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)

The efficacy of an anti-prostaglandin, tolfenamic acid (T.A.), in the prevention of side-effects after insertion of a copper-T200 intrauterine contraceptive device (I.U.D.) was evaluated in a double-blind trial in 160 women. T.A. relieved pain and reduced bleeding after insertion and during three subsequent menstruations without serious side-effects. A scoring system for the assessment of I.U.D. side-effects showed that the acceptability of I.U.D. was significantly better in women treated with T.A. than in those given placebo.
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PMID:Anti-prostglandin therapy in prevention of side-effects of intrauterine contraceptive devices. 7 60

Precursor B-lymphoblastic lymphoma (B-LBL) may present as a solitary bone tumor. Fewer than 10 cases with a proven precursor B-cell phenotype have been reported in the English literature. In this report, we describe four cases of B-lymphoblastic lymphoma presenting as a localized intraosseous mass, which clinically and histologically mimicked Ewing's sarcoma. Three tumors occurred in the tibia and one in the humerus. In all four cases, the initial diagnosis was either "Ewing's sarcoma" or "consistent with Ewing's sarcoma." All four patients were female. Three were children and one was an adult; mean age was 12.5 years (range, 4 to 31 years). All had extremity pain without significant constitutional symptoms. In three cases, the tumors were osteolytic on radiographic evaluation, and in one case, osteosclerotic. Immunohistochemical stains on paraffin-embedded tissue showed that the neoplastic cells expressed terminal deoxynucleotidyl transferase, CD43, vimentin, and CD99 (MIC2 gene product) in all cases. Three cases were negative for CD45. CD79a was positive in all four cases studied; however, CD20 (L26) was positive in only two of four cases. CD3 was negative in all cases. Two cases showed focal granular cytoplasmic staining for keratin. Two cases analyzed by polymerase chain reaction (PCR) revealed clonal rearrangement of the immunoglobulin heavy chain (IgH) gene. Follow-up revealed that the three pediatric patients, who received a high-dose multiagent chemotherapy regime for LBL, are disease free at follow-up intervals of more than 1, 11, and 12 years, respectively. The adult patient died two years after diagnosis with disseminated disease. Although rare, B-lymphoblastic lymphoma should be considered in the differential diagnosis of small round cell tumors of bone. A diagnosis of Ewing's sarcoma should be made only after complete immunophenotyping and, if necessary, molecular diagnostic tests to exclude lymphoblastic lymphoma. A limited panel of antibodies can lead to an erroneous diagnosis; B-lymphoblastic lymphoma may be negative for CD45 and CD20 but positive for CD99 and even for keratin, mimicking Ewing's sarcoma. Correct diagnosis is extremely important because LBL usually is curable in the pediatric age group with appropriate therapy.
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PMID:Precursor B-Lymphoblastic lymphoma presenting as a solitary bone tumor and mimicking Ewing's sarcoma: a report of four cases and review of the literature. 966 42

A 43-year-old man was admitted to our hospital because of hemophagocytic syndrome (HPS) in August, 1998. A CT scan, gallium scintigraphy, gastrofiberscopy and colonofiberscopy showed no evidence of malignant lymphoma. Virus-associated HPS was suspected because of an increased titer of anti-Epstein-Barr (EB) virus antibody (EBV VCA IgG 2,560x, EBV EA IgG 40x, EBNA 20x). The HPS resolved spontaneously for 40 hospital days, but two weeks into the period of HPS remission, the patient developed pain and marked swelling of the right thigh muscle, and pectoral, biceps brachii, quadriceps femoralis and masseter muscles. Otherwise, CT scan and gallium scintigraphy showed no abnormal findings. A biopsy of the right quadriceps femoralis muscle revealed non-Hodgkin's lymphoma with muscle infiltration. Immunohistologic examination confirmed T-cell type (CD3, CD43, CD45, CD45RO) lymphoma, and Southern blot analysis for T-cell receptor revealed a rearranged band. The lymphoma cells were negative for EBV genome monoclonality. The patient responded well to CHOP therapy and achieved a complete remission. This is considered a very rare case of T-cell lymphoma infiltrating multiple skeletal muscles following an episode of hemophagocytic syndrome.
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PMID:[Skeletal muscle T-cell lymphoma following hemophagocytic syndrome]. 1107 Sep 31

