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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report a case of renal cell carcinoma with pulmonary metastases treated with recombinant alpha interferon and subsequently presenting as congestive heart failure due to a dilated cardiomyopathy. A 66-year-old man presented himself to the department of internal medicine at our hospital with a complaint of persistent cough with sputum on August 27, 1988. Ultrasonogram, computed tomography and angiography showed a right renal cell carcinoma and chest x-ray films disclosed bilateral multiple nodular shadows, probably representing metastases of the renal tumor. After being transferred to our department, the patient underwent the ligation of the right renal artery and vein and the postoperative treatment with recombinant alpha interferon, achieving a complete response for pulmonary metastases and a partial response for the primary region. On February 14, 1990 the patient was admitted to our hospital with a complaint of dyspnea to be diagnosed as congestive heart failure due to dilated cardiomyopathy. The interferon therapy was suspected to have caused the heart disease, and four months after discontinuation of interferon therapy the heart failure symptoms had improved, but hypokinesis of the cardiac wall still persisted. To our knowledge, this may be the first case of alpha interferon-related cardiomyopathy in Japan.
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PMID:[Dilated cardiomyopathy following alpha interferon therapy of renal tumor with pulmonary metastases: a case report]. 141 58

Crude estimation of the selection probability ratio (SPR), described previously, was extended to stratified and multivariate estimation and used to assess selection bias in a case-control study of renal adenocarcinoma. It was shown that the directly pooled estimate of the SPR, using the same weights as the directly pooled estimate of the exposure odds ratio (OR) from the case-control study (assuming the OR and SPR are common to all strata and data are abundant), can be multiplied with the OR to yield an adjusted OR that is free from selection bias. Medical records of 548 interviewed cases were compared with 640 noninterviewed cases, and interviews of 640 controls were compared with mailed questionnaires from 272 (60%) of the noninterviewed controls. Age-sex-adjusted point estimates of SPRs ranged from 0.65 to 1.4. Multivariate estimates from binomial regression ranged from 0.34 to 2.0. Higher socioeconomic status and history of renal stones were predictors of participation by both cases and controls. Obesity in women, hypertension, and nonsmoking were predictors in cases only. Heart disease was associated with control participation and case nonparticipation. This study cast doubt on the OR for obesity in women and hypertension in the case-control risk analysis.
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PMID:Analysis of selection bias in a case-control study of renal adenocarcinoma. 209 Feb 81

We performed clinical analysis of 12 patients with renal cell carcinomas associated with tumor thrombosis in the inferior vena cava. Eleven cases were men, and one was a woman; their ages range from 48 to 76 years old with a mean of 58 years. Nine tumors were observed on the right side, the other 3 tumors were observed on the left side. In five cases, the distant metastases of the disease were noticed at the first visiting to our hospital. Lung metastases were found in five and bone or liver in each one. Chief complaints were macroscopic hematuria in 8 cases (67%), and were weight loss or general fatigue. The symptoms of obstruction of the inferior vena cava, such as venous dilatation of abdominal wall, edema of lower extremities and varicocele of the testes, were seen in 6 cases. The level of the tumor thrombosis was preoperatively determined by CT, echography, cavography or MRI. The level was near the right atrium in one, near the hepatic vein in 8 and near the renal vein in 3, although there was no case extending into the right atrium. Transperitoneal nephrectomy and thrombectomy in the inferior vena cava were performed in 9 cases. Surgery could not be performed in the other 3 patients of their poor general condition or severe heart disease. One patient died because of massive hemorrhage during the operation. The other complications were transient renal failure in 3 cases and postoperative bleeding in one case. In 4 patients without distant metastases or regional lymph nodes metastasis, two died of multiple metastasis of renal cell carcinomas and diabetic coma. The other two cases are alive without disease for 4 and 40 months after operation. For renal cell carcinoma extending into the inferior vena cava without metastasis, nephrectomy and thrombectomy should be performed using the extracorporeal circulation.
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PMID:[Clinical analysis of renal cell carcinoma with extension into the inferior vena cava]. 279 51

