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)

This study presents a retrospective look at 115 patients evaluated here from 1957 to 1974. In this series, 57 percent were males and 43 percent females, 84 percent were Caucasian and 16 percent Negro. Lesions confined to or originating in the antrum made up 67 percent while nonantral lesions were 33 percent. Mean age at diagnosis was 59.1 years. Smoking and drinking history did not appear to be contributory. Antral lesions were retrospectively staged according to Sisson's TNM classification. Sixteen tumor types were involved, with the most common being epidermoid. Diagnosis was most often made by intranasal or Caldwell-Luc biopsy. Most frequent symptoms, as well as earliest symptoms, were nasal obstruction, localized pain, and epistaxis. Average duration of symptoms was 6.4 months. Therapy was generally in the form of radiotherapy alone, preoperative radiotherapy and surgery, surgery and postoperative radiotherapy, or surgery alone. Local recurrences occurred in 44 percent of antral lesions and 50 percent of non-antral lesions. Regional (cervical) nodal metastases developed in 25 percent of antral lesions and 11 percent of non-antral lesions. Distant metastases developed in 30 percent of antral cases and 35 percent of non-antral cases. Five-year survival was 32 percent (35 percent determinate) for the total group. The more advanced the staging of the antral lesions, the worse the prognosis. Best survival figures were in the areas of preoperative radiotherapy and surgery at 38 percent (43 percent) and surgery alone at 56 percent (59 percent).
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PMID:Malignant neoplasms of the nasal cavities and paranasal sinuses: (a retrospective study). 85 Apr 51

Data from ten cases with carcinoma of the adrenal cortex, diagnosed between 1981 and 1988, have been extensively reevaluated. Six patients suffered from a hormonally active tumor with proven clinical and laboratory signs of hypercortisolism and/or hyperandrogenism. Female patients dominated the cohort (eight of ten). No preference for particular age (35 to 64, mean 52) or lateralisation of the tumor was recognisable. In all cases signs for endocrinopathy and/or tumor disease lead to investigative intervention. Nonspecific symptoms like pain, reduction of weight and fatigue were registered most frequently. In three patients an abdominal tumor was palpable. Investigation of hormone levels and imaging procedures (sonography and CT scan) assured correct diagnosis in all cases. Since prior to operation metastases have been detected in five cases and in eight cases capsular invasion was proven histologically only, one patient was free of tumor after operation but developed hepatic metastases later on. Altogether nine of ten patients developed metastases later on. Seven of the patients died from the perioperative period up to 8.4 +/- 8.15 months. Mean survival of all patients was 20.5 +/- 24.5 months. Histological grading and assessment of anaplasia did not correlate with either survival or tumor stage. None of the patients presented with tumor stage I according to the TNM system by MacFarlane (55). All four patients with advanced disease in stage IV died within the first year after operation. Eight patients were treated with 1 to 6 g of the adrenolytic o,p'DDD (mitotane, Lysodren). In one of these cases, a sonographically documented remission lasting for over eight years was observed. A second patient with anaplastic carcinoma showed a reduction of the size of pulmonary metastases under continuous therapy with o,p'DDD and a cyclic polychemotherapy. After the latter was discontinued, the course was progressive.
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PMID:[Adrenal cortex carcinoma: diagnosis, therapy and course in 10 cases]. 143 4

The aim of the study was to assess the value of routine bone scintigrams, independent of the primary tumor stage or the presence of symptoms, in the postsurgical follow-up of breast cancer patients for the early detection of bone metastases. For this purpose 1,000 patients with postsurgical breast cancer without previous documentation of metastatic disease, who were admitted to the special oncology hospital, Onkologische Klinik Bad Trissl, entered a prospective study in 1987-1988. The parameters followed were the TNM stage of the primary tumor, the presence of pain, bone pain as revealed by a thorough physical examination, and the patient's history for the assessment of risk factors. In addition, a whole-body skeletal scintigram, supplementary X-rays, and additional diagnostic measures were performed, if necessary, to detect bone metastases. It was shown that in 856 of 894 patients (groups 1-6) without clinical symptoms, the clinical examination and radiological and scintigraphic diagnostic measurements, demonstrating the absence of bone metastases, gave matching results, but in 12 of the 894 patients the results of all examinations remained questionable. In another 12 of the 894 patients (groups 1-3) radiological and/or scintigraphical evidence for the presence of bone metastases was found. In 14 of 79 cases (groups 7-10) with clinically suspicious symptoms these were proven to be signs of metastases by subsequent scintigrams, supplementary X-rays, and additional diagnostic measures. In 65 of the 79 patients with clinically suspicious symptoms, bone metastases could not be confirmed by obtaining bone scintigrams or X-rays while in the other 14 patients (groups 9 and 10) evidence for the presence of bone metastases was found in the scintigrams and/or X-rays. However, 10 of these 14 patients were high-risk patients for developing bone metastases as they had axillary lymph node infiltration. The other 4 patients were of the low-risk group as they had positive receptor status or no axillary lymph node infiltration at the time of primary diagnosis. In 13 of 27 patients (groups 11-14) with clinical symptoms indicating the presence of bone metastases this diagnosis was confirmed by scintigrams and/or X-rays (groups 11 and 12), while it was possible to exclude the presence of bone metastases in spite of the symptoms in 11 of the 27 patients. In the other 3 patients the results of the additional examinations remained questionable.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Value of bone scanning in the follow-up of breast cancer patients. A study of 1000 cases. 222 39

