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F H Straus

Publications and source records attributed to F H Straus.

At least 37 records · Page 2Linked to original sources
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The glucagon stimulation test has been superseded in recent years by the clonidine suppression test because it can provoke dangerous increases in blood pressure in patients with pheochromocytomas.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↗
PubMed1986

Graves' disease and thyroid cancer.

The relationship between Graves' disease or its therapy and carcinoma of the thyroid remains uncertain. We studied 20 patients found to have thyroid cancer in glands previously treated for Graves' disease between 1961 and 1986 at the University of Chicago Medical Center. Sixteen (80%) occurred in women and four (20%) occurred in men. The mean age at operation was 37 years (range, 19 to 69 years) and did not differ by sex. Fifteen of the 20 cancers (75%) were papillary while five (25%) were follicular. Six individuals (30%) had a history of external radiation to the head and neck as an infant, child, or young adult. Two others had received radioiodine (RAI) therapy for Graves' disease 1 and 19 years earlier. Patients were divided into three groups: group I: four patients (20%) had a neck mass 4, 14, 20, and 41 years after having had a subtotal thyroidectomy (STT) for Graves' disease; three of four had a history of external irradiation therapy. These tumors behaved aggressively, resulting in the death of two of the four patients. group II: 11 patients (55%) had diffusely enlarge toxic goiters without a nodule. A carcinoma was diagnosed intraoperatively on frozen section in only two of these patients. The others received STT. After recognition on permanent section, those carcinomas that were 4 mm or greater in diameter received postoperative RAI. One recurrence occurred and was treated successfully with further RAI. group III: Five patients (25%) had Graves' disease and a palpable thyroid nodule. None of them had had a prior thyroidectomy for Graves' disease, as in group 1. Thyroid carcinoma was diagnosed in all patients preoperatively or intraoperatively, and a total thyroidectomy was performed. Each patient is alive and well with a mean follow-up of 5 years. Between 1971 and 1981, 194 patients had surgery for Graves' disease, and 10 (5.2%) were found to have an associated carcinoma; six patients (3.1% of the total) did not have a nodule or any other suspicion of malignancy before surgery. During the same time, 303 patients received RAI therapy for Graves' disease and one (0.3%) has subsequently developed thyroid carcinoma. Thyroid cancer associated with Graves' disease is found more commonly in surgically treated patients than in patients after RAI therapy. The greatest risk factor in our patients was previous external radiation to the head and neck. Such individuals should be treated with total thyroid ablation rather than the usual STT, since they are at risk of developing aggressive thyroid cancers if thyroid remnants are left.

Adult↗
PubMed1984

Selective surface staining of bladder tumors by intravesical methylene blue with enhanced endoscopic identification.

Intravesical instillation of methylene blue resulted in selective surface staining of bladder tumors in vivo without staining the background of normal urothelium. Staining of human bladder tumors in vivo was accomplished by the intravesical instillation of 0.1% methylene blue in 0.9% saline through a foley catheter under 20 cm of hydrostatic pressure up to a maximum volume of 400 ml. After 5 minutes contact time, the methylene blue solution was drained, and the bladder was washed with saline. Thereafter, either endoscopic or open surgery was performed. The transitional cell carcinomas in 45 of 48 patients bound methylene blue to the surfaces of the tumors but not to normal urothelium. Higher grade tumors usually bound the dye more extensively than lower grades. The three patients, whose tumors did not bind methylene blue, had received previous chemotherapy, which might account for their being falsely negative. Carcinoma in situ and dysplasia did stain blue. Areas of hyperplasia and cystitis, however, did not bind methylene blue. In vivo intravesical staining with methylene blue has been a simple and safe procedure which has enhanced the endoscopic localization for biopsy and fulguration/resection of transitional cell carcinomas.

Carcinoma in Situ↗
PubMed1984

Transrectal aspiration biopsy versus transperineal core biopsy for the diagnosis of carcinoma of the prostate.

Transrectal aspiration and transperineal core biopsies were performed on 38 patients with suspicious prostatic examinations. The false negative rate was 14 per cent by the core method but no cancer was missed by the aspiration technique. There was insufficient material for diagnosis in 14 per cent of the biopsies obtained by the core technique but in only 3 per cent with the aspiration biopsy method. Malignant cells were confirmed by cytology in 1 patient who had had 2 normal core biopsies. The cytological grade was only moderately consistent with the Gleason sum. No complications developed after either procedure. Transrectal aspiration biopsy offers several advantages over conventional biopsy methods and should be used regularly to diagnose abnormalities of the prostate.

Adenocarcinoma↗
PubMed1983

Rectal carcinoid tumors--treatment and prognosis.

Because of their location, rectal carcinoid tumors present a special therapeutic challenge for the surgeon. Only about 15% of these tumors manifest metastases and the others can be cured by complete local excision; hence performing a low anterior resection or an abdominoperineal resection for all patients would result in excessive rates of morbidity and death. Present-day treatment programs call for radical cancer resections only for lesions 2 cm in diameter or larger and local resection for all others. However, in a review of 595 patients, including 29 from the University of Chicago Hospitals, it was determined that this practice results in undertreatment of 24% (19/78) of all rectal carcinoid tumors that were associated with metastases, for 5% of all lesions smaller than 2 cm also had metastases. Invasion of the muscularis propria, we found, was an excellent additional prognostic sign for tumor progression. If the criteria for radical cancer resection included both size (all tumors 2 cm or larger and invasion of the muscularis propria in all smaller lesions, only 6% (5/78) of all aggressive tumors would have been missed and only 1.2% of all individuals with rectal carcinoid tumors would have received too limited an operation. It is hoped that the use of these new criteria will improve present-day survival statistics for patients with rectal carcinoid tumors.

