PubMed Health⌕ Search

Biomedical subjects

C Feind

Publications and source records attributed to C Feind.

At least 19 recordsLinked to original sources
PubMed1996

A novel tumor-derived mediator that sensitizes cytokine-resistant tumors to tumor necrosis factor.

Therapeutic successes following treatment of murine tumors with tumor necrosis factor-alpha (TNF) have not been easily applied to clinical oncology because the concentrations of TNF required in humans induces systemic toxicity. This has led us to identify mediators which could sensitize tumors to the effects of TNF, permitting administration of lower doses and possible realization of the therapeutic potential of this cytokine. Our study reports the ability of a novel cytokine, endothelial-monocyte-activating polypeptide II (EMAP II), to sensitize initially resistant murine and human tumors to TNF-induced regression employing a murine model. Recombinant (r) EMAP II was purified from Escherichia coli transformed with a plasmid expressing mature EMAP II. The B16 melanoma, raised in C57BL/6 mice, or a human fibrosarcoma (HT-1080), grown in immunocompromised mice, was injected intratumorally with either vehicle or rEMAP II/heat-treated EMAP II (50-100 micrograms) followed by systemic TNF/heat-treated TNF (5 micrograms) and assessed for tumor volume, hemorrhage, and histologic appearance. Both the B16 melanoma and the HT-1080 human fibrosarcoma underwent thrombohemorrhagic and acute inflammatory changes concomitant with regression or significantly slowed growth after administration of intratumor EMAP II followed by systemic TNF. Omission or inactivation of either cytokine abrogated this effect. These results demonstrate that local treatment of certain tumors with EMAP II results in enhanced susceptibility to TNF-mediated induction of thrombohemorrhage and regression.

Animals↗
PubMed1996

Parathyroid surgery using monitored anesthesia care as an alternative to general anesthesia.

BACKGROUND: Although there have been several reports in the literature describing a renewed interest in performing thyroid surgery under local anesthesia (LA), there has been little information regarding parathyroid surgery under local anesthesia. METHODS: We retrospectively reviewed our experience of 49 LA parathyroid patients over a 9-year period at a single institution. A bilateral cervical block (C2-C3) was administered by a single surgeon using lidocaine and bupivacaine. RESULTS: The study included 39 females and 10 males with an average age of 62 years (range, 35-89 years). Every surgery was curative and the final pathology revealed 46 parathyroid adenomas and 3 cases of parathyroid hyperplasia. Forty-seven percent of the patients were discharged within 6 hours of operation and the remaining patients had a 1.4-day average length of hospital stay. A group of age- and sex-matched controls who underwent parathyroid surgery using general anesthesia (GA) served as a control group with 27% of operations performed as outpatients and an average length of stay of 1.6 days. Return to work averaged 6 days for the LA group versus 8 days for the GA. In the LA group, there was one instance of postoperative hemorrhage requiring reoperation and one instance of conversion to GA secondary to an inability to tolerate LA. There were no instances of recurrent laryngeal nerve injury or permanent hypoparathyroidism in either group. CONCLUSIONS: These data suggest that experienced surgeons can perform parathyroid surgery safely and effectively using LA as an alternative to GA.

Adult↗
PubMed1996

Detection of circulating thyroid cells in peripheral blood.

BACKGROUND: Detection of circulating malignant thyroid cells may provide a method to identify postoperative patients at risk for metastatic thyroid cancer. METHODS: On the basis of tissue specificity of thyroglobulin gene expression and the sensitivity of the reverse transcriptase-polymerase chain reaction (RT-PCR) analysis, we performed RT-PCR using primers for thyroglobulin on blood samples from patients with thyroid disease to detect thyroglobulin RNA transcripts. Postoperative peripheral blood samples from 100 patients, including patients with known metastatic thyroid cancer (six papillary and three follicular), thyroid cancer and no evidence of current metastases (63 papillary, 10 follicular, and five patients with both papillary and follicular), benign thyroid disease (six nontoxic nodular goiters), and normal volunteers (seven). RESULTS: Thyroglobulin transcripts were detected in nine of nine patients with metastatic thyroid cancer, seven of 78 patients with thyroid cancer and no current metastases (although of these seven patients, five had a history of metastatic disease that had been previously treated by surgery, one had a coexisting parathyroid cancer, and one had both papillary and follicular thyroid cancers), zero of six patients with benign thyroid disease, and zero of seven normal volunteers. Identity of amplicons was confirmed by restriction enzyme digestion and by cloning and sequencing of RT-PCR amplified thyroglobulin fragment (the latter in a limited number of cases). CONCLUSIONS: These data indicate that RT-PCR can be used to detect thyroglobulin mRNA in peripheral blood. The presence of these transcripts correlates with the existence of extrathyroidal disease.

