Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0231807 (exertional dyspnea)
 3,402 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 79-year-old male, admitted because of severe dyspnea on exertion, showed echocardiographic findings of a large tumor in the dilated right ventricle. The right ventricular outflow tract was nearly occluded by the tumor mass, and the mass was attached to the interventricular septum by a pedicle. The tumor removal operation was successful. The size of the tumor was 40 mm x 90 mm, and the weight 70 g. Microscopic findings showed typical myxomatous tissue with high cellularity, and no malignancy was observed. This is the oldest reported patient with right ventricular myxoma which was cured by operation.
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PMID:Large right ventricular myxoma in a 79-year-old male. 879 51

We report a 67-year-old man who developed pulmonary hypertension as an initial clinical manifestation of occult gallbladder adenocarcinoma. He had a 6-week history of persistent dry cough followed by progressive dyspnea on exertion. Physical examination and chest roentgenogram revealed signs of precapillary pulmonary hypertension. He died of shock 1 h after pulmonary angiography, which failed to show any intravascular filling defects. Autopsy disclosed a mucin-producing small adenocarcinoma (2 cm diameter) and a gallstone in the gallbladder with a few small metastases to peri-aortic, peri-bronchial and mediastinal lymph nodes. Macroscopically, there was no gross thrombotic pulmonary embolism or pulmonary metastases. However, microscopically, more than 60% of the small pulmonary arteries less than 1 mm in diameter were occluded with pulmonary tumor microemboli. This case emphasizes the need to include tumor pulmonary embolism in the differential diagnosis of pulmonary hypertension whether or not there is evidence of an underlying malignant tumor.
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PMID:Subacute pulmonary hypertension due to pulmonary tumor microembolism as a clinical manifestation of occult gallbladder adenocarcinoma. 907 Sep 64

Recreational and subsistence hunters and anglers consume a wide range of species, including birds, mammals, fish and shellfish, some of which represent significant exposure pathways for environmental toxic agents. This study focuses on the Department of Energy's (DOE's) Savannah River Site (SRS), a former nuclear weapons production facility in South Carolina. The potential risk of contaminant intake from consuming mourning doves (Zenaida macroura), the most popular United States game bird, was examined under various risk scenarios. For all of these scenarios we used the mean tissue concentration of six metals (lead, mercury, cadmium, selenium, chromium, manganese) and radiocesium, in doves collected on and near SRS. We also estimated risk to a child consuming doves that had the maximum contaminant level. We used the cancer slope factor for radiocesium, the Environmental Protection Agencies Uptake/Biokinetic model for lead, and published reference doses for the other metals. As a result of our risk assessments we recommend management of water levels in contaminated reservoirs so that lake bed sediments are not exposed to use by gamebirds and other terrestrial wildlife. Particularly, measures should be taken to insure that the hunting public does not have access to such a site. Our data also indicate that doves on popular hunting areas are exposed to excess lead, suggesting that banning lead shot for doves, as has been done for waterfowl, is desirable.
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PMID:A risk assessment for consumers of mourning doves. 985 92

Wilms' tumor is a highly curable neoplasm. Greater that 90% of all children with this disease can be expected to become long-term survivors. Although radiation therapy (RT) was once the mainstay of nonsurgical treatment, its use has been reduced both in indications and in dosage because of the chemoresponsiveness of the tumor. In the Third National Wilms' Tumor Study (NWTS 3), patients with stage II tumors were shown not to require postoperative RT, and in patients with stage III tumors, 10 Gy was sufficient. In NWTS 5, patients with stage III favorable histology (FH), stage IV FH (with abdominal stage III), and stage II-IV anaplastic and all patients with clear cell sarcoma receive 10 Gy to to the abdomen (usually given as 1.8 Gy x 6-total doe 10.8Gy). Results from the International Society of Paediatric Oncology, in which downstaged patients had a higher incidence of abdominal relapse, and the United Kingdom Children's Cancer Study Group first Wilms' Tumor Study, in which omission of whole-lung RT led to lowered survival in stage IV patients, suggest caution in further modifications of RT at this time.
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PMID:Wilms' Tumor: Changing Tole of Radiation Therapy. 1071 15

