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)

Simultaneous radiohyperthermotherapy (SRH) is a combined hyperthermia-radiation therapy in which irradiation is given during heating. Mutual interference between the high energy radiotherapy system (Toshiba LMR-15A) and the 13.56 MHz capacitive heating system (Omron HEH-500C) was tested with phantom materials prior to a clinical trial with SRH. The energy and flatness of irradiation were not affected by the heating system within the range of clinical use. The high energy radiotherapy system did not affect the increase or distribution of temperature during simultaneous treatment. The results of this phantom study indicated that these apparatuses would not produce clinically significant mutual interference during SRH. A clinical trial was performed on a 57-year-old woman with postoperative recurrence of rectal cancer. This is the first reported clinical case treated with true SRH in which external irradiation was administered during mid capacitive heating. Twelve SRH treatments were performed on the recurrent lesion at a frequency of twice a week for six weeks using the apparatuses described above. There was a significant reduction in pain after treatment. The tumor marker carcinoembryonic antigen (CEA) level decreased after treatment. On CT images taken after treatment, the tumor site became a low density area which indicated necrosis. There were no side effects. These results suggest that further clinical study of SRH should be performed to clarify its advantages.
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PMID:Report of a study using phantom materials, and clinical experience with simultaneous radio-hyperthermotherapy. 148 36

Main clinical symptoms and signs in diffuse malignant pleura mesotheliomas are thoracic pain (58%) and gradually increasing dyspnoea (50%). Pleural effusion is the most frequent x-ray manifestation (80%), but it is haemorrhagic in only 50% of the cases. Cytology has a sensitivity of approx. 50%; with the epithelial type it yields definitely better results (76%) than with the biphasic (49%) or fibrous (25%) types. The carcinoembryonic antigen level is usually low in the effusion, but enhanced values do not exclude a diffuse malignant pleura mesothelioma. For differentiation against metastasised adenocarcinomas, which is often difficult, it is recommended to effect histological examination of the tumour tissue obtained either by pleura punch biopsy (sensitivity 40-50%) or by thoracoscopy (sensitivity 90-95%). In this manner, accurate staging is possible in conjunction with CT. Particularly in case of fibrous growth, it is sometimes only thoracotomy that enables final diagnostic clarification.
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PMID:[Diagnosis of diffuse pleural mesotheliomas]. 187 93

The pharmacology, toxicity, and therapeutic effectiveness of etoposide (VP-16) given by the intrapleural route were examined in a phase I trial. Ten patients with malignant pleural effusion received 100, 150, or 225 mg/m2 VP-16 infused over 2 h into the pleural space after drainage of pleural fluid. The administration of VP-16 was tolerated well, with no local pain, increase in cough, dyspnea, or infection. Myelosuppression was mild at doses of 150 mg/m2 or less but severe at 225 mg/m2. Drug levels were followed in both plasma and pleural fluid for up to 12 h. Clearance of VP-16 from the pleural cavity was low at 2 ml/min m2. Peak pleural-fluid drug levels in patients receiving 225 mg/m2 exceeded 300 micrograms/ml, whereas peak drug concentrations in corresponding plasma samples obtained at the same time amounted to less than 10 micrograms/ml. Serial chest X-rays showed no disappearance of pleural effusion in nine evaluable patients. However, follow-up investigation of pleural fluid characteristics [carcinoembryonic antigen (CEA), lactic dehydrogenase (LDH), and cytologic examination] suggested some evidence of local therapeutic benefit.
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PMID:Intrapleural etoposide for malignant effusion. 218 91

The value of radioiodinated metaiodobenzylguanidine (MIBG) in imaging thyroid medullary carcinoma (MTC) was investigated (18 studies) in 12 patients with proven MTC. Calcitonin (CT), carcinoembryonic antigen (CEA) and tissue polypeptide antigen (TPA) were also determined. The patients were divided into two groups. Group I comprised 7 patients who had relapsed; two of them were also studied before total thyroidectomy. In the 2 cases studied before total thyroidectomy 123/131I-MIBG imaged the primary tumor (partially) and the residual tumor involved lobe. The residual/recurrent tumor present in 4 and some of the remote metastases in 3 out of 5 were detected. Group II includes 5 patients studied postoperatively with no evidence of disease. A residual tumor in one of the 2 patients without evidence of disease on the basis of conventional diagnostic modalities but with elevated tumor markers was visualized; the outcome was correctly negative in 3. One patient underwent treatment with 131I-MIBG. A total dose of 27.1 GBq (733 mCi) was given. Relief of pain and partial regression of the lesions was achieved.
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PMID:The possible use of radioiodinated metaiodobenzylguanidine (MIBG) in medullary thyroid carcinoma. 248 94

This study was performed to ascertain the role of serum markers and simple clinical data in detecting pancreatic cancer and in distinguishing this malignancy from chronic pancreatitis and other gastrointestinal diseases. Serum CA 19-9, tissue polypeptide antigen and carcinoembryonic antigen were measured in 38 control subjects, 37 patients with pancreatic cancer, 39 with chronic pancreatitis and 44 with extra-pancreatic diseases mainly of gastrointestinal origin. Clinical data recorded included age, sex, presence of pancreatic calcifications, weight loss, pain, jaundice, alcohol abuse, diabetes mellitus. Serum markers gave a correct allocation of the subjects in 48.1% of the cases with pancreatic cancer patients correctly predicted in 62.2%. Clinical data correctly diagnosed 74.2% of subjects. Chronic pancreatitis was identified in 84.6% of the cases and pancreatic cancer in 64.9%. The first clinical variables selected were pain and age. The addition of serum markers to clinical data did not enhance accuracy of the results. We conclude that the diagnosis of chronic pancreatic diseases should first be suspected on the basis of accurately recorded simple clinical data; serum markers seem to be only occasionally useful. Since indicative clinical data and serum markers become positive in the advanced phases of pancreatic cancer, early diagnosis of this malignancy still remains an objective to reach.
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PMID:[Role of serum markers and or various clinical parameters in the diagnosis of pancreatic carcinoma]. 248 91

