Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0403608 (ureter)
 9,655 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Total Hysterectomy has been until non performed by extracervical "enucleation" of the fascia of the uterine corpus with amputation of the vagina. The new method leaves the extrafascial highly vascularised vascular stem, the corresponding nerves and the topography of the ureter untouched. It is limited to an intrafascial cylindriform enucleation of the cervix. The diameter of the cervical cylinder can be determined beforehand by vaginal sonography. Punching-out is effected from a new instrument C.U.R.T. (= calibrated uterine resection tool) of 10-20 mm diameter. A cervicohaemostaser provides for safe transvaginal haemostasis in the residual cervix. The transvaginal sexual sensations of the patient are not impaired due to the fact that the cardinal ligaments are preserved as well as the nerve supply of the cervical fascia. Suspension of the cervical fascia at the supporting ligaments of the uterus can be performed in an ideal manner. Pelviscopic extirpation of the uterus is done in the classical way used in abdominal hysterectomy with ligature and suture. Morcellated cylinders of 2-3 cms in diameter, of the cervix and corpus uteri and even of myomas up to the size of a child's head, will suffice for relevant histological examination. The physical stress to which the patient is exposed is about the same as in routine surgical pelviscopy. The abdominal space remains practically unopened in pelviscopic transabdominal hysterectomy. Pelviscopic transabdominal hysterectomy with and without adnexae according to the CASH technique corresponds to surgery performed with a minimum of invasiveness. It is fully sufficient as regards cancer prophylaxis with respect to cervical or endometrial cancer.
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PMID:[Hysterectomy via laparotomy or pelviscopy. A new CASH method without colpotomy]. 183 98

Symptomatic clinical changes and urodynamic changes are apparent in the female urinary tract system during pregnancy, the menstrual cycle and following the menopause. The sex hormones exert physiological effects on the female urinary tract, from the ureters to the urethra, with oestrogens having an additional influence on the structures of the pelvic floor. High affinity oestrogen receptors have been identified in bladder, trigone, urethra and pubococcygeus muscle of women. Oestrogen pretreatment enhances the contractile response of animal detrusor muscle to alpha-adrenoceptor agonists, cholinomimetics and prostaglandins, as well as enhancing the contractile response to alpha-agonists in ureter and urethra. Progesterone on the other hand decreases tone in the ureter, bladder and urethra by enhancing beta-adrenergic responses. The dependence on oestrogens of the tissues of the lower urinary tract contributes to increased urinary problems in postmenopausal women. Urinary symptoms due to atrophic mucosal changes respond well to oestrogen replacement therapy. However, because they recur when treatment is stopped, continuous therapy with low dose natural oestrogens is recommended. Oestrogens may be of benefit in postmenopausal women with stress incontinence, but the doses necessary for clinical effect are higher than for the treatment of atrophic urethritis. The practice of adding a progestagen to long term oestrogen therapy to reduce the risk of endometrial carcinoma may, however, exacerbate stress incontinence by decreasing urethral pressure. Cyclical therapy with oestrogens may therefore be more appropriate particularly in women who are not suitable for surgery or have a mild degree of stress incontinence, along with other conservative measures such as pelvic floor exercises and alpha-adrenoceptor agonists. The place of oestrogen therapy in motor urge incontinence has not been determined. The risk of developing endometrial carcinoma as a result of long term high dose oestrogen replacement therapy must be borne in mind but remains to be clarified. However, oestriol has less of a uterotrophic effect compared to other oestrogens in standard therapeutic doses and is to be preferred. Side effects are usually dose related and tend not to be a problem with low dose therapy.
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PMID:Sex hormones and the female urinary tract. 306 38

Wertheim radical hysterectomy combined with pelvic lymphadenectomy was performed at the Helsinki University Central Hospital on 132 women of whom 120 had cervical carcinoma from Stage IA to early IIB and 12 had endometrial carcinoma Stage II. None of the patients died or had severe complications during their hospitalisation. The left ureter was accidently transected in two patients and both were corrected immediately. Wound complications occurred in 16 patients (12%). The high incidence of wound complications is probably partly related to the low-dose heparin prophylaxis. The initial clinical staging was found to be correct in 85% of the cases. Five cases were under-staged. All ten patients cases of early Stage IIB were over-staged, none of whom had parametrial invasion. The predictive value of lymphangiography was low, 14% in histologically positive cases and 89% in negative cases of lymph node metastases. Lymphangiography proved to be only of value in facilitating complete lymph node dissection. Intra-operative lymphangiographic control revealed radio-positive nodes and lead to further dissection in 30 patients (24%).
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PMID:Wertheim radical hysterectomy. Surgical complications, accuracy of clinical staging and value of lymphangiography in cervical carcinoma. 402 80