In accordance with international statistics 25% of all patients with bronchogenic carcinoma can be treated by resection at the moment the diagnosis is established. The 5 year survival rate is in most series 25%. Important prognostic factors are: TNM-stage, histological classification, biological nature of the tumour and involvement of lymph nodes; discussed are further localisation of the primary tumour and immunological status. The summarizing statistics show that the carcinoma of squamous cell type has the best chance of a 5 year survival with a rate of more than 50%. In small-cell carcinoma extremely different 5 year survival rates between 0 and 20% are reported. In the surgical treatment it is obvious that the number of lobectomies are increasing in comparison to pneumonectomies. The postoperative mortality rate differs for "radical" pneumonectomy between 20% and 35%, for simple pneumonectomy between 7% and 10% and for lobectomy below 2%. Determinant for the postoperative course is the preoperative estimation of the risk factors. The 5 year survival rate after broncho- or angioplastic procedures varies in different series between 9,8% and 36%. In segmentectomies and wedge resections the 5 year survival rate was up to 56%. Primary palliative resections are indicated for pain reduction and improvement of the quality of life.
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PMID:[Surgical position and possibilities in bronchial carcinoma]. 625 18

Parotid gland cancers are uncommon neoplasms whose management is complicated by their variable histopathology, their equally variable clinical course, and the intricate relationship of the facial nerve to the parotid gland and potential threat to the muscles of facial expression. In order to expand the limited familiarity with this unusual cancer that any single surgeon may acquire, a review is presented of factors influencing survival, including histopathology, lymph node metastasis, facial nerve palsy, skin involvement, size (stage), recurrence, pain, deep lobe and distant metastasis. The personal experiences of the author, experiences at the University of Virginia, and those in the literature were reviewed to derive the principles of treatment based on the TNM staging system and histopathologic diagnosis.
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PMID:Parotid cancer: a rational basis for treatment. 744 Jan 80

Recently attention has been focused on the optimal timing of chemotherapy within the treatment regimen for patients with metastatic prostate cancer, i.e., hormonal manipulation, preferably maximal androgen blockage (MAB) consisting of chemical/surgical castration followed by treatment with antiandrogens. We have conducted a randomized prospective clinical trial, investigating the efficacy and toxicity of MAB (orchiectomy followed by flutamide therapy) alone as compared to MAB combined with methotrexate (MTX, 50 mg/m2/week) in 53 patients with newly diagnosed stage IV(M1) prostatic cancer (UICC TNM Classification 1987). The observed remission rates (complete + partial) of 42.3% in the MAB + MTX arm and 29.6% in the MAB arm did not differ significantly. The response rates (complete + partial + stable disease) of 73.1% and 66.7% for MAB + MTX and MAB respectively, also showed no significant difference. Neither progression-free survival (median 18/5 and 23.8 months for MAB + MTX and MAB, respectively) nor overall survival (median: 37.4 and 36.1) months in the MAB + MTX and MAB arm, respectively) could be improved by the addition of MTX to MAB Only the extent of metastatic pain reported by the patients was consistently less under MAB + MTX than under MAB alone (P<0.1). Both treatment regimens were well- tolerated with slightly more undesirable effects in the MAB + MTX arm. Our results do not provide evidence for the achievement of marked gains by combining chemotherapy with endocrine therapy in newly diagnosed patients with stage IV (M1) prostate cancer.
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PMID:Maximal androgen blockade in combination with methotrexate for treatment of metastatic prostate cancer. 860 66

Unresectable hepatocellular carcinoma is related to a poor prognosis. Encouraging response rates and survival have been reported with intra-arterial (i.a.) chemotherapy and chemo-embolisation, but limited data are available on the association of the two treatment modalities. We therefore started a new programme combining i.a. chemotherapy with chemo-embolisation. The treatment regimen consisted of L-leucovorin (100 mg/m2 i.v.), 5-fluorouracil (800 mg/m2 i.a.), and carboplatin (250 mg/m2 i.a.). Chemo-embolisation with mitoxantrone (10 mg/m2) plus ethiodized oil followed immediately. The same treatment plus gelatin sponge was given after 28 days. 26 patients entered the study and were evaluable for response and side-effects. Main patient characteristics were: males 21, females 5: median age 68 years (range 42-76 years); stage TNM II-III 17, IVA 9; Child's A 12, Child's B 14; elevated baseline alpha-fetoprotein 17; cirrhosis 25. 14 patients had a partial response (54%; 95% confidence interval 33-73%), 3 had stabilisation and 9 had progressive disease. Median survival was 11 months (range 2-20+). 16 patients had grade I-II pain and 15 grade I-II fever. Our results indicate that the regimen is safe, well tolerated and capable of inducing objective remissions in a high percentage of patients with hepatocellular carcinoma.
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PMID:Intra-arterial chemotherapy followed by chemo-embolisation in unresectable hepatocellular carcinoma. 907

