Malignant, definition

There is a tendency to think of medicinal chemistry as primarily a logical exercise. A specific and trivial example would be the much maligned QSAR exploration of methyl, ethyl, butyl, futile. This author believes that equating medicinal chemistry with QSAR is incorrect. There is a definite place for what might for want of a better term be called high-order pattern recognition. A specific example is the time tested... 

Early diagnosis of skin cancer is the key to improved prognosis. Diagnostic accuracy and clinical skills are two essential factors in the appropriate management of skin cancer. On presentation to a clinician s office, patients may offer a history of a new growth or an area of irritation. Conversely, the skin cancer may have been present for years undetected by the patient. The definitive diagnosis of any suspected cutaneous malignancy should be confirmed by a biopsy prior to treatment. 

Patients with brain metastases have a poor prognosis. Untreated patients generally have a median survival of 1 month. The choice of treatment depends primarily on the status of the patient s underlying malignancy and the number and sites of brain metastases. The primary definitive treatments for brain metastases are surgery and radiation therapy. Pharmacologic modalities are... 

Determine the need for long-term maintenance therapy with monthly bisphosphonates. Is the patient beginning definitive therapy for a responsive malignancy ... 

Laboratory studies with mice and rats have conclusively demonstrated that the injection of cadmium metal or salts causes malignancies (sarcoma) at the site of injection and testicular tumors. However, the simultaneous administration of zinc is protective against sarcoma and interstitial cell tumor development (USEPA 1980). In rats, no dose-related increases in tumors were found at maximum oral daily doses of 4.4 mg Cd/kg BW (USPHS 1993). Among humans, the available epidemiological evidence is not sufficient to conclude that cadmium is definitely implicated as a carcinogen (USEPA 1980 Nomiyama 1982), although cadmium exposure is associated with lung cancer in humans (Shimada et al. 1998). 

Tetranectin (TN). Tetranectin is a plasma protein of about 80 kDa. A reduction in the serum TN level has been described in malignant disease and in other conditions with tissue remodeling, whereas it does not seem to exhibit acute-phase reactant behavior. Using a polyclonal ELISA to determine the TN concentrations in pair of CSF/serum quotient in pair of CSE and serum, it was found that the CSE/serum quotient compared to the QAib was compatible with intrathecal TN synthesis. In clinically definite multiple sclerosis a reduced CSF/serum quotient was found, suggesting that the hypothesis of a reduced TN level as a marker of tissue remodeling may be extended to the CNS (C5). 

A cohort of workers with definite and lengthy exposure to hydroquinone had low cancer rates compared with two comparison populations the reason for the lower than expected rates is unclear. A cohort of lithographers, some of whom had worked with hydroquinone, had an excess of malignant melanoma based on five cases only two of the cases had reported exposure to hydroquinone. 

Rueffert, H., Olthoff, D., Deutrich, C., Meinecke, C. D., and Froster, U. G. (2002). Mutation Screening in the Ryanodine Receptor 1 Gene (RYR1) in Patients Susceptible to Malignant Hyperthermia Who Show Definite IVCT Results Identification of Three Novel Mutations. Acta Anaesthesiol Scand 46(6) 692-8. 

This classification allows for seronegative patients to be classified as having PNS (no. 1). In addition, the set of definitions takes into consideration that new antibody specificities are still being characterized (no. 3). Different clinical subtypes are still being described in association with well-known antibodies, and such cases are also included. Finally, a negative screening for malignancy does not exclude PNS, as spontaneous remission is known to occur. As cancer is ultimately detected in the majority of patients with symptoms and a well-characterized antibody, the number of false positives is probably low (no. 4). 

Shiloh R, Valevski A, Bodinger L, Misgav S, Aizenberg D, Dorfman-Etrog P, Weizman A, Munitz H. Precautionary measures reduce risk of definite neuroleptic malignant syndrome in newly typical neuroleptic-treated schizophrenia inpatients. Int Clin Psychopharmacol 2003 18 147-79. 

Ras-driven malignancies. However, further studies in other more relevant models and organ systems are required before any definitive conclusions can be drawn. 

Before initiating treatment, the clinician should rule out the presence of myasthenia-like syndromes such as Eaton-Lambert syndrome, which has clinical features similar to those of myasthenia but typically spares the eyes. Definitive diagnosis is important, because approximately 70% of Eaton-Lambert patients harbor malignant neoplasms, usually bronchogenic carcinoma. 

Methotrexate is used widely as a DMARD for rheumatoid arthritis, psoriatic arthritis, and for its steroid-sparing effects in many other conditions, especially if azathioprine is not tolerated. In high dose, with folinic acid rescue, methotrexate is used to treat solid and haematological malignancies (see p. 612). Low dose methotrexate slows the progression of rheumatoid arthritis. The evidence for a true disease-modifying effect on psoriatic arthritis is less definite, but methotrexate is often preferred to other DMARDs for its beneficial effect on the skin lesions. 

Although not in strict accord with the definition of Chapter 11, the word chemotherapy is in general use in this coimection and it would be pedantic to avoid it. It arose because some malignant cells can be cultured and the disease transmitted by inoculation, as with bacteria. The more precise term cytotoxic chemotherapy is adopted here. 

This synopsis of circumscribed structural defects clearly shows that solid focal alterations may be hypoechoic or hyperechoic as well as benign or malignant. The value of ultrasonography is the actual detection and not the definite specific diagnosis of such focal findings ... 

---