Lung cancer is the leading cause of cancer death among men and women in
the United States with 170,000 deaths per year. This exceeds the sum of the
next three leading causes of death due to cancer: breast, colon, and prostate.
There are over 1 million deaths worldwide due to lung cancer, making it truly
an epidemic. Fewer than 15% achieve a 5-yr survival. The vast majority (85%)
present with advanced disease, although stage I patients may have a 5-yr
survival approaching 70% (1).
Đái tháo nhạt (ĐTN) là tình trạng bệnh lý do mất khả năng tái hấp thu nước ở ống thận, hậu quả của sự thiếu ADH tương đối hoặc tuyệt đối dẫn đến tiểu
nhiều, uống nhiều, nước tiểu có tỉ trọng thấp và uống nhiều, bệnh có thể xảy ra do kém phóng thích ADH (ĐTN trung ương hoặc thần kinh) hoặc do thận đáp ứng kém với ADH (ĐTN thận). Có khoảng 50% trường hợp ĐTN không rõ nguyên nhân.
Đa niệu (polyuria) khi lượng nước tiểu 3lít/24h. Triệu chứng này thường kèm theo triệu chứng uống nhiều (polydipsia)
Sự bài tiết nước tiểu phụ thuộc vào hormone thần kinh AVP (arginin – vasopressin) hay ADH (antidiuretic hormone) được tổng hợp ở vùng hạ đồi.
Lung cancer is the most frequent cause of cancer deaths in both men and
women in the U.S. (1). Although tobacco smoking is accepted as the number
one cause of this devastating disease, our understanding of the acquired genetic
changes leading to lung cancer is still rudimentary. Lung cancer is classifi ed
into two major clinic-pathological groups, small cell lung carcinoma (SCLC)
and non-small cell lung carcinoma (NSCLC) (2). Squamous cell carcinoma,
adenocarcinoma, and large cell carcinoma are the major histologic types of
In contrast to the ingestion of water, its excretion is tightly regulated by physiologic factors. The principal determinant of renal water excretion is arginine vasopressin (AVP; formerly antidiuretic hormone), a polypeptide synthesized in the supraoptic and paraventricular nuclei of the hypothalamus and secreted by the posterior pituitary gland.
Sequence of events leading to the formation and retention of salt and water and the development of edema. ANP, atrial natriuretic peptide; RPF, renal plasma flow; GFR, glomerular filtration rate; ADH, antidiuretic hormone. Inhibitory influences are shown by broken lines.
Incomplete ventricular emptying (systolic heart failure) and/or inadequate ventricular relaxation (diastolic heart failure) both lead to an elevation of ventricular diastolic pressure.
Approach to the patient with polyuria. ATN, acute tubular necrosis; ADH, antidiuretic hormone
Excessive filtration of a poorly reabsorbed solute such as glucose, mannitol, or urea can depress reabsorption of NaCl and water in the proximal tubule and lead to enhanced excretion in the urine. Poorly controlled diabetes mellitus with glucosuria is the most common cause of a solute diuresis, leading to volume depletion and serum hypertonicity. Since the urine Na concentration is less than that of blood, more water than Na is lost, causing hypernatremia and hypertonicity.
Etiology Vasopressin is an antidiuretic hormone normally produced by the posterior pituitary gland. Ectopic vasopressin production by tumors is a common cause of the syndrome of inappropriate antidiuretic hormone (SIADH), occurring in at least half of patients with SCLC.
Compensatory mechanisms, such as decreased thirst, suppression of aldosterone, and production of atrial natriuretic peptide (ANP), may mitigate the development of hyponatremia in patients who produce excessive vasopressin.
Aldosterone: Enhances Na+ reabsorption at the collecting duct of the kidney Aneuploidies: Abnormal numbers of chromosomes that may occur as a consequence of abnormal meiotic division of chromosomes in gamete formation Antidiuretic hormone (arginine vasopressin): Acts to conserve water by increasing the permeability of the collecting duct of the kidney Blastocyst: At the 8- to 16-cell stage, the blastomere develops a central cavity and becomes a blastocyst. The cells on the outer layer differentiate to become trophoblasts. ...