The monoclonal antibody 44-3A6 detects a cell-surface protein that has been shown to be a useful marker in distinguishing adenocarcinomas from other histologic tumor types in a variety of tissues. The objective of this study was to determine whether 44-3A6 could be used as a tool in the classification of salivary gland neoplasms. These complex tumors share overlapping pathologic features but distinct clinical outcomes. This study used 44-3A6 to immunohistochemically describe the pattern and frequency of this antigen in salivary gland neoplasms. Formalin-fixed, paraffin-embedded tissue sections of 22 benign and 26 malignant salivary tumors were evaluated. The patient population consisted of 25 (52.1%) women and 23 (47.9%) men selected from archival pathology files to reflect a range of salivary gland diseases. Normal surrounding salivary glands were found to have intense focal staining almost exclusively localized to ductal luminal cells. There was little staining of either myoepithelial or acinar cells. A wide spectrum of expression was found between and within tumor types, but a trend toward more expression of this antigen with decreasing differentiation was seen. A significant increase in staining was also seen in those tumors with ductal differentiation (n = 41) as opposed to those with predominantly acinar (i.e., acinic cell carcinoma) or myoepithelial (i.e., myoepithelioma; n = 8) differentiation (2.6 vs. 1.3, p < 0.05). No correlation was found between staining intensity and facial paralysis, pain, skin involvement, TNM stage, residual disease, or disease-free or total survival. Therefore this antigen appears to designate a duct luminal phenotype in normal and neoplastic salivary tissues.
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PMID:Expression of the adenocarcinoma-related antigen recognized by monoclonal antibody 44-3A6 in salivary gland neoplasias. 959 57

Prognosis and outcome of patients with pancreatic carcinoma is poor. The aim of the study was to investigate (1) which factors of medical history and clinical status as well as which laboratory parameters determine survival in pancreatic carcinoma and (2) whether specific data can be used as prognostic parameters or for early diagnosis of pancreatic carcinoma. In total, 287 patients with pancreatic carcinoma were enrolled in the study. In 193 subjects, only palliative treatment was possible. Survival was assessed using univariate survival probability curves by Kaplan-Meier. Comparison of patient groups with regard to survival was achieved using the log-rank test. Multivariate analysis was carried out using the Cox regression model. Overall, 22 factors, showing a significant impact on survival in pancreatic carcinoma were found, e.g., tumor-associated factors such as (1) tumor stage according to the UICC classification including TNM-based staging, grading, tumor site, and vascular infiltration; (2) preoperative habits and signs and symptoms (physical condition, pain, loss of appetite, ethanol consumption); (3) change of laboratory parameters (CA 19-9, bilirubin, prothrombin time, urea, C-reactive protein), and (4) type of intervention (surgical approach, R0/1/2 resection). Using multivariate analysis, seven factors (UICC tumor stage and site, surgical intervention including number of resected lymph nodes, chemotherapy, occurence of a carcinoma in relatives, preoperative physical condition, night sweat) were determined. In the 193 patients with palliative treatment, only ten factors (among them UICC tumor stage including the presence of metastases; data from the medical history such as physical condition, loss of appetite, and carcinoma in relatives, and laboratory parameters including prothrombin time, protein content, and aspartate aminotransferase levels) were found to be important. Chemotherapy had the strongest impact on survival which was confirmed by multivariate analysis, followed by tumor stage (UICC) and preoperative appetite. Besides tumor-associated determinants, data from the medical history, and pathological laboratory parameters, the prognosis in pancreatic carcinoma is considerably determined by the treatment such as interventional and/or using antineoplastic agents.
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PMID:Prognostic parameters determining survival in pancreatic carcinoma and, in particular, after palliative treatment. 1138 55

Back pain constitutes a nearly universal experience, Point, one-year period and lifetime prevalence reach or exceed, in some European countries, 40%, 70% and 80%, respectively. No health care system is able to cope with the entire quantity and spectrum of cases. Clinically useful distinctions are urgently required. A basic classification distinguishes specific from non-specific cases. Non-specific back pain may then be graded on its actual severity in terms of pain intensity and disability. This already implies limited prognostic information. Staging assumes a more or less unidirectional course with definable phases and transition periods and definitely adds to prognosis (cf. the TNM-system in oncology). So far there seems to be no generally accepted staging system for chronic back pain, although some promising proposals can be presented. The disorder, once it has become chronic, has a rather unfavourable prognosis, although single episodes still have a high probability of completely resolving within a few weeks. An underestimated risk factor for a chronic-disabling course of current back pain is (besides its acute grade and stage) its previous history.
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PMID:How epidemiology contributes to the management of spinal disorders. 1198 28


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