Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0392680 (shortness of breath)
 5,217 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty-six patients with metastatic cancer were entered into a phase I trial of concurrent recombinant interleukin-2 (IL-2) and recombinant interferon-gamma (IFN-gamma). IL-2 was administered as a continuous intravenous infusion for 5 days. IFN-gamma was administered by a daily intramuscular (IM) injection during the 5 days of IL-2 administration. Treatment was repeated twice after 9-day rest periods. After a 2-week rest, patients without evidence of tumor progression were retreated. Natural killer (NK)- and lymphokine-activated killer (LAK)-cell activity were assayed in each patient before treatment, on day 1, and on day 5 of each cycle. Constitutional symptoms occurred in most patients but were not dose-limiting. Other toxicities included hypotension responsive to fluids, transient elevations in liver function tests, erythema/pruritus, eosinophilia, and transient leukopenia/thrombocytopenia. The maximum-tolerated dose (MTD) of the combination was 1 x 10(6) U/m2/d of IL-2 combined with 0.50 mg/m2/d of IFN-gamma. The dose-limiting toxicity was pulmonary manifesting as rales and shortness of breath. The dose of the combination that resulted in the optimal generation of in vivo LAK-cell activity was a dose of at least 0.25 mg/m2/d of IFN-gamma combined with 1 x 10(6) U/m2/d of IL-2. Objective clinical responses were seen in five of 26 patients. These included a partial response of 2 months duration in a patient with non-Hodgkin's lymphoma (NHL), mixed responses in a patient with NHL and two patients with renal cell carcinoma (RCC), and an ongoing assessable response in a patient with bone metastases from RCC. The recommended dose for phase II trials of this combination is 0.50 mg/m2 of IFN-gamma and 1 x 10(6) U of IL-2.
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PMID:A phase I trial of recombinant interleukin-2 combined with recombinant interferon-gamma in patients with cancer. 211 71

In July 1979, a 72-year-old white woman presented to the Bernalillo County Medical Center Emergency Department with complaints of shortness of breath and wheezing. She had been asthmatic since childhood. Current management included bronchodilator therapy and continuous low flow oxygen. An apparently curative left radical nephrectomy had been performed in 1978 for renal cell carcinoma. Her evaluation in the emergency room included multiple attempts at right radial artery puncture for blood gases. The arterial blood gases were obtained only after repeated efforts by several individuals. The patient was discharged from the emergency room after receiving subcutaneous terbutaline and intravenous aminophylline. Approximately one week later, she noticed a swelling on her right wrist at the site of the punctures. Over the ensuing three weeks, the lesion doubled in size and became painful. In chest clinic, one month after emergency room visit, we found a 1 cm by 1 cm raised erythematous tender nodule on the right wrist overlying the radial artery pulse. We did not hear a bruit, the lesion did not feel fluctuant, and attempts to aspirate fluid were unsuccessful. Because we thought the lesion represented local infection, we began oral antibiotic therapy. The lesion was unchanged after 1 1/2 weeks of therapy and was excised. Pathologic examination showed a well-defined cutaneous nodule with histology diagnostic of a keratocanthoma. The patient developed a recurrence of the tumor at the excision site a few weeks later and required a wide excision, also under local anesthesia. She has since remained clinically free of recurrent tumor.
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PMID:Keratoacanthoma as a complication of arterial puncture for blood gases. 711 51

Subcutaneous administration of low doses of recombinant interleukin-2 (IL-2) and interferon-alpha (IFN-alpha) on an out-patient basis has been reported not to significantly compromise the response frequency compared to intravenous IL-2 in patients with renal cell carcinoma and melanoma. As part of an ongoing program to develop a biotherapeutic concept in patients with colorectal carcinoma (CRC) we studied the clinical effects of such a regimen in 15 patients with metastatic CRC. The daily dose of IL-2 varied between 4.8-14.4 x 10(6) U/m2 and of IFN-alpha between 3-6 x 10(6) U/m2. The cycle length was 6 weeks. The course was repeated every 8 weeks until disease progression. Maximum 4 cycles were administered. Maintenance therapy was given to responding patients once a week every month. No patient showed a major response (CR or PR). Six patients had a stable disease ranging from 3 months to 18 months with a median duration time of 5 months. The median survival of all patients was 13 months. The main adverse reactions were fever, chills, anorexia and shortness of breath. No treatment related deaths occurred. 6/14 patients developed abnormal concentration of serum levels of thyroid hormones. It is concluded that the present treatment schedule using IL-2 and IFN-alpha in advanced CRC seemed not to be of clinical benefit.
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PMID:Subcutaneous interleukin-2 and alpha-interferon in advanced colorectal carcinoma. A phase II study. 778 Apr 87

