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)

This report presents the results of induced hypertension chemotherapy combined with radiotherapy for 44 advanced cancer patients (involving locoregional and/or remote recurrences). The lesions were 16 breast cancers, five soft tissue sarcomas, four lung cancers, four malignant lymphomas, three uterine cancers, two tongue cancers, and one parotid gland cancer, soft palate cancer, malignant thymoma, pancreatic cancer, vaginal cancer, urinary bladder cancer and rectal cancer each. The results, ive., eight complete remissions, 20 partial remissions and 16 cases of no change, were almost satisfactory.
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PMID:[Induced hypertension chemotherapy combined with radiotherapy in 44 advanced cancer patients]. 374 62

Distal esophageal varices are most frequently associated with portal hypertension, while varices of the upper esophagus are occasionally observed in patients with vena caval obstruction. One hundred and nineteen cases of upper esophageal varices (downhill varices) have been reported in the literature. We report 6 cases (4 men and 2 women), with vena caval obstruction. Upper gastrointestinal hemorrhage occurred in one patient. Endoscopy showed varices in the proximal third of the esophagus in 5 patients and in the proximal half of the esophagus in the other patient. Superior vena cavogram demonstrated total or partial occlusion of the vena cava in 6 cases, with opacification of the right azygos vein in 4 cases and thrombosis of this vein in one case. Superior vena caval obstruction was secondary to malignant lymphoma in 2 cases, to malignant thymoma in 2 cases, to malignant thyroid tumor in one case and to anaplastic bronchogenic carcinoma in one case. Clinical symptoms of vena caval obstruction are present in 91.4 p. 100 of the cases in the literature. Upper gastrointestinal hemorrhage are observed in 7.6 p. 100 of cases. It is generally agreed that the predominant factors involved in the determination of the downward extension of varices along the esophagus are the level of superior vena caval obstruction and its duration. Because of the risk of digestive hemorrhage and of the topographic meaning of the degree of extension, upper esophageal varices should be routinely searched in patients with vena caval hypertension.
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PMID:[Upper esophageal varices. Study of 6 cases and review of the literature]. 665 76

A 65-year-old man visited our hospital with complaints of tingling sensation in the distal parts of his extremities and dysuria, which first appeared 2 months before admission. He had no abnormal findings on physical examination. Neurological examination revealed sensory impairment of glove and stocking type, mild motor weakness and muscular atrophy in the proximal parts of arms and legs, and absent tendon reflexes in knees and ankles. Fasciculation was observed on his shoulders and upper extremities, and myokymia on the abdominal wall and bilateral calves. He had hyponatremia, which was proved to be caused by SIADH. Anti-acetylcholine receptor antibody, anti-GM1 ganglioside antibody and anti-galactocerebroside antibody were detected in the serum. Chest X-ray showed mass shadows in the mediastinum, which were confirmed as malignant thymoma by needle biopsy. Orthostatic hypotension, neurogenic bladder and anhidrosis were observed by the autonomic function tests. Lesions responsible for orthostatic hypotension and SIADH were suspected in the afferent fibers from baroreceptors, since an reactive increase of plasma arginine vasopressin to orthostatic hypotension was blunted and reflex hypertension in the cold pressor test was well-preserved, while overshoot in Valsalva's maneuver was absent. It is important that afferent baroreceptor dysfunction may be associated with paraneoplastic neurological syndrome, since lesions in acute autonomic neuropathy are usually in the efferent fibers.
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PMID:[A case of paraneoplastic autonomic and sensorimotor neuropathy with dysfunction in the afferent limb of baroreflex arc]. 840 86

A 74-year-old male, who had been treated for hypertension at the out-patient clinic, was admitted to our hospital because of an abnormal shadow on a chest radiograph. After diagnosis of thymoma by needle biopsy surgery was carried out on July 6, 1995, when an extended thymectomy along with removal of the entire tumor was done. During the surgery it was noticed that there was not one, but two independent tumors located in the anterior mediastinum, the upper left portion was growing from the level of the crania to the left brachiocephalic vein, whereas the lower right portion was growing towards the right thoracic cavity in front of the pericardium. Both tumors were encapsulated firmly, and connected to each other by scantly loose connective tissues. There was no continuity or sarring between the two tumors. Histologically both were diagnosed to be lymphocytic thymoma. We believe that this case is a good example of multiple thymomas and provides evidence of the potential multicentricity of thymoma. It is possible that extended thymectomy may be seeded for a complete resection of thymomas.
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PMID:[Resection of multiple thymoma: a case report]. 939 65

Ectopic ACTH secretion due to malignant tumours is the most frequently underdiagnosed form of Cushing's syndrome. The majority of neoplasms causing ectopic ACTH syndrome are small-cell cancers of the lung or carcinoids. Other well-documented cases include adenocarcinoma of the lung, medullary thyroid carcinoma, pancreatic islet tumours and malignant thymoma. We report a rare case of metastatic colonic adenocarcinoma with ectopic ACTH syndrome. Clinical features such as proximal muscle weakness, peripheral oedema, hypertension or hirsutism in women, or the presence of unexplained hyperglycaemia, hypokalaemia or metabolic alkalosis in patients with known malignancy strongly suggest ectopic ACTH syndrome. Removal of the source of ACTH is the treatment of first choice, but often not feasible. Most often, treatment modalities are only palliative, with drugs directed against hypercortisolism such as aminoglutethimide, metyrapone, ketoconazole or mifepristone.
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PMID:[Cushing syndrome due to ectopic ACTH secretion: an uncommon case presentation, diagnosis and therapy]. 1042 Apr 45