Magnetic resonance is a unique, noninvasive imaging modality which allows direct, multiplanar imaging and the possibility of obtaining biochemical information in vivo. Presently, MR appears most applicable to the evaluation of central nervous system abnormalities. The high sensitivity of MR in the evaluation of intracranial pathology suggests that it may eventually replace CT for many suspected diseases, if future investigations are able to improve its specificity. As previously noted, MR may be more diagnostic than other radiologic studies in the evaluation of suspected Chiari malformation, syringomyelia, congenital abnormalities, tumors of the spinal axis, and disc space infection. In the chest, MR appears to be more accurate than CT in the determination of the extent of mediastinal tumor, but at present cannot replace CT because of the lack of experience in imaging parenchymal nodules and benign diseases. MR of the breast is promising, but the size of the lesion may prove to be a limiting factor with magnetic field strengths commonly being utilized. There are inherent difficulties in the evaluation of cardiac disease with MR, but it offers a noninvasive method of investigating congenital heart disease and may provide valuable information in suspected myocardial ischemia and altered cardiac function. MR provides a new method of evaluating the vascular system, both in terms of providing anatomic information on large and medium-sized vessels and flow analysis. In the abdomen, MR appears to be most sensitive in the evaluation of suspected hepatic masses, but as with the brain, greater specificity will be needed to replace CT. At the present time, MR offers no distinct advantage over conventional imaging modalities in the evaluation of pancreatic disease, it maybe more accurate than CT in the staging of renal cell carcinoma. Larger studies are needed to determine the role of MR in the investigation of retroperitoneal adenopathy and adrenal abnormalities. In the pelvis, MR offers the hope of earlier diagnosis of prostatic carcinoma and may replace CT for staging of prostatic carcinoma and transitional cell carcinoma of the bladder. Limited MR experience with benign disease of the female pelvis suggests that it is currently more accurately evaluated with ultrasound. MR appears to be highly sensitive and specific for the diagnosis of avascular necrosis and may provide an early clue in suspected osteomyelitis. Finally, in vivo MR spectroscopy may provide unique metabolic information that was unobtainable prior to the advent of magnetic resonance, if this proves to be technically feasible.
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PMID:Magnetic resonance. Principles and applications. 639 70

Polythelia (congenital supernumerary nipples) is a marker for more serious anomalies of the urinary and cardiovascular systems. It is associated with obstructive abnormalities of the kidney or the renal collecting system, renal agenesis, renal cell carcinoma, supernumerary kidneys, cardiac conduction disturbances and congenital heart disease.
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PMID:Polythelia and associated conditions. 661 93

43-year-old male with non-Hodgkin's lymphoma which was resistant to standard treatment received high-dose chemotherapy followed by autologous stem cell transplantation. He had a past history of nephrectomy due to renal cell carcinoma. He had received adriamycin at a total dose of 280mg/m2, but had no episode of heart disease. His chest radiograph, electrocardiogram and serum creatinine were within normal ranges at the start of high-dose chemotherapy. He was given 120 mg/kg of cyclophosphamide (CPM) over two days. Serum creatinine levels elevated two days before transplantation, and he felt discomfort of the chest followed by severe arrhythmia. He died of heart failure one day after the transplantation. Postmortem examination revealed diffuse myocardial hemorrhage with degeneration and necrosis of the heart muscle. CPM is one of the useful antitumor alkylating agents for the treatment of malignant neoplasms. Although conventional doses of CPM can be used without adverse cardiac effects, high-dose CPM has been reported to induce cardiotoxicity in a few cases. Patients often develop fatal acute heart failure. For the safe use of high-dose CPM, we must consider about the dosing schedule, early detection of adverse cardiac effects, and patient risk factors.
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PMID:[Myocardial hemorrhage due to high-dose cyclophosphamide treatment in a case of non-Hodgkin's lymphoma]. 847 91

Metanephric adenoma is a rare benign renal epithelial tumor. We have experienced two cases of metanephric adenoma. The first case was a left renal tumor found by ultrasonography in a 26-year-old woman. The abdominal computed tomography (CT) revealed a 90 mm mass that was enhanced slightly in the early phase, and enhanced further in the late phase. Laparoscopic radical nephrectomy was performed with suspicion of renal cell carcinoma. The second case was a right renal tumor found by CT imaging for heart disease in a 64-year-old man. An abdominal CT revealed a 30 mm mass that was the same as our findings in the first case. Laparoscopic partial nephrectomy was performed with the suspicion of renal cell carcinoma. In both cases, tumor cells are positive for WT-1 and CD57 in immunohistochemical staining ; the final diagnosis was metanephric adenoma. It is difficult to differentiate metanephric adenoma from renal cell carcinoma by preoperative imaging ; the diagnosis depends on morphological and immunohistochemical profiles.
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PMID:[Metanephric Adenoma : A Report of Two Cases]. 3036 21