Patients with endometrial carcinomas who have undergone only radiation therapy represent a negative selection, because of the many concomitant diseases. In the author's group of 134 cases such patients were on average 7 years older than those who had undergone surgery. Even with computer-calculated opposing-field therapy with intracavity packing, radiation damage to the urinary tract must be expected. Of the 134 patients, 75 (55.9%) had pathologic urological findings following radiation therapy. The most commonly affected organ was the bladder (55.2%), followed by the kidneys (21.6%) and the ureter (7.5%). Radiation damage to the urethra could not be verified. The urological complications were hardly affected by the stage of the tumor, but considerably so by the time interval: the rate of urological complications was 68.9% higher after 5 years than after 1 year. Therefore, accurate statements concerning urological complications following primary radiation therapy for endometrial carcinoma cannot be made until 5 years have elapsed.
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PMID:[Urologic complications following radiotherapy of cancers of the corpus uteri]. 405 45

Hereditary nonpolyposis colorectal cancer (HNPCC), also termed Lynch syndrome, may account for as much as 10-15 percent of the total colorectal burden. Lynch syndrome I is characterized by site-specific colorectal cancer (CRC) with early (congruent to age 45) onset, predilection to the proximal colon (congruent to 70%), and a marked susceptibility to metachronous CRC (45% following hemicolectomy or segmental resection). Lynch syndrome II shows the same colonic features but includes an excess of extra-colonic CRCs, namely carcinoma of the endometrium, ovary, small bowel, stomach, pancreas and transitional cell carcinoma of the ureter and renal pelvis. These findings form the basis for our surveillance recommendations: full colonoscopy initiated at age 25 and repeated every other year, and, in Lynch syndrome II variant, biannual endometrial aspiration biopsy. Screening for the remaining cancer types is dependent upon the availability of screening modalities and the pattern of cancer expression within specific families. The excess of metachronous CRC mandates that subtotal colectomy be performed for any CRC. The lack of premonitory physical stigmata has forced clinicians to diagnose HNPCC based on the family history in concert with the natural history features of the cancer phenotype within the pedigree. Problems with this approach include variable gene penetrance, the fact that cancer affected may or may not be gene carriers, death of gene carriers prior to developing cancer, and difficulty with pathology verification of tumor site and type. Partial resolution of these problems is possible now that HNPCC has been linked to chromosomes 2p and 3p and the susceptibility gene at chromosome 2p has been cloned.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Genetics, natural history, surveillance, management, and gene mapping in the Lynch syndrome. 767 41

Hereditary nonpolyposis colon cancer (HNPCC) is an autosomal dominant trait responsible for approximately 6% of colorectal cancers. Linkage of the HNPCC trait to the D2S123 locus on 2p15-16 has previously been reported in two families. This HNPCC locus is now designated "COCA1." We have tested seven Canadian HNPCC families, who have a variety of clinical presentations, for linkage to a panel of microsatellite polymorphisms in the vicinity of D2S123. One family was clearly linked to the COCA1 locus (LOD = 4.21), and a second family is likely to be linked (LOD = 0.92). In three families linkage was excluded. In the remaining two families the data were inconclusive. In the linked family, individuals with cancer of the endometrium or ureter share a common haplotype with 12 family members with colorectal cancer. This supports the suspected association between these extracolonic neoplasms and the HNPCC syndrome. In addition, five of the six individuals with adenomatous polyps (but no colorectal cancer) have the same haplotype as the affected individuals, while the sixth carries a recombination. One individual with colorectal cancer carries a recombination that places the COCA1 locus telomeric to D2S123. This study localizes the COCA1 gene to an 8-cM region that is consistent with the location of the hMSH2 gene. We also confirm that families presently classified as HNPCC are genetically heterogeneous.
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PMID:Hereditary nonpolyposis colon cancer: analysis of linkage to 2p15-16 places the COCA1 locus telomeric to D2S123 and reveals genetic heterogeneity in seven Canadian families. 819 29

We report 59 patients who were considered candidates for laparoscopically assisted surgical staging (LASS) to manage their clinical stage I adenocarcinoma of the endometrium. Their ages ranged from 40 to 85 years, with a mean of 69; their weights ranged from 102 to 267 pounds, with a mean of 153 pounds. Patients with intraperitoneal disease were taken off study. Laparoscopic pelvic and para-aortic lymphadenectomies were performed based on the grade of the tumor and the depth of myometrial invasion. Six patients were discovered to have intraperitoneal disease. Of the remaining 53 patients, 29 underwent lymphadenectomy, 1 of whom had positive para-aortic nodes. Of the 24 patients who did not have laparoscopic lymphadenectomy, 2 should have, according to the study criteria; however, obesity precluded this from being performed. Eight patients had grade 3 lesions; of these, 4 lesions had metastasized. The remaining 3 patients with metastatic disease had grade 2 lesions. Complications were related to the laparoscopically assisted vaginal hysterectomy and resulted in two laparotomies: one for a transected ureter and the other for a cystotomy. Estimated blood loss was < 200 cc and the average hospital stay was 2.9 days. We feel that LASS is an attractive alternative to the traditional surgical approach in patients with stage I endometrial carcinoma.
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PMID:Laparoscopically assisted surgical staging (LASS) of endometrial cancer. 824 71

