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PubMed1987

Intermittent claudication associated with cancer--case studies.

Cancer was diagnosed in 15 patients among 300 consecutive patients with intermittent claudication. The cancer-associated claudication is characterized by a more accelerated course of claudication, more often requires vascular surgery, and moreover, the lasting relief of claudication depends upon the efficiency of cancer therapy. It is the authors' impression that cancer-associated claudication is predetermined by atherosclerosis and aggravated by cancer through the chronic hypercoagulability state secondary to neoplasm. The clinical picture is characterized by rapid progression, with the frequent necessity of vascular surgery for limb salvage and a higher incidence of graft occlusion. Awareness of this possibility of hidden malignancy may be related to the clinical picture of hemodynamic deterioration of the underlying arterial insufficiency. A high index of suspicion leads to earlier diagnosis of neoplasm. Effective oncologic therapy will often bring the symptomatic relief of ischemic symptoms in the lower extremities. This report indicates that associated neoplasm has a more vicious course of the underlying arterial insufficiency and intermittent claudication.

Adenocarcinoma↗
PubMed2006

A randomized controlled trial of 0.5% ferric hyaluronate gel (Intergel) in the prevention of adhesions following abdominal surgery.

INTRODUCTION: Intestinal adhesion following abdominal surgery is a significant sequela to abdominal surgery. Intergel is a hyaluronate-based gel that reduces the incidence of postoperative adhesions when added to the peritoneal cavity before closure in gynecologic surgery. This is a randomized controlled trial evaluating the efficacy and safety of Intergel in colorectal resections. Although the study aimed to recruit 200 patients based on power analysis, recruitment was suspended because of the high morbidity in the treatment group. METHODS: A total of 32 patients were randomized to either Intergel treatment (treatment group) or no treatment (control group) following open abdominal surgery. Primary endpoints included the incidence of adhesive obstruction, the need for subsequent adhesiolysis, and the incidence of wound and anastomotic complications. A secondary endpoint involved quality-of-life assessment. RESULTS: Seventeen patients were randomized to the treatment group and 15 to the control group. All patients, except 1 in the treatment group, underwent resection and anastomosis of the colon or rectum for benign or malignant disease. A significant difference was observed in the number of patients with postoperative morbidities between the 2 groups (65% treatment group versus 27% control group, P = 0.031). There was a high rate of anastomotic dehiscence (5 treatment group versus 1 control group, P = 0.178) and prolonged postoperative ileus (10 treatment group versus 2 control group, P = 0.011) observed in treatment group. One case of peritonitis occurred in the treatment group in the presence of an intact anastomosis. Wound complications were more common in treatment group but failed to reach statistical significance. CONCLUSION: The use of Intergel in abdominal surgery where the gastrointestinal tract is opened leads to unacceptably high rates of postoperative complications.

Adjuvants, Immunologic↗
PubMed2003

Does pizza protect against cancer?

We analyzed the potential role of pizza on cancer risk, using data from an integrated network of case-control studies conducted in Italy between 1991 and 2000. Cancer sites were: oral cavity and pharynx (598 cases), esophagus (304 cases), larynx (460 cases), colon (1,225 cases) and rectum (728 cases). Controls were 4,999 patients admitted for acute, non-neoplastic conditions to the same hospital network as cases. Odds ratios for regular pizza consumers were 0.66 (95% confidence interval, CI = 0.47-0.93) for oral and pharyngeal cancer, 0.41 (95% CI = 0.25-0.69) for oesophageal, 0.82 (95% CI = 0.56-1.19) for laryngeal, 0.74 (95% CI = 0.61-0.89) for colon and 0.93 (95% CI = 0.75-1.17) for rectal cancer. Pizza appears therefore to be a favorable indicator of risk for digestive tract neoplasms in this population.

Case-Control Studies↗
PubMed2005

[Scintigraphic procedures in internal medicine--indications, limits, possibilities].

Scintigraphy continues to play an important diagnostic role in internal medicine. Many diagnostic questions can only be answered with scintigraphic methods. The application of specific radiopharmaceutical tracers offers the unique possibility to visualize ongoing functional changes, associated with diseases concerning internal medicine. The diagnostic potential of modern scintigraphic procedures such as PET for internal medicine is not yet sufficiently used and will continue to grow with hybrid systems, such as PET-CT and SPECT-CT.

