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)

42 patients with metastatic breast carcinoma were treated with aminoglutethimide, which inhibits adrenal steroid hormone synthesis. Treatment was stopped in 2 patients before response could be assessed; of the other 40, 15 (37.5%) had an objective response, 1 (2.5%) showed a response in bone but not in soft tissue, and 4 (10%) had complete or very great relief of metastatic bone pain but no radiological evidence of improvement. 19 (53%) of 36 patients with bone metastases responded to treatment (15 had X-ray evidence and 4 had pain relief), as did 5 (45%) of 11 patients with soft tissue metastases, 2 (25%) of 8 with malignant marrow infiltration, 1 (14%) of 7 with lung metastases, and none of 13 with liver metastases. Response was commonest in patients who had previously responded to other forms of endocrine therapy. Side-effects, usually mild and transient, occurred in a few patients; the most important were an initial period of somnolence in 9 patients and a rash in 5.
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PMID:Aminoglutethimide in treatment of metastatic breast carcinoma. 8 May 76

A 39-year-old man had pain and swelling of the terminal phalanx of a finger. Radiograph was interpreted as osteomyelitis, and amputation through the mid-phalanx was performed. Histology revealed Ewing sarcoma. Lung metastases rapidly developed. Right lung irradiation and systemic chemotherapy, including doxorubicin, were instituted. He developed progressive severe right ventricular failure which was attributed to effects of large pulmonary metastases. Autopsy showed massive right ventricular metastases, the primary pathological cause of the heart failure, without evidence of doxorubicin cardiomyopathy.
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PMID:Ewing sarcoma: phalangeal primary with fatal cardiac metastases. 54 62

The influence of surgical tumour removal and of the emotional-pain stress described by Desiderato on the lung metastases development and lung vascular internal surface state was studied in C57BL mice with Lewis carcinoma. Scanning electron microscopy revealed a stress-damaging effect on vascular walls. It is possible to assume that the stress damage of pulmonary blood vessels greatly influences the stimulation of metastases. Concrete mechanisms responsible for this phenomenon are elucidated.
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PMID:[Endothelial changes in the pulmonary blood vessels of mice with Lewis lung carcinoma and experimental stress]. 231 35

The records of 14 patients with fibrosarcoma of the jaws--10 in the mandible and four in the maxilla--from the files of the Netherlands Committee on Bone Tumours were studied. The mean age of the patients was 30 years; more men than women were involved; pain and especially swelling were the symptoms most frequently present. The radiographic appearance often indicated the malignant nature of the lesion. Histologically 42% of the tumours were low-grade malignant. The 5-year survival rate was 71%, which is more favourable than either fibrosarcoma located elsewhere in the skeleton or osteosarcoma of the jaws. Radical surgery is the therapy of choice. All cases with an unfavourable course acquired lung metastases.
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PMID:Fibrosarcoma of the jaws. 394 16

Two hundred eighty-three pathologic fractures and 23 impending fractures of the hip and femur were analyzed and compared after surgical treatment. One hundred ninety-six fractures were treated by internal fixation or prosthetic replacement and the adjunctive use of methylmethacrylate, and 110 were treated by surgery without the use of methylmethacrylate. Pain relief, ambulatory activities and survival rates were all enhanced in the methylmethacrylate group. The six failures of fixation in the nonacrylic group might have been prevented by the use of bone cement. Breast carcinoma was the most common metastasis, comprising 56% of the series. Kidney metastases, when treated aggressively, showed many long-term survivors. Lung metastases gave the worst prognoses. The overall series survival rates were 59% at six months and 48% at 12 months. The incidence of complications including infection were not related to the use of methylmethacrylate or preoperative radiation. Although many authors have reported the advantages of methylmethacrylate in stabilization of pathological fractures, none have compared the results by analyzing pain relief, ambulatory ability and survival times in those treated with and without bone cement. This study appears to clearly indicate that methylmethacrylate enhances the stability of the pathological fracture and contributes to achieving the goals of treatment in these severely compromised patients.
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PMID:The pathology and treatment of metastatic disease of the femur. 617 83

Our experience with 234 patients having resection of metastatic lesions of lung is reviewed. Most bilateral lung metastases were removed though a median sternotomy. Exploration of the contralateral lung with simultaneous removal of all lesions is possible through such an incision, and moreover, it appears to give less pain postoperatively. The over-all median survival time of the patients was 21.4 months, with a surgical mortality of 2.6 per cent. The therapeutic results were analyzed according to various factors. Incomplete resection and the presence of a positive hilar mediastinal node, or both, resulted in poor survival rate of the patients. Generally, the survival rates of the patients were found to be proportional to the disease-free interval and the tumor doubling time. Patients with a solitary lesion and those with two lesions removed had the best survival time. There was no difference in the survival rates of patients with unilateral and bilateral pulmonary multiple metastases. Treatment of metastases to the lung should be carefully planned in consultation with physicians who are acquainted with the natural history of the primary tumor, as lung resection is a part of the multimodal therapy of patients with solid tumor.
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PMID:Surgical management of metastases to the lung. 720 61

