Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 31-year old woman was admitted to our clinic complaining of high blood pressure, dizziness, constipation, mental irritability and weight loss. The physical examination revealed goiter in her neck. The plasma levels of norepinephrine and epinephrine were 3.45 and 0.76 ng/ml, respectively. Urinary excretion of norepinephrine was 1 mg and epinephrine was 32.2 micrograms/24-hours. The examination by radiography and radioactive isotope revealed a tumor in the left adrenal region and another in the left lower lobe of the thyroid. After the operations, pheochromocytoma and papillary adenocarcinoma of the thyroid gland were recognized pathologically. However, 17 months later, the recurrence of pheochromocytoma in the contralateral adrenal region was discovered and removed. Although the co-existence of bilateral pheochromocytoma and papillary adenocarcinoma of the thyroid gland is not one of multiple endocrine neoplasia, to the best of our knowledge, only 7 such cases have been reported in the published literature.
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PMID:Bilateral pheochromocytoma associated with papillary adenocarcinoma of the thyroid gland; report of an unusual case. 286 43

All cases of endometrial adenocarcinoma treated at the Geisinger Medical Center from January 1970 to June 1980 were retrospectively reviewed in an attempt to elucidate the clinical and pathologic profiles of the various histologic subtypes. Complete clinical and pathologic data was available in 418 cases of stage I endometrial adenocarcinoma. The frequency of the histologic subtypes were adenocarcinoma 66%, adenoacanthoma 16%, adenosquamous 5%, papillary 8%, clear cell 3%, and secretory 2%. Absolute 5-year survival was adenocarcinoma 88%, adenoacanthoma 91%, adenosquamous 62%, papillary 63% (P less than 0.01), clear cell 43% (P less than 0.001), and secretory 89%. When comparing the clinical and pathologic profile of the various histologic subtypes, adenosquamous (52%, P less than 0.001) and clear cell (43%, P less than 0.05) were associated with the highest percentage of grade 3 differentiation. Adenosquamous (38%, P less than 0.05) and clear cell (36%) also had the highest percentage of deep myometrial invasion. Papillary subtype (46%, P less than 0.05) was associated with the highest percentage of nulliparity. There was no difference among the subtypes when comparing menopausal status, exogenous estrogen, obesity, hypertension, diabetes, or uterine size. In summary, (1) adenocarcinoma and adenoacanthoma are the most frequent subtypes; (2) adenosquamous, papillary, and clear cell have decreased 5-year survival; (3) the decreased 5-year survival in adenosquamous and clear cell subtypes appears to be associated with increased grade 3 differentiation and deep myometrial invasion while the poor prognosis associated with papillary subtype was not related to grade or myometrial invasion.
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PMID:Endometrial adenocarcinoma histologic subtypes: clinical and pathologic profile. 292 Sep 49

The effect of treatment with intravenously administered Angiotensin II (AT II) on blood flow in normal and malignant tissues was investigated clinically. The time course of the effect of AT II was directly recorded by laser doppler velocimetry (LDV) via a probe placed on the surface of normal and malignant tissues. Intravenous administration of AT II resulted in an approximate 3.5 (1.3-14.0)-fold increase in blood flow in eleven malignant tissues, such as breast cancer with direct extension to the skin and abdominal skin metastasis of gastric adenocarcinoma. On the other hand, the blood flow in normal skin was decreased under AT II-induced hypertension, but a reactive hyperemia-like increase was observed soon after the withdrawal of AT II. These results strongly suggested that intravenously administered AT II can act as an adjuvant to enhance, by varying degrees, drug delivery to tumor tissue in cancer chemotherapy and that the administration of chemotherapeutic agents is undesirable soon after the withdrawal of AT II.
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PMID:[Continuous measurement of tumor blood flow under hypertension induced by angiotensin II--clinical studies with laser Doppler velocimetry]. 294 27

