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Biomedical subjects

F H Straus

Publications and source records attributed to F H Straus.

At least 19 recordsLinked to original sources
PubMed1991

Response to orchiectomy following Zoladex therapy for metastatic prostate carcinoma.

Serum testosterone and prostate-specific antigen (PSA) levels were measured in 3 patients with Stage D2 prostate cancer before and after discontinuation of the long-acting LHRH agonist, goserelin acetate (Zoladex). The patients had received goserelin acetate for ten, sixteen, and thirty months prior to discontinuing the drug because of progressive metastatic disease. In all 3 patients, PSA and testosterone levels increased after goserelin acetate was discontinued. In 2 patients the testosterone level reached normal levels. A bilateral orchiectomy was performed one hundred sixty, one hundred, and seven days, respectively, after the drug was discontinued. In all 3 cases PSA and testosterone levels were reduced following castration, although PSA levels again began to increase within two weeks of orchiectomy in 2 of the 3 patients. These findings suggest that suppression of testosterone by LHRH agonists is not permanent and if tumor progression occurs, maintaining hormone suppression may still be beneficial.

Aged↗
PubMed1990

Natural history, treatment, and course of papillary thyroid carcinoma.

We have analyzed the course of papillary thyroid carcinoma in 269 patients managed at the University of Chicago, with an average follow-up period of 12 yr from the time of diagnosis. Patients were categorized by clinical class; I, with intrathyroidal disease; II, with cervical nodal metastases; III, with extrathyroidal invasion; and IV, with distant metastases. Half of the patients had a history of thyroid enlargement known, on the average, for over 3 yr. In 15% of patients given thyroid hormone, the mass decreased in size. The peak incidence of cancer was when subjects were between 20-40 yr of age. Tumors averaged 2.4 cm in size; 21.6% had tumor capsule invasion, and 46% of patients had multifocal tumors. Sixty-six percent of the patients had near-total or total thyroidectomy. The overall incidence of postoperative hypoparathyroidism was 8.4%, but the incidence was zero in 83 near-total or total thyroidectomies carried out by 1 surgeon. Twenty-five percent of the patients had continuing or recurrent disease, and 8.2% died from cancer. Deaths occurred largely in patients with class III or IV disease. Cervical lymph nodes were associated with increased recurrences, but not increased deaths. Extrathyroidal invasion carried an increased risk of 5.8-fold for death, and distant metastases increased this risk 47-fold. Age over 45 yr at diagnosis increased the risk of death 32-fold. Tumor size over 3 cm increased the risk of death 5.8-fold. Surgical treatment combining lobectomy plus at least contralateral subtotal thyroidectomy was associated, by Cox proportional hazard analysis, with decreased risk of death in patients with tumors larger than 1 cm and decreased risk of recurrence among all patients, including patients in classes I and II, compared to patients who underwent unilateral thyroid surgery or bilateral subtotal resections. By chi 2 analysis, 131I ablation of residual thyroid tissue after operation was associated with decreased risk of recurrence in tumors larger than 1 cm and decreased risk of death in patients in classes I and II with tumors more than 1 cm in size. The data strongly support the use of more extensive initial surgery in class I and II patients with tumors more than 1 cm in size as well as postoperative radioactive 131I ablation of thyroid remnant tissue.

Age Factors↗
PubMed1990

N-ras 61 oncogene mutations in Hürthle cell tumors.

Mutations of ras oncogenes are believed to play an important role in the initiation or progression of human tumors. In thyroid tumors the incidence of ras activation by specific point mutations has been reported to range from 33% in follicular adenomas up to 60% in anaplastic carcinomas. Because of our long-standing interest in Hürthle cell tumors, we began a study of 70 such cases to determine the incidence of ras mutations and their clinical correlates. Analysis of N-ras sequences at codon position 61, with the polymerase chain reaction method and oligonucleotide probe hybridization, showed point mutations of the normal codon CAA* in eight tumor samples. One was a mutation from CAA to AAA, one from CAA to CTA,* and six from CAA to CGA. These mutations would result in amino acid substitutions of lysine, leucine, or arginine for the normal glutamine at position 61 in the N-ras protein. Identical ras mutations in two tumors and some of their surrounding thyroid tissue may indicate that activating ras point mutations are an early event in carcinogenesis. The incidence of mutations was 1 of 24 (4%) of the histologically benign tumors, 5 of 34 (15%) of the intermediate tumors (with vascular or capsular permeation), and 2 of 12 (17%) in the malignant group. Four of these eight patients died of metastatic thyroid disease and four are alive without evidence of recurrence.

Adenoma↗
PubMed1989

Improved safety of glucagon testing for pheochromocytoma by prior alpha-receptor blockade. A controlled trial in a patient with a mixed ganglioneuroma/pheochromocytoma.