Base Sequence↗
PubMed1994

Thyroid surgery using monitored anesthesia care: an alternative to general anesthesia.

Forty consecutive patients undergoing thyroid surgery under local anesthesia (LA) by a single surgeon over a 5-year period were included in this retrospective review. In all cases, the indication for LA was patient request. The study included 29 females and 11 males with an average age of 44 years (range 22-66 years). Body habitus was thin in 12.5%, average in 67.5%, and obese in 20%. Operations consisted of 21 unilateral thyroid lobectomies, 3 partial thyroidectomies, 3 subtotal thyroidectomies, and 13 total thyroidectomies. The pathology revealed benign disease in 45% and malignant disease in 55%. All procedures were performed using lidocaine and/or bupivacaine to administer a deep cervical plexus block as well as a field block. Mild additional intraoperative intravenous sedation was provided in most cases. Two patients were converted emergently to general endotracheal anesthesia because of inability to tolerate LA in one and a seizure secondary to intraarterial injection of lidocaine in the other patient. There were no instances of wound infection hemorrhage, recurrent laryngeal nerve injury, or hypoparathyroidism. In conclusion, thyroid surgery in selected patients can be performed safely using LA by experienced surgeons. If patients are carefully prepared preoperatively, LA offers a simple and reasonable alternative to general anesthesia.

Adult↗
PubMed1985

Medullary carcinoma of the thyroid gland. Clinical, pathological, and immunohistochemical features with review of the literature.

Twenty medullary carcinomas of the thyroid gland were examined for the presence of immunoreactive calcitonin, thyroglobulin, glucagon, keratin, gastrin/CCK, carcinoembryonic antibody (CEA), insulin, serotonin, adreno-corticotropic hormone (ACTH), prostatic acid phosphatase, and somatostatin using the immunoperoxidase peroxidase-antiperoxidase technique. In addition, they were stained with mucicarmine, alcian blue/periodic acid-Schiff (PAS), Grimelius, Congo red, crystal violet, and Fontana-Masson stains. Calcitonin-immunoreactive cells were absent in one tumor and present in 19 tumors (95%). Thyroglobulin was present in seven tumors (35%). Twenty tumors contained CEA-immunoreactive cells (100%). Fourteen cases were immunoreactive to serotonin (70%) and 12 were positive for somatostatin (60%). Glucagon- and gastrin/CCK-immunoreactive cells were found in two cases each (10%). Four tumors (20%) contained ACTH-immunoreactive cells and three cases (15%) were positive for prostatic acid phosphatase. Five cases (25%) contained keratin-immunoreactive cells. One case was immunoreactive to insulin (5%). Grimelius-positive cells were present in 19 of the cases (95%). Mucin-containing cells were present in 65% of the cases. The validity of the immunocytochemical localizations was tested by specific absorption of each antibody with the corresponding antigen. The demonstration of immunoreactivity for multiple antigens in each of the 20 cases suggests that the origin of medullary thyroid carcinomas is from a neuroendocrine cell potentially capable of producing numerous hormone substances. In addition, as the neoplastic cells in 35% of the tumors contained hormonal substances as well as thyroglobulin, it is suggested that papillary or follicular tumors mixed with a neuroendocrine component exist more commonly than previously suspected. Finally, psammoma bodies might be present in pure medullary carcinoma of the thyroid gland.

Acid Phosphatase↗
PubMed1985

Presence of neuron-specific enolase and somatostatin in human parathyroid tissues.