Twenty-five patients were identified with non-pituitary, nonadrenal ACTH-secreting tumors (bronchial carcinoid, bronchial small cell carcinoma, pancreatic islet cell carcinoma, medullary thyroid carcinoma, thymic carcinoids, metastatic adenocarcinoma, and pancreatic cystadenoma). Clinical features were weakness, hypertension, cushingoid appearance, peripheral edema, personality disorders, and hyperpigmentation. Biochemical features were a markedly increased urinary free cortisol level (all patients), hypokalemia (71 percent of patients), and an elevated ACTH level (72 percent of patients). Surgical therapy consisted of bilateral total adrenalectomy (56 percent of patients). Twelve percent underwent transsphenoidal hypophysectomy and 36 percent had excision of their tumor. No surgical therapy was undertaken in 28 percent. Bilateral total adrenalectomy in patients with a slow-growing malignancy or an unknown tumor secreting ACTH is beneficial in relieving symptoms and prolonging life. Excision of nonmalignant ACTH-producing tumors yields an excellent long-term prognosis.
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PMID:Ectopic ACTH syndrome. Diagnostic and therapeutic aspects. 298 90

All cases of endometrial adenocarcinoma from January 1970 to December 1980 treated at the Geisinger Medical Center were reviewed retrospectively. One hundred eighty-eight cases of stage I grade 2 adenocarcinoma of favorable histologic subtype (adenocarcinoma, adenoacanthoma) and limited myometrial invasion (less than one-third of the myometrium) were identified. Surgery and adjuvant radiotherapy was used in 136 cases, and 52 cases were treated with surgery alone. There was no statistically significant difference between the two groups in menopausal status, parity, exogenous estrogen, obesity, hypertension, diabetes, or uterine size. Five-year survival for the surgery and radiotherapy group was 94% (128 of 136), and the recurrence rate was 2.2% (three of 136). The five-year survival for the surgery-alone group was 98% (51 of 52), and the recurrence rate was 1.9% (one of 52). There was no statistically significant difference in five-year survival or recurrence between the two groups. This study suggests that surgery alone is adequate treatment for stage I grade 2 adenocarcinoma of favorable histologic subtype and limited myometrial invasion. This study also shows a possible benefit in the combined use of histologic subtype, grade, and myometrial invasion as prognostic indicators and as guides for adjuvant radiotherapy.
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PMID:Adjuvant radiotherapy for stage I, grade 2 endometrial adenocarcinoma and adenoacanthoma with limited myometrial invasion. 312 68

An esophagovisceral anastomotic leak is a life-threatening postoperative complication, especially in the mediastinum. Of the 242 patients who underwent intrathoracic esophagogastric anastomosis for esophageal carcinoma (182 patients) and adenocarcinoma of the cardia (60 patients) between January 1980 and June 1985, 14 (5.8%) had esophageal anastomotic leakage and two died (0.8%). Various clinical and biologic parameters and aspects of operative technique were studied prospectively and analyzed statistically to identify possible factors responsible for leaks. Both bivariate and multivariate statistical analysis with logistic regression showed that the following clinical and biologic factors do not influence anastomotic leakage: tumor stage, the curative or palliative purpose of resection, neoplastic permeation of anastomotic margins, total protein concentration below 5 gm/dl, albumin concentration below 3 gm/dl, patient's age, diabetes, high blood pressure, cirrhosis of the liver, and cardiac, respiratory, or renal diseases. Technical factors, on the contrary, were statistically significant and of great clinical importance: manual as opposed to mechanical suturing (chi 2 = 8.8, p = 0.013) and single-layer as opposed to double-layer suturing (chi 2 = 9.9, p = 0.043). The level of the anastomosis was found to be a further statistically significant factor: The incidence of leakage was greater when the anastomosis was located between the azygos vein and the lower pulmonary vein (chi 2 = 15.5, p = 0.004) than above the azygos vein or below the lower pulmonary vein.
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PMID:Esophagovisceral anastomotic leak. A prospective statistical study of predisposing factors. 328 Aug 82

