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)

Because of the increasing survival-time of tumor-patients bone metastasis is becoming an important subject in surgery. In the case of osteolysis of the femur a concept of treatment in consideration of various localisations is presented. In 81 patients with pathological fractures of the femur or osteolysis in this region from January 1987 to June 1992 96 stabilizing operations were performed. Almost one half of the patients suffered from breast carcinoma followed by hypernephroma, Plasmocytoma, bronchial-carcinoma and prostate-carcinoma. The average survival time after stabilization of the femur was 8.3 months. After the operation the condition of the patients improved on an average by 0.64 units of the modificated Karnowsky-Index. Surgical treatment of osteolysis in the femur is indicated either in pathological fractures or if instability is imminent. Moreover patients who suffer from severe pain should also receive palliative surgery. With regard to the site of the lesion various types of endoprostheses and osteosynthesic devices can be used. If the femoral neck or the intertrochanteric region is affected arthroplasty with cemented endoprosthesis may be performed. In subtrochanteric osteolysis long and thin endoprosthesis can be used as well as Gamma-nails. Pathological fractures in the shaft of the femur should be treated with intramedullary static locked nails, which can be strengthened by supplementary lateral plates. If the distal metaphysis of the femur is involved compound osteosynthesis with methylmethacrylate and dynamic condylar screws or angle plates can be used.
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PMID:[Surgical treatment strategies in femoral metastases]. 823 49

Solitary extramedullary plasmacytomas are uncommon neoplasms. They occur most frequently in the upper aerodigestive tract and account for 4% of the nonepithelial tumors in this site. The evolution of a plasmacytoma is unsteady and symptoms at presentation have included dystonia, dysphagia, oral pain, cough, and dyspnea on exertion. Plasmacytoma of the upper aerodigestive tract has not been previously reported as a cause of obstructive sleep apnea.
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PMID:Plasmacytoma as a cause of obstructive sleep apnea. 876 30

Transplant patients have increased risk for developing neoplasia. This is due to the use of more potent and long-term immunosuppression. We report a case of a 46-year-old man with a cadaver renal transplant who developed an intramedullary plasmacytoma in an unusual location. The patient had a total right elbow replacement and received 4 weeks of local radiotherapy. The pain completely resolved and the low-dose immunosuppression was continued.
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PMID:Intramedullary plasmacytoma in an unusual location in a renal transplant patient. 895 44

Plasmacytoma of the jaw bones and oral cavity, as in other anatomic sites, comprises three distinct entities: multiple myeloma, solitary plasmacytoma of bone, and extramedullary plasmacytoma. This article is a retrospective study of 13 cases; 9 occurred in the mandible and 4 in the maxilla. The most common radiographic finding was a radiolucency that many times was superimposed on the roots or apices of nearby teeth. The most common symptom was localized pain, and the most frequent clinical sign was a raised red lesion on the alveolar ridge. The disease affects older persons, and the posterior mandible is the most frequently reported location. The degree of dysplasia of tumor cells was evaluated as there is a reported correlation with survival rates.
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PMID:Plasmacytoma of the oral cavity and jaws: a clinicopathologic study of 13 cases. 911 60

Simultaneous occurrence of localized plasmacytomas of both hands and feet has not been reported so far. Here we report a 40-year old female patient, who had at presentation pain and deformity. Of hands and feet, with numerous cystic lytic lesions of phalangeal, metacarpal and metatarsal bones, detected by X-rays. The biopsy of the affected bone showed moderately differentiated plasmacytoma of lambda light chain type (lambda-LC). Serum and urine biochemical analysis revealed the existence of lambda LC monoclonal component. The patient was treated by local radiotherapy and subsequent systemic chemotherapy, which consisted of 3 cycles of the M-2 protocol and 7 cycles of melphalan-prednisone. Five years after the diagnosis, the absence of plasmacytoma was confirmed by puncture biopsy of the left hand phalanx. Monoclonal protein in serum and urine was not detected.
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PMID:Multifocal plasmacytoma of hand and foot bones. 917 18

