Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Recent studies suggest that the HMG-CoA reductase inhibitor simvastatin--similar to vascular endothelial growth factor (VEGF)--may promote angiogenesis by activation of a protein kinase Akt-nitric oxide synthase dependent pathway in endothelial cells, an effect that may be beneficial in the treatment of ischemic heart disease. However, induction of angiogenesis by VEGF contributes importantly to the blood supply of developing tumors and tumor metastases as well. Thus, it can be hypothesized that chronic systemic treatment of elderly patients with a drug that induces angiogenesis by a VEGF-like manner will also promote tumor growth.
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PMID:Can simvastatin promote tumor growth by inducing angiogenesis similar to VEGF? 1186 4

Coronary artery ectasia (CAE) is a rare form of coronary artery disease. It has previously been shown that nitrate derivatives induce exertional angina in patients with CAE. Furthermore, there is limited data about the effects of other anti-ischemic agents in CAE. The aim of this study was to investigate the effect of trimetazidine on exercise performance in patients with CAE. The study population consisted of 56 patients with isolated CAE (32 males, mean age: 58 +/- 9 years). The presence of myocardial ischemia was evaluated by treadmill exercise test. The exercise test was positive in 49 patients at baseline and in 27 patients during trimetazidine therapy (P < 0.01). The exercise test induced angina in all of the patients who have had a positive test result. Significant ST depressions were observed in 42 and 23 patients before and after the treatment, respectively (P < 0.01). The extent of ST depression at peak exercise was significantly lower on trimetazidine (0.9 +/- 0.5 vs 1.5 +/- 0.6 mm, P < 0.01). With trimetazidine, the exercise duration increased from 7.8 +/- 2.1 to 8.7 +/- 2.4 min (P = 0.04) and cardiac work-load also increased from 8.9 +/- 2.3 to 10.4 +/- 2.1 mets (P < 0.01). The results suggest that trimetazidine can relieve exercise-induced angina and improve exercise performance in patients with CAE.
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PMID:Effect of trimetazidine on exercise performance in patients with coronary artery ectasia. 1290 28

Hypoxia-inducible transcription factor 1 (HIF-1) and HIF-2alpha regulate the expression of an expansive array of genes associated with cellular responses to hypoxia. Although HIF-regulated genes mediate crucial beneficial short-term biological adaptations, we hypothesized that chronic activation of the HIF pathway in cardiac muscle, as occurs in advanced ischemic heart disease, is detrimental. We generated mice with cardiac myocyte-specific deletion of the von Hippel-Lindau protein (VHL), an essential component of an E3 ubiquitin ligase responsible for suppressing HIF levels during normoxia. These mice were born at expected frequency and thrived until after 3 months postbirth, when they developed severe progressive heart failure and premature death. VHL-null hearts developed lipid accumulation, myofibril rarefaction, altered nuclear morphology, myocyte loss, and fibrosis, features seen for various forms of human heart failure. Further, nearly 50% of VHL(-/-) hearts developed malignant cardiac tumors with features of rhabdomyosarcoma and the capacity to metastasize. As compelling evidence for the mechanistic contribution of HIF-1alpha, the concomitant deletion of VHL and HIF-1alpha in the heart prevented this phenotype and restored normal longevity. These findings strongly suggest that chronic activation of the HIF pathway in ischemic hearts is maladaptive and contributes to cardiac degeneration and progression to heart failure.
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PMID:Hypoxia-inducible factor-dependent degeneration, failure, and malignant transformation of the heart in the absence of the von Hippel-Lindau protein. 1828 56

A 95-year-old woman who presented with ischemic heart disease was admitted due to a sensation of chest compression. Endoscopy was performed due to anemia which showed an irregular ulcerative lesion in the duodenal bulb which a biopsy revealed to be high-grade neuroendocrine carcinoma. Distant metastasis was found and the patient died from the original disease 3 months after the first medical examination. The result of autopsy was neuroendocrine carcinoma of duodenum and invasion and metastases to multiple organs. We report a case of neuroendocrine carcinoma originating from the duodenum excluding the papilla which is extremely rare in Japan.
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PMID:[A case of neuroendocrine carcinoma which originated in duodenal bulb]. 2005 87

Malignant involvement of the heart and pericardium is uncommon in advanced cancer, and rarely results in cardiac symptoms. Myocardial ischaemia due to metastatic disease is particularly uncommon. We report a case of a young man in whom myocardial ischaemia was diagnosed at presentation of Hodgkin's disease, and which resolved as the underlying lymphoma responded to chemotherapy.
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PMID:An unusual presentation of Hodgkin's disease. 2159 58

