Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:Q86TM3 (cage)
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Bronchial cancer associated with a homolateral malignant pleurisy is classed as T4 whether the pleural disease is a direct extension or metastatic. Effusions without neoplastic cells do not enter into the TNM classification. Investigations of pleural disease consist initially of needle biopsies, completed sometimes by a thoracoscopy, which enable a precise staging and also the achievement of a pleurodesis. A review of the literature does not currently establish the value of a pleurectomy in cases of a homolateral effusion in bronchial carcinoma. Surgical excision may be carried out in a case of neoplastic pleurisy where no pleural invasion is found without knowing the benefits in terms of survival. The inverse exists, with local or diffuse pleural invasion without pleurisy, which are difficult to evaluate by imagery techniques. Thus certain authors recommend pleural lavage during surgical operations for bronchial cancer even without pleural disease: positive cytology seems to be a poor prognostic feature and would justify adjuvant treatment. Thoracoscopy should be carried out when the neoplastic nature of a pleurisy has not been established by needle biopsy in order to evaluate the resectability of the tumour in the absence of surgical contra-indication. In the case of a disabling neoplastic pleurisy a pleurodesis carried out at the time of pleuroscopy may avoid the recurrence of the effusion. Talc is most often employed for pleurodesis but Bleomycin or Tetracycline are also used. In the case of failure to re-expand a shrunken lung the failure of the pleurodesis may lead to a pleuroperitoneal shunt. The type of homolateral pleural disease in bronchial cancer with local invasion by contiguity as against pleural metastases should appear in the TNM classification because there are different treatments and also a different prognosis.
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PMID:[Pleural effusion]. 969 Mar 6

We studied 94 cases of multiple hydatid cysts in the liver, over a period of ten years. These cases accounted for 31.3% of all cases of hydatid cysts treated surgically in the Visceral Surgery Department of Avicenne Military Hospital in Marrakech. In these patients, who were often young and male, the principal symptoms were pain in the right hypochondrium (71.3%) and hepatomegaly (24.5%). In about 10% of cases, the cysts were discovered by chance. Ultrasound and CT scans facilitated diagnosis and determination of the position of the cysts, with reliability reaching 100% for CT scans. The cysts had burst in the bile ducts in 26.6% of cases and were infected in 8 cases. They were multivesicular in 77.5% of cases. Association with hydatidosis at another site was observed in 28 cases: in the peritoneum in 15, the thorax in 7, the diaphragm in 4, the spleen in 2 and the kidney in 1 case. Surgically, the route most frequently used was double incision below the rib cage (49.5%). It is not possible to recommend one particular way to treat cysts and the most appropriate approach to treatment depends on the site, type and number of cysts. Resection of the prominent dome is the technique most frequently used (57.25%). However, in recent years, the use of cystectomy has been increasing (20.2%) due to the considerable decreases in post-operative morbidity and duration of hospital stay that it affords. The principal post-operative complications observed were abscesses under the diaphragm (6 cases), biliary leakage (5 cases), pleurisy (6 cases) and the formation of abscesses in the vestigial cavity (4 cases). The rate of morbidity in the RDS appeared high, accounting for 75% of total morbidity. Only one patient died. This patient died from severe hepatic insufficiency due to the near destruction of the liver by the hydatosis. We observed two recurrences during follow up. Both underwent further surgery and neither suffered complications.
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PMID:[Moroccan experience in the surgical treatment of multiple hydatid cysts in the liver]. 1164 Oct 82