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

A 39-year-old man with an ACTH producing oncocytic carcinoid of the thymus is reported here. His symptoms were pigmentation, facial and pretibial edema, and high blood pressure. Endocrinological examination revealed the ectopic ACTH syndrome and, especially, high content in the intrathoracic venous blood. On histological examination, the tumor was found to be composed of uniform eosinophilic cells, with no argentaffin granules being demonstrated. Ultrastructural findings revealed a large number of mitochondria and numerous distinct electron-dense neurosecretory granules in the cytoplasm. Abnormally high levels of ACTH, beta-endorphin and gamma-MSH were also found in this tumor tissue. By total extirpation of the tumor, clinical symptoms and laboratory data were entirely normalized.
 ...
PMID:An ectopic, ACTH producing, oncocytic carcinoid tumor of the thymus: report of a case. 674 52

Carcinoid tumors with hepatic involvement can produce intense flushing, tachycardia, hypotension or hypertension and diarrhoea. Patients with limited cardiac reserve may not tolerate these effects under anaesthesia. Valvular heart disease associated with carcinoid tumors has been reported, but there is no record in the literature of such an association with coronary artery disease. This report presents the anaesthetic management of a patient with coronary artery disease and carcinoid tumor undergoing myocardial revascularization. Emphasis is placed on the rational use of anaesthetic and adjunctive agents which will minimize the incidence of carcinoid symptons. The salient features of the management are prevention of release of vasoactive substances by the use of promethazine hydrochloride during operation, the avoidance of stropine, prophylactic administration of corticosteroids and smooth induction of anaesthesia by the use of diazepam and dimethyl-tubocurarine iodide (Metocurine).
 ...
PMID:Anaesthetic management of a patient with carcinoid tumor undergoing myocardial revascularization. 696 32

An observation of carcinoid syndrome in a woman of 47 suffering from malignant carcinoid of the ileum with metastases into the liver and right ovary is described. The clinical picture included diarrhea, heat waves, bronchospasms, hypertension, hyperserotoninemia, affection of the mitral valve and left atrium. "Carcinoid plaques" in the endocardium formed due to excessive proliferation under the influence of serotonin and kinins of polypotent subendothelial cells followed by their differentiation into fibroblast-like and smooth-muscle elements and production of basophilic interstitial substance. The receding rheumatic affection of the mitral valve may be the cause of the predominant involvement of the left part of the heart.
 ...
PMID:[Changes in the heart in the carcinoid syndrome]. 723 50

A case of general anaesthesia for removal of carcinoid metastases is presented. Evidence of serotonin hypersecretion was shown by raised levels of 5-hydroxyindoleacetic acid, hypertension and tachycardia. The rarity of osteoblastic carcinoid metastases is discussed.
 ...
PMID:Anaesthesia for removal of carcinoid metastases. A case of serotonin-secreting secondary tumour in the lumbar spine. 743 18

In the severe crisis of carcinoid syndrome the flush is usually accompanied by hypotension and occasionally shock. Injection of octreotide, the long-acting analog of somatostatin, usually prevents or aborts this vasomotor reaction. A small minority of carcinoid syndrome patients manifest hypertension during their crises and little has been reported in the literature on their management. We present the first case reports of the response of patients with hypertensive carcinoid crisis to treatment with octreotide. The world literature contains reports of 20 prior cases of hypertensive carcinoid crises occurring in association with the stress of surgery and anesthesia. Review of these cases reveals no common feature, other than hypertension, that might clearly distinguish them from the typical hypotensive carcinoid syndrome patient. It is hypothesized that the mechanism of action of octreotide correcting the blood pressure changes in all carcinoid crises is via its known inhibition of vasomotor product release from the tumor and blocking receptors for these substances. We suggest that hypertensive as well as hypotensive carcinoid crises respond to octreotide and that this agent should be considered for prophylactic and emergency use in all carcinoid syndrome patients prior to and during anesthesia and surgery.
 ...
PMID:Octreotide treatment of carcinoid hypertensive crisis. 796 29

