Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case is reported of nontraumatic hemobilia, which occurred twice in the same patient. Initially it was due to carcinoma of the gallbladder and 7 years later it was due to a ruptured intrahepatic aneurysm. The management of these two conditions is reviewed. The clinical marker of nontraumatic hemobilia originating in the gallbladder is the hemocholecyst and the treatment is cholecystectomy. Ruptured intrahepatic aneurysm can be diagnosed only by angiography. Cholangiography is indicated to rule out pathologic conditions of the ducts. In the absence of hepatobiliary sepsis selective hepatic artery ligation is the preferred treatment, otherwise hepatic resection is required.
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PMID:Nontraumatic hemobilia: disparate episodes 7 years apart in the same patient. 44 52

Infectious mural endocarditis is uncommon and not well documented. The clinical setting and pathologic features of five patients with Aspergillus mural endocarditis are described. Leukemia, carcinoma, renal transplantation, and hepatic failure were the primary diseases. Associated conditions include high-dose corticosteroids, cytotoxic therapy, renal failure, gram-negative sepsis, and endotracheal intubation. All patients received prolonged antibiotic therapy or treatment with three or more antibiotics. All had clinically undetected aspergillosis and severe fungal pneumonia. Fungal myocardial abscesses were present in each patient. Aspergillus mural endocarditis developed in more than 40% of patients with cardiac aspergillosis. Endocardial vegetations were contiguous with underlying myocardial infection; yet they may develop initially as a subendocardial focus rather than from a myocardial abscess. Aspergillus mural endocarditis progressed to destroy the mitral valve ring and served as a source of mycotic embolization to vital organs.
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PMID:Aspergillus mural endocarditis. 45 81

Subphrenic abscess is reported in two patients, one previously operated on for pancreatic carcinoma and the other for clear cell carcinoma of the left kidney. The subphrenic abscess presented with cachexia and low grade fever six months and one year after surgery. Metastatic carcinoma was erroneously diagnosed in both patients. Despite massive antibiotic treatment, both patients succumbed to sepsis. Because of the inherent diagnostic challenge, delineation of a subphrenic abscess in cancer patients without clear-cut evidence of a metastatic spread is crucial.
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PMID:Subphrenic abscess simulating metastatic carcinoma. 47 41

Terminal endocarditis develope in cancer patients almost latently. There is no difference between the so-called "tumor-endocarditis" and other verrucous endocarditis associated with terminal tuberculosis, sepsis or rheumatism. It is more frequent in cases with large or ulcerated primary tumours and multiple metastases than in cases with early cancer. It also develope more frequently in well differentiated cancer (squamous and adenocarcinoma) than in indifferentiated forms of cancer. Terminal endocarditis is often seen in patients with cancer of the gallbladder, pancreas, liver, stomach, rectum, and ovary. In carcinoma of the liver, pancreas and biliary tract the trend to embolism is more reduced through icterus than the trend to terminal endocarditis.
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PMID:[Endocarditis in cancer necropsies (author's transl)]. 47 52

The spectrum and incidence of liver disease is described among a large series of patients with inflammatory bowel disease. The incidence of significant liver disease identified by the presence of serial biochemical abnormalities of liver function was 8.2 per cent. Transient peri-operative changes in liver function tests are common and usually relate to underlying intra-abdominal sepsis. Percholangitis, sometimes termed portal triaditis, is one of the commoner lesions, and is usually associated with extensive colitis and improves with resection of the underlying bowel disease. Cirrhosis of the liver is an important but uncommon complication and is usually associated with extensive long-standing disease. Stenosing cholangitis and biliary tract carcinoma are both important though rare associations. They are both associated with extensive disease of long-standing, but resection of the underlying inflammatory bowel disease does not necessarily protect the individual from these complications. Although stenosing cholangitis is a diffuse lesion of the biliary tree it is important to exclude strictures of the extra-hepatic biliary tree which may be amenable to surgical correction. Hepatic dysfunction is rarely the sole indication for advising surgery for the underlying bowel disease but the identification of the nature of the hepati- dysfunction provides a rational basis for such a decision and opportunities for the surgical correction of the hepatic lesion itself.
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PMID:The spectrum of hepatic dysfunction in inflammatory bowel disease. 48 86

