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)

Sepsis was diagnosed in 9.5%-14.1% of fatalities in children. It was more frequently umbilical and caused by staphylococci, although of late mixed bacterial microflora was not infrequently detected. In 39 observations studied in detail sepsis was combined with acute respiratory infections (ARI) among which most important were viral respiratory infections (AVRI) as well as mycoplasmosis. The most important was the fact that AVRI not only were conducive to the generation of sepsis but caused its exacerbation. In the latter cases the development of fresh septic metastases was observed. This was associated with local (vascular damage) and general (disorders in the immunological status) changes in the patients arising as a result of AVRI.
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PMID:[Effect of viral respiratory infections on the development and course of bacterial sepsis]. 708 91

Resection with preservation of the anal sphincters is new widely accepted as providing satisfactory treatment for carcinoma of the upper rectum. However, restorative resection is less widely performed for tumours of the lower rectum because anastomosis can be technically difficult when performed low in the pelvis. Between 1973 and 1980, 76 patients with rectal carcinoma underwent rectal resection and restoration of bowel continuity by means of a sutured anastomosis between colon and anal canal. The pathological characteristics of these tumours were similar to those of all cases of carcinoma of the rectum treated at St. Mark's Hospital between 1948 and 1972. Two patients developed pelvic sepsis following colonic necrosis and anastomotic breakdown. Eight developed pelvic sepsis without major anastomotic breakdown. No patient died as a result of pelvic sepsis. Sixty-nine of the 70 patients who were able to be assessed were either completely normal functionally or had only minor deficiencies of bowel function. Six patients have been observed to develop recurrent pelvic tumour, localized to the pelvis in 4 patients and concurrent with the development of widespread metastases in 2. Twenty-one of 32 patients are alive 3 years and 12 of 19 patients are alive 5 years after a curative operation for rectal carcinoma. These results are comparable with those seen following total excision of the rectum and pelvic floor for similarly sited tumours.
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PMID:Resection and sutured colo-anal anastomosis for rectal carcinoma. 708 51

We studied 31 autopsied cases of gestational choriocarcinoma encountered at the Northwestern University Trophoblastic Disease Center in the past two decades to learn if the clinical and morphologic aspects of these cases have been altered by therapy. These cases were analyzed for cause of death, distribution of tumor and histologic patterns in relation to the amount of chemotherapy. Tumor hemorrhage and/or pulmonary insufficiency were the most common causes of death, irrespective of the amount of therapy although other factors including drug toxicity, sepsis, and uremia led to death in six cases. The amount of chemotherapy generally did not affect the number or distribution of metastases. Histologically, nine cases showed extensive or complete necrosis. Eighteen of the remaining tumors had typical biphasic patterns, but four patients who received multiple courses of chemotherapy had atypical patterns with a marked predominance of cytotrophoblast and infiltrative growth. These atypical patterns do not appear to be a direct result of chemotherapy but may represent a more aggressive form of this tumor. This study shows that fatal gestational choriocarcinoma can have a variety of clinicopathologic features which reflect not only the biologic capabilities of the neoplasm but also the effects of chemotherapy and prolonged disease.
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PMID:Fatal gestational choriocarcinoma. Clinicopathologic study of patients treated at a trophoblastic disease center. 711 8

The investigation of sepsis and a number of complications of purulent wounds in 336 patients has shown the expediency to distinguish three stages of the microbial and metabolic toxemia. The third stage of toxemia is found to be the most dangerous (terminal) one. The lethality rate by the data of different scientists can reach 95%. The effective antiseptic method was found to be microvasoplegy, forced antiseptics (antibiotics) with forced diuresis or peritoneal dialysis. The third stage of toxemia with multiple metastases gave poor results after treatment by all the routine methods.
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PMID:[Difficulties in the treatment of wound infection and complications of suppurative wounds]. 715 89