Adolescent↗
PubMed1997

Expression of pancreatic digestive enzymes in normal and pathologic epithelial cells of the human gastrointestinal system.

Pancreatic digestive enzymes have rarely been reported in human nonpancreatic organs. We examined their expression in the epithelial cells of the nonpancreatic gastrointestinal organs, looking for pancreatic alpha-amylase, trypsin, chymotrypsin and pancreatic lipase. Western blotting, enzyme assay and pancreatic alpha-amylase mRNA were also used in selected specimens. In normal tissues, immunoreactivity of one or more of these enzymes was frequently noted in cells of the salivary glands, stomach, duodenum, large pancreatic ducts, extrahepatic bile ducts and gall bladder. The epithelium of the normal oesophagus, small intestine and colon were consistently negative for these enzymes. In pathologic tissues, immunoreactivity for one or more enzymes was present in epithelial cells of pleomorphic adenomas of the salivary glands, oesophageal squamous cell carcinoma, gastric adenoma and adenocarcinoma, pancreatic adenocarcinoma, cholecystitis, adenocarcinoma of the gall bladder and extrahepatic bile duct, and colon adenoma and adenocarcinoma. Western blotting showed a specific band of each enzyme in some specimens of normal stomach. In situ hybridization for pancreatic alpha-amylase mRNA showed specific signals in the normal stomach, but not in the normal colon. Reverse transcriptase polymerase chain reaction analysis for pancreatic alpha-amylase mRNA revealed specific signals in the normal stomach. Enzyme assay revealed that the stomach and gall bladder showed these activities. The data suggest that pancreatic digestive enzymes are produced by several epithelial cell types of the nonpancreatic gastrointestinal organs, that the organs positive for pancreatic enzyme have a common cell lineage, and that neoplasms continue to express or neoexpress these enzymes after neoplastic transformation.

Adult↗
PubMed2002

Neuroimmunotherapy of untreatable metastatic solid tumors with subcutaneous low-dose interleukin-2, melatonin and naltrexone: modulation of interleukin-2-induced antitumor immunity by blocking the opioid system.

OBJECTIVES: The preliminary applications of the psychoneuroimmunological knowledges to the treatment of human diseases have confirmed the possibility to amplify IL-2-dependent anticancer immunity by the pineal hormone melatonin (MLT) or by opioid antagonist, such as naltrexone (NTX), which act by activating TH1 lymphocytes or suppressing TH2 lymphocytes, respectively. At present, however, there are no data about the immunobiological effects of a concomitant administration of both MLT and NTX on IL-2-induced anticancer immunity. This preliminary study was carried out to evaluate whether the association of NTX may further enhance the lymphocytosis induced by the neuroimmunotherapy with IL-2 plus MLT. MATERIALS & METHODS: The study included 14 consecutive untreatable metastatic solid tumor patients. According to a cross-over randomized study, the patients were treated during two consecutive immunotherapeutic cycles at 21-day intervals with IL-2 plus MLT alone or with IL-2 plus MLT plus NTX. IL-2 was injected subcutaneously at 3 MIU/day for 6 days/week for 4 weeks, MLT was given orally at 20 mg /day in the evening every day, and NTX was given orally at 100 mg in the morning every next day. For the immune evaluation, venous blood samples were drawn before the onset of treatment and at weekly intervals. RESULTS: Lymphocyte mean number significantly increased after both IL-2 plus MLT and IL-2 plus MLT plus NTX. However, the concomitant administration of NTX induced a significantly higher increase in lymphocyte mean number with respect to that achieved with IL-2 plus MLT alone. In contrast, the increase in eosinophil mean number was significantly higher on IL-2 plus MLT alone. CONCLUSIONS: This preliminary study shows that the association of NTX further amplifies the lymphocytosis obtained by IL-2 plus MLT. Since the lymphocytosis represents the most important favourable prognostic variable predicting the anticancer efficacy of IL-2 immunotherapy, it is probable that a cancer neuroimmunotherapy with IL-2 plus both MLT and NTX to activate TH1 and suppress TH2 cells respectively, may deserve more promising results in the treatment of human neoplasms according to the psychoneuroimnunological knowledge.

Adjuvants, Immunologic↗
PubMedDate not supplied

[Clinical evaluation of the efficacy of the combined determination of serum markers CEA, CA 19.9, CA 72.4 as indexes of gastro-intestinal tract neoplasms].