This report documents for the first time the association of hypertrophic osteoarthropathy with ovarian adenocarcinoma metastatic to the lung, in a 47-year-old woman who became totally incapacitated by her joint pain. Surgical removal of the lung metastases resulted in prompt relief of her pain. Theories of the pathogenesis of this clinical syndrome are reviewed. They include neurovascular, humoral and estrogenic mechanisms. Pulmonary arteriovenous shunting has also been considered in the pathogenesis. Operation should be considered in all patients who area incapacitated by joint pain associated with metastatic disease in the lungs.
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PMID:Hypertrophic osteoarthropathy complicating metastatic ovarian adenocarcinoma. 728 16

The clinical and pathologic data from two cases of medulloblastoma with systemic metastases, and 101 previously reported cases were evaluated to define better the clinical presentation and natural history. Patients ranged in age from six months to 48 years, with a mean of 13 years; two thirds of the patients were male. Ventricular shunts had been inserted in 20% of the patients. Systemic metastases occurred on an average of two years after the diagnosis of the primary tumor in patients without shunts, but only 1.3 years in patients with shunts. Fifty-nine percent of the patients were known to have experienced recurrence or spread of medulloblastoma within the central nervous system by the time systemic metastases appeared. Ninety percent showed radiologic evidence of bone metastases, of which 60% were osteoblastic. Bones most frequently involved were pelvis, femur and vertebrae; pain was the most common initial symptom. At autopsy, lymph node metastases were found in 65% and liver metastases were found in 28% of all cases in addition to bone metastases in 82%. Lung metastases occurred in 9% of the patients without shunts, compared with 30% of patients with shunts. The average survival was seven months after the appearance of systemic metastases for patients both with and without shunts. Approximately 5% of patients with medulloblastoma may be expected to develop systemic metastases. This development is associated with increased morbidity and a shortened life expectancy.
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PMID:Systemic metastases from medulloblastoma: report of two cases and review of the literature. 729 79

Therapy with tamoxifen has been used in 109 woman with advanced breast carcinoma; 75 of them had been previously submitted to ovariectomy, hormonal treatment and or polychemotherapy. Tumors were localized in the breast in 21 cases, in the lymph nodes in 34 cases, in the dermis in 32 cases; there were 26 cases with lung metastases and 62 cases with bone metastases. Fifty-one patients showed multiple tumor involvement, but only 57 patients referred to have pain. Objective responses were obtained in 36 percent of the cases (15 patients with complete remission and 25 responses over 50 percent). An additional 30 percent of minor responses was also obtained. Pain disappeared in 68 percent of the cases. According to the tumor localization, objective responses were obtained in 26 out of 62 osseous metastases, in 16 out of 34 lymph node involvement, 12 out of 26 lung metastases, 12 out of 32 dermic localizations, and 6 out of 21 breast tumors. Drug tolerance was excellent, and maximum therapeutic response occurred between 3 and 15 months after beginning of treatment with tamoxifen. These results encourage the usefulness of tamoxifen in the treatment of patients with advanced breast carcinoma.
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PMID:[Treatment of advanced breast cancer with tamoxifen (author's transl)]. 740 44

Lung nodules in patients with a history of malignancy usually require tissue diagnosis that will provide prognostic information and dictate further therapy. Patients with a favorable tumor histologic condition and limited tumor burden were often considered for resection. This is usually accomplished by wedge resection through open thoracotomy when the lesions were peripheral. However, complications related to open thoracotomy often exclude poor-risk patients, especially those with impaired pulmonary function. Currently, technique of thoracoscopic resection is opening up new vistas and unimagined options for the thoracic surgeon in the management of pulmonary diseases. With the application of thoracoscopy and small incisions, it is now possible for the thoracic cavity and its contained organs to be thoroughly explored. Our recent experience with the thoracoscopic resection as a primary treatment for lung metastases is the focus of this report. Forty-seven patients with a history of malignancy and new lung metastases underwent this type of resection. Postoperatively, there is less pain, quick functional recovery, and excellent cosmetic healing. It is a safe and promising approach.
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PMID:Application of thoracoscopy for lung metastases. 763 11


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