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Biomedical subjects

F T Kraus

Publications and source records attributed to F T Kraus.

At least 37 records · Page 2Linked to original sources
PubMed1985

Chorioamnionitis: a comparative histologic, bacteriologic, and clinical study.

Using morphologic and bacteriologic techniques, we examined placentas from 224 deliveries considered potentially complicated by infection. The severity of the chorioamnionitis was graded histologically according to the intensity of the inflammatory infiltrate. Chorioamnionitis or funisitis occurred in 111 placentas. Neonatal morbidity in this group was 48 (43%) as compared with 14 (12%) in those without chorioamnionitis. Pathogens were cultured from 49 of the 111 placentas with chorioamnionitis. Neonatal morbidity or mortality occurred in 28 (58%) of the group with positive cultures but occurred also in 20 (32%) of the 63 with chorioamnionitis from which no pathogens were cultured. Perinatal mortality was especially high (64%) among premature infants (less than 30 weeks) with infection. A comparison of culture techniques (surface swab versus swab of subchorionic fibrin after searing amnionic surface) showed similar rates of recovery but less contamination using the deep culture technique. Neonatal morbidity and mortality with severe chorioamnionitis (grades II and III; 62% and 82%) were significantly greater than with little or no chorioamnionitis (grades I and 0; 43% and 36%). Higher grades of histologically demonstrable chorioamnionitis are associated significantly with the highest rates of neonatal morbidity or mortality. In many instances, pathogens are not recovered by conventional aerobic and anaerobic bacteriologic study. A search for other infectious agents (viruses, mycoplasmas, chlamydiae) deserves attention.

Acute Disease↗
PubMed1984

Subchorionic fibrin cultures for bacteriologic study of the placenta.

Previous bacteriologic studies of the placenta have been hampered by a high rate of contamination of vaginal flora. In the present study, cultures of the subchorionic fibrin layer of the placenta were compared to conventional swab-cultures of the surface of the fetal membranes for recovery of aerobic and anaerobic bacteria. Parallel cultures of membrane surface and subchorionic fibrin (SCF) were done in the placentas of 33 deliveries suspected clinically of being complicated by infection (CD). Placentas from 46 uncomplicated deliveries were similarly cultured to serve as controls. SCF cultures were positive in 11 of 33 CD placentas and in only 1 of 46 controls (P less than 0.001). SCF cultures showed contaminating vaginal flora in 2 of 79 while surface cultures showed vaginal contamination in 16 of 79 (P less than 0.01). Recovery of pathogens was similar by the two methods: 10 of 33 and 14 of 33 respectively. One hundred ninety-one additional CD placentas were cultured by the SCF technique. Forty-nine of the 224 SCF cultures yielded pathogens with a predominance of group B hemolytic streptococci, anaerobic gram positive cocci and anaerobic gram negative rods (81 total isolates). Escherichia coli was isolated in 5 cases. Cultures showing exclusively contaminating vaginal flora were obtained from only 3 of the 224 placentas. Subchorionic fibrin cultures combine technical simplicity, low rate of contamination and excellent recovery of pathogens. The bacterial types found by this method are the predominant species that cause endometritis, pelvic infections, and neonatal septicemia. Subchorionic fibrin culture is a useful technique for the bacteriologic diagnosis of infection in the placenta.

Bacteria↗
PubMed1984

Isolated noninfectious granulomas of the ovary.

Four examples of noninfectious granulomas of the ovary were studied. All four occurred in premenopausal women. One patient had a salpingo-oophorectomy for a symptomatic ovarian mass; the other three examples were incidental findings in hysterectomy and salpingo-oophorectomy specimens. None of the patients had a history of systemic granulomatous disease, nor have any of the patients developed any symptoms on follow-up, which varies from 2 to 7 years.

Adolescent↗
PubMed1984

Minimal deviation endocervical adenocarcinoma: clinical and histologic features, immunohistochemical staining for carcinoembryonic antigen, and differentiation from confusing benign lesions.