Recently, the right gastroepiploic artery (RGEA) has been used in coronary artery bypass graft (CABG) as an alternative arterial graft. Because of the improvement of prognosis after CABG, malignant diseases are more common in older patients. However, there is a serious problem in patients with gastric cancer after CABG with RGEA graft. In these patients, an interruption of coronary blood supply through the RGEA may cause a life-threatening myocardial ischemia. Therefore, an appropriate strategy is very important to avoid risk while retaining the curability of the operation. We herein describe a 76-year-old Japanese man with advanced gastric cancer who underwent CABG using the RGEA. Abdominal computed tomography (CT) showed #6 lymph nodes (sub-pyloric lymph nodes) metastases surrounding the RGEA. We concluded that curative resection was impossible while preserving the RGEA and started combination chemotherapy using S-1 and cisplatin. After 2 courses of that, #6 lymph nodes were reduced extremely. Thereafter the patient underwent distal gastrectomy with regional lymph node dissection around the RGEA without excision of the RGEA. Histologically, there were no metastases in #6 lymph nodes. Neoadjuvant chemotherapy may be effective for preserving the RGEA graft in a patient with advanced gastric cancer after CABG.
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PMID:Curative Resection Following Neoadjuvant Chemotherapy for Advanced Gastric Cancer With Preservation of a Right Gastroepiploic Artery Coronary Artery Bypass Graft: A Case Report. 2556 54

Cardiac metastases in bronchogenic carcinoma may occur due to retrograde lymphatic spread or by hematogenous dissemination of tumour cells, but direct invasion of heart by adjacent malignant lung mass is very uncommon. Pericardium is frequently involved in direct cardiac invasion by adjacent lung cancer. Pericardial effusion, pericarditis, and tamponade are common and life threatening presentation in such cases. But direct invasion of myocardium and endocardium is very uncommon. Left atrial endocardium is most commonly involved in such cases due to anatomical contiguity with pulmonary hilum through pulmonary veins, and in most cases left atrial involvement is asymptomatic. But myocardial compression and invasion by adjacent lung mass may result in myocardial ischemia and may present with retrosternal, oppressive chest pain which clinically may simulate with the acute myocardial infarction (AMI). As a result, it leads to misdiagnosis and delayed diagnosis of lung cancer. Here we report a case of non-small-cell carcinoma of right lung which was presented with asymptomatic invasion in left atrium and retrosternal chest pain simulating AMI due to myocardial compression by adjacent lung mass, in a seventy-four-year-old male smoker.
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PMID:Bronchogenic Carcinoma with Cardiac Invasion Simulating Acute Myocardial Infarction. 2704 70

A 78-year-old woman with hypertension, diabetes, dyslipidemia, and revascularized ischemic heart disease was diagnosed with gastric adenocarcinoma in 2011, with suspected bilateral adrenal metastatic disease, and was treated with subtotal gastrectomy and palliative chemotherapy. A follow-up gastroscopy in 2015 identified a protruding, erosive mid-esophageal lesion suggestive of extrinsic compression or ulcerated submucosal lesion, which had not been described previously. Follow-up was advised, and the lesion persisted after three months. The patient had no esophageal symptoms, and subsequent thoracoabdominal CT scans found no bony abnormalities in the cervicothoracic spine or mediastinal changes. Endoscopic ultrasound was recommended given the patient's cancer history.
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PMID:Extrinsic esophageal compression by the vertebral body. 2848 Jul 23

Pneumonia remains one of the most important causes of mortality. In Portugal, it is the first cause of respiratory death, excluding lung cancer. This is a retrospective cohort study designed to seek for explanations, identifying the characteristics of patients and measure the impact of each one of them on the risk of dying from pneumonia. We analyzed demographic and clinical data of all patients (pts) with 18 years or older with pneumonia requiring hospitalization registered on the national health service registry of mainland Portugal over 2015. A total of 36366 patients corresponding to 40696 pneumonia hospital admissions in 2015 were analyzed. Most of the patients were very old (median age 80 years). Hospital mortality for pneumonia was higher among older (30,3% pts>75 years). Pneumococcus is the more frequent bacterial isolate, reaching 41.2% of the isolates of total pneumonia cases. The frequency of pneumococcus decreases with aging; conversely, gram-negative bacteria and staphylococcus increase. Pneumococcus is more frequently identified in the winter, closely related to influenza outbreaks. Gram-negative bacteria are more prevalent during the summer months. Diabetes, obesity, COPD, and tobacco smoking are not associated with an increased risk of dying from pneumonia. Patients older than 75 years; living in a senior house; or with chronic renal disease, lung cancer, metastatic disease, mobility impairment, cachexia, dementia, cerebrovascular disease, and ischemic heart disease are at greater risk of dying from pneumonia. Comorbidities contribute decisively to the risk of dying from pneumonia in the hospital, regardless of their type or origin.
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PMID:Pneumonia mortality, comorbidities matter? 3178 63


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