Plasmacytomas are localized neoplastic proliferations of monoclonal plasma cells. When multifocal, the process is referred to as multiple myeloma. These lesions exhibit a pattern of antigen expression and cytomorphology that usually leads to a ready diagnosis. However, potentially troublesome variations in immunophenotype occur. We describe a case of a plasmacytoma from a patient who presented with sudden onset of pain and a lytic lesion of the left proximal humerus. Hematoxylin and eosin-stained sections showed a lymphoproliferative lesion composed of large lymphoid cells, some with plasmacytoid and immunoblastic features. The lesion also showed significant mitotic activity. Immunohistochemical staining was positive for CD45 (LCA), CD56 (N-CAM), CD43 (MT1), and cytokeratin CAM5.2. There was also clonal staining for lambda light chains. In addition, flow cytometric analysis showed positivity for myeloid markers such as CD13, CD33, CD38, and CD138. Significant negative markers include CD20 (L26), CD45RO (UCHL-1), and CD79alpha. The unusual phenotypic features of this plasmacytoma illustrate potential diagnostic pitfalls. It is important to fully study such lesions to correctly classify them, because this has significant impact on prognosis and management.
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PMID:Plasmacytoma with aberrant expression of myeloid markers, T-cell markers, and cytokeratin. 1137 26

Most spontaneous abortions occur before 12 weeks' gestation, and most are due to chromosomal errors in the conceptus. Relatively few truly spontaneous abortions take place between 12 and 20 weeks' gestation. Thereafter, between 20 and 30 weeks another type of premature spontaneous termination due to ascending infection becomes prevalent. The number of cells expressing the various lymphocytic markers changes throughout pregnancy. In the present study, we investigated the immunohistochemical expression of mononuclear infiltrations in paraffin-embedded placentas, from fetuses after spontaneous abortion (8th, 10th, and 12th week of gestational age), and those after therapeutic abortion at the same time, using a panel of monoclonal antibodies for the identification of leukocytes (CD45/LCA), B-lymphocytes (CD20/L-26), T-lymphocytes (CD45RO/UCHL1) and CD5 cells. Immunologic factors in human reproductive failure are plausible mechanisms of infertility and spontaneous abortion. Approximately 25% of cases of premature ovarian failure appear to result from an autoimmune etiology. Unfortunately, current therapeutic options for these women are limited to exogenous hormone or gamete substitution. Local inflammation at the sites of endometriosis implants are postulated to mediate the pain and reduce fecundability associated with this clinical syndrome. The recruitment of immune cells, particularly monocytes and T cells, neovascularization around foci of invading peritoneal lesions, and the possible development of antiendometrial autoantibodies support an immunologic basis of this disorder. To date, treatment of pain and infertility associated with endometriosis is primarily surgical, although immune-based adjuvants are theoretical possibilities for the future. Finally, although hypotheses supporting immunologic mechanisms of recurrent pregnancy loss have been popular over the past decade, most clinical investigations in this area do not provide compelling evidence for this position. Reputable specialists in reproductive medicine use experimental immunotherapies judiciously in selected cases of repetitive abortion. For example, the use of anticoagulation therapy can be beneficial in cases with documented antiphospholipid antibodies. At present, however, efficacious immunotherapy protocols for general application have not been established. Despite these caveats, continued strides in our understanding of human reproductive immunology, should yield considerable future progress in this field. We conclude that, 1) maternal cells, probably CD45RO/UCHL1 positive cells, cross the maternofetal barrier and participate in spontaneous (involuntary) abortions, 2) a small proportion of maternal cells (approximately 30%), probably CD5 positive cells, also cross the maternal fetal barrier and cause growth delay and recurrent reproductive failure. The results were statistically significant (p < 0.0001, Student's t-test).
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PMID:Spontaneous abortions with increased CD5 positive cells in the placental tissue during the first trimester of gestation. 1183 55

