspiration biopsy under interventional ultrasound was performed, aspirating yellow-white semi-transparent mucinous substance, which was highly suspicious of malignancy by cytology. He died 74 days after the first admission. Autopsy revealed primary mucinous adenocarcinoma of the renal pelvis. This was thought to be the 14th case of primary mucinous adenocarcinoma of the renal pelvis reported in the Japanese literature.
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PMID:[The primary mucinous adenocarcinoma of renal pelvis: a case report]. 283 18

Twenty-one patients with inoperable colon cancer in the pelvis were treated with intra-arterial 5-fluorouracil (5-FU) and mitomycin C, given bilaterally into the internal iliac arteries. Seventeen of the 21 patients had failed previous radiation therapy and 15 had also failed systemic intravenous chemotherapy. Eighteen of the 21 patients received intra-arterial treatments because of pelvic pain. Effect of this treatment on the pain could be evaluated in 16 patients. A measurable decrease in pain medication occurred in 8 of 16, whereas a subjective feeling of pain relief was observed in 12 of 16 patients for a mean period of 3.5 months. However, objective tumor response was considered definite only if associated with a greater than 50% decline of an elevated plasma carcinoembryonic antigen level; this was observed in 5 of 11 patients (45%). Reduction in tumor mass as measured by imaging techniques was observed in two of ten patients in whom it was evaluable. Improvement in hydronephrosis was observed in five of seven evaluable patients. Hematuria was present in 12 patients and improved in 10 of those patients. The most significant side effect of chemotherapy was perineal and gluteal skin erythema, which was observed in 36% of the patients after the first course and in 24% during the second course. This frequently escalated to cutaneous vesiculation and desquamation. This side effect was prevented by concurrent administration of steroids. Pelvic arterial infusion of 5-FU and mitomycin C can offer temporary pain relief to patients who have failed other means of therapy. Objective antitumor effects may have also resulted but were much harder to assess in this group of patients.
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PMID:Palliation of pelvic recurrence of colorectal cancer with intra-arterial 5-fluorouracil and mitomycin. 299 49

A 45-year-old man was admitted to hospital on November 26, 1985 with the chief complaint of left hypochondrial pain. Excretory and retrograde pyelography revealed left hydronephrosis due to extrinsic obstruction of ureter. Computerized tomography and angiography revealed that a tumor of the small intestine was the cause of ureteral obstruction. In addition to the presence of a tumor, a fistula in the small intestine was disclosed on the upper gastrointestinal series. During the operation, a large mass which involved several organs was identified without mobility. The sophisticated operation was composed of wide resection of small intestine including the tumor, left hemicolectomy, left nephroureterectomy, splenectomy, partial pancreatectomy, duodeno-ileostomy and transverse sigmoidostomy was done on December 19, 1985. Pathological diagnosis was malignant lymphoma, diffuse small cell type infiltrating ureter, kidney and perirenal connective tissue. Because of poor postoperative course systemic chemotherapy was not performed and he died of disseminated intravascular coagulation on April 2, 1986.
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PMID:[Hydronephrosis presenting as the first sign of malignant lymphoma of the small intestine: report of a case]. 304 77

A case of ureteral obstruction secondary to diverticulitis is described. The patient had a 2-month history of lower left quadrant pain before an operation. As an intravenous pyelogram showed persistent hydronephrosis, an operation was performed. At the operation, a fibrotic mass which encased the left ureter and sigmoid colon was found. Ureterolysis and segmental sigmoidectomy were carried out. The pathological specimen showed two diverticula and subserosal cicatrization.
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PMID:Ureteral obstruction secondary to sigmoid diverticulitis. 323 31

The occurrence of hydronephrosis and hydroureters during pregnancy has been termed physiological, inasmuch as it is seen in more than 80%, most frequently and most pronounced in primigravida. The dilatation develops during the second trimester, and becomes more prominent on the right side, is only seen above the linea terminalis and disappears within a few weeks after birth. The condition is not seen in women whose ureters do not cross the pelvic brim. The extent of the dilatation can be reduced by placing the woman on the side least affected or in the knee-elbow position. After a survey of the literature, the conclusion is reached that today there is every probability that hydronephrosis during pregnancy develops as a result of compression of the ureters between the pregnant uterus and the linea terminalis. It has not been demonstrated that the change in hormonal balance during pregnancy is of importance. The clinical significance of hydronephrosis lies in the association between ureteral obstruction and the high frequency of ascending urinary tract infection during pregnancy and in the understanding of the importance--in the treatment of infection--of improving drainage by means of a change in position. Isotope renographic studies seem to show a possible relationship between bilateral ureteral obstruction and the development of pre-eclampsia. Similarly, it appears that acute hydronephrosis or worsening of an existing hydronephrosis has been somewhat overlooked as a possible cause of uncertain abdominal pain during pregnancy. These conditions should be examined by means of ultrasonography, and an attempt at treatment by a change in position should be made. In cases of continued pain or affected renal function, treatment should consist of the insertion of a ureteral catheter.
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PMID:Hydronephrosis during pregnancy: a literature survey. 328 Mar 55

