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)

Selective intraarterial infusion of the ethylcellulose microcapsules of mitomycin C (MMC-mc) exerts its potential therapeutic effects through both infarction and prolonged local, drug activity, i.e., chemoembolization. Twenty patients with intractable primary, recurrent or metastatic carcinoma were treated with single or fractionated infusion of MMC-mc via percutaneous arterial catheterization. The target sites were the kidney, liver, prostate, urinary bladder, uterus, sigmoid colon, Douglas' pouch and bone. Fourteen patients had over 30% reduction in measurable maximum tumor diameter, 5 had 10 to 30% reduction and 1 showed less than 10% reduction, but concurrent 2 bone lesions had no reduction. Improvement of symptoms and signs such as pain, massive hemorrhage, dysuria, anorexia and hydronephrosis was observed at an early stage of the treatment in all patients. Eight patients with highly invasive carcinoma of the kidney, urinary bladder and cervix were initially treated with MMC-mc followed by successful radical operation. Systemic toxicity was mild and all patients tolerated the treatment. Although the follow-up periods are less than 21 months, 12 patients are alive with or without tumor and 11 of them are doing well. The present results indicate that chemoembolization with MMC-mc is effective as a preoperative or palliative measure in the treatment of invasive carcinoma of various organs.
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PMID:Arterial chemoembolization with mitomycin C microcapsules in the treatment of primary or secondary carcinoma of the kidney, liver, bone and intrapelvic organs. 616 62

A total of 4 patients with persistent outflow obstruction after pyeloplasty for hydronephrosis was reoperated with renal autotransplantation and pyelocystostomy. All 4 patients had undergone an unsuccessful Anderson-Hynes pyeloplasty and 2 also had had a second operation. All patients had relief of pain, normalization of urine outflow and improved renal function during an observation of 27 to 37 months. Occasional asymptomatic bacteriuria occurred in 2 patients. Thus, renal autotransplantation and pyelocystostomy may be considered a useful and safe method to eliminate persistent outflow obstruction after unsuccessful pyeloplasty.
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PMID:Autologous renal transplantation and pyelocystostomy after unsuccessful pyeloplasty. 634 5

Out of 350 cases of hydronephrosis due to malformation of the ureteropelvic junction, seventeen were acute. Two of these cases, localized in a single kidney, induced anuria in one case, and rupture of the kidney in the other (a baby aged 17 days). The fifteen other cases were revealed by an extremely painful symptomatology, which might have led to severe diagnostic errors. The diagnosis relies on IVU during the period of pain, visualizing a kidney which is barely functioning, if at all. An aberrant vessel was found on the lower pole in 75 per cent of cases, but this, like infection, is only an aggravating factor, though infection may necessitate temporary diversion by cutaneous nephrostomy. All fifteen patients were treated by ureteropelvic resection, and the results were always better than for chronic hydronephrosis because the calicopelvic dilatation is reversible in acute hydronephrosis, and the renal parenchyma still function correctly.
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PMID:[Acute hydronephrosis in children]. 652 36

In 11 patients who underwent Anderson-Hynes pyeloplasty for unilateral hydronephrosis, renal function was examined with split-clearance technique immediately after the operation and 2-5 years postoperatively. The studies shortly after pyeloplasty showed decreased glomerular filtration rate (GFR) and renal plasma flow (RPF) in most of the hydronephrotic kidneys. GFR improved slightly during the follow-up period, but RPF did not increase. The tubular dysfunction, expressed as moderately increased fractional excretion of electrolytes, showed significant improvement only as regards magnesium. The study indicates that reconstructive surgery is not warranted if the aim is to improve renal function in an asymptomatic patient with normal total GFR. On the other hand, patients with pain caused by the renal obstruction should always be subjected to surgery.
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PMID:Renal function in idiopathic hydronephrosis. 661 35

It is suggested that lower polar renal vessels are a common cause of idiopathic hydronephrosis and that the Hellstrom operation, combined with pelviureteric lysis, is an effective and simple treatment of such cases. The operation is described and a prospective study of 15 cases so treated is outlined. The results were studied by clinical, radiological and renographic criteria and showed that deconvolution renography is a less valuable means than the relief of pain and improvement in appearance of the IVU and diuretic urograms in assessing results. The operation is minor and cannot make things worse and there is no possibility of urine leakage or late stenosis.
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PMID:The Hellstrom operation for hydronephrosis. 683 84

Thirty-four patients who received radiation therapy for carcinoma of the cervix developed hydronephrosis. Twelve of 34 (35%) had no evidence of pelvic malignancy, and the obstruction was caused by periureteral fibrosis. The incidence of obstructive uropathy due to periureteral fibrosis not associated with recurrent tumor increased when the obstructing lesion was unilateral, the clinical staging of the cervical carcinoma prior to therapy was Stage IB or Stage II rather than Stage III or Stage IV, and the obstructing lesion appeared 2 or more years after the completion of radiation therapy. The appearance of hydronephrosis in association with ipsilateral leg edema, and sciatic pain these patients strongly suggest a recurrent tumor. The diagnosis of periureteral fibrosis should be considered in all patients who develop obstruction of the urinary tract after radiation therapy for carcinoma of the cervix. Laparotomy is indicated if all other methods of investigation fail to confirm the presence of a malignant lesion.
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PMID:Postradiation ureteral obstruction: a reappraisal. 746 96