The presence of three regulatory peptides, corticotropin-releasing hormone, neuropeptide Y and endothelin-1, was studied by radioimmunoassay in the tumor tissue of an ACTH-secreting bronchial carcinoid. A 36-year-old female was admitted to hospital because of moon face, central obesity and hypertension. High levels of plasma ACTH and cortisol and urinary 17-OHCS and 17-KS were found. One mg dexamethasone did not suppress plasma ACTH and cortisol levels, but 8 mg did so slightly. Corticotropin-releasing hormone (100 micrograms, iv) stimulated plasma ACTH levels (0 min; 34.8 pmol/l; 30 min; 41.1 pmol/l). The computerized tomography showed the presence of a tumor in the right lung. This lung tumor was removed surgically and has been shown by microscopical examination to be a bronchial carcinoid with ACTH-positive cells. The tumor tissue concentrations of corticotropin-releasing hormone, neuropeptide Y and endothelin-1 were 3.34 pmol/g wet weight, 8.07 pmol/g wet weight and 0.92 pmol/g wet weight, respectively, although plasma concentrations of these three peptides were not elevated. Reverse phase high performance liquid chromatography showed that immunoreactive peptides in the tumor tissue were mainly eluted in the position of the standard peptides. These findings indicate that this case of ACTH-secreting bronchial carcinoid had high levels of corticotropin-releasing hormone, neuropeptide Y and endothelin-1 in its tumor tissue and suggested that these peptides may act locally, in a paracrine or autocrine manner, in the tumor.
 ...
PMID:An ACTH-secreting bronchial carcinoid: presence of corticotropin-releasing hormone, neuropeptide Y and endothelin-1 in the tumor tissue. 838 6

A case of a 38-years-old patient with carcinoid syndrome (paroxysmal skin flush, diarrhoea, abdominal pain) is documented although the search of the primary tumor was not able to localise it (possibly an intestinal one). Confirmatory diagnosis had a biochemical support in 262 mg/24 h urinary elimination of 5 HIAA (metabolic of serotonine). Particular aspects of the case are illustrated through intravitam documentation of the liver metastases (via portal vein) and the damage of the right heart (Hedinger syndrome) resulting from the involvement of the tricuspid valve apparatus (with clinical, phonomechanographic and echocardiographic abnormalities). The fatal evolution of the patient was due to uncontrolled aggravation of the portal high blood pressure syndrome (refractory ascites to diuretic treatment). It was impossible to us to obtain the morphopathological data. The specific elements of the carcinoid syndrome (including a convincing indirect illustration) with right cardiac involvement (known as Hedinger syndrome) are discussed, as well as the hypothetical place in pancreas of the primary carcinoid tumor.
 ...
PMID:[The heart: bystander or participant in neoplasms? The Hedinger syndrome (carcinoid cardiopathy)]. 945 74

In the article we discuss the role of serotonin in maintaining homeostasis paying special attention to the endocrinological aspect of the matter. It has been proved that it contributes to hypothalamus and hypophysis secretion regulation and interferes with paracrine activity in digestive and reproductive system. It is also an important constituent of platelets and takes part in aggregation and coagulation. It is known to be an atherogenic factor and to act as a growth stimulator for blood cells. It can be produced in exceed amounts by neoplasm or be released by activated thrombocytes during stress or coagulation. The influence of this hormone on the most of regulation mechanisms seems obvious. Presence of many different receptors as well as their number in all the structures of mammalian body makes it possible to use a range of agonists and antagonists in research concerning psychiatric diseases (e.g. bulimia, anorexia, depression), Alzheimer disease, migraine, hypertension, carcinoid related syndrome, multiple endocrine neoplasms and pre-menstrual syndrome. The promising results enable to use some of the modifiers in their clinical treatment though more research is needed for fully satisfactory effects.
 ...
PMID:[Serotonin--structure, activity and clinical significance]. 1009 81