Thirteen patients with a diagnosis of very well-differentiated endocervical adenocarcinoma were studied in order to characterize the histological and immunohistochemical features of minimal deviation adenocarcinoma (MDA). Five of these patients had neoplasms composed of structures almost identical to normal endocervical glandular patterns. These five neoplasms, representing MDA, were characterized by a haphazard proliferation of both large, claw-shaped glands, and smaller, slit-shaped, pointed glands. Focal mild cytologic atypia was identified in each case. Immunohistochemical stains displayed focal cytoplasmic carcinoembryonic antigen (CEA) in each neoplasm. Two of the five patients with MDA died of their neoplasms; both presented with advanced disease. Three well-differentiated adenocarcinomas lacked the deceptively bland appearance of MDA. Two of these three well-differentiated endocervical adenocarcinomas also contained CEA. Atypical endocervical gland proliferations originally diagnosed as MDA in five patients were reclassified as benign lesions on the basis of histologic pattern, findings after subsequent surgical procedures, and benign subsequent clinical courses. Of these five benign lesions, only reserve cell hyperplasia was found to contain CEA. Minimal deviation adenocarcinoma should be distinguished from the more common well-differentiated endocervical adenocarcinoma and from atypical benign lesions. Criteria for these distinctions are presented. While the histological appearance of an endocervical gland proliferation is the paramount basis for identifying an MDA, immunohistochemical staining represents a useful diagnostic aid.

Adenocarcinoma↗
PubMed1984

Psammoma bodies in endocrine tumors of the gastroenteropancreatic axis: a rather common occurrence.

Seventeen of 204 cases of gastroenteropancreatic tumors contained psammoma bodies (8%). Of these 17, ten were B cell tumors, representing 33% of the B cell tumors studied. Three tumors of the appendix and four tumors of the small bowel also had psammoma bodies. Electron microscopic studies revealed that the bodies appeared to have two possible sites of origin: intracellular (type I) and intraluminal from secretory products of the tumor cells (type II). Awareness by surgical pathologists of the fact that variable degrees of calcification in endocrine tumors of the gastroenteropancreatic system is a rather common occurrence may be important, especially in frozen section diagnosis.

Calcinosis↗
PubMed1984

Surgical pathology of gastric and duodenal neuroendocrine tumors masquerading clinically as common polyps.

We report 12 cases of silent neuroendocrine neoplasms of the stomach and proximal duodenum masquerading clinically as common polyps. Five lesions were in the stomach, while seven were in the duodenum. Excision by endoscopic polypectomy usually did not remove all neoplastic tissue. The prognosis of these lesions is good even when the tumors are incompletely resected, although bleeding and secretory-product-related morbidity may precipitate surgery. Morphologic features by light or electron microscopy were not predictive of any given secretory product(s).

Adult↗
PubMed1982

Alveolar soft-part sarcoma--A malignant angioreninoma: Histochemical, immunocytochemical, and electron-microscopic study of four cases.

This combined ultrastructural and immunohistochemical study of four alveolar soft-part sarcomas analyzes the characteristic granules in order to elucidate the histogenesis of this unusual neoplasm. The granules have the ultrastructural features and staining characteristics of renin, react with antiserum to renin, and like renin, incorporate zinc into the crystalline storage granules. The cell appears to be a modified smooth muscle cell analogous to renal juxtaglomerular cells and the cells of juxtaglomerular cell tumors. As there is no association with hypertension, it would appear that alveolar soft-part sarcomas either do not secrete or the product is a form of renin that does not act upon the angiotensin system.

Adult↗
PubMed1981

Intramural papilloma of the vagina: evidence of Müllerian histogenesis.