A total of 24 patients with renal cell carcinoma involving the inferior vena cava underwent thoracoabdominal radical nephrectomy with removal of tumor thrombus by an open or closed technique. The tumor extended in the inferior vena cava to the level of the renal or lower hepatic veins in 18 patients and it reached the level of the diaphragm or right atrium in 6. Of the 24 patients 3 with preoperative findings minimally suggestive of disseminated disease were shown later to have metastases in the questionable areas, 3 with disease at the level of the diaphragm had incomplete resections, 4 had metastases to regional lymph nodes and 1 had questionable preoperative findings and lymph node metastases. Only 13 of the 24 patients (54 per cent) did not have either disseminated or residual tumor postoperatively. The mean survival duration of this subgroup (20 months) was comparable to that of the group as a whole (21 months). However, 4 patients from this subgroup are free of disease, with a mean followup of 30 months. There was 1 postoperative death. Morbidity, including renal failure, intraoperative hypotension and sepsis, was common. The results in this series suggest that the prognosis for patients with renal cell carcinoma and inferior vena cava involvement is guarded.
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PMID:Results of inferior vena cava resection for renal cell carcinoma. 724 72

A retrospective study was made of 106 locally and regionally advanced epidermoid carcinomas of the trunk and extremity treated from 1949 to 1970. Forty-six of the tumors had a known cause, of which radiation exposure was the most common. In addition to axillary and inguinal nodal metastases, these cancers also manifested intransit, epitrochlear and popliteal lymphatic metastatic disease. Surgical treatment consisted of wide monobloc resection for the majority of the primary neoplasms, amputation being necessary for tumors fixed to skeletal or neurovascular structures. Clinically enlarged regional lymph nodes were subjected to biopsy, but elective regional node dissection did not offer therapeutic benefit. Patients with biopsy proved nodal metastases were treated by either radical nodal dissection or high exarticulation, with similar results. Actuarial five year survival rates after definitive surgical treatment were 71 per cent for patients with regional node-negative and 57 per cent for those with regional node-positive tumors. Local and regional recurrences of tumors were frequent in patients who had deep seated tumors of the trunk and postsacral region, or bulky nodal disease, despite pathologically negative resection margins. Uncontrolled recurrent tumor with sepsis and compromise of vital organ function was the most common cause of death. Radiation therapy achieved partial regression of the tumor in eight patients and complete regression in one of 15 patients. A critical analysis is made of the various clinicopathologic factors which affect prognosis, and the possible means of improving the results of treatment are discussed.
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PMID:Treatment of regionally advanced epidermoid carcinoma of the extremity and trunk. 736 Dec 47

Indications for surgery, operative procedures, and the early and late sequelae of surgery for Crohn's ileocolitis have been studied in a series of 250 patients admitted to Mount Sinai Hospital, New York, between 1960 and 1975. The most common indications for surgery were small-bowel obstruction in ileocolitis, and medical intractability in Crohn's colitis. Early postoperative complications (within 30 days of surgery) followed 79 operative procedures (15%), and were most commonly wound infections (7%), intra-abdominal abscess (2.6%), and postoperative intestinal obstruction (2.4%). Late sequelae (30 days to 15 years following surgery) included intestinal obstruction in 36 patients, external fistulae in 41 patients, and ileostomy problems in 19 patients, and were most frequently caused by recurrent disease in the terminal portion of the ileum. Mortality following surgery for Crohn's disease may be subdivided into two groups, early and late. All eight early postoperative deaths were secondary to sepsis, present in every instance prior to operation. The eight late deaths were caused by metastatic cancer in six and recurrent disease in two. Resection of excluded segments of bowel, as in four of the patients in this series, will reduce the late cancer risk.
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PMID:Surgery and its sequelae in Crohn's colitis and ileocolitis. 746 65

Previous studies have suggested that women with uterine rhabdomyosarcomas (RMS) represent a distinct group of patients who present at an older age, are less responsive to treatment, and have a poorer prognosis than patients with vaginal RMS. During the Intergroup Rhabdomyosarcoma Study (IRS) III and the IRS IV pilot study, 14 patients were registered with uterine primary RMS. Three patients presented with cervical tumors that were completely removed (group 1). Eight patients had initial biopsies with gross residual disease (group 3), and 3 had metastatic disease at presentation (group 4). Of the 5 patients treated with primary chemotherapy or chemotherapy and radiation, 2 had delayed hysterectomy and vaginectomy, 1 had no further surgery, and 2 had exploratory laparotomy with no evidence of disease. There were no relapses or deaths in this group. One patient underwent initial resection of a broad ligament mass, experienced an early (3-week) recurrence of the mass while on chemotherapy, and progressed to developing distant metastases and death. Four patients died of chemotherapy toxicity or sepsis, one after achieving a complete response from chemotherapy and hysterectomy. This primary chemotherapy or chemotherapy and radiotherapy regimen resulted in 8 of 9 (89%) patients (not including those who died of chemotoxicity) surviving between 1.5 and 6 years without evidence of disease. Of the surviving patients, 2 had hysterectomy and vaginectomy, but pathological specimens showed only localized microscopic residual tumor. This report suggests that less vigorous operative resection may be possible in combination with primary chemotherapy when treating uterine rhabdomyosarcomas.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Conservative management of uterine pediatric rhabdomyosarcoma: a report from the Intergroup Rhabdomyosarcoma Study III and IV pilot. 747 49

