Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 26-year-old female with an alveolar soft-part sarcoma of the vagina, manifesting itself during and after pregnancy, is described. The presenting symptoms were pain and an increase in the size of the mass. Local excision, followed by radiotherapy and chemotherapy, was ineffective and the tumor reoccurred within 6 weeks. Reoperation with removal of a portion of the vagina, surrounding tissues, and adjacent periosteum of the pubic bone has resulted in a stabilization of the disease.
 ...
PMID:Alveolar soft-part sarcoma of the vagina. 671 2

This discussion of vaginal bleeding in adolescents reviews the causes of dysfunctional uterine bleeding (complications of pregnancy, pelvic inflammatory disease and/or complications of the use of oral contraceptives or IUDs, blood dyscrasias, trauma and foreign bodies, tumors, and other causes) as well as the diagnosis and treatment of dysfunctional uterine bleeding. Menstrual irregularities are the most common cause of abnormal vaginal bleeding in adolescence and can be managed easily in the office. On occasion an adolescent needs to be hospitalized for acute menorrhagia; very rarely a surgical procedure such as dilatation and curettage is necessary. Dysfunctional uterine bleeding is defined as abnormal uterine bleeding without local anatomic causes. It is a diagnosis of exclusion and requires an adequate examination of the vagina, cervix, and other pelvic organs. Some local bleeding presents as irregular vaginal bleeding in adolescents and is diagnosed as dysfunctional bleeding. The diagnosis of pregnancy and related complications (threatened abortion, incomplete or complete abortion, ectopic pregnancy, and postabortal trophoblastic disease) may present as irregular bleeding in the practitioner's office. A teenager may give a history of pregnancy if she is questioned about it closely and confidentially. A high index of suspicion will help the clinician to make this diagnosis. Salpingitis should be suspected in any teenager who presents with low abdominal tenderness, pain, abnormal bleeding, low grade fever, and tenderness on cervical movement. Approximately 10% of teenagers with blood dyscrasias present with cyclic hypermenorrhea. Vaginal ulcerations and objects introduced into the vagina occasionally cause irregular bleeding. Such tumors as clear cell adenocarcinoma of the vaginal and sarcoma botyroides may present as metrorrhagia. These etiologic factors comprise as most only about 5% of adolescents who complain of irregular vaginal bleeding. The most common cause of such bleeding is anovulation or oligoovulation due to the noncyclic release of follicle stimulating hormone (FSH) and luteinizing hormone (LH) during adolescence. Although the most common cause of this cyclic disturbance is the hypothalamic pituitary ovarian axis, some well known endocrine disorders can also produce this picture. 95-97% of adolescents will have no organic reason for their irregular bleeding. The diagnosis of dysfunctional uterine bleeding is then made. Detailed suggestions are provided on how to proceed which will prevent grave errors in the diagnosis and treatment of dysfunctional uterine bleeding in adolescents. The patient who has been bleeding very heavily and has a hematocrit less than 30 may have to be hospitalized. A medical D and C can be done with a progestational agent. Such patients may need a transfusion of packed cells and should be kept on oral iron. They also need cycling with Ovral for 2-3 months and must be followed carefully.
 ...
PMID:Vaginal bleeding in adolescents. 674 72

The work deals with the results of clinical and X-ray examination of 96 patients with fibrous dysplasia of the skull bones; 60 (62.5%) of these patients were sent to the clinic with an erroneous diagnosis. Sarcoma, osteoma, and osteoblastoclastoma were the most frequently recorded erroneous diagnosis. The condition of the end plates and the structure of the pathological focus are of leading importance in the differential diagnosis of the disease discussed. The pain syndrome, the soft-tissue component and the periosteal spicules and peaks are not encountered in fibrous osteodysplasia. The zone of the anomaly progresses only in the period of body formation. In adults osteodysplasia follows a stable course.
 ...
PMID:[Differential diagnosis of fibrous osteodysplasia of the bones of the skull]. 683 12