A 91-year-old man was admitted with colliquative diarrhea, anorexia and weight loss. He had a history of healed tuberculosis, hypertension and atherosclerotic abdominal aortic aneurysms. On admission, shortness of breath without cough, exertional dyspnea, and ascites were also noticed. His chest X-ray and CT showed almost normal findings in the lung fields except for calcified old pleurisy. Since laboratory tests revealed thrombocytopenia, low fibrinogen, and increased CA19-9. DIC induced by an unknown cancer was diagnosed. He died on the eighth day due to progressive respiratory failure which did not respond to oxygen therapy. Autopsy revealed that he had a poorly differentiated adenocarcinoma in the cecum complicated with pulmonary lymphangitis carcinomatosa. Lymphangitis should be considered in the case of unexplained progressive respiratory failure developing in patient with cancer, even in the absence of X-ray findings.
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PMID:[A very elderly autopsy case of cecal cancer with pulmonary lymphangitis carcinomatosa]. 1103 30

We report a unique case of a combined pulmonary large-cell neuroendocrine carcinoma and spindle-cell carcinoma. The patient was a 54-year-old female smoker who presented with a 4-month history of increased left-sided chest pain and exertional dyspnea. The left upper lobectomy specimen revealed an 8.0-cm mass with central necrosis. Microscopically, the epithelial areas were composed of well-defined nests of large cells with peripheral palisading expressing low-molecular-weight keratin, synaptophysin, chromogranin, and neuron-specific enolase. The spindle-cell component consisted of pleomorphic cells arranged in fibrosarcoma and malignant fibrous histiocytoma-like patterns. These spindle cells were positive for low-molecular-weight keratin and vimentin with focal expression of CD68 and muscle-specific actin. Electron microscopy in the spindle-cell areas showed cell junctions and numerous tonofilaments, indicative of epithelial differentiation. The tumor behaved aggressively and the patient died with extensive metastases 4 months after surgery. The combination of neuroendocrine malignancies and spindle-cell carcinomas appears to be uncommon in the lung. Previous reports have described this association in single case reports of anaplastic small-cell carcinoma and atypical carcinoid, but not in large-cell neuroendocrine carcinoma.
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PMID:Combined large cell neuroendocrine carcinoma and spindle cell carcinoma of the lung. 1151 7

Exposures of the American public occurred nationwide from the testing of nuclear weapons in the United States, the Pacific, and the former Soviet Union. After decades of diminished public awareness on the subject of health risks resulting from exposure to fallout, the release of the National Cancer Institute's 1997 report on nationwide exposure to 131I from the Nevada Test Site (NTS) has led to renewed interest. Public requests for information are focused on individual and family health problems, the right to credible and full disclosure of information, and the need for medical care and assistance for exposure-related health problems. Public concerns have been raised regarding: (a) the lack of information on the potential health risks from exposure to all biologically significant radionuclides in fallout; (b) the lack of independent oversight that includes public participation; (c) governmental portrayal of exposures averaged over very large segments of the population without identification of much larger values for individuals or population subgroups likely to be at highest risk; and (d) a governmental response to known or suspected human exposures that consumes large periods of time and devotes considerable funding to various research-related activities before serious consideration is given to addressing health care responsibilities to exposed individuals. To some extent, these complaints and concerns are rooted in the legacy of government secrecy surrounding the development and testing of nuclear weapons, public distrust of government sources of information about radiation exposures and health risks, and the imposition of past exposures without informed consent. Members of the public participating in the oversight of dose reconstruction projects and epidemiologic studies are requesting information on the total impact from all relevant sources of exposure at each site that might contribute significantly to an individual's risk, including exposure to local releases and to NTS and global fallout. Information is being requested on individual doses and risks from these cumulative exposures, with estimates of uncertainty, including estimates of the absorbed organ dose (as opposed to the effective dose), the risk of disease incidence as opposed to the risk of a cancer fatality, and the chance that a person's diagnosed disease was caused by past exposure (i.e., the probability of causation). This paper attempts to address some of these concerns. We conclude by noting that many individuals exposed in childhood during the 1950's to 131I in fallout from nuclear weapons production and testing would qualify for compensation and medical care if the present rules for the adjudication of claims for atomic veterans and radiation workers at DOE sites were to be extended to the public.
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PMID:A perspective on public concerns about exposure to fallout from the production and testing of nuclear weapons. 1200 22