The aim of our study was to evaluate the usefulness of the tumor markers CA 72.4, CEA and CA 19.9 in the monitoring of gastrointestinal carcinomas. Our experience demonstrated the usefulness of the determination of CA 72.4 in the follow up of patients with gastrointestinal neoplasms.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1986

[Smooth muscle tumors of the alimentary tract--a review of 397 cases].

397 cases of smooth muscle tumor of the alimentary tract were analysed. 385 were collected from the domestic literature in the recent 10 years and 12 are added by the authors. The tumor occurred more frequently in patients 40-60 years old. Diameter of the tumor ranged from 0.5-35 cm. The diameter of leiomyosarcoma was larger than that of leiomyoma on an average. The ratio of benign to malignant incidence was 3.2:1. Exclusive of 204 (51.4%) cases which occurred in the esophagus, the ratio was 1.1:1 in the other 193. In the 12 cases reported by the authors, it was 1:3. In the 193 cases of the GI tract, the lesion occurred in the stomach in 50.8%, in the small intestine in 29.0%, in the colon 1.0% and in the rectum 19.2%. The three most common clinical symptoms of those in the stomach and small intestine were abdominal mass (54.3%), bleeding (49.1%) and abdominal pain (45.7%). These 12 cases reported comprised 0.019% of 62, 088 patients admitted into our hospital, 0.09% of 12,678 tumor inpatients during the same period and 0.61% of 1,983 of malignant tumors in the alimentary tract. The preoperative diagnostic accuracy of this tumor was low, only 7.7% of all the GI neoplasms. On basis of the present data, improving the preoperative diagnostic accuracy is stressed.

Adolescent↗
PubMed1995

[Mortality among the dye industry workers. II. An analysis of malignant neoplasm mortality].

A mortality study was carried out among workers employed in a plant producing different kinds of dyes, including benzidine. The cohort comprised 8,523 males and 2,006 females whose vital status was recorded between Jan 1, 1945 and Dec. 31, 1991. They had worked in this plant for, at least, 3 months between Jan. 1, 1945 and Dec 31, 1974. The cohort was divided into 4 subcohorts: I. those exposed only to benzidine: II. those exposed to benzidine and other occupational hazards; III. those involved directly in the dye production but not exposed to benzidine, and IV. those not involved directly in the dye production-mainly administrative staff. Death risk was estimated on the basis of standardized mortality ratio (SMR) determined by means of the person-years method. The general population of Poland was taken as a reference group. The observed number of deaths in the cohort and each subcohort was compared with expected deaths. The comparison was based on national rates by adjustment for age, gender and calendar time. Significant excessive mortality due to cancer of urinary bladder was observed in the male subcohort I (SMR = 14.69), II (SMR = 16.34) and III (SMR = 3.17); due to malignant neoplasm of pancreas in the male subcohort II (SMR = 3.26); due to malignant neoplasm of testis in the male subcohort III (SMR = 3.17); due to malignant neoplasm of pancreas in the male subcohort II (SMR = 3.26); due to malignant neoplasm of testis in the male subcohort III (SMR = 3.23). Significant excessive mortality due to malignant neoplasm of liver and intrahepatic bile ducts was found in the female subcohort IV (SMR = = 2.36).

Chemical Industry↗
PubMed2005

Nutrient induced thermogenesis during major colorectal excision--a pilot study.

OBJECTIVE: Hypothermia may occur during general anaesthesia and is associated with postoperative coagulopathy, ischaemic cardiac events, wound infections and increased metabolic expenditure due to shivering. The purpose of the present pilot study was to determine whether the administration of certain amino acids (Vamin 18) during general anaesthesia could prevent postoperative hypothermia. PATIENTS AND METHODS: Two groups of patients were studied. The study group comprised 10 patients who underwent complex major colorectal operations. In this group an infusion of 500 mls of Vamin 18 (Fresenius Kabi Ltd) was commenced immediately after induction of anaesthesia but prior to the skin incision. In a control group (n=10) who underwent similar surgical procedures Vamin 18 was not administered. In both groups core body temperature, using an oesophageal probe was recorded during the procedure and recovery period. Ambient theatre and recovery room temperature and other body warming techniques were standardized for all patients. Statistical analysis was performed using t-test for comparison of linear temperature changes at different times during the procedure for both groups of patients. RESULTS: The body temperature was statistically significantly reduced in both groups at skin incision when compared with temperature prior to induction of anaesthesia. ( STUDY GROUP: mean 0.74 degrees C, SD=0.38, P =<0.001; CONTROL GROUP: mean 0.54 degrees C, SD=0.43, P=0.003]. The increase in body temperature between the time of skin incision and recovery period was statistically significant (P=0.012) in the study group but not so in the control group (P=0.730). CONCLUSION: The results of the present pilot study demonstrate that complex colorectal operations are associated with a decrease in body temperature which is most marked immediately after the induction of anaesthesia. The perioperative administration of Vamin 18 appears to increase the rate of recovery of body temperature. The impact of this thermogenic effect on perioperative morbidity and mortality should be studied in a prospective randomised clinical trial.