Adult↗
PubMed1983

Coexisting thyroid and parathyroid disease--are they related?

A high prevalence of non-C cell, thyroid gland disease associated with primary hyperparathyroidism (HPT) has been reported in 11 uncontrolled studies. Yet experimental evidence linking these thyroid and parathyroid gland lesions is lacking. To test the hypothesis that the coexistence of these lesions is significant, we analyzed 124 consecutive cases of parathyroidectomy (110 women, mean age 53.5 +/- 12.7 years). Patients in the group with HPT who had visible or palpable thyroid disease at the time of operation were age-, sex-, and race-matched with autopsy controls. There was no statistical difference in the prevalence of total macroscopic thyroid lesions between the autopsy control group (46.4%) and the group of patients with HPT (54%, P = 0.8). Microscopic lesions in the absence of macroscopic abnormalities were found in an additional 26% of the autopsy control patients. Since in the surgical group, only those with macroscopic abnormalities underwent thyroid biopsy, no accurate calculation can be made of the microscopic lesions in those 55 patients with HPT who did not have macroscopic abnormalities. There was no difference in the prevalence of autoimmune or thyroid nodular disease between the two groups except for the presence of seven macroscopic nonmedullary thyroid carcinomas in the HPT group and none in the autopsy control group (P less than 0.001). One microscopic carcinoma was found in the autopsy group, however. An increased prevalence of parathyroid adenomas in nonmedullary thyroid disease has been suggested by other studies. We were unable to confirm this association. In fact, the incidence of parathyroid adenomas found unsuspectedly in 229 consecutive thyroidectomies was 0.43%. Thus with the exception of macroscopic, nonmedullary carcinomas, there was no evidence that thyroid disease accompanies HPT. Furthermore, parathyroid adenomas were not more frequent in surgical thyroid disease. Lesions of the thyroid and parathyroid glands are prevalent in middle-age women. This probably is the major factor that accounts for their coexistence.

Biopsy↗
PubMed1983

Five cases of parathyroid lipohyperplasia.

Lipoadenoma is the accepted diagnosis of a single enlarged parathyroid gland that contains large quantities of mature fat cells and focal myxoid stroma, all widely separating small parenchymal cell nests in patients with hyperparathyroidism. Here we are reporting, for the first time, on five cases of hyperparathyroidism in which all four parathyroid glands are enlarged and each gland is noted to have an admixture of fat and parenchymal cells. We will introduce the descriptive diagnosis of lipohyperplasia to name this condition and keep it in perspective with other forms of parathyroid disease. All five patients were women between the ages of 36 and 62 years who underwent neck exploration, at which time four enlarged light-tan parathyroid glands were observed. Three and one half gland resections were performed, and all patients returned to a normocalcemic state except one who had borderline serum hypercalcemia after operation. Most of the resected parathyroid glands weighed in the range of 100 to 200 mg. The largest measured gland weighed 820 mg. Parathyroid histology showed an admixture of mature fat cells with parathyroid parenchymal cells often in a 1:1 ratio. One patient who had renal failure exhibited a lower ratio of fat cells. Two patients had chronic lymphocytic thyroiditis that was severe enough to require synthetic thyroid hormone therapy. Two patients had a history of urinary tract infections. Three patients had hypertensive cardiovascular disease, and several patients had arteriosclerotic cardiovascular disease. One patient had diabetes mellitus, one had a history of pituitary adenoma, and one had polydipsia. All of these patients were first seen with parathyroid glands measuring an average of five times normal size, yet they showed the usual 50% fat/50% parenchyma pattern of normal mature parathyroid glands. This means that the enlarged glands contain a 500% increase in parathyroid tissue, justifying the diagnostic term "lipohyperplasia." This easily represents enough parathyroid tissue to generate excessive parathyroid hormone production. At this time, there is no explanation of the pathogenesis of lipohyperplasia or how it varies from other previously described forms of parathyroid hyperplasia.

Adenoma↗
PubMed1982

Staging of breast cancer and survival rates. An assessment based on 50 years of experience with radical mastectomy.

The correlation of staging criteria for mammary carcinoma with the curability of primary and recurrent local and regional lesions was assessed by follow-up after 1,259 consecutive radical mastectomies performed in women under age 70 between 1927 and 1978. Using a staging scheme revised in the light of our experience, the incidence of recurrence by 20 years was 34% +/- 2.7% for pathological stage I, 65% +/- 2.6% for stage II, and 83% +/- 2.5% for stage III. Recurrence after 20 years was observed in one of 178 patients. After treatment of local recurrence, three of 51 patients survived 20 years. By restriction of entry into clinical or pathological stages I and II, currently employed revisions of staging criteria appear to increase survival in all stages, while placing patients with possibly curable lesions in stages III and IV.

Adult↗
PubMed1980

Sandwich radiotherapy (3,000 and 4,500 rads) around radical retropubic prostatectomy for stage C prostatic carcinoma.

Supervoltage external radiotherapy has been sandwiched around radical retropubic prostatectomy as a potentially curative procedure for Stage C or D1 adenocarcinoma of the prostate. Preoperatively, 3,000 rads were delivered to the pelvis and prostate by approximately 18 by 20 cm. AP-PA opposing ports over a three-week period. After three weeks' rest, radical retropubic prostatectomy was done. After three weeks' postoperative recovery, additional radiotherapy was delivered as follows: 2,000 rads to the pelvis and prostatic fossa by AP-PA opposing ports, plus 2,500 rads to the prostatic fossa alone by 360 degree rotation, plus 4,500 rads to the abdominal periaortic-caval lymph node area. Fifteen cases have been followed for up to five and one-half years to date without serious complications of the therapy and without demonstrable recurrent or residual tumor in the pelvis.

Adenocarcinoma↗
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↗