The relative rarity and anatomical position of retrorectal tumors may lead to difficulty in diagnosis and surgical treatment. The clinical features and management of 20 such tumors (chordoma 8, neurilemmoma 3, teratoma 3, hemangiopericytoma 1, chondrosarcoma 1, osteosarcoma 1, dermoid 1, lipoma 1, and undifferentiated sarcoma 1) have therefore been reviewed. Low back or sacral pain was present in 18 patients and, although all tumors were palpable on rectal examination, pain had been present for a median of 12 months before diagnosis. Mean tumor size was 9.4 cm (range: 2.5-17 cm). Sacral bone destruction was demonstrated radiographically in all chordomas and three sarcomas, but in none of the benign tumors. Three patients had undergone previous partial removal of their tumors. Surgical resection was carried out using a combined abdominal and transsacral approach in 13, a transsacral approach in the right lateral position in four and transabdominally in three. There was one operative death following secondary operation for chbrdoma. Four of 12 patients with malignant tumors are alive and well at seven months to eight years. One died of a myocardial infarct without recurrence at 11 years. For small benign tumors, the right lateral position permits maximal flexibility for resection either by the transsacral, transabdominal or a combined approach. For bulky or malignant tumors, a combined abdominal transsacral approach in the right lateral position permits vascular control and provides good exposure for protection of vital structures and wide resection.
 ...
PMID:Abdominosacral approach for retrorectal tumors. 692 81

A review of the Japanese literature revealed 41 well-documented metastatic tumours of the mouth and jaws. The incidence was 1.5 times higher in females than in males and 76% were in the fourth to seventh decades with a mean of 44 years. Instead of the breast which is the most frequently encountered site of origin of metastatic tumours in Caucasians, the uterus followed by the lung, kidney and stomach was the site of primary carcinoma with the highest incidence. Histologically, carcinomas of glandular origin showed the highest rate of metastasis which was followed by choriocarcinomas. Squamous cell carcinoma and sarcoma were unusual. Metastasis occurred in the gingiva in 23 cases and bony involvement was noted in 16 cases. The most common symptoms were swelling, pain, bleeding, paraesthesia and loosening of teeth. The radiographic appearance was quite variable with no specific diagnostic characteristics. The oral lesions were treated by surgery, irradiation or chemotherapy in 32 cases, while no treatment was carried out in seven cases. Prognosis was very poor with 33 fatal cases due to multiple metastases.
 ...
PMID:Metastatic tumours of the mouth and jaws. A review of the Japanese literature. 696 Nov 86

Twenty-six patients with soft tissue sarcoma who participated in a randomized controlled clinical trial were studied to compare the impact of treatments on quality of life. Patients were treated with amputation plus chemotherapy or with limb-sparing surgery plus radiation therapy plus chemotherapy. After completion of treatments, when the patients' physical status had stabilized, a "Quality of Life Assessment" was administered. It consisted of the Psychosocial Adjustment to Illness Scale, the Sickness Impact Profile, the Barthel Function Scale, the Katz Activities of Daily Living Scale, nd an economic assessment. In addition, clinical assessments of mobility, pain, sexual relationships, and treatment trauma were obtained. Analysis of these assessments indicated that our hypothesis that limb-sparing surgery plus irradiation would provide improved quality of life when compared to amputation was not substantiated.
 ...
PMID:Quality of life assessment of patients in extremity sarcoma clinical trials. 705 1

Spindle cell lipoma is a neoplasm of adipose tissue that primarily affects posterior necks and shoulders of men in their fifth to seventh decades. It consists of a mixture of adipose tissue and spindle-shaped cells that could be misinterpreted as sarcoma. A clinical and pathological study of two patients, both men, with vascular variants of spindle cell lipoma is presented. These tumors were unusual clinically, in that one caused pain on motion and the other was painful to palpation. On microscopic examination, their vascularity was augmented over previously described examples of spindle cell lipoma.
 ...
PMID:Vascular spindle cell lipoma. 709 19