We evaluated the clinical and laboratory features of multiple myeloma in our patients and reviewed the factors that affected their survival. The study included 36 patients (12 women and 24 men) with multiple myeloma whom we followed up until death between October 1978 and June 1995. The age range was 34 to 75 years (mean age, 53.9). The chief complaints on admission were lumbar pain and pain in the extremities (77.8%) and generalized weakness (61.1%). The most common laboratory findings were severe anemia (hemoglobin < 8.0 g/dl) (50%), elevated erythrocyte sedimentation rate (75%), monoclonal spike in the serum protein electrophoresis (44.4%), and lytic skull lesions (72.2%). Twenty-three (64%) patients had a monoclonal IgG, 9 (25%) had IgA, 1 had IgD, 2 had light chain disease, and 1 was nonsecretory. Localized plasmacytoma was detected in 4 patients and 4 patients had amyloidosis in rectal and gingival biopsies. According to the Durie-Salmon staging system, 2 patients were in stage 1, 8 were in stage 2, and 26 were in stage 3. The mean survival was 31.4 +/- 4.3 months (range: 1 to 96). The 5-year survival rate was 11%. Sex, age at diagnosis, stage of the disease, hemoglobin level, platelet count, level of serum calcium, creatinine, serum paraprotein, and type of paraproteinemia were tested as prognostic parameters. We could not establish a statistically meaningful effect of these parameters on survival time. The first and second most common causes of death were renal failure and infection, respectively.
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PMID:Multiple myeloma in the region of Bursa, Turkey: a retrospective analysis. 921 19

The case histories of 8 dogs with spinal pain and neurologic deficits associated with vertebral plasma cell tumor are reviewed. Four dogs had solitary plasmacytoma, 3 had multiple myeloma, and 1 dog had 2 vertebral lesions with no evidence of disseminated disease. Four dogs were treated: 2 with multiple myeloma received chemotherapy only and survived 17 and 26 months, respectively. Two dogs with solitary plasmacytomas of the spine had chemotherapy and radiotherapy: the 1st survived 4 months and was euthanized after developing radiation myelopathy; the 2nd survived 65 months before developing multiple myeloma. The diagnosis of solitary plasmacytoma of the spine versus multiple myeloma is discussed.
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PMID:Vertebral plasma cell tumors in 8 dogs. 1022 2

Most patients with plasma cell tumors receive radiation therapy at some time during the course of their disease. Plasma cell tumors are radio-responsive, but the systemic nature of the disease in most patients limits the application of localized irradiation. In patients with solitary plasmacytomas (osseous and non-osseous), radiation therapy is the primary treatment modality. It provides excellent local control that may translate into a long remission and even cure. Adequate dose and careful anatomic planning are essential. In patients with multiple myeloma, effective palliation of pain can be achieved with relatively small fields and low doses of radiation. Hemibody irradiation has been shown to provide cost-effective palliation but is associated with toxicity and has failed to contribute to a more definitive therapeutic approach. Hemibody irradiation is rarely used today. Total-body irradiation is often employed in conditioning regimens prior to autologous or allogeneic stem-cell transplantation for multiple myeloma. However, the magnitude of its contribution to the efficacy of high-dose programs in multiple myeloma remains to be studied. This article explores the rationale for and various aspects of providing effective radiotherapy in patients with plasma cell tumors.
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PMID:Radiotherapy in the management of plasma cell tumors. 1068 Jan 52

A male patient aged 38 was complaining from severe musculo-arthral pains and high body temperature of 39 degrees C. He was admitted to the clinical hospital after long and detailed diagnostic procedures--conducted during previous hospitalization, which focused on Plasmocytoma. Serological examinations relating to Lyme disease were undertaken in the clinical hospital and the results appeared positive. The patient received Vibramicin for a prolonged treatment lasting 30 days. Radiological findings showed distraction in both hip joints (especially the right one), with areas of bone erosion, severe osteoporosis and calcifications in periarthral soft tissues. After pharmacological treatment the body temperature normalized and the pain became less severe. The state of the patient's health improved from subjective and objective point of view.
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PMID:[Lyme disease: a case report]. 1080 30

Focal irradiation has emerged as a useful modality in the management of malignant brain tumors. Its main limitation is radiation necrosis. We report on the radiation dose distribution in the cerebellum of a patient who developed imaging and autopsy diagnosis of radiation necrosis after permanent iodine-125 implants for a solitary osseous plasmacytoma of her left occipital condyle. A 55-year-old woman initially presented with neck and occipital pain and a lytic lesion of her left occipital condyle. A cytological diagnosis of solitary osseous plasmacytoma was made by transpharyngeal needle biopsy. After an initial course of external beam radiation, the patient required further treatment with systemic chemotherapy 21 months later for clinical and radiographic progression of her disease. She ultimately required subtotal surgical resection of an anaplastic plasmacytoma with intracranial extension. Permanent low-activity iodine-125 seeds were implanted in the tumor cavity. Satisfactory local control was achieved. However, clinical and imaging signs of radiation damage appeared 28 months after iodine-125 seed implantation. Progressive systemic myeloma led to her death 11 years after presentation and 9 years after seed implantation. Radiation dose distribution is described, with a discussion of toxicity from focal radiation dose escalation.
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PMID:Brain necrosis after permanent low-activity iodine-125 implants: case report and review of toxicity from focal radiation. 1131 Sep 21


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