So far, laparoscopic approaches to kidney and adrenal have been limited because of their retroperitoneal location. We here report eight renal and adrenal endoscopic procedures performed in seven patients: two adrenalectomies for hyperaldosteronism, one adrenalectomy for isolated metastasis from an adenocarcinoma of the lung; two nephrectomies for end-stage infected hydronephrosis, two partial nephrectomies for small circumscribed lesions of the kidney, and one endoscopic resection for pain relief of a voluminous cyst at the kidney. The approach was transperitoneal in two cases and retroperitoneal in five cases using the retropneumoperitoneum insufflation technique. One patient was operated by a combined approach using the retro- and transperitoneal routes. All procedures were successfully completed endoscopically. The retroperitoneoscopic approach of the kidney is safe and does not interfere with the peritoneal organs. Its working space is tenuous, but allows a direct access on the kidney with good exposure of its pedicle. For adrenal surgery, the retroperitoneoscopic dissection is more difficult, because movements of instruments are often impaired by the closeness of the costal margin and the iliac crest. However, in case of difficulties we found it very convenient to switch from a retroperitoneal endoscopic approach to a combined coelioscopic and retroperitoneoscopic operation. Far from excluding each other, both approaches are complementary, particularly for difficult situations (i.e., previous peritoneal or retroperitoneal surgery).
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PMID:From laparoscopic training on an animal model to retroperitoneoscopic or coelioscopic adrenal and renal surgery in human. 748 67

ESWL of urinary stones is a well-established treatment in adult patients. The treatment of urinary stones in children has gained increasing importance in recent years. From 1987 to 1993, a series of 27 children with urolithiasis in all parts of the urinary tract were treated by ESWL. Treatment was performed with general anaesthesia or analgosedation. During the treatment no complications occurred. On average, 34 sessions of ESWL, with 2165 shockwaves and 22.3 kV energy, were performed. Minor early complications, such as fever, pain and hydronephrosis, were observed in 7 patients. The overall stone clearance rate was 92%. Stone recurrence occurred in only 1 patient. There were no late complications, such as malfunction of the kidney, skeletal deformation or hypertension after 38 months of follow up. In conclusion, ESWL is the treatment of first choice in paediatric urolithiasis.
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PMID:[Extracorporeal shockwave lithotripsy in children. Complications and long-term results]. 767 42

We performed laparoscopic dismembered pyeloplasty in a boy with right ureteropelvic junction obstruction using 4 cannula sites, and a dismembering and reanastomosis technique identical to that used in open pyeloplasty. Interrupted sutures were placed and tied intracorporeally. A nephrostomy tube was placed under direct vision for drainage but no ureteral stent was used. Total operating time was 5 hours. The patient was discharged home 36 hours after the procedure. The nephrostomy tube was removed 10 days postoperatively after radiographic demonstration of patency and 24 hours of clamping without pain. Followup excretory urography at 6 weeks showed much less hydronephrosis and a widely patent anastomosis. Our case illustrates the technical features and feasibility of laparoscopic pyeloplasty in children, and should encourage further development of pediatric urological reconstructive laparoscopic techniques.
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PMID:Pediatric laparoscopic dismembered pyeloplasty. 775 71

To evaluate the role of laparoscopic nephrectomy in the management of benign renal diseases, 12 patients undergoing laparoscopic nephrectomy were compared to 13 undergoing a classical flank nephrectomy. Both groups were similar in regard to patient age and indications for surgery. The underlying pathological conditions included vesicoureteral reflux, tuberculosis, hydronephrosis, hypertension and failed pyeloplasty. Overall, operative time ranged from 105 to 360 minutes (mean 145) for the laparoscopic group and 60 to 240 minutes (mean 156.6) for the open surgery group. Hospital stay and interval to return to regular preoperative activities were 2 to 6 days (mean 3.5) and 10 to 21 days (mean 16) for patients undergoing laparoscopic nephrectomy, which was significantly shorter than for those undergoing a flank procedure, 3 to 16 days (mean 8) and 35 to 84 days (mean 32.3), respectively. Pain medication requirements were also markedly decreased after laparoscopic nephrectomy. Of the patients in the laparoscopic group 2 experienced complications with only 1 requiring conversion to open nephrectomy. The laparoscopic technique is an effective as the flank approach for benign renal conditions, while providing a more rapid recuperation and superior cosmetic result.
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PMID:Comparison between standard flank versus laparoscopic nephrectomy for benign renal disease. 786 91


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