The events of September 11, 2001 have focused attention on the possibility of nuclear terrorism, and 1-10 Sv is arguably the dose range of biological interest, since doses in this range both pose a risk of acute effects and are potentially survivable. Because of this interest, a coalition of U.S. government agencies (NCI, DOD, DOE) and the Radiation Research Society convened a workshop in December 2001 "to focus on molecular, cellular and tissue changes that occur [at doses of 1-10 Sv] and potential mechanisms of radioprotection". A draft report of this workshop was posted on the NCI website in February 2002. According to the draft, the workshop was also intended to "determine the research opportunities and resources required [and] develop a research-action plan for further discussion and implementation." Injuries after exposure to ionizing radiation are important to patients with cancer and to populations potentially subject to accidental or intentional exposure. In these populations, partial- or whole-body exposures in the range of 1-10 Sv are possible. The consequences of exposure of limited tissue volumes to doses above 10 Sv have been researched because of their applicability to cancer therapy, while exposure to doses below 1 Sv has been researched because of nuclear fallout and space exploration issues. Except for research aimed at protection of members of the armed forces, the intervening dose range has received relatively little attention. The workshop participants concluded that although we currently have only a limited ability to deal with the consequences of radiation exposures in this range, focused research would have the potential of rapidly expanding such capabilities.
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PMID:Report on an interagency workshop on the radiobiology of nuclear terrorism. Molecular and cellular biology dose (1-10 Sv) radiation and potential mechanisms of radiation protection (Bethesda, Maryland, December 17-18, 2001). 1207 12

Primary mediastinal liposarcomas are extremely rare malignancies that remain asymptomatic until large and, even then, initial symptoms are nonspecific. We report a 48-year-old man followed up for asymptomatic multiple bullae who suffered progressive weight loss and dyspnea on exertion. Radiography and computed tomography of the chest showed a large mass with calcified nodules in the left pleural cavity and giant bullae in the right pleural cavity. Previous computed tomography of the chest showed a small tumor of mediastinal adipose tissue with calcified nodules. Tumor growth was calculated at about 500 times the tumor volume per 3.6 years. We completely resected the mediastinal tumor and conducted a bullectomy through a median sternotomy. The microscopic pathological diagnosis was well-differentiated/sclerosing liposarcoma. The man underwent no postoperative adjunctive irradiation and remains well 8 months after surgery.
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PMID:Primary liposarcoma of the mediastinum. 1207 3

As the genomes of mammalian species become sequenced and gene functions are ascribed, the use of differential gene expression (DGE) to evaluate organ function will become common in the experimental evaluation of new drug therapies. The ability to translate this technology into useful information for human exposures depends on tissue sampling that is impractical or generally not possible in man. The possibility that the DGE of nucleated cells, reticulocytes, or platelets in blood may present the necessary link with target organ toxicity provides an opportunity to correlate preclinical with clinical outcomes. Adriamycin is highly effective alone and more frequently in combination with other chemotherapeutic agents in the treatment of a variety of susceptible malignancies. Adriamycin-induced cardiomyopathy was examined as an endpoint to measure the utility of DOE on whole blood as a predictor of cardiac toxicity. Statistically significant gene changes were observed between relevant blood and cardiac gene profiles that corroborated the accepted mechanisms of toxicity (oxidative stress, effects on carnitine transport, DNA intercalation). There were, however, clear indications that other target organs (bone marrow and intestinal tract) were affected. The divergent expression of some genes between the blood and the heart on day 7 may also indicate the timing and mechanism of development of the cardiomyopathy and confirm current therapeutic approaches for its prevention. The data demonstrate that whole blood gene expression particularly in relation to oxidative stress, in conjunction with standard hematology and clinical chemistry, may be useful in monitoring and predicting cardiac damage secondary to adriamycin administration. Appendices A & B, referenced in this paper, are not printed in this issue of Toxicologic Pathology. They are available as downloadable text files at http://taylorandfrancis.metapress.com/openurl.asp?genre=journal&issn=0192-6233. To access them, click on the issue link for 30(4), then select this article. A download option appears at the bottom of this abstract. In order to access the full article online, you must either have an individual subscription or a member subscription accessed through www.toxpath.org.
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PMID:Correlation of simultaneous differential gene expression in the blood and heart with known mechanisms of adriamycin-induced cardiomyopathy in the rat. 1218 37


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