The association of a casual reading of blood pressure (BP) in 1963 to subsequent 15-year cancer mortality was examined in a cohort of 10,059 middle-aged and elderly men. Systolic BP (SBP), but not diastolic BP, predicted significantly long-term cancer mortality occurring in 369 subjects. The covariate-adjusted relative risk (RR) estimated by Cox's proportional hazard model was 1.10 [95% confidence interval (CI), 1.00-1.21]. In patients aged less than 60 at the beginning of the study, increased cancer mortality was mainly observed in association with SBP of more than 150 mm Hg. In subjects aged 60 or above, the estimated RR was 1.21 (95% CI, 1.03-1.42). Exclusion of 40 men in whom diagnosis made prior to 1963 or death occurred through 1965 did not alter the results. An excess mortality in men who reported pharmacologic treatment for hypertension while under follow-up was fully accountable by their age, BP, and smoking habits. Analysis by site suggested that the association was mainly due to increased mortality from cancer of the digestive and genitourinary organs (estimated RR's, respectively, 1.20 and 1.26; 95% CI's, respectively, 1.03-1.39 and 0.99-1.59). Analysis by histologic subtype suggests an association with adenocarcinoma (RR = 1.19, 95% CI, 1.04-1.37) but not squamous cell or transitional cell carcinomas, myeloma, lymphomas, and leukemias.
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PMID:Elevated systolic blood pressure as a predictor of long-term cancer mortality: analysis by site and histologic subtype in 10,000 middle-aged and elderly men. 345 26

In a review of 440 patients treated for endometrial adenocarcinoma at this center since 1974, 21 patients with tumors of papillary histology were identified. Eleven (2.5%) lesions contained histologic changes characteristic of uterine papillary serous carcinoma: complex papillary architecture, high nuclear/cytoplasmic ratio, and irregular epithelial tufting. Ten lesions (2.3%) containing areas of papillary morphology but lacking the criteria for the diagnosis of papillary serous tumors were termed papillary endometrioid adenocarcinoma. Patient age, stage, and the presence of obesity, hypertension, and diabetes were similar in both groups and reflected those characteristics well established for endometrial adenocarcinoma in general. Fewer papillary serous tumors (16.7%) and papillary endometrioid tumors (33.3%) contained progesterone receptors than did other adenocarcinomas (52.3%). In clinical stage I, surgical findings indicating a more advanced stage were present in 40% of patients with papillary serous tumors compared to 10% in papillary endometrioid tumors and 12.5% in nonpapillary adenocarcinomas (P = 0.03, Fisher's exact test). Recurrences were observed in 50% of patients with papillary serous lesions compared to 42.9% in papillary endometrioid lesions and 24.3% in other adenocarcinomas. Survival for clinical stage I papillary serous tumors was worse than that for nonpapillary grade 3 controls (P = 0.042) and survival for papillary endometrioid lesions was not different from that of the same controls. These findings support those of J. L. Chen, D. C. Trost, and E. J. Wilkinson (Int. J. Gynecol. Pathol. 4, 279-288 (1985)) that papillary serous and papillary endometrioid adenocarcinomas represent two distinct subtypes of papillary endometrial neoplasia.
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PMID:Malignant papillary lesions of the endometrium. 362 28

We have described a 63-year-old man, taking diethylstilbestrol for adenocarcinoma of the prostate, who had papilledema. Lumbar puncture revealed intracranial hypertension without pleiocytosis. CT scan was normal, consistent with the diagnosis of pseudotumor cerebri. At craniotomy for placement of a ventriculoperitoneal shunt, the dura was found to be infiltrated with adenocarcinoma. In patients with known malignancy and elevated intracranial pressure, lumbar puncture and CT scan alone are not enough to rule out meningeal carcinomatosis; repeated lumbar puncture or cervical cisternal puncture may be necessary to document malignant cytology.
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PMID:Pseudopseudotumor cerebri: meningeal carcinomatosis presenting as benign intracranial hypertension. 362 23

Histopathological findings in 226 post-menopausal bleeding women were reviewed retrospectively. Adenocarcinoma of the endometrium was diagnosed in 7% and hyperplastic endometrium in 15%. The incidence of malignancy showed a definite rise with advancing age, increasing amount and duration of bleeding, prolonged time interval between the menopause and onset of bleeding, and enlarged uterus. Adenocarcinoma of the endometrium was associated in 40% of the patients with either obesity, diabetes mellitus, or hypertension. The most frequent histopathological finding was atrophic endometrium (45%).
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PMID:Histopathological findings in 226 women with post-menopausal uterine bleeding. 371 79


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