We prospectively studied patients with Streptococcus bovis septicemia for the presence of gastrointestinal lesions. This study was prompted by our reported findings of the association of fecal carriage of S. bovis with carcinoma of the colon. We studied 29 patients with 30 episodes of S. bovis septicemia. Fifteen completed gastrointestinal evaluations that included colonscopy, surgery, or autopsy. Eight of these had carcinoma of the colon, three had adenomatous polyps of the colon without carcinoma, and two had carcinoma of the esophagus. The 14 patients who did not have complete evaluations included one each with carcinoma of the stomach, gastric lymphoma, and adenomatous polyp of the colon and three with colonic masses not further delineated. Nineteen patients had no gastrointestinal signs or symptoms or stools positive for occult blood at admission. The results of our study suggest that all patients with S. bovis septicemia need aggressive evaluation of the gastrointestinal tract, especially the colon.
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PMID:Streptococcus bovis septicemia and carcinoma of the colon. 48 53

Vindesine, a new vinca alkaloid, has shown therapeutic activity in several human malignancies. A phase II study in 26 patients with squamous cell carcinoma of the esophagus was performed. Sixty percent of these patients had received prior chemotherapy. The starting dose was 3.0 mg/m2, which was escalated by 0.5 mg/m2 to a maximum of 4.5 mg/m2. Treatment was given once weekly for 7 weeks and every other week thereafter. Twenty-three patients were evaluable for response and toxicity. One complete remission (3 months), three partial remissions (5, 4, and 2+ months), and two minor responses (1.5 and 1 month) were seen. The major toxic effects were peripheral neuropathy, leukopenia, fever and myalgias, and alopecia. There was one drug-related death from leukopenia and sepsis. Vindesine has demonstrated therapeutic activity in esophageal carcinoma. Further studies with this agent are indicated.
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PMID:Vindesine in the treatment of esophageal carcinoma: a phase II study. 52 35

Cushing's syndrome may be caused by pituitary ACTH, ectopically produced ACTH, adrenocortical tumor or medication. Cushing's disease, due to excessive pituitary ACTH resulting in adrenocortical hyperplasia, remains a complex endocrine disorder for which no single treatment is wholly satisfactory. Twenty-two patients with surgically treated Cushing's syndrome are presented: Four with benign adrenocortical adenoma, two with adrenocortical carcinoma and 16 with adrenocortical hyperplasia. The four benign adenomas were excised with the one death due to respiratory failure and sepsis. Both patients with carcinoma and liver metastases died of their tumors. Of the 16 patients with adrenocortical hyperplasia and Cushing's disease, eight underwent subtotal adrenalectomy and thereafter eight had total intra-abdominal adrenalectomy with autotransplantation of adrenal tissue to the thigh. There was one operative death. Total adrenalectomy has now replaced subtotal resection in most clinics. All eight of the patients who had adrenal autotransplantation exhibited biopsy or functional evidence of some degree of graft survival. On patient stopped steroid replacement permanently and another developed recurrent Cushing's syndrome from the grafts. Of a total of 26 reported patients with adrenal autotransplants surveyed, 22 exhibited evidence of graft survival, 16 were able to discontinue steroid replacement therapy and three eventually developed recurrent Cushing's syndrome from the transplants. There is now strong evidence that most patients with Cushing's disease harbor a pituitary basophil ademona, and in the future the initial surgical attack may be directed to the pituitary rather than to the adrenals.
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PMID:Surgical management of Cushing's syndrome with emphasis on adrenal autotransplantation. 68 95

Fifty patients who had developed empyema after pulmonary resection for primary carcinoma of the lung were individually paired with patients who had not suffered this complication. Pairs were matched as far as possible for age, sex, extent of operation, histology of tumour, extent of primary spread, extent of lymphatic spread, and use of postoperative radiotherapy. Analysis of survival times both for the matched pairs and for the two groups of patients showed no significant difference in long-term survival. The results suggest that any immunological suppression of carcinoma cells due to sepsis in the pleural space is ineffective in prolonging survival.
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PMID:Influence of postoperative empyema on survival after pulmonary resection for bronchogenic carcinoma. 71 81

The clinical course, operative treatment, and results of 129 patients with carcinoma obstructing the left side of the colon were reviewed. There were 64 cases of incomplete obstruction, all secondary to primary adenocarcinoma of the colon. Sixty-five patients had complete obstruction; 37 of these had primary adenocarcinoma of the colon, and the rest, cancer from other primary sites, largely the genitourinary tract. The operations involving colostomy only or colostomy as part of a staged resection resulted in high operative mortality and low long-term survival, in addition to a high rate of postoperative sepsis. Results of operations involving primary resection of obstructing tumor were superior in all the above factors studied.
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PMID:Carcinoma obstructing the left side of the colon. 84 62


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