The association of parathyroid abnormalities with apudomas prompted us to examine parathyroid tissues for the presence of neuron-specific enolase and somatostatin. Enolase was present in extracts of 29 out of 29 parathyroid specimens; tissue content was significantly higher in adenoma than in hyperplasia tissues (p less than 0.005). Somatostatin was present in 14 of 33 specimens. Immunoreactive somatostatin measured in tissue extracts' fluids coeluted on Sephacryl chromatography along with synthetic somatostatin-14 in studies of two parathyroid carcinoma specimens. Since neuron-specific enolase has been found only in neural and neuroendocrine cells, our results suggest that human parathyroid glands may contain neuroendocrine elements. The differential content of neuron-specific enolase in adenoma versus hyperplasia specimens may be diagnostically useful in selected cases. The significance of the presence of somatostatin in some but not all parathyroid tumors requires further investigation. Taken together with our prior findings of gastrin and pancreatic polypeptide in some human parathyroid glands, we postulate that human parathyroid tumors contain neural crest elements.

Adenoma↗
PubMed1985

Incidence of cancer in surgically treated thyroid nodules based on method of selection.

A retrospective review of thyroidectomies to rule out cancer at Columbia Presbyterian Medical Center indicated that the maximum cancer incidence achievable in surgical specimens was only 57% if all microfollicular adenomas and thyroid cancers were removed. The size distribution of follicular cancer and microfollicular adenoma was similar and it does not appear to be useful in deciding which microfollicular lesions need to be surgically excised to exclude carcinoma. The incidence of thyroid cancer in patients undergoing thyroidectomy was not influenced by the introduction of fine-needle biopsy (FNB) at Columbia Presbyterian Medical Center. FNB did appear to increase the incidence of cancer at an affiliated community hospital. Coarse-needle biopsy definitely improved the incidence of cancer in patients undergoing thyroidectomy and was superior to FNB and clinical selection alone. A combination of FNB and coarse-needle biopsy when possible yielded a 41% incidence of cancer and appears to be the most useful technique for patient selection.

Adenocarcinoma↗
PubMed1983

Pancreatic polypeptide (PP) immunoreactivity in human parathyroid culture media.

Media from cultures of normal and abnormal human parathyroid fragments were assayed for parathyrin (PTH) and pancreatic polypeptide (PP) using sensitive radioimmunoassays. PP immunoreactivity was present in media (Day 6-7 in vitro) from cultures of 3/10 adenomas and 6/6 3 degrees hyperplastic glands (mean = 126. fmole/mg protein/day) (range = 6.-675.), and was not suppressed by 0 leads to 3 mM calcium challenge. PP was undetectable in media from cultures of one parathyroid carcinoma, one 1 degree hyperplasia, and one normal parathyroid. Medium C-terminal PTH levels were quite variable (26.-2,545,000. pg/mg protein/day). Presence of PP immunoreactivity in media from cultures of some hyperplastic parathyroids and some parathyroid adenomas suggests that PP may be released from these tissues in vitro. The significance of elevated PP levels in the MEA syndromes may be of special clinical relevance to this observation.

Adenoma↗
PubMed1983

The incidence of carcinoma in encapsulated follicular thyroid lesions diagnosed by large needle biopsy.

During the period from 1975 to 1982, there were 132 patients who had encapsulated thyroid lesions diagnosed by Tru Cut needle biopsy. One hundred and nineteen patients have had operations and 20 had cancer. The 20 cancers occurred in a group of 86 lesions that were classified as microfollicular. No cancers were seen in lesions classified as macrofollicular. The incidence of cancer in the microfollicular group was 23%. This incidence of cancer was the same in Hürthle cell and non-Hürthle cell microfollicular lesions.

Biopsy, Needle↗
PubMed1983

Immunotherapy of thyroid cancer by induction of autoimmune thyroiditis.

An animal model was used to investigate the most effective way to create autoimmune thyroiditis. Several modified forms of thyroglobulin (TG) with and without Freund adjuvant were tested. TG altered with the diazonium derivatives of arsanilic and sulfanilic acids was found to be the most effective immunizing agent for inducing autoimmunity. Human TG altered in the same manner was used to induce autoimmune thyroiditis in humans with untreatable metastatic thyroid cancer. There was minimal toxicity during the therapy and it was possible to create autoimmune thyroiditis in three of eight patients. Antibodies to TG were induced in five of eight patients. The clinical response to the immunotherapy was minimal, however, and it was not possible to demonstrate any significant measurable response to therapy.

Adenocarcinoma↗
PubMed1982

Radioiodine total body scan versus serum thyroglobulin levels in follow-up of patients with thyroid cancer.