Adult↗
PubMed1989

Coffee consumption and digestive tract cancers.

The relationship between coffee drinking and the risk of digestive tract neoplasms was analyzed in a case-control study of 50 cases of cancer of the mouth or pharynx, 209 of the esophagus, 397 of the stomach, 455 of the colon, 295 of the rectum, 151 of the liver, 214 of the pancreas, and 1944 control subjects admitted for acute, non-digestive tract disorders. There was no significant or consistent association between coffee and cancers of the mouth or pharynx, esophagus, stomach, liver, or pancreas. In particular, for pancreatic cancer, the multivariate relative risks for the intermediate and upper tertiles were 1.05 and 1.01, respectively. There were significant inverse trends in risk with measures of coffee consumption for colon and rectal cancers, the multivariate relative risks according to tertiles of coffee consumption being 0.86 and 0.64 for colon and 0.97 and 0.66 for rectum. This apparent protection is in agreement with some (but not all) previous epidemiological evidence and finds a possible biological interpretation in terms of interference on bile secretion, causing reduced bile acid and neutral sterol concentrations in the bowel. In conclusion, the results of this study, the major interest of which lies in the opportunity of drawing up an overall pattern of risk for various digestive neoplasms, offer further reassurance as regards the effects of coffee on digestive tract carcinogenesis.

Adult↗
PubMed1985

[Cutaneous prickle-cell epitheliomas and visceral cancer].

We have studied the incidence of internal malignant neoplasms on patients with squamous cell carcinoma (SCC). This incidence has been compared to expected number of malignant neoplasm in that population by a precise statistical analysis. Two-hundred and eighty-three SCC confirmed by histology are diagnosed on 235 patients (159 men, 76 women). These patients have been followed between December 1970 and November 1982 at the specialized consultation on cutaneous tumors. We have examined all these patients, questioned their doctors, consulted their medical case history, to search an internal malignant neoplasm. Twenty-eight patients had a malignant neoplasm: this malignant tumor has been found 11 times before and 17 times at the same time or after SCC. These 17 malignant neoplasms are the only statistically interesting cases. The annual incidence of malignant neoplasms related to age and sex has been evaluated by consulting French registers. The French incidence has been compared to foreign incidences. This incidence enables us to calculate the expected observed numbers (12 and 5). The expected numbers are 9.15 for men and 2.1 for women. These numbers are not statistically different from observed numbers (12 and 5). The incidence of internal malignant neoplasms on patients with SCC is not different from the incidence of general population.

Adult↗
PubMed1993

["Siphon" structure of the digestive system and a method for "siphon" one-stage terminal lateral small-to-large intestine anastomosis with invagination].

The authors have suggested a hypothesis according to which the alimentary canal consists of the separate autonomous S-shaped functional structures possessing the antireflux and sphincter-like properties. The principle mentioned was used in 9 patients who had a "siphon" one-story invagination small-to-large intestinal anastomosis been created.

Adult↗
PubMed2005

[Characteristics of neoplasm occurrence of renal allograft recipients and their prognosis].