Hereditary nonpolyposis colorectal cancer (HNPCC) dates to Warthin's description of family G, which he began studying in 1895. Warthin's observations were not fully appreciated until 1966 when two families with an autosomal dominant inheritance pattern of nonpolyposis colorectal cancer (CRC) and endometrial cancer were described. This condition was first termed the "cancer family syndrome" and was later renamed HNPCC. Some have proposed that HNPCC consists of at least two syndromes: Lynch syndrome I, with hereditary predisposition for CRC having early (approximately 44 years) age of onset, a proclivity (70%) for the proximal colon, and an excess of synchronous and metachronous colonic cancers and Lynch syndrome II, featuring a similar colonic phenotype accompanied by a high risk for carcinoma of the endometrium. Transitional cell carcinoma of the ureter and renal pelvis and carcinomas of the stomach, small bowel, ovary, and pancreas also afflict some families. Current estimates indicate that HNPCC may account for as much as 6% of the total CRC burden. There are no known premonitory phenotypic signs or biomarkers of cancer susceptibility in the Lynch syndromes. This report will summarize current knowledge, with emphasis on the manner in which this knowledge can be employed effectively for diagnosis and management of HNPCC.
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PMID:Genetics, natural history, tumor spectrum, and pathology of hereditary nonpolyposis colorectal cancer: an updated review. 848 67

Human genital skin fibroblasts contain both the full-length 110 K androgen receptor protein (AR-B, apparent M(r) approximately 110,000) and an 87 K N-terminally truncated AR isoform (AR-A, apparent M(r) approximately 87,000). These two AR species are structurally analogous to the A- and B-isoforms of the progesterone receptor (PR). We examined the distribution pattern of human AR isoforms in a variety of fetal and adult tissues by Western blot analysis. Relative levels of immunoreactive AR proteins in high salt tissue extracts were estimated by densitometry in comparison to a standard normal genital skin fibroblast preparation. High AR levels (AR-A + AR-B = 0.8-7.7) were present in male and female reproductive tissues from mid-trimester fetuses, including penis, prostate, testis, epididymis, scrotal skin, labial skin, uterus/cervix, and ovary. AR-A and AR-B (0.08-0.9) also were found in 14 non-genital fetal tissues (bladder, fat, lung, great vessel, trachea, muscle, scalp skin, kidney, thyroid, intestine, thymus, ureter, stomach and rectum). AR-A accounted for 4-26% of the AR protein detected in these tissues. Ten other fetal tissues had low levels of AR-B (0.02-0.3) and little or no detectable AR-A. AR-B also was the predominant or only immunoreactive AR species found in 17 adult human tissues. AR levels in adult reproductive tissues (prostate, endometrium, ovary, uterus, fallopian tube, testis, seminal vesicle, myometrium, and ejaculatory duct) ranged from 0.1 to 2.2. Immunoreactive AR (0.4-0.8) also was present in specimens of prostate carcinoma, endometrial carcinoma, thyroid carcinoma and kidney. Lower levels of AR (0.03-0.1) were detected in adult breast, colon, lung and adrenal gland specimens. This study demonstrates that immunoreactive AR protein is present in a wide variety of human fetal and adult tissues and that two AR isoforms are expressed in many tissues.
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PMID:A and B forms of the androgen receptor are expressed in a variety of human tissues. 880 38

Hereditary non-polyposis colorectal cancer (HNPCC) is an autosomal, dominantly inherited disease leading to a marked increase in cancer susceptibility, notably colorectal cancer, affecting up to one in 400 individuals in the Western world. Four genes responsible for the majority of cases have been identified. Colorectal cancer in affected people tends to be right sided, occur at an earlier age, and there is a propensity for synchronous or metachronous lesions. Extra-colonic tumours may occur with an elevated frequency, most importantly cancer of the endometrium, but also stomach, hepatobiliary system, small bowel, proximal ureter and renal pelvis, and ovary. On account of these features, management guidelines for members of HNPCC kindreds require modification from those generally advised for patients with sporadic tumours. The cardinal feature for the identification of affected families is the family history. All clinicians have a duty to identify such patients under their care as appropriate screening and surgery should lead to an improved prognosis for such patients and their families.
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PMID:[Hereditary nonpolyposis colorectal cancers]. 884 75


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