A 68-year-old male visited Hospital A for treatment of epistaxis, his chief complaint. He was told that he had an easily-bleeding tumor in the nasal cavity. Based of biopsy, a diagnosis of amelanotic melanoma was made. Operation was performed for removal of the tumor. About 8 months after discharge, he visited Hospital B with complaints of lumbar pain and epistaxis. After biopsy at Hospital B, malignant lymphoma (diffuse large cell) was diagnosed, and the patient was referred to our hospital. On bone marrow puncture and biopsy, tumor cell infiltration was observed. Flow cytometric surface marker analysis revealed that these tumor cells were negative for CD45. Results of HE staining of the nasal cavity tumor were insufficient for diagnosis, and staining by immunohistochemistry was necessary to confirm the diagnosis. On immunohistochemical staining of the nasal cavity tumor tissue and bone marrow biopsy tissue, LCA, L26 and UCHL-1 were negative, and S-100 and HMB-45 positive. Recurrence of amelanotic melanoma accompanied by bone marrow infiltration was therefore diagnosed. The incidence of amelanotic melanoma with primary lesions in the nasal cavity is low. However, in making the diagnosis of a nasal cavity lesion, the possibility of such a melanoma should be kept in mind. In many cases, it is difficult to diagnose amelanotic melanoma with HE staining alone, and immunohistochemistry must be used.
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PMID:[A case of amelanotic melanoma of the nasal cavity]. 1218 11

Topics covered in this statement on IUDs include: mechanism of action; contraindications; efficacy; duration of use; counseling; IUD selection; insertion; the complications of perforation, bleeding and pain, infection, pregnancy, ectopic pregnancies, and expulsion; removal; and follow-up care. The newer copper- and hormone-releasing IUDs have high continuation rates, and the pregnancy rates are low. The removal in February 1986 of the Lippes Loop, the Copper 7, and the Copper T200 from the US market was for commercial reasons and not because of concerns about safety and efficacy. The Food and Drug Administration (FDA) approves these IUDs, and it is likely that the already FDA-approved Copper T380A will be available in the US during 1988. In its December 1986 meeting, the World Health Organization (WHO) scientific group on the mechanism of action, safety, and efficacy of IUDs concluded that all IUDs stimulate a foreign body reaction in the endometrium which is potentiated by the action of copper, and progestagen-releasing IUDs produce endometrial suppression much as that seen when the drug is administered by other routes. Further, the scientific group indicated that it is unlikely that 1 single mechanism of action accounts for the anti-fertility effect of IUDs. Several absolute contraindications to IUDs are recognized, including: acute or chronic pelvic inflammatory disease (PID); known or suspected pregnancy; abnormal uterine bleeding; confirmed or suspected malignancy of the genital tract; and congenital uterine abnormalities or fibroids distorting the cavity in a manner incompatible with proper IUD placement. The newer copper devices (TCu220C, TCu380Ag, TCu380A, and Multiload 375) have the lowest failure rates. Counseling of the IUD user should include telling her about all alternative family planning methods and advising her of the type of IUD to be inserted and the proper time for replacement if it is a medicated device. The available evidence from many countries suggests that properly trained nonphysicians can insert IUDs as well as doctors. The IUD may be inserted at any time convenient to the user if it can reasonably be determined that she is not pregnant. The medical indications for removal are pregnancy, acute inflammatory disease, endometrial or cervical malignancy, perforation and partial expulsion of the IUD, and abnormal or excessive bleeding. Whenever possible, it is useful to examine IUD users 3 months after IUD insertion, and annual checks are useful to ensure the IUD is in place.
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PMID:Statement on intrauterine devices (IUDs). 1226 53