A 65-year-old woman was seen in September, 1986, because of general malaise and dull pain in the left flank. Physical examination was unremarkable. Murmur was not heard over the abdomen. An excretory urogram showed left hydronephrosis and a retrograde pyelogram showed extrinsic obstruction at the level of the transverse process of the 5th lumbar spine. Computed tomography (CT) showed a mass with irregular calcification in its center. The mass was assumed to be located in the left iliac artery and as it was enhanced homogeneously, iliac aneurysm was suspected. Angiography revealed an aneurysm of the left iliac artery involving common, external and internal iliac arteries. The patient was treated by ligation of aneurysm, aorto-femoral graft bypass and ureterolysis. Histopathological findings showed aneurysm due to atherosclerosis. A postoperative excretory urogram showed improvement of hydronephrosis. Ureteral obstruction due to iliac aneurysm is unusual but it should be considered when performing differential diagnosis of extrinsic ureteral obstruction. CT is a useful diagnostic tool and aortography should be done to make a final diagnosis. Treatment is based on resection or ligation of aneurysm with ureterolysis.
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PMID:[Ureteral obstruction secondary to iliac artery aneurysm]. 338 94

The diagnosis of sarcoidosis was made in a 40-year-old man when, in addition to enlarged mediastinal and hilar lymph nodes (sarcoidosis I), he also had peripheral lymph node enlargement. Pulmonary infiltrations (sarcoidosis II) developed subsequently. Three years after diagnosis pulmonary symptoms first became manifest, at the same time as pain in the kidney region. The urogram revealed hydronephrosis caused by enlarged retroperitoneal lymph nodes (CT scan). After treatment with corticosteroids the urogram was normal.
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PMID:[Hydronephrosis caused by enlarged retroperitoneal lymph nodes in sarcoidosis]. 366 39

An autopsy case of squamous cell carcinoma of the renal pelvis associated with giant hydronephrosis, which is the fourth case in the Japanese literature, is reported. A 37-year-old man, who had been found to have a left abdominal mass was admitted because of dyspnea and lumbar pain. At autopsy the left kidney contained 2,550 ml of turbid yellowish fluid in the pelvis, with a tumor protruding from the cystic wall. Histologically, the tumor was mostly composed of squamous cell carcinoma, which showed keratinization and pearl formation, with focal transitional cell carcinoma and squamous metaplasia. The ureteropelvic junction was slightly obstructed by muscular hypertrophy and fibrosis.
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PMID:[Squamous cell carcinoma of the renal pelvis associated with giant hydronephrosis--report of an autopsy case]. 379 8

The recent published literature dealing with urinary tract calculi during pregnancy has been summarized. Our own experience with 17 patients, (0.08% of the deliveries) in a recent 12-year interval has been described. Emphasis must be placed on the safety and limitations of renal ultrasonography. Excretory urography should be performed in patients with urinary infection not responding after 48 hours of antibiotic therapy, with declining renal function, with massive hydronephrosis on renal echography, or with pain and dehydration from vomiting. The timing of postinjection films is critical; a 3-hour film and, if needed, a 6-hour film are recommended. Criteria for intervention (nonoperative or operative) include calculous pyelonephritis, persistent massive hydronephrosis with impairment of renal function, and protracted pain or sepsis.
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PMID:Renal calculi in pregnancy. 389 20

The value of ultrasound and 131-Hippuran renography for diagnosing hydronephrosis during pregnancy was investigated. In a control series of 31 symptom-free pregnant women the ultrasonographically measured renal pelvic diameters in the three trimesters were 5, 10 and 12 mm on the right side and 3, 4 and 5 on the left, respectively. In ten healthy non-pregnant women the pelvic diameter varied from 3 to 9 mm on the right side and from 2 to 6 mm on the left side when measured during antidiuresis and water diuresis. Out of 35 pregnant women complaining of flank pain, 31 showed an increased renal pelvic diameter. These 35 women also underwent renography on the same day as the ultrasound examination. In 6 of 27 pregnant women with right-sided pain and in 3 of 8 with left-sided pain, diuresis renography indicated acute ureteral obstruction and in 6 of these 9 patients impairment of renal parenchymal function was also evident. In some cases the impaired renal function was fully reversed after surgical intervention. It is concluded that ultrasound investigation of the kidney is a valuable method for screening prior to renography. Since the negative prediction value of using 17 mm as the upper limit of the pelvic diameter was 100%, patients with a smaller pelvic diameter may not need to be referred further for renography or urography, and radiation will thus be minimized. On the other hand, renography is indicated when the pelvic diameter is more than 17 mm in patients complaining of flank pain.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Evaluation of hydronephrosis in pregnancy using ultrasound and renography. 391 76


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