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)

Suramin sodium is an aromatic polysulfonated compound that was originally introduced as an antiparasitic agent in the 1920s. Recently, in view of its ability to bind and disrupt the function of multiple growth factors and cellular enzyme systems, the authors have been evaluating the role of suramin as an antitumor agent. In this study, 12 patients with metastatic renal cell carcinoma received parenteral suramin by continuous infusion to a peak plasma suramin level greater than 200 micrograms/ml. No objective radiographic responses were observed, although greater than 90% necrosis of multiple tumor sites was documented at autopsy in one patient and normalization of tumor-related hypercalcemia occurred in another patient. Two patients had stable disease of 10 and 28 weeks' duration, respectively. Significant toxicities included hypotension related to sepsis and resulting in renal insufficiency (one patient), development of liver function abnormalities (one patient) marked thrombocytopenia (one patient), prothrombin time prolongation (all patients), vortex keratopathy (two patients), and Grade 1 sensory neuropathy (two patients). On the basis of the current results, suramin does not appear to be an active single agent against metastatic renal cell carcinoma when administered by this dosing schedule.
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PMID:A pilot study of suramin in the treatment of metastatic renal cell carcinoma. 200 38

A total of 44 patients with infiltrating, locally advanced bladder cancer (stages T 3a-b, T 4a-b and N+/N0) were treated with the systemic chemotherapy regimen of cisplatin, methotrexate and vinblastine (CMV) in the neoadjuvant setting, of whom 39 were evaluable for response. After planned radical cystectomy and 2 to 3 cycles of chemotherapy no tumor was found on the pathological specimen of 4 patients (10%), the tumor was downstaged in 19 (49%) and no change was observed in 16 (41%). Toxicity included leukopenia in 29 patients (66%), 1 of whom died of granulocytopenic sepsis, nausea and vomiting in 39 (89%) and mild to moderate mucositis in 18 (41%). Median followup is 12 months with a range of 6 to 39 months. Of 32 patients followed for longer than 6 months 6 (19%) experienced progression or recurrence of disease. We conclude that preoperative CMV chemotherapy is effective in inducing downstaging of the tumor, although systemic toxicity limits its use to cautiously selected patients.
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PMID:Systemic preoperative chemotherapy with cisplatin, methotrexate and vinblastine for locally advanced bladder cancer: local tumor response and early followup results. 200 92

The advances in the antibiotic therapy of acute bacterial infections can be shown by the decreasing frequency of complications and fatalities in children. The annual death-rate from pneumonia in children aged one month to 15 years has fallen in Schleswig-Holstein from 1.8 (1954-1958) to 0.6 per 10,000 (1969-1973). At the same time the total death-rate in the same age group has fallen from 14.5 to 9.3 per 10,000 children. The percentage of pneumonia in the total death-rate was 5.3% in 1971-1973: 1.6% in the first month of life and after the sixteenth year 2.3%. Pneumonia was in fourth place (after accident, malformation and neoplasm) as a cause of death in children more than one month old. Of 245 children operated on for congenital heart disease in 1983-1984, bacterial and fungal infections occurred in 3.6% compared to 17.8% of 469 in 1968-1972. Staphylococcal infections decreased from 3.4% to 0.8% and those caused by gram-negative bacteria from 6.9% to 0. Perioperative prophylaxis was performed with cefotaxime plus piperacillin in 1983-1984 versus oxacillin plus ampicillin in 1968-1972. Between 1984 and 1989, 944 children (premature babies and term babies) were treated in the intensive care unit of the University Children's Hospital of Kiel. The incidence of sepsis was 5% (congenital sepsis 4%, sepsis acquired after birth 1%). Early diagnosis and treatment of severe bacterial infections with cefotaxime plus piperacillin reduced the mortality rate of sepsis to 2%. Sepsis never developed under treatment with cefotaxime plus piperacillin.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Progress of antibiotic therapy in pediatrics]. 200 18