Two groups of patients were studied to compare the efficacy of serum thyroglobulin (Tg) levels to 131I total body scans in the follow-up of patients with thyroid cancer. All of the group of 30 patients without recurrence had undetectable Tg levels on and off thyroid hormone replacement, and all had negative total body scan results although eight patients showed uptake in remnant thyroid tissue. In the second group of 37 patients with documented recurrent or metastatic disease, 34 (92%) had positive serum Tg levels, although the levels in five of these patients were undetectable while on thyroid replacement, and 31 (84%) had positive total body scan results. The false negative results of the two tests were not overlapping, and of those with positive Tg levels, 29 showed a significant increase once thyroid hormone therapy had been withdrawn. We conclude that although the percentages of positive Tg levels and body scan results in patients with recurrent disease are similar, both tests are required to minimize the number of patients with undiagnosed metastases. Second, thyroid-stimulating hormone suppression has a definite although unpredictable effect on serum Tg levels in patients with thyroid cancer, and thyroid hormone should be withdrawn prior to measurement of serum Tg to minimize the number of false negative results.

Follow-Up Studies↗
PubMed1982

Comparison of fine-needle and coarse-needle biopsies in evaluating thyroid nodules.

The purpose of this study was to compare the results of fine-needle biopsy (FNB) and coarse-needle biopsy (CNB) in evaluating patients with dominant thyroid nodules. Five hundred twenty-six patients were seen because of solitary thyroid nodules. Three hundred of these underwent satisfactory CNB and FNB. Using the incidence of cancer found at operation as a guide to the specificity of the biopsy, CNB was better than FNB in determining underlying pathologic condition. The main difference between the two techniques was the inability of FNB to distinguish adenomatous hyperplasia from true adenoma. FNB, however, was as good as most older techniques in selecting patients for surgery. The main limitation of CNB was that it could only be applied on 69% of solid lesions.

Biopsy, Needle↗
PubMed1979

Thyroglobulin in benign and malignant thyroid disease.

Thyroglobulin (TG) is a 19S glycoprotein produced by normal thyroids and almost all nonmedullary thyroid cancers. Radioimmunoassays measure serum levels of TG, and these levels are abnormally elevated in patients with metastatic thyroid cancer. Data from our study show that TG measurement is not effective in screening high-risk populations for thyroid cancer. Nevertheless, serum TG determinations are useful for assessing the presence and possibly the extent of residual or recurrent nonmedullary thyroid cancer in patients who have undergone total thyroidectomy.

Adenocarcinoma↗
PubMed1978

Serum clearance rates of immunologically reactive thyroglobulin.

Serum thyroglobulin levels have been shown to have a role in detecting the presence of residual or recurrent disease in most patients who have undergone total thyroidectomy for thyroid cancer. It has not yet been determined at what interval postoperatively to begin following serum thyroglobulin levels in these patients to detect residual disease. Eight patients who underwent total thyroidectomy were studied to determine the clearance rate of this glycoproteint. Serial samples were obtained pre- and postoperatively and clearance rate curves were plotted for each patient. The average half-life of thyroglobulin was 14 hours, with a range of 8 to 22 hours. Based upon these results, it appears that 4 weeks is a sufficient period of time to allow for the clearance of the residual thyroglobulin in patients undergoing total thyroidectomy. Elevated levels of serum thyroglobulin after this time represent residual thyroid tissue or the presence of metastatic thyroid carcinoma.

Adolescent↗
PubMed1977

Serum thyroglobulin and recurrent thyroid cancer.

Many thyroid malignancies are sufficiently differentiated to produce thyroglobulin both in situ and in perpipheral blood. Since patients who have undergone total thyroidectomy for malegnancy should not have normally circulating thyroglobulin, their serum thyroglobulin may provide a simple and specific tumour marker for recurrent disease. Of 30 such athyroid patients who were studied, all of the 20 patients who were disease-free ten years after thyroidectomy had minimal (less than15 ng/ml) serum-thyroglobulin levels while all of 10 patients with recurrences had raised levels (greater than 90 ng/ml). Controls ranged from 0 to 60 ng/ml. This assay should prove valuable in following patients who have undergone total thyroidectomy for recurrent thyroid malignancy.

Adolescent↗