A 68-year-old Chinese male with a history of renal cell carcinoma presenting with increasing shortness of breath and hemoptysis was found to have subtotal left main bronchial obstruction secondary to a metastatic endobronchial tumor. The mass was completely resected through a rigid ventilating bronchoscope, and a silicone stent was placed over the tumor bed in the left main bronchus. He remained asymptomatic with no evidence of bronchoscopic recurrence 4 months after the procedure. Obstructive endobronchial metastases from nonpulmonary primaries are rare. Endoluminal resection with stent placement can provide good palliation in this group of patients with limited survival.
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PMID:A case of bronchial obstruction by metastatic renal cell carcinoma. 869 55

Primary cardiac neurilemoma, a benign tumor, is extremely uncommon. To our knowledge only eight cases have been reported in the literature. We report a case of a 72-year-old man who presented with complaints of progressive shortness of breath and chest pain, seven years after a right nephrectomy for renal adenocarcinoma. An intra-right atrial tumor was surgically removed; the lesion was found to be a neurilemoma of the right atrium. This case report describes the surgical removal and rarity of neurilemomas, their predisposition to be right-sided in the heart and their coincidental association with other types of cancer.
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PMID:A primary intracavitary right atrial neurilemoma. 1169 45

A 70-year-old man, who had undergone a radical nephrectomy for localized renal cell carcinoma (RCC) three years ago, was recently evaluated for shortness of breath. During his work-up, a transesophageal echocardiogram and magnetic resonance imaging indicated an extensive vena caval thrombus originating from the renal vein stump. Successful vena caval thrombectomy with cardiopulmonary bypass confirmed that the thrombus was comprised of RCC. This is a rare type of RCC recurrence with an unusual timing (3 years after a nephrectomy), alerting the importance of strict follow-up on all patients even after complete surgical excision of all suspected tumors.
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PMID:Recurrence of renal cell carcinoma with extensive vena caval thrombus three years after radical nephrectomy. 1191 69

Approximately 190 new cases of renal cell carcinoma infiltrate into the inferior vena cava and right atrium every year. Echocardiography often plays a major role in establishing the diagnosis and in guiding surgical therapy. This report describes a patient who presented with shortness of breath but had no classic signs or symptoms of renal cell carcinoma other than chronic anemia. Transthoracic two-dimensional echocardiography and transesophageal echocardiography established the diagnosis of a right atrial mass extending from the inferior vena cava that was later discovered to be renal cell carcinoma.
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PMID:Renal cell carcinoma presenting as right atrial mass. 1192 79

Arteriovenous (AV) fistulas are common in renal cell carcinoma. These are usually small and asymptomatic. Case reports have previously described symptomatic fistulas in primary renal cell tumour or, less commonly, bone metastases. The current study describes a patient with lung metastases from renal cell carcinoma who developed a symptomatic pulmonary AV fistula. The patient presented with debilitating progressive shortness of breath, which resolved after coiling of the pulmonary AV fistula. Supporting radiographs include a unique ventilation-perfusion finding of perfusion tracer in the kidney that is diagnostic of a pulmonary shunt. This is the first report of a pulmonary fistula from renal cell carcinoma. This rare complication of renal cell carcinoma reflects its diverse clinical presentations and unique tumour biology.
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PMID:Pulmonary arteriovenous fistula in a patient with renal cell carcinoma. 1740 Aug 80

A 41 year old white female presented with upper respiratory distress and shortness of breath appeared on initial computed tomography (CT) scan to have a large left retroperitoneal mass with left renal vein extension including a mass up to the level of the atrium. This presentation suggested hypernephroma. She proved, however, to have an adrenal cortical carcinoma which displaced the kidney, exhibiting vascular invasion within the gland and non-adherent extension into the vena cava, atrium, common hepatic vein and left renal vein, where some adherence was present. This unusual tumor required extensive surgery for removal, including use of cardiopulmonary bypass, with good results.
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PMID:Adrenocortical tumor with left renal vein, vena cava and intrahepatic venous extension. 1821 91

Left ventricular metastases from renal cell carcinoma without vena caval or right atrial involvement are extremely rare. Herein, we present the case of a 69-year-old man who had undergone radical nephrectomy for renal cell carcinoma in 1984. Eighteen years thereafter, we discovered metastatic disease in his left ventricle.When the metastasis was identified, the patient had no symptoms other than shortness of breath. He underwent surgical removal of a highly vascular mass from the left ventricular wall and resection of a nodule in the upper right pulmonary lobe. Upon pathologic examination, both tumors were metastatic renal cell carcinomas. The patient recovered uneventfully and was free of cardiac recurrence more than 6 years after the surgery. We describe our treatment of this patient and discuss some current approaches to the treatment of renal cell carcinoma that has metastasized to the heart.
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PMID:Renal cell carcinoma, metastatic to the left ventricle. 1943 86


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