A 38-year-old woman presented with hypertension and a renal cell carcinoma. Raised urinary 5-hydroxyindoleacetic acid values >300 micromol/l, predictive of carcinoid tumour, were found during the perioperative period. The values returned towards normal 2 weeks post-surgery. Immunohistochemical examination of the renal cell carcinoma with neuroendocrine markers was negative. Despite a diligent search, no carcinoid tumour could be identified and the patient was well 4 years later. There was no dietary or drug explanation for this pseudocarcinoid.
 ...
PMID:Renal cell carcinoma presenting as a pseudo-carcinoid tumour. 1050 48

The plasma soluble melanins (PSM) form spontaneously in vitro and in vivo and their formation involves oxidative polymerization and copolymerization of dopa, catecholamines, homogentisic acid, 3-hydroxyanthranilic acid, p-aminophenol, p-phenylenediamine, and other end(ex)ogenous ortho and para polyhydroxy-, (poly)hydroxy(poly)amino- and polyamino-phenyl compounds. The build up of PSM is visible within 2-3 h after the start of incubation at 37 degrees C with 1 mg/ml of plasma. PSM also form similarly in blood and these processes cause hemolysis. The mean quantity of PSM in normal human plasma is 1.61+/-0.1 (S.D.) mg/ml (n = 20) and in normal human urine is 1.1+/-1.2 g/24 h collection (n = 8). They contribute to the yellow color of plasma and urine. Antioxidants delay the formation of PSM. The deposited melanins also form from these precursors. Reactive oxygen side products (ROSP) are generated during and after melanogenesis. Melanins in vivo are generally associated with proteins or with proteins and lipids. The PSM-protein-lipid complexes are called plasma soluble lipofuscins (PSL), because they have histochemical and fluorescence properties similar to those of solid lipofuscins. The soluble and deposited melanins (SDM) and their intermediates have similar toxic chemical reactivities. The oxidizing quinoid (they can produce partially and completely substituted conjugates) and the semiquinoid free radical intermediates are also moieties in most human melanin structures. Soluble melanins formed from dopa, or dopamine, or norepinephrine in weak alkaline solution have been shown to be toxic to human CD4+ lymphoblastic cells (MT-2) at higher than 10 microg/ml concentrations. Alkaptonuria with high levels of homogentisic acid in the plasma is a potentially fatal disease, exhibiting the toxic effects of the homogentisic acid melanin (soluble and deposited), its intermediates and the ROSP. Patients with alkaptonuria develop arthritis and often suffer from other diseases too, including cardiovascular disease (frequent cause of death) and kidney disease. Pheochromocytoma, with high levels of catecholamines in the plasma is another potentially fatal disease. The catecholamine PSM of pheochromocytoma have very light yellow or practically no colors, due to the concentrations and chemical structures. Pheochromocytomas can cause hypertension, cardiovascular disease (frequent cause of death), kidney disease, stroke, cancer, amyloid formation and can mimic many other diseases, including acute pancreatitis, carcinoid, neuroblastoma, psychiatric illness, hypercalcemia, retinal vascular lesions, and diabetes mellitus. Pheochromocytoma is potentially fatal even in patients without hypertension. Following trauma and surgery, heavily pigmented eyes are apt to experience greater inflammation than lightly pigmented eyes. In Parkinson's disease those neurons are lost first in the substantia nigra and locus ceruleus which contain the greatest amounts of neuromelanins. The antihypertensive alphamethyldopa causes Parkinson's syndrome. It forms PSM in a short time in vitro. The side effects of L-dopa (immobility episodes alternate with normal or involuntary movements; psychotic abnormalities) suggest that the SDM, their intermediates and the ROSP present naturally in vivo are involved in the cause of Parkinson's disease and Alzheimer's disease. There is a large overlap between these two diseases. (ABSTRACT TRUNCATED)
 ...
PMID:The probable involvement of soluble and deposited melanins, their intermediates and the reactive oxygen side-products in human diseases and aging. 1124 35


<< Previous 1 2 3 4 5 6 7 Next >>