Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0034065 (pulmonary embolism)
 14,979 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

For the maintenance therapy of breast cancer, drugs which act as antagonists/partial agonists of hormone receptors against the breast tissue are used in the conventional clinical practices. However, during the course of treatment the patients may encounter systems related complications. Drugs like tamoxifen, which block the action of estrogens at its receptors in mammary gland; and the recently designed antiestrogens and selective estrogen receptor modulators (SERM) like raloxifene, toremifene and the progesterone antagonist mifepristone (RU-486) are used in the treatment for estrogen and/or progesterone receptor positive breast tumors. These drugs show, however, both acute and long-term toxicity like endometrial hyperplasia and cancer, menopausal symptoms, edema, thromboembolic events like pulmonary embolism and so on. Using molecular docking method, we studied the binding of these drugs at an array of receptors present within the physiological system. In addition, the molecular basis of the antiglucocorticoid and antiandrogenic side effects of mifepristone have also been studied. Our results show weak to moderate binding of these drugs at various receptors of the body. This may explain the toxicity and pathophysiological shifting by these drugs during the long term use of these drugs.
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PMID:Computational molecular docking assessment of hormone receptor adjuvant drugs: Breast cancer as an example. 1914 36

We report a 54-year-old female with recently diagnosed multiple cardiac thrombi and pulmonary embolism that was treated with thrombolytics and anticoagulants. She presented again with worsening dyspnea and was found to have persistent large cardiac thrombi on echocardiogram. Surgical findings revealed a single right atrial mass originating from inferior vena cava and extending into the pulmonary artery. The mass was successfully removed. Final pathology revealed a benign smooth muscle and vascular mass with estrogen and progesterone receptor positivity favoring uterine intravenous leiomyoma. She was discharged on warfarin and leuprolide therapy. This diagnosis requires a high index of suspicion, especially in a middle-aged woman with right atrial mass and history of an existing leiomyoma, hysterectomy or myomectomy.
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PMID:Uterine intravenous leiomyomatosis with femoral vein, intracaval, intracardiac and pulmonary artery extension. 3176 84

Intravascular leiomyomatosis (IVL) is a very rare condition. It is characterized by the proliferation of benign smooth muscle cells within vascular structures without invasion of these tissues. Symptoms depend on the site of origin and the extent of invasion. Rarely, this neoplasm is located in the inferior vena cava or in the pulmonary vasculature potentially causing symptoms of dyspnea, chest pain, or syncope. We report the case of a 53-year-old woman who was referred to our hospital with extensive pulmonary embolism comprising of a subtotal occlusion of the right pulmonary artery with extension into the left pulmonary artery. Due to persistent dyspnea (New York Heart Association class II) despite anticoagulation, after a six-week period, imaging was repeated and showed stable findings. As she was not responding to adequate anticoagulant therapy, intima sarcoma of the pulmonary artery was suspected, and a pulmonary endarterectomy (PEA) was performed. A smooth, white, intravascular mass was easily and completely removed. Analysis demonstrated a lesion consisting of cells without atypia, showing expression of alpha-smooth muscle actin (alpha SMA) and desmin with partial expression of estrogen receptor (ER) and progesterone receptor (PR), leading to the diagnosis of intravascular leiomyomatosis. The patient fully recovered. Complete surgical removal of the intravascular tumor is recommended to relieve symptoms and prevent possible complications. Clinicians have to be aware that in unresolved pulmonary embolism, nonthrombotic and rare causes, like an intima sarcoma or intravascular leiomyomatosis, should be considered.
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PMID:Intravascular Leiomyomatosis as a Rare Cause of Nonthrombotic Pulmonary Embolism. 3273 36