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

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

This investigation addresses the possibility of providing mouse embryos or other foreign objects with a protective mucin coat by transferring them into the oviduct of a live rabbit doe. Mouse embryos at the 8 or 16-cell stage, rabbit oocytes and latex spheres resembling mouse embryos in size were transferred to the ligated oviducts of ovulation-induced rabbit does. The does were killed 24 h later to have their oviducts flushed. A large proportion of the latex spheres (89%) and of the ovulated oocytes of the recipient does (92%) was recovered. The recovery rates for transferred rabbit oocytes, either intact or with the zona pellucida removed, were 61% and 51%, respectively, whereas that for mouse embryos was extremely poor (20%). Rabbit oocytes with or without zona were enveloped in a thick mucin coat regardless whether they had been transferred or ovulated by the recipients. The same applied to empty rabbit zonae. Mouse embryos and latex spheres were also covered by a mucin coat, but it was four times thinner. While residing in the rabbit oviduct, the mouse embryos continued developing to a stage comparable to what would have been expected in situ. During the subsequent in vitro culture, mouse embryos continued developing to the expanded blastocyst stage. They did, yet, not hatch from the zona. It may be concluded that particles of various origins, when placed into the oviduct of ovulated rabbit does, will be provided with a mucin covering which is, however, considerably thinner than that surrounding oocytes or zonae pellucidae originating from rabbits.
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PMID:Coating of objects introduced into the oviduct of pseudopregnant rabbit does. 1899 96

Scleromyxedema (SM) is a sclerotic variant of lichen or papular mucinosis in which lichenoid papules and scleroderma-like features are both present. It is a rare deposition disorder characterized by generalized papular and sclerodermoid eruptions, mucin deposition, increased fibroblast proliferation, fibrosis, and monoclonal gammopathy (also known as paraproteinemia) mainly of the immunoglobulin G-lambda type in the absence of thyroid disease. It usually affects middle-aged adults and shows no gender or racial predilection. In addition to the skin findings and paraproteinemia, patients with SM have variable multisystem affections that mimic systemic sclerosis; the systems which are commonly involved include the gastrointestinal tract, musculoskeletal, pulmonary, cardiovascular, renal, and central nervous systems, leading to significant morbidity and mortality. Prominent symptoms include dysphagia, proximal muscle weakness, and dyspnea on exertion; less common but important findings include central nervous system involvement in the form of encephalopathy, convulsions, coma, and psychosis.
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PMID:Scleromyxedema: a case report and review of the literature. 2387 93

Trousseau syndrome is most commonly defined as a hypercoagulability syndrome associated with mucin-producing adenocarcinoma. We report here a rare case of Trousseau syndrome presenting as pulmonary arterial hypertension. The patient complained of cough and increasing exertional dyspnea. Rapidly progressive symptom development of pulmonary arterial hypertension accompanied by right heart failure was observed, and the patient died on hospital day 2. An autopsy revealed Krukenberg tumors on both ovaries and a signet-ring cell gastric carcinoma. In the lungs there was tumor embolism with signet-ring cells to some extent, but the peripheral pulmonary arteries were occupied primarily by pulmonary embolism with platelets, fibroblasts, and fibrotic organized thrombi.
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PMID:Rapidly progressive symptom development of pulmonary arterial hypertension: a case report of Trousseau syndrome. 2427 7

Interstitial lung disease (ILD) is becoming one of the main causes of death of patients with systemic sclerosis (SSc). The prevalence of ILD associated with SSc (SSc-ILD) varies from 33% to 100% according to diagnostic methods. Clinical features such as dyspnea on exertion, dry cough, and chest pains are not specific and usually late-appearing, implying more specific tests in the diagnostic, prognosis, and follow-up of ILD in patients with SSc. High resolution thoracic CT scanner (HRCT) is more sensitive than chest X-ray in the detection of SSc-ILD. Pulmonary function tests (PFT) are non-invasive and periodically used to assess the impacts of SSc on respiratory function. Diagnostic values of bronchoalveolar lavage and histological examination on lung biopsy are controversial. However, these techniques are essential for studying cellular and molecular mechanisms underlying the pathophysiology of SSc-ILD. Several biomarkers such as surfactant-A (SP-A), -D (SP-D), mucin-like high molecular weight glycoprotein (KL-6), and chemokine CCL-18 have been implicated in SSc-PID. Serum levels of these proteins are correlated with the severity of SSc-ILD, as assessed by HRCT and/or PFT. Finally, alveolar concentration of exhaled nitric oxide can be used to screen SSc patients with high risk of deterioration of respiratory function, in whom immunosuppressant treatment could be useful in preventing the evolution to irreversible lung fibrosis.
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PMID:[Use of pulmonary function tests and biomarkers studies to diagnose and follow-up interstitial lung disease in systemic sclerosis]. 2545 18