The long-term clinical and functional results of coloanal anastomosis (CAA) in the management of low and midrectal cancer were analyzed and compared with an age matched group of patients with abdomino-perineal resection (APR). Between 1977 and 1990 85 patients underwent CAA following resection for carcinomas of the mid and low rectum (67 male and 18 female, mean age 57.3 years). In 62 patients the tumor was in the lower and in 23 patients in the middle third of the rectum. A hand-sewn anastomosis was performed in 20 patients, in the 65 most recent patients the anastomosis was performed using a circular stapling instrument. No patient died as a result of pelvic sepsis. Anastomotic leakage occurred in 7% (handsewn 20%, stapled 3%), anastomotic strictures in 2.4%. 9 months after CAA complete or near complete continence was achieved by 85% of the patients. One patient was totally incontinent. More than 3 years postoperatively (1977-1987) 57 patients with curative resection could be analyzed. 39% of the patients had Dukes' A, 31% Dukes' B and 30% Dukes' C lesions. After a mean (+/- SD) length of follow-up of 6.7 years (3-13.6 years) local recurrence cumulative rates were 11% after CAA and 17% after APR, distant recurrence rates were 33% and 34% respectively. According to Dukes' stage the cancer-related 5-years survival of patients after CAA was in Dukes' A stage 88%, in Dukes' B 56%, in Dukes' C 29% and after APR 100, 53, and 22% respectively (p greater than 0.05). From these results we conclude that intersphincteric resection with CAA is a safe and efficient alternative to APR in many distal rectal carcinomas.
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PMID:[Rectum resection with colo-anal anastomosis. Results of continence with radical surgery]. 202 65

It is currently hypothesized that the mechanisms of cancer cachexia involve the host's production of inflammatory cytokines, which in turn orchestrate a series of complex interrelated steps that ultimately lead to a chronic state of wasting, malnourishment, and death (see Fig. 1). The metabolic changes seen in the tumor-bearing host are similar, but not identical, to those seen in sepsis and inflammation and appear to result from a generalized response of the host to the stimulus of invasion--the tumor. Although there are likely to be several humoral factors, of either host or tumor origin (see Fig. 1), involved in cancer cachexia, recombinant DNA methodology has provided sufficient amounts of only a few cytokines to enable careful investigation of their cachectic potential. TNF/cachectin has been most extensively studied and appears to play a clear role, because administration of low-dose continuous or escalating doses simulates changes associated with cancer cachexia. In addition, these cachectic changes have been blocked by a specific antisera. IL-1, IL-6, and interferon-gamma all have potential as mediators of cancer cachexia and more work is clearly indicated. It is possible that, given our current understanding of the mechanisms of cancer cachexia, it can be theorized that TNF, which causes many of the manifestations of cancer cachexia, and IL-1 are released by macrophages in response to tumor (see Fig. 1). Interferon-gamma appears to potentiate these effects and may also be necessary for the complete syndrome of cancer cachexia. IL-6 probably is released as another mediator, principally mediating the acute phase response seen in cancer cachexia. Other factors are certain to be involved. Further study into the mechanisms and possible treatment of cancer cachexia is needed, because a large proportion of cancer patients who are incurable by current therapies continue to suffer from this lethal wasting diathesis. Furthermore, specific strategies to reverse the cachectic changes associated with cancer will likely improve antitumor treatment.
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PMID:Mechanisms of cancer cachexia. 202 66

A 52-year-old Japanese man manifested various clinical signs and symptoms such as vomiting, high fever, dyspnea, cough, sweating, palpitation, eosinophilic leukocytosis and hepatosplenomegaly. These histamine-related clinical manifestations showed a dramatic response to steroid therapy. After 10 months of hospitalization, he suddenly succumbed to candidal septicemia at the end of the third cycle of steroid therapy. Autopsy revealed neoplastic proliferation of immature basophils in various internal organs without involvement of the skin. The neoplastic cells, positive immunohistochemically for leukocyte common antigen, possessed lobulated nuclei and weakly metachromatic cytoplasmic granules, predominantly of the basophil type, which exhibited weak naphthol ASD-chloroacetate esterase activity. Mast cell-type granules were also observed ultrastructurally. The neoplastic infiltration was associated with fibrosis in the liver, spleen and bone marrow and with extramedullary hematopoiesis in the liver, spleen, lymph nodes and perihypophyseal tissue. The bone marrow showed uneven and multifocal involvement. Despite the lack of leukemic manifestations and the results of chromosomal analysis, the most suitable diagnosis was aleukemic basophilic leukemia within the category of chronic myeloproliferative disorder. Kinship of this neoplasia to systemic mastocytosis is discussed.
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PMID:An unusual form of chronic myeloproliferative disorder. Aleukemic basophilic leukemia. 203 58

