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)

The records of 66 patients with osteosarcoma of the jaw were reviewed. The ages of the 42 males and 24 females ranged from 12 to 79 years (mean, 34.2 years). Swelling and pain, the most frequent presenting complaints, were noted an average of three months before the patient was seen by a physician. Fifty-one percent of the lesions involved the maxilla and 49% involved the mandible. The most common sites of involvement were the body of the mandible and the alveolar ridge of the maxilla. Radiologically, most of the lesions in the maxilla were osteoblastic (50%), whereas most of those in the mandible were osteolytic (43%). Chondroblastic osteosarcoma was the most frequent histologic type (48%) and was associated with the best survival rate (47%). Treatment included radical and local surgery with radiotherapy, chemotherapy, or various combinations. The recurrence rate for all treatment modalities was 70%. Patients treated by initial radical surgery had the best survival (80%). Survival decreased to 27% with local surgery. Of the 43 (65%) patients who died, most died with uncontrolled local disease; only four patients had documented distant metastasis, which involved lung, cervical lymph nodes, spinal column, and brain.
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PMID:Osteosarcoma of the jaw. 657 39

15 consecutive patients with osteosarcoma underwent preoperative chemotherapy with high dose methotrexate (HDMTX) containing regimens according to the T7 or T10 protocols of ROSEN, Preoperative chemotherapy was well tolerated and did not impair surgical procedures. 67% of the patients responded clinically with reduction of pain and tumor size. Histologic examination of the tumor after preoperative chemotherapy revealed extensive necrosis in 53% of patients. In a retrospective analysis, patients with extensive necrosis (group B) were compared with those with little or no necrosis (group A). Patients from group B had a longer relapse free and overall survival period than group A. In addition, patients of group A had significantly higher initial levels of alkaline phosphatase than group B. The incidence of a 2.5-fold increase of the transaminases 2-3 days after HDMTX was significantly greater in patients of group B compared to group A. In the absence of documented necrosis after chemotherapy according to the T7 or T10 protocols, further use of HDMTX is not indicated. New aspects on the treatment of osteosarcoma, derived from recent publications, are discussed.
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PMID:[The Zurich experience with preoperative high-dose methotrexate in osteosarcomas]. 657 41

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.
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PMID:Abdominosacral approach for retrorectal tumors. 692 81

Twelve patients with florid reactive periostitis of the small bones of the hands and feet are presented. Clinically, the lesion usually presents as a swelling of the affected part, sometimes accompanied by pain, tenderness, and redness. Histologically, the lesion may be mistaken for benign and malignant neoplasms such as osteosarcoma or parosteal osteosarcoma or osteochondromas. The features that distinguish reactive periostitis from the several diagnostic possibilities are presented. It is important for the clinician and the pathologist to recognize the existence of florid reactive periostitis in the hands and feet and to treat accordingly. Local excision appears to be adequate treatment; follow-up indicates little risk for local recurrence.
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PMID:Florid reactive periostitis of the tubular bones of the hands and feet. A benign lesion which may simulate osteosarcoma. 694 56

Six cases of small-cell osteosarcoma, a tumor that resembles Ewing's sarcoma but produces osteoid matrix, are presented. The patients were young (6-31 years of age) and presented with symptoms of pain and/or swelling of 1-10 months duration. The lesions demonstrated a wide variation in radiographic appearance. Histologically, the tumors were composed of small, round cells that produced variable amounts of osteoid. In three cases chondroid was also present. Two of the six patients were treated with surgery alone and four received radiation and either single- or multiple-agent adjuvant chemotherapy. The two patients who received radiation and multiple-agent adjuvant chemotherapy have no evidence of disease at four and ten years after diagnosis. Recognition of this tumor as distinct from Ewing's sarcoma and from other forms of osteosarcoma is important to determine the incidence, clinical features, and optimal therapy for this tumor.
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PMID:Small-cell osteosarcoma. 695 93

The surgical management of bone metastases should relieve pain and improve function. Of the operative cases (170 in the last 10 years), 30% underwent resectional therapy with successful implantation of an endoprosthesis. Surgical management of primary malignant bone tumors should result in cure. Since 1976, in 44 of 54 cases of osteosarcoma a tumor resection was performed and in 40 cases the operation was adequate. A rotation plasty operation was performed in 15 of the 44, a tumor endoprosthesis was implanted in 22, and other methods were used in seven.
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PMID:[Surgical therapy of malignant bone tumors and results of the treatment]. 696 62

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.
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PMID:Radio frequency hyperthermia of advanced human sarcomas. 724 1

Transcatheter arterial infusion and arterial embolization are employed in the treatment of various neoplasms. In patients with carcinoma of the colon metastatic to the liver, the hepatic arterial infusion (HAI) of floxuridine and Mitomycin produced a 55% partial response and a 12% complete response, as well as an improved median survival of 18 months. In metastatic breast carcinoma, a 30% response was achieved. In some cases, proximal embolization of aberrant hepatic arteries was performed to redistribute the hepatic flow to a single vessel to assist infusion of the entire liver using a single catheter. Devascularization by hepatic artery embolization has also been used to treat hepatic neoplasms. Arterial occlusion of renal carcinoma, followed after four to seven days by nephrectomy and hormonal therapy, produced a 36% response rate in 49 patients with distant metastases. In 14 patients with osteosarcoma treated with cis-diaminedichloroplatinum (CDDP) arterial infusion, a 57% response rate was achieved. Benign bone tumors were treated with arterial occlusion with a 60% response rate. Tumors of the pelvis were managed by bilateral internal iliac artery infusion using CDDP. In 21 patients with recurrent bladder carcinoma, control of pain and hematuria and prolonged survival were achieved.
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PMID:Current status of transcatheter management of neoplasms. 745 17

Stress fractures of the femoral diaphysis in young children are rare. Pain and an antalgic gait are the most common features. There is usually no history of either trauma or a recent increase in physical activities. Initial radiographs may be normal. Technetium bone scanning is the most sensitive method of early diagnosis, but may not be diagnostic. Computed tomography and magnetic resonance imaging are useful in early confirmation of the diagnosis. Serial radiographs will show maturation of the periosteal new bone with evidence of repair. Biopsy should be avoided, except in cases of obvious neoplasm shown by computed tomography or magnetic resonance imaging, or in cases with progressive cortical destruction shown on serial radiographs, because fracture callus may be difficult to distinguish from osteosarcoma. Treatment consists of protected weight bearing and activity restriction until resolution of symptoms and radiographic evidence of healing.
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PMID:Stress fractures of the femoral diaphysis in young children. A report of 2 cases. 764 34

A review of 280 primary malignant bone tumours diagnosed during 1984-1988 is presented. These constituted 3.14% of all malignant tumours. Male to female ratio was 2.3:1. Majority of these patients presented with rapidly growing mass, pain and deformity. Histologically, osteosarcoma was the most frequent (36.4%) primary malignant tumour. Male to female ratio was 3.31:1. More than 49% of these cases were in their second decade of life. In females the greatest frequency was in 10-15 years and in males 16-20 years age groups. Femur was the most frequent site. Other common malignant bone tumours included chondrosarcoma (22.1%), plasma cell myeloma (15.0%) and Ewings's sarcoma (8.6%). Miscellaneous cases of fibrosarcoma, chrodoma, adamentinoma and ameloblastoma were also seen. This study outlines the frequency, symptomatology and histological pattern of various malignant bone tumours in northern areas of Pakistan.
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PMID:Pattern of malignant bone tumour in northern areas of Pakistan. 868 40


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