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

During an 18-month period, a prospective study comparing the findings at computed tomography (CT) and magnetic resonance (MR) imaging was conducted on 35 patients who satisfied the following criteria: prior surgery for rectal cancer (11 curative resections, 24 rectal amputations), perineal pain and/or elevated carcinoembryonic antigen (CEA) level, and a soft-tissue mass in the presacral fossa demonstrated at CT. Twenty-two patients had tumor recurrence; 13 patients had only inflammatory changes or radiation fibrosis. At a single examination of each patient (with no reference to prior baseline studies), MR imaging was more accurate than CT, largely because MR imaging was more successful in the distinction of recurrence from fibrosis based on the differences in signal intensity on T2-weighted images.
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PMID:Recurrent rectal cancer: diagnosis with MR imaging versus CT. 339 51

A Phase I study of caracemide evaluating a short intravenous infusion repeated every 21 days is presented. Patients were entered at 85 mg/m2 with subsequent escalation levels of 170, 425, 595, and 795 mg/m2. Mild to moderate nausea and vomiting occurred at all dose levels. An apparent allergic reaction was observed at the 425 mg/m2 level. A "burning pain" originating in the mucosal areas of the head and neck, progressing to the chest and abdomen, was noted at the 425 mg/m2 level. Because of this observation, the infusion time was extended to 4 h. At the 795 mg/m2, this toxicity precluded completion of the 4 h infusion. Pharmacokinetic evaluation disclosed blood levels of 0.74-2.31 microgram/ml at the 425 mg/m2 during the 0.5 h infusion. At the same dose for a 4 h infusion time, blood levels were 0.15-0.18 microgram/ml. At 595 mg/m2 administered as a 4 h infusion, blood levels increased to 0.33 +/- 0.14 microgram/ml. The drug was cleared rapidly from the blood compartment with a half-life of 2.5 min and a total body clearance of 11.51/min/m2. No partial or complete response was observed. However, an advanced colon carcinoma patient experienced subjective pain relief with a decrease in carcinoembryonic antigen. The dose-limiting toxicity of caracemide using the 4 h infusion was an intolerable "burning pain" with a maximum tolerated dose of 795 mg/m2. Further characterization of this dose-limiting toxicity is required prior to further clinical evaluation of caracemide.
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PMID:Phase I study and pharmacokinetics of caracemide (NSC-253272) administered as a short infusion. 343 42

Hyperthermic isolation-perfusion (I-P) was used to treat 27 patients with refractory pelvic cancer. All patients except one achieved pelvic isolation as manifested by selective pelvic heating and by pharmacologic monitoring. Patient response was good, with rapid pain relief in 75% and tumor control as detected by physical examination, computed tomographic scan, and decline in carcinoembryonic antigen levels. Pelvic drug exposure averaged 7.8 times that of systemic drug exposure. Of the 20 patients with recurrent rectal adenocarcinoma, one complete response (duration, eight months), seven partial responses (average duration, greater than or equal to 10 months), four patients with stable disease (average duration, greater than or equal to 12 months), and five with disease progression were observed. Three patients could not be evaluated due to late deaths as a consequence of their disease. There were two postoperative deaths in the remaining seven patients, one due to drug toxicity and one due to probable cardiac arrhythmia. Pelvic I-P has evolved with the avoidance of laparotomy and increased drug dose. We conclude that hyperthermic I-P for pelvic cancer is a safe, effective procedure and an excellent therapeutic option for patients with persistent pelvic cancer.
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PMID:Hyperthermic pelvic isolation-perfusion in the treatment of refractory pelvic cancer. 367 95

Lumbosacral or primary buttock pain and cutaneous anesthesia in the distribution of the posterior femoral cutaneous nerve were the initial symptoms in 5 patients later proven to have extensions of previously resected colorectal malignancy. The initial electromyographic impression of an inferior gluteal nerve mononeuropathy associated with recurrent neoplasia was confirmed by a positive colon biopsy in 1 case and widespread pelvic metastasis demonstrated at laparotomy in the 4 remaining cases. Four of the 5 patients also had increased levels of carcinoembryonic antigen. Roentgenographs and other laboratory data were otherwise normal in all 5 cases. Entrapment of the inferior gluteal nerve and the accompanying posterior femoral cutaneous nerves is facilitated by its medial, intrapelvic fixation at its origin from the sciatic nerve and the crowding effect of the piriformis muscle above, the dorsal rim of the sciatic notch behind and the inferior gluteal vessels and nodes below. The demonstration of hypestesia over the inferior lateral buttock and a concomitant history of colorectal malignancy should alter the examiner to the possible presence of an inferior gluteal nerve neuropathy.
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PMID:Electromyographic evidence of inferior gluteal nerve compromise: an early representation of recurrent colorectal carcinoma. 705 17


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