Fifty-five patients had resection of locally recurrent rectal cancer. Fourteen patients (25 per cent) had distant metastases, which were resected concurrently in six (11 per cent). Thirty-three patients (60 per cent) had preoperative (one patient) or postoperative (32) external beam radiotherapy (45-60 Gy). The 5-year survival rate was 18 per cent with a median survival of 24 months. The median symptom-free interval was 24 months. At a median follow-up of 28 months 53 per cent of patients had a second local recurrence and 24 per cent metastases only. Treatment complications occurred in 12 patients (22 per cent), three (5 per cent) of whom died 3-10 months after operation. Variables that were significantly related with longer survival and palliation were the radical nature of the operation, the absence of severe symptoms (such as pain, obstruction or sepsis), a recurrent tumour diameter of less than 5 cm measured on the resected specimen and a normal carcinoembryonic antigen level after reoperation. A Cox regression model showed that recurrent tumour diameter was the only independent prognostic variable. Surgery for local recurrence achieved local control in 47 per cent of patients with a low morbidity and mortality rate.
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PMID:Prognostic factors in surgery for local recurrence of rectal cancer. 748 78

Inflammatory myofibroblastic tumor (IMT) or inflammatory pseudotumor is a spindle cell proliferation of disputed nosology, with a distinctive fibroinflammatory and even pseudosarcomatous appearance. Although the lung is the best known and most common site, inflammatory myofibroblastic tumor occurs in diverse extrapulmonary locations. We report our experience with 84 cases occurring in the soft tissues and viscera of 48 female patients and 36 male patients between the ages of 3 months and 46 years (mean, 9.7 years; median, 9 years). A mass, fever, weight loss, pain, and site-specific symptoms were the presenting complaints. Laboratory abnormalities included anemia, thrombocytosis, polyclonal hypergammaglobulinemia, and elevated erythrocyte sedimentation rate. Sites of involvement included abdomen, retroperitoneum, or pelvis (61 cases); head and neck, including upper respiratory tract (12 cases); trunk (8 cases); and extremities (3 cases). The lesions ranged in size from 1 to 17 cm (mean, 6.4; median, 6.0). Excision was performed in 69 cases. Eight had biopsy only. Five patients received chemotherapy or radiation in addition to undergoing biopsy or resection as initial treatment. Sixteen patients had multinodular masses involving one region. Clinical follow-up in 53 cases revealed that 44 patients were alive with no evidence of disease, four were alive with IMT, and five were dead. Thirteen patients had one or more recurrences at intervals of 1-24 months (mean, 6 months; median, 10 months). No distant metastases were documented. The five patients who died had complications either due to the location of the lesion (heart, peritoneum, retroperitoneum, or mesentery) or related to treatment (lymphoproliferative disorder following hepatic transplantation; sepsis following wound infection). The abdominal masses were the largest. All tumors were firm and white with infiltrative borders and focal myxoid change. Three basic histologic patterns were recognized: (a) myxoid, vascular, and inflammatory areas resembling nodular fasciitis; (b) compact spindle cells with intermingled inflammatory cells (lymphocytes, plasma cells, and eosinophils) resembling fibrous histiocytoma; and (c) dense plate-like collagen resembling a desmoid or scar. Immunohistochemistry demonstrated positivity for vimentin, muscle-specific actin, smooth muscle actin, and cytokeratin consistent with myofibroblasts. Based on this series, inflammatory myofibroblastic tumor is a benign, nonmetastasizing proliferation of myofibroblasts with a potential for recurrence and persistent local growth, similar in some respects to the fibromatoses.
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PMID:Extrapulmonary inflammatory myofibroblastic tumor (inflammatory pseudotumor). A clinicopathologic and immunohistochemical study of 84 cases. 866 41


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