BACKGROUND & OBJECTIVE: Renal allograft recipients are more likely to develop neoplasm than general population because of long-term immunosuppressive treatment and concurrent infections. This study was designed to analyze the clinical features of neoplasm occurrence of renal allograft recipients, and the effect of radical surgery (RS) on their prognosis. METHODS: Records of 2 160 renal allograft recipients treated in our center from Oct. 1987 to Apr. 2003 were retrospectively studied. The time to neoplasm development, pathologic type of tumor, patients' survival time were analyzed to explore the clinical features of neoplasm developing after kidney transplantation. Recipients developed neoplasms were divided into RS group and non-RS group according to their treatment pattern. The effect of RS on patients' survival was estimated. RESULTS: A total of 33 patients developed neoplasms after transplantation. Among them,11(33.3%) developed neoplasms in digestive system. The median survival time of RS group (10 patients) was 41.5 months, that of non-RS group (23 patients) was 6.0 months. The 20-month survival rate of RS group was 70.0%, while that of non-RS group was 13.0%. CONCLUSIONS: Renal allograft recipients are more likely to develop neoplasm than general population. Moreover, their main malignancies are liver cancer, skin cancer, lymphoma and thyroid carcinoma, which differ from those observed in general population. Early diagnosis and treatment, especially feasible RS, will improve short-term outcome, while long-term therapeutic effect needs to be further observed.

Adult↗
PubMed2004

Percutaneous radiofrequency ablation of lung neoplasms: initial therapeutic response.

PURPOSE: To evaluate the feasibility, safety, and initial therapeutic effect of radiofrequency (RF) ablation in the treatment of unresectable malignant lung tumors. MATERIALS AND METHODS: Fifty-four lung neoplasms in 31 patients were treated with RF ablation. Thirteen tumors were primary lung cancers and 41 were pulmonary metastases. Tumor sizes ranged from 0.7 to 6.0 cm, with a mean size of 2.7 +/- 1.3 cm. After the RF electrode was placed in the tumor with computed tomographic (CT) fluoroscopic guidance, RF energy was applied. Initial therapeutic response was evaluated by (18) F fluorodeoxyglucose positron emission tomography (FDG-PET) and contrast-enhanced CT. The disappearance of FDG uptake on PET images and tumor enhancement on CT images were considered to indicate complete tumor necrosis. Complete necrosis rates were evaluated according to tumor size and type (primary or secondary lung neoplasm). RESULTS: RF ablation was technically successful in all lesions. Complete necrosis was achieved in 32 of the 54 tumors (59%) after initial RF session. There was a significant difference in the rate of complete tumor necrosis between tumors 3 cm or less and tumors larger than 3 cm (69% vs. 39%; P <.05). Tumor type did not influence complete necrosis rates. Lung abscesses developed in two patients with large tumors. CONCLUSION: Lung RF ablation is a feasible, relatively safe, and promising treatment for unresectable lung neoplasms. Tumor size is an important factor in achieving complete tumor necrosis.

Aged↗
PubMed2001

Immunohistochemical detection of fibroblast growth factor receptors in normal endocrine cells and related tumors of the digestive system.

Endocrine tumors (ETs) of the digestive system produce several growth factors including acidic and basic fibroblast growth factors (aFGF and bFGF, respectively), which are thought to be involved in the growth of tumor cells and in the proliferation of tumor stromal cells. Their actions depend on binding to four specific receptors--FGFR1, FGFR2, FGFR3, and FGFR4--whose distribution in normal endocrine cells and related tumors of the gastroenteropancreatic (GEP) system has previously been examined. Formalin-fixed, paraffin-embedded normal tissues and 60 well-characterized GEP endocrine tumors were immunostained using specific antibodies directed against various GEP hormones, aFGF, FGFR1, FGFR2, FGFR3, and FGFR4. Acidic FGF immunoreactivity (IR) was found in gut EC cells; FGFR1 immunoreactivity in rare duodenal endocrine cells and in pancreatic A cells; FGFR2 immunoreactivity in gastric and duodenal G cells, pancreatic B cells, and rectal EC cells; FGFR3 immunoreactivity in duodenal G cells; and FGFR4 immunoreactivity in rectal L cells and in pancreatic B, PP, and A cells. Immunoreactivity for at least one of the four FGFRs was found in all tumors, independently of FGFR expression in the putative cell of origin. EC cell tumors, which were all positive for aFGF, were found to express at least three different FGFRs. FGFRs also were localized in the stromal cells of all the tumors examined. The tumor stroma was more abundant in EC cell tumors than in other types of neoplasms. The results suggest that aFGF-FGFR interaction may be involved in the modulation of normal endocrine cell functions and in the regulation of tumor growth and stromal proliferation of EC cell carcinoids.

Adolescent↗