A clinicopathologic study was made of 170 cases of elastofibroma detected in Okinawa Prefecture, Japan. A majority of the cases of elastofibroma were detected in the mainland of Okinawa and its offshore islands Tonaki-jima and Aguni-jima. The 21 cases from Tonaki Island had a familial occurrence. Simultaneously, 55 of the total cases were recognized to have occurred within the same family lines. Besides the growth of elastofibroma in the subcapsular region, there was a high rate of growth in the infraolecranons area. A case of multiple elastofibroma including the lateral thoracic wall as well as the ischial tuberosities, was also studied. In this disease, there was found to be an excessive amount of elastic material produced by fibroblasts as well as obstacles in the course of forming elastic fibers. Therefore, it was considered that this tendency was a sort of reactive hyperplasia taking place with a constitutional predisposition in the background. All cases should undergo biopsy to rule out sarcoma. No other treatment is necessary in asymptomatic patients. Local excision is all that is necessary in those with pain.
 ...
PMID:Elastofibroma in Okinawa. A clinicopathologic study of 170 cases. 711 5

A phase I study of intracarotid cis-diamminedichloroplatinum was performed in 11 patients with intracerebral tumors (five glioblastoma, four melanoma, one meningeal sarcoma, and one lung carcinoma) progressing after radiation +/- chemotherapy. The internal carotid artery was temporarily cannulated by a percutaneous transfemoral approach. All patients received i.v. heparin, mannitol, and fluids; seven received dexamethasone, 50 mg i.v., twice the day before and the day of treatment. Intracarotid cis-diamminedichloroplatinum, 60 to 100 mg/sq m in 175 to 250 ml 0.45% NaCl solution with 1000 units heparin, was infused over 1 hr. Six patients received two or more courses (maximum of 6) at 2- to 8-week intervals. Gastrointestinal toxicity was mild to moderate. Ototoxicity was minor. Central nervous system (CNS) toxicity was focal, severe, permanent, and possibly due to embolus in one patient at 75 mg/sq m; focal and reversible in one patient at 100 mg/sq m; and generalized but reversible in one patient at 75 mg/sq m. Possible CNS toxicity was noted in two additional patients. Two patients with CNS toxicity developed permanent ipsilateral retinal toxicity, and one patients without CNS toxicity developed bilateral decreased visual and auditory acuity 2 weeks after his sixth treatment. Renal and hematological toxicity and orbital pain were mild. Response status included: early death, one; probable responses, six (2+ 4+, 6, 6+, 8, and 8+ months); stabilization, two (3+ and 4 months); and failure, two. We recommend cis-diamminedichloroplatinum (60 mg/sq m) every 2 to 4 weeks for Phase II studies. Severe CNS and retinal toxicity are possible.
 ...
PMID:A phase I study of intracarotid artery infusion of cis-Diamminedichloroplatinum(II) in patients with recurrent malignant intracerebral tumors. 719 71

Hyperthermia greater than or equal to 42 degrees C is tumoricidal in vitro and in many animal models, although such temperatures have only recently been achieved experimentally in some human cancers. A recently developed radio frequency device that provides safe hyperthermia to any depth without surface tissue injury now permits evaluation of the effects of hyperthermia on advanced human sarcomas. Twelve patients with large sarcomas located intraabdominally [7], in the chest wall [2], proximal extremity [2], and the neck [1], were evaluated in this study. Tumor types include liposarcoma [3], rhabdomyosarcoma [2], leiomyosarcoma [2], neurofibrosarcoma [2], and one each malignant mesothelioma, undifferentiated sarcoma, and osteosarcoma. Intratumor temperatures greater than or equal to 42 degrees C were observed in all tumors, with virtually no normal tissue injury. Selective tumor heating greater than or equal to 45 degrees C occurred in 9/12 (75%) and greater than or equal to 50 degrees C in 6/12 (50%). One to five weekly treatments greater than or equal to 50 degrees C and ten daily treatments greater than or equal to 45 degrees C resulted in significant tumor necrosis and pain relief in some patients. Hyperthermia of advanced sarcomas is possible with little host toxicity and may be of potential therapeutic benefit.
 ...
PMID:Radio frequency hyperthermia of advanced human sarcomas. 724 1


<< Previous 1 2 3 4 5 6 7 8 9 10