An unusual case of bilateral blindness secondary to a cavernous sinus thrombosis is reported. A woman who had undergone reconstructive surgery after tumor resection of the floor of the mouth, was readmitted 1 month later with bilateral proptosis and signs of sepsis. There were no complaints of blurred vision. A CT-scan of the orbits demonstrated a bilateral cavernous sinus thrombosis (CST) secondary to an infection at the skull base behind the myocutaneous flap. A few days later she became blind, due to bilateral central retinal artery occlusion and anterior ischemic optic neuropathy. The general critical condition improved with intensive AB treatment. The patient recovered well without neurological defects apart from her permanent bilateral blindness. There were no signs of tumor recurrence. To our knowledge, this is the first documented case of bilateral blindness in a patient suffering from CST.
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PMID:Bilateral blindness in cavernous sinus thrombosis. 205 Apr 71

A review of 51 patients who underwent total pharyngolaryngectomy between 1972 and 1989 was undertaken and factors influencing hospital mortality and long-term survival were examined. All patients had advanced hypopharyngeal or cervical oesophageal cancer, and alimentary continuity was restored with either subcutaneous colon (39 patients) or stomach (12 patients). The overall hospital mortality rate was 25% (13 patients). Mortality was mainly caused by cardiac problems or sepsis. The 1-year survival rate was 36% and two of 26 patients (8%) survived more than 5 years. Survival was better when gastric transposition was used for reconstruction (P = 0.01). Other significant factors affecting survival were operative year, presence of metastatic cervical lymphadenopathy and microscopic pharyngeal penetration. It is concluded that surgical ablation is a viable option for advanced hypopharyngeal and cervical oesophageal neoplasia, with stomach interposition the preferred method of reconstruction. Although the prognosis is poor, satisfactory short-term palliation can be achieved.
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PMID:Surgical treatment of hypopharyngeal tumours. 205 7

Granular cell tumors are lesions that account for less than 10 per cent of benign biliary tumors and only 1 per cent occur in the biliary tract. Since the first description, 45 other cases have been described to which we add a case. In reviewing the literature, a striking predominance in black females is evident. The most frequent location of these tumors in the biliary tree appears to be the common bile duct (50%), followed by the cystic duct (37%), the hepatic ducts (15%), and the gallbladder (4%). Most patients have been treated with resection followed by restoration of biliary continuity using biliary enteric diversion. In the case presented, the tumor was located at the hepatic confluence with extension into the hepatic substance requiring segmental duct cholangiojejunostomy after resection. This resulted in fulminant sepsis and death despite adequate preoperative biliary decompression and the lack of signs or symptoms of infected bile. Alternative forms of management in the treatment of this benign condition at this location are discussed.
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PMID:Resection of a granular cell tumor at the hepatic confluence. A precarious location for a benign tumor. 205 52

The authors describe the results of five pediatric patients with nonmetastatic osteosarcoma of an extremity, admitted from 1987 to 1989 to the Hospital Infantil del Estado de Sonora. Four patients presented with their primary tumor located at the distal end of the femur, whereas one had a primary lesion of the humerus. All of them received preoperative chemotherapy consisted of two cycles of cisplatin and adriamycin. One of the patients presented immediate complications after first cicle and died due to overwhelming sepsis by Candida albicans. Surgery was an amputation in one patients and block ressection in three cases. Necrosis was good in three cases, fair in one. Postoperative chemotherapy consisted of bleomycin, cyclophosphamide and dactinomycin every four weeks alternated with cisplatin plus adriamycin. One of the three patients, in which block ressection was made, had a local recurrence 12 months after diagnosis, without metastasis. He underwent desarticulation and died four months later of leukoencephalopathy and no tumor was found on necropsy. Three patients have remained continuously free of disease with follow up of 20, 26 and 31 months after diagnosis and are out of chemotherapy since 5, 12 and 17 months, respectively. In two of them the affected extremity still is safe.
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PMID:[Treatment of osteosarcoma in children with pre- and postoperative chemotherapy and block resection of the tumor]. 206 45


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