The glucagon stimulation test has been superseded in recent years by the clonidine suppression test because it can provoke dangerous increases in blood pressure in patients with pheochromocytomas. We describe the first patient in whom a pheochromocytoma was diagnosed by a glucagon test, after which the blood pressure (but not the plasma catecholamine) response to a second injection of glucagon was blocked by pretreatment with phenoxybenzamine. After the tumor (which contained both pheochromocytoma and ganglioneuroma tissue) was removed, a third glucagon test result was negative. This experience suggests that patients with normal plasma catecholamine levels who are suspected of harboring a pheochromocytoma may be accurately diagnosed, but potentially dangerous increases in blood pressure may be minimized, by performing the glucagon test after alpha-adrenergic blockade.

Adrenal Gland Neoplasms↗
PubMed1979

Pancreatitis associated with thiazide administration. A role for the parathyroid glands?

Twenty-one of a total of 72 patients with acute pancreatitis admitted to a university hospital over a three-year period were found to have "idiopathic" pancreatitis. Of these, six nonalcoholic patients without gallbladder disease were receiving one of the thiazide diuretics prior to the onset of pancreatitis. Three patients taken from an earlier series likewise had pancreatitis associated with thiazide administration and at the time of autopsy harbored parathyroid hyperplasia. It is suggested that both the parathyroids and the pancreas may be affected by thiazide administration, and that a history of ingestion of these drugs should be sought in patients who have idiopathic pancreatitis.

Aged↗
PubMed1979

Primary histiocytic lymphoma of the epididymis.

The first documented case of primary histiocytic lymphoma of the epididymis is presented. The tumor showed distinct nodularity, which is unusual for extranodal lymphomas, and marked sclerosis. Extensive staging work-up showed no evidence of extraepididymal spread. Unusual features included the youth of the patient at presentation and the severe diffuse atrophy of the adjacent testicular parenchyma. Following orchiectomy and radiotherapy, there has been no subsequent clinical evidence of systemic disease.

Adult↗
PubMed1979

Familial nesidioblastosis: severe neonatal hypoglycemia in two families.

Severe neonatal hypoglycemia with pathologic findings of diffuse nesidoblastosis of the pancreas is described in five children of both sexes from two families with unaffected parents. This appears to represent an autosomal recessive disorder of pancreatic development. Despite extensive testing, the diagnosis of hyperinsulinism was difficult in the index case of each family and delayed definitive treatment. Medical therapy with steroids and diazoxide was unsuccessful; pancreatectomy was required to treat persistent hypoglycemia. An abnormality of circulating glucagon found in one child with this disorder suggested that hyperinsulinism may not be the sole hormonal imbalance present, but rather that this disease is one of generalized disturbance of islet cell function. The history of severe, persistent neonatal hypoglycemia in an older sibling should lead the physician to investigate subsequent children for the presence of asymptomatic hypoglycemia.

Chromosome Aberrations↗
PubMed1979

Association of diethylstilbestrol exposure in utero with cryptorchidism, testicular hypoplasia and semen abnormalities.

Epididymal cysts and/or hypoplastic testes have been found in 31.5 per cent of 308 men exposed to diethylstilbestrol in utero, compared to 7.8 per cent of 307 placebo-exposed controls. Analyses of the spermatozoa have revealed severe pathological changes (Eliasson score greater than 10) in 134 diethylstilbestrol-exposed men (18 per cent) and 87 placebo-exposed men (8 per cent). Further investigation of the 26 diethylstilbestrol-exposed men with testicular hypoplasia has revealed that 65 per cent had a history of cryptorchidism. Only 1 of the 6 placebo-exposed controls with testicular hypoplasia had a history of testicular maldescent. Although none of our Diekmann's lying-in study group has had carcinoma to date one must keep in mind the reported increased risk of testicular carcinoma in testes that are or were cryptorchid. A 25-year-old man who was not part of the study group was treated recently by us for a testicular carcinoma ( mixed anaplastic seminoma plus embryonal cell carcinoma) and he had a history of diethylstilbestrol exposure in utero and cryptorchidism.

Abnormalities, Drug-Induced↗
PubMed1979

Transcatheter bronchial brush and forceps biopsies. Histologic evaluation.

The histologic findings in transcatheter brush and forceps biopsies from 472 cases over a six-year period are evaluated. Diagnostic accuracy based on histologic findings was 38% and based on cytologic findings was 70%. When the two methods of examination were used, however, the overall accuracy was improved to 76%. In Hodgkin's disease and some inflammatory processes histologic examination is essential for the diagnosis. The transcatheter biopsies under fluoroscopic control are especially useful for securing tissues from the peripherally located lesions. When possible, examination of tissue obtained by transcatheter as well as forceps biopsies is encouraged.

Adenocarcinoma↗
PubMed1979

Crystallization studies in a urothelial-lined living test tube (the catheterized female rat bladder). I. Calcium oxalate crystal adhesion to the chemically injured rat bladder.