A papillary tumor occurred in the posterior-superior vaginal wall of a 5-year-old girl who was free of recurrence one year following surgical excision. The light microscopic features included papillae lined by eosinophilic cells with uniform, bland nuclei, solid areas of identical cells, and scattered glandular lumina which contained mucopolysaccharides. Foci of eosinophilic hyaline globules were another distinctive feature. Electron microscopy of the tumor demonstrated features associated with müllerian neoplasms including projecting microvilli, whorls of perinuclear cytoplasmic microfilaments, conspicuous lysosomes, squamous metaplasia, complex cytoplasmic interdigitations, and pseudoinclusions of "cytoplasmic" collagen. Previously described "mesonephric papillomas" of the vagina and cervix are compared with the tumor of the authors' patient. The previously described tumors share some histologic and clinical features, although they were superficial rather than intramural proliferations. The authors conclude that the ultrastructure, location, and documented presence of müllerian structures in the vagina favor a müllerian origin for this vaginal tumor. A number of other vaginal tumors that occur in children and young women show different light microscopic features.

Child, Preschool↗
PubMed1981

C-cell hyperplasia developing in residual thyroid following resection for sporadic medullary carcinoma.

Four days following resection of a medullary carcinoma of the thyroid, a 49-year-old man experienced elevated serum calcitonin levels. There was no evidence of metastasis. A re-exploration of the patient's neck demonstrated a histologically normal thyroid remnant that demonstrated C-cell hyperplasia by immunoperoxidase staining. The lack of a familial history, a normal parathyroid, and the absence of C-cell hyperplasia in non-tumorous thyroid of the original resection support the concept that the patient had a sporadic tumor. Patients who had undergone incomplete thyroidectomies for non-familial disease are at risk for developing C-cell proliferation and possibly medullary carcinoma. We conclude that the C-cell hyperplasia in this thyroid remnant is the source of the elevated calcitonin level; this mechanism may also explain postoperatively elevated calcitonin levels in some patients with medullary carcinoma treated by partial thyroidectomy and high calcitonin levels for a variable period after complete thyroidectomy.

Adult↗
PubMed1980

Polypoid sarcoma of the pulmonary trunk: analysis of the literature and report of a case with leptomeric organelles and ultrastructural features of rhabdomyosarcoma.

A case of polypoid sarcoma of the pulmonary trunk is described in an 80-year-old woman who had a 21-year history of episodic chest pain and hemoptysis. Ultrastructural examination revealed Z bands, characteristic of rhabdomyosarcoma, and leptomeric organelles. This is the 60th reported case of sarcoma of the pulmonary trunk. Symptoms in reported cases were variable, usually caused by tumor emboli to the lungs or by right ventricular outflow obstruction. Angiography was diagnostic. The tumor was characteristically polypoid, often multicentric, and by definition was fixed to the pulmonary trunk or valves. Non-differentiated sarcoma (often uniquely pleomorphic) was found in 37% of patients, leiomyosarcoma (once confirmed by electron microscopy) in 17%, myxosarcoma in 13%, elements of rhabdomyosarcoma in 8%, fibrosarcoma in 8%, elements of chondrosarcoma in 11%, and 5% were malignant mesenchymomas. The authors suggest that these tumors originate from the undifferentiated tissues of the bulbus cordis and propose the name myenchymoma for the tumor.

Adult↗
PubMed1980

Histogenesis of morphologic variations in tumors of the uterine wall.

We investigated seven uterine wall lesions, selected because of the presence of unexpected patterns or components, to determine their relationship to normal uterine constituents. These lesions included a bizarre leiomyoma, a palisading leiomyoma which resembled a schwannoma, two myxomas, irradiated myometrium, a plexiform tumor, and a leiomyoma with tubular structures. All of these lesions except for the epithelial component of the plexiform tumor showed ultrastructural characteristics of smooth muscle, demonstrating a common origin from the myometrium. Two tumors, the plexiform tumor and the leiomyoma with tubules, had the pattern of epithelial structures suggesting origin from müllerian mesencyme: the plexiform tumor resembled incompletely differentiated endometrium and the tubular structures in the leiomyoma had features of mesothelium. We conclude that these varied and often confusing morphologic patterns reflect the capacity of uterine smooth muscle and stroma to undergo a wide spectrum of alterations including differentiation toward epithelial structures. Changes of this type occur in benign and malignant uterine stromal neoplasms and do not in themselves have prognostic significance.