A 5 year multicenter randomized study was conducted in Denmark, Finland, and Sweden to compare 2 copper IUDs, the Copper T 200 (Cu T200) and the Nova-T. The 2 devices have the same type of copper wire surrounding a central part made of silver, and both have surface areas of 200 sq mg. The effective life of both devices has been estimated at 5 years at least. 1865 insertions were made, 322 after legal abortions and the remainder intramenstrually. For the Nova-T, the cumulative net and crude rates/100 women were 2.2 and 3.4 for pregnancy, 9.3 and 12.5 for expulsion, 26.7 and 34.7 for pain and bleeding, 4.8 and 7.2 for infection, 2.9 and 5.1 for other medical cause, 14.5 and 23.3 for desire for pregnancy, 6.4 and 10.9 for other personal cause. For the Cu T200, the rates were 5.8 and 8.7 for pregnancy, 7.2 and 9.9 for expulsion, 23.7 and 29.8 for pain and bleeding, 4.3 and 6.5 for infection, 5.2 and 8.3 for other medical cause, 12.3 and 19.3 for desire for pregnancy, and 5.5 and 10.0 for other personal cuase. In 27,540 woman-months of use of the Nova-T and 29,481 woman-months of use of the Cu T200 respectively, there were 18 and 49 pregnancies, 79 and 62 expulsions, 218 and 204 removals for pain and bleeding, 39 and 37 for infection, 23 and 43 for other medical causes, 114 and 100 for desire for pregnancy, and 51 and 43 for other personal causes. There were 918 insertions of the Nova-T and 947 of the Cu T200. Among Nova-T and Cu T200 users respectively, 103 and 112 left the study, 153 and 172 completed 60 months of use, and 120 and 125 were lost to follow-up. The Pearl Index was .8 for the Nova-T and 2.0 for the Cu T200. There were 2 extrauterine pregnancies with the Nova-T and 5 with the Cu T200. Pregnancy rates for the Nova-T were lower in all 3 countries. Finland had the highest pregnancy rates and the lowest rate of removal for pain or bleeding. The pregnancy rate of the Cu T200 was strongly influenced by age and parity. The pregnancy rate of the Nova-T was less affected by age and was independent of parity. The rates of removal for pain and bleeding indicate that the Nova-T was as well tolerated by young women and nulliparas as by older parous women.
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PMID:[Nova-T and Copper-T 200 in a five year's clinical comparison]. 1231 1

300 Women at Cairo's Al-Zahraa Hospital, using 1 of 3 different IUds (CuT 200, multiload Cu250, and Lippes loop size C) to compare the rate of complications encountered among the 3 groups. Failed insertion was highest among the Cu T200 group with a rate of 3.24/HWY, hundred woman years. Accidental pregnancy was highest among that group as well. With a rate 2.16/HWY compared with 1.10/HWY among the ML Cu250 group and none among the Lippes Loop group. The spontaneous expulsion rate was the same for the Cu T200 and Lippes Loop, i.e., the rate was 4.32/HWY and 4.44/HWY for the 2 groups, respectively, compared with 1.10.HWY for the ML Cu250. The highest removal rate because of pain or bleeding was encountered among the ML Cu250 users, i.e., the rate was 4.41.HWY compared with 3.33/HWY among the Lippes Loop group and 1.08/HWY for the Cu T200 group. The overall failure rate was 8.82/HWY for ML Cu250, 11.89/HWY for Cu T200, and 11.10/HWY for the Lippes Loop group.
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PMID:A clinical study comparing the performance of three IUCDs (Multiload Copper 250, Copper T 200, and Lippes Loop C). 1231 12

The purpose of this study was to determine the discriminative factors between rheumatoid arthritis (RA) patients with and without major depression (MD). We assessed subjective sleep quality, pain, and cell-mediated immune functions in RA patients with (n = 20) and without (n = 20) MD by using Pittsburgh Sleep Quality Index (PSQI), visual analogue scale (VAS), and fluorescein isothiocyanat (FITC) labeled CD3, CD4, CD8, CDI9, CD45, CD56, and HLADR T monoclonal antibodies by flow cytometry. We found that the RA patients with MD had significantly higher pain level, poorer sleep equality, higher HDRS points, and higher HLADR T cell level than those without MD; and that these variables are discriminant factors between patient groups. These findings suggest that the RA patients with MD may be differentiated from those without MD by using VAS, PSQI, and HLADR levels; that these variables correctly classify the depressed and non depressed groups up to an accuracy level of 96.8%.
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PMID:Sleep quality and immune functions in rheumatoid arthritis patients with and without major depression. 1470 12


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