We developed an in vivo technique to study crystallization in a urothelial-lined "living test tube" by employing the catheterized female rat bladder. Calcium oxalate crystals adherent to the bladder urothelium were distinguished from free or intraluminal crystals. Chemical injuries of the urothelium induced by either 0.1 N HCL or 5 per cent Triton X 100 in saline resulted in marked calcium oxalate crystal adhesion to the injured urothelium. Control bladders without urothelial injury remained free of adherent crystals but formed large numbers of small free crystals relatively uniform in size. Histologic and fresh microscopic evaluations of urothelial injury and crystal adhesion are presented.

Animals↗
PubMed1978

Patterns of human thyroid parenchymal reaction following low-dose childhood irradiation.

Microscopic changes in the thyroids of 68 patients who had received low-dose childhood irradiation to the head and neck and who presented with palpable thyroid abnormalities culminating in surgery are compared to 34 control thyroids obtained from age- and sex-matched autopsy cases. Eighty-eight percent of irradiated thyroids showed moderate to severe focal hyperplasia, 51% contained single or multiple adenomas or adenomatous hyperplastic nodules, 68% exhibited chronic lymphocytic thyroiditis, 51% revealed colloid nodules, 42% presented with oxyphile change, 25% had mild fibrosis and 59% contained well-differentiated papillary, follicular or mixed thyroid carcinoma averaging 1.6 cm in diameter. Three small carcinomas were of the sclerosing type. The non irradiated thyroids showed 32% colloid nodule formation, 17% focal hyperplasia, 6% adenomatous hyperplasia and no identifiable carcinomas. Several nonspecific histologic abnormalities are now recognized as following low-dose radiation to the thyroid, the most important being focal hyperplasia, which may represent a pre-malignant change in thyroid parenchyma.

Adolescent↗
PubMed1978

Pathological aspects of the infertile testis.

In this review, the pathological findings from testicular biopsies of men suffering from various types of infertility are presented. The causes of male infertility are divided into three major categories: pretesticular, testicular, and post-testicular causes. The pre-testicular causes of infertility may be defined as extra-gonadal endocrine disorders, such as those originating in the hypothalamus, pituitary, or adrenals, which have an adverse effect on spermatogenesis. The testicular causes of infertility are primary defects of the testes. The post-testicular causes of infertility consist primarily of obstructions of the ducts leading away from the testes. Cases in which the spermatozoa are normal in number but greatly impaired in motility, presumably due to faulty maturation or improper preservation of the spermatozoa during their sojourn in the epididymides, or due to biochemical abnormalities of the seminal plasma, are also included in the postesticular category.

Androgens↗
PubMed1977

Roentgenographic findings in work hypertrophy of the muscularis propria of the terminal ileum.

This case is presented as an uncommon example of valvulae thickening caused in part by work hypertrophy of the circular muscular layer. This normal response of smooth muscle may occur in association with progressively obstructing lesions of the colon or ileocecal valve. Recognition of a similar abnormal small-bowel appearance may suggest the presence of a more distal obstructing lesion.

Adenocarcinoma↗
PubMed1977

Squamous carcinoma of the stomach after luetic linitis plastica.

This report illustrates many of the long term complicatio of syphilis involving the stomach. A 49-year-old woman with diffuse squamous metaplasia of the gastric mucosa developed invasive pure squamous cell carcinoma. The literature is reviewed and the probable pathophysiology is discussed.

Adenocarcinoma, Scirrhous↗
PubMed1975

Osteosclerosis in primary hyperparathyroidism.

Osteosclerosis in adults with primary hyperparathyoidism is rare; the usual skeletal manifestation, when presented, is diffuse osteropenia. We describe a patient with generalized osteosclerosis in association with primary hyperparathyroidism. The findings are documented by conventional and fine-detail radiography, absorptiometric bone mineral analysis, quantitative microradiography and histologic examination of bone. The unique features are contrasted with the manifestations recorded in a recently studied group of 87 hyperparathyroid patients. The data presented here support a causal relationship in this patient between parathyroid hormone excess and the development of densely sclerotic bones.

Adenoma↗
PubMed1975

Thyroid hemangioma.

A case is presented of a fifty-six year old man with a thyroid hemangioma presenting as a neck mass with tracheal deviation and unilateral vocal cord paralysis. A standard thyroid scan yielded equivocal findings. The diagnosis was determined preoperatively by the use of a 99m-technetium angiogram that disclosed the vascular nature of the lesion. Subsequent arteriography demonstrated the main arterial supply of the mass to be from both inferior thyroid arteries. Operative removal of the mass was accomplished through a standard transverse cervical incision. Pathologic study revealed that the vascular tumor involved both the surrounding normal thyroid parenchyma and also a microfollicular adenoma. This case points out the value of utilizing all available diagnostic means in atypical cases of thyroid disease.

Angiography↗