Adult↗
PubMed1979

Effects of irradiation on mixed müllerian tumors of the uterus.

A retrospective study of 54 patients with histologically proven malignant mixed müllerian tumors of the uterus was undertaken with main emphasis on the evaluation of the effects of irradiation on pelvic tumor control. The tumors were staged according to the FIGO classification for endometrial carcinoma and 24 were classified as Stage I, 10 as Stage II, 13 as Stage III and seven as Stage IV. Patients with Stage I and II were treated with surgery alone (9 patients, three surviving) or preoperative intracavitary irradiation (13 patients, eight surviving) or preoperative combination of intracavitary and external irradiation (12 patients, six surviving). Five patients with Stage III and IV were treated with surgery alone, two were treated with a combination of irradiation and surgery and 11 with radiation alone. None of these patients survived. In seven patients showing no residual tumor in the uterine specimen after irradiation, no pelvic failures were noted, whereas seven of 17 (41.2%) with residual tumor developed pelvic recurrences. In patients with Stage I treated with surgery alone, three out of six recurred in the pelvis whereas only three of 17 (17%) receiving preoperative irradiation developed pelvic recurrences. However, in Stage II six of eight patients treated with preoperative irradiation failed in the pelvis. Correlation with the doses of irradiation given to the uterus or the pelvic lymph nodes indicate that with doses below 5000 rads a significantly higher number of pelvic recurrences take place, whereas these are uncommon with doses over 6000 rads. The difference in pelvic recurrences between dosage levels is not, however, statistically significant. It is suggested that patients with Stage I and II malignant mixed müllerian tumors of the uterus should be treated with preoperative radiation and total hysterectomy with bilateral salpingo-oophorectomy. Patients with more advanced disease have extremely poor prognosis and should be treated with radiation therapy alone. This tumor has a high propensity to spread through lymphatics and hematogenous metastases are seen in approximately 75% of the patients. Because of this dissemination, significant improvements in survival rate will not be seen until effective cytotoxic agents are available.

Female↗
PubMed1978

Endometrial lesions in uteri resected for atypical endometrial hyperplasia.

Resected uteri from a series of 48 consecutive patients with atypical endometrial hyperplasia ("carcinoma in situ") identified in curettings were studied to determine the frequency of associated adenocarcinoma. Thirty-nine of the women had received estrogen or oral contraceptives. Twelve uteri (25%) contained small superficial foci interpreted as well differentiated adenocarcinoma. Consideration of this observation together with the absence of adenocarcinoma in the extensive experience reported in other studies of women with atypical hyperplasia treated with progestogens alone shows a deficit of patients with progression to invasive carcinoma. We reconcile this apparent conflict with the hypothesis that lesions classified as focal well-differentiated endometrial adenocarcinoma occurring with atypical hyperplasia in perimenopausal women exposed to estrogen are common and are consistently reversed by progestogen therapy.

Adenocarcinoma↗
PubMed1978

Annulate lamellae in human malignant tumors: report of three cases.

During the course of applying electron microscopy to diagnostic surgical pathological specimens, three malignant tumors (malignant melanoma, fibrous mesothelioma, lymphoblastic lymphoma) were found to contain annulate lamellae, distinctive intracytoplasmic organelles composed of membrane stacks interrupted by constrictions or pores. In one case both annuli and lamellae were present, a combination rarely described in human tissue and in animal models. In this material, the annuli of the annulate lamellae were structurally similar to nuclear pores. It is postulated that the abundant fibrils are probably related to the unusual configuration of the annulate lamellae. A morphologic relationship of the annulate lamellae to both the endoplasmic reticulum (cases 1 and 2) and the nuclear membrane (case 3) supports the theory that annulate lamellae may be related to both of these structures.

Abdominal Neoplasms↗