This paper reviews treatment strategies of myasthenia gravis (MG) that are currently in use: 1. enhancement of neuromuscular transmission with acetylcholinesterase inhibitors; 2. short-term immunotherapies, including plasma exchange and intravenous immunoglobulin therapy; 3. immunosuppression; 4. surgical thymectomy and thymomectomy. Acetylcholinesterase blockers are still used as the first-line treatment of MG. Although most of patients benefit from these drugs, the improvement is usually incomplete and often wanes after weeks or months of treatment. When clinical symptoms are not adequately controlled by anticholinesterase drugs, immunosuppressive therapy is suggested, but indications for treatment take into account age and clinical symptoms (ocular versus generalised myasthenia). Steroids are the most commonly used and most consistently effective immunosuppressive agents for MG treatment but they also have the highest incidence of potential side effects. The use of azathioprine, for monotherapy in initial immunosuppression treatment of MG is controversial. However, data are available, including a randomised trial, to support the use of azathioprine as an adjunctive drug with corticosteroids. Retrospective analyses of the treatment of MG have shown that cyclosporine is also effective but renal toxicity and hypertension are the major factors limiting its use. Mycophenolate mofetil appeared also to be effective as adjunctive therapy in the treatment of refractory and steroid-dependent MG. Intravenous immunotherapy (IVIg) is recommended as an adjunct in the management of MG exacerbations. According to new publications, there are no pronounced differences in the efficacy of IVIg treatment and plasma exchange. Thymomectomy is beneficial and should be considered for all patients with thymoma-associated MG. However, in cases with non-thymomatous autoimmune MG, thymectomy is recommended only for patients below age 55-60 and within the first 6-12 months of disease duration.
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PMID:[Actual aspects of myasthenia gravis treatment]. 1291 9

Thallium-201 (Tl-201) is widely used for myocardial perfusion imaging, but is also reported to have potential tumor-seeking properties. Tl-201 uptake has been described in various malignant diseases, including thymic tumors. Thymomas are the most frequent tumors of the anterior mediastinum, and chest pain is one of the major presentation symptoms. Sometimes, a thymoma may be overlooked on chest plain film. We report on a case of a 63-year-old man who had a history of hypertension and suffered from intermittent chest pain for several weeks. He underwent a Tl-201 stress test to evaluate the presence of coronary artery disease, and during the test, abnormal uptake over focal extracardiac activity in the left upper mediastinum was incidentally revealed. Furthermore, chest computed tomography identified a 6-cm left anterior mediastinal mass. Mediastinal tumor resection was carried out, and the pathological examination demonstrated an invasive epithelial-type thymoma, which had invaded the left innominate vein. Subsequently, the patient received postoperative radiotherapy and thenceforth responded well to treatment. A Tl-201 scan has the potential to play a part in tumor detection and clinical assessment of therapeutic effects.
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PMID:Incidental detection of an invasive thymoma during thallium-201 imaging for coronary artery disease. 1509 60

A subgroup of limbic encephalitis is associated with antibodies against voltage-gated potassium channels (VGKC), and responds well to immuno-modulating therapies. Anti-VGKC antibodies are also found in Isaacs' syndrome and Morvan's syndrome, both of which are sometimes complicated by thymoma. We describe a 52-years-old man with limbic encephalitis, thymoma, and anti-VGKC antibodies, who presented with autonomic dysfunctions such as severe intestinal pseudo-obstruction, hyperhidrosis and hypertension. Thymectomy and corticosteroid therapy remarkably improved his symptoms. Brain magnetic resonance imaging showed hypothalamic lesions, in addition to the bilateral involvement of the medial temporal lobes. This patient had severe autonomic dysfunctions resembling those of Morvan's syndrome. This case may represent a subgroup of VGKC-antibody associated syndromes with a wide spectrum of symptoms, including Isaacs' syndrome, Morvan's syndrome, and limbic encephalitis.
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PMID:Potassium channel antibody-associated encephalitis with hypothalamic lesions and intestinal pseudo-obstruction. 1837 60

We report a 40-year old woman with bilateral partial ptosis, complete external ophthalmoplegia, and weakness and fatiguability of upper limbs. She was on treatment for hypertension for 5 months at the time of admission. She was found to have generalised myasthenia gravis and membranous nephropathy with end-stage renal disease. Her symptoms and signs improved within 2 months on treatment with neostigmine and prednisolone. It is postulated that either thymic hyperplasia or the subclinical stage of a thymoma may be the underlying aetiological factor in this patient.
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PMID:Case of generalised myasthenia gravis with membranous nephropathy. 1859 Feb 68

Extrinsic left atrial compression is an uncommon source of hemodynamic compromise that can be caused by many mediastinal structures including bronchogenic cysts, carcinoma, lymphoma, thymoma, aortic aneurysm and diaphragmatic hernia. We describe an unusual case of a 26-year-old man presenting with symptoms of left heart failure. Transthoracic echocardiography demonstrated extrinsic left atrial compression caused by a metastatic testis non-seminomatous germ cell tumor. Compression of the left atrium caused impaired left atrial filling, leading to pulmonary venous hypertension and pulmonary edema. To our knowledge, the present case is the first reported case of mediastinal metastatic testis non-seminomatous germ cell tumor causing symptoms of left heart failure by externally compressing the left atrium.
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PMID:Mediastinal testicular tumor compressing the left atrium in a young male presenting initially with symptoms of left heart failure. 1918 28


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