Search PubMed⌕ Search

Biomedical subjects

S Z Freed

Publications and source records attributed to S Z Freed.

At least 37 records · Page 2Linked to original sources
PubMed1982

Abnormal levels of plasma hormones in men with prostate cancer: evidence toward a "two-disease" theory.

The 24-hr mean plasma concentrations of 13 hormones or hormone metabolites (cortisol, testosterone, dihydrotestosterone, dehydroisoandrosterone, dehydroisoandrosterone sulfate, androsterone, androsterone sulfate, estrone, thyroxine, triiodothyronine, LH, FSH, and prolactin) were measured in 16 rigorously screened patients (aged 55-80) with stage C or D prostate cancer and 36 normal men. Nine of the hormones showed no abnormalities in the patients but four (testosterone, dihydrotestosterone, cortisol, and estrone) showed abnormalities. Testosterone and dihydrotestosterone, which, respectively, decreased with age and showed no change with age in the normal men, rose sharply with age in the patients. The patients' curves crossed the normal curves at about age 65; patients 65 or above showed normal values while patients under age 65 showed significantly subnormal levels of both hormones: testosterone averaged 282 ng/dl in patients vs 434 ng/dl in controls (P less than 0.0001) and dihydrotestosterone averaged 70 ng/dl in patients vs 99 ng/dl in controls (P less than 0.01). Cortisol, which was age invariant in the normal men, fell sharply with age in the patients; patients under 65 had significantly elevated levels (10.1 vs 6.9 micrograms/dl; P less than 0.0001), while patients 65 or older had normal levels. Estrone levels were age invariant in both patients and controls, but the mean level in patients was markedly elevated (81 vs 47 pg/ml in controls; P less than 0.001). The cortisol/testosterone ratio almost completely separated prostate cancer patients under 65 from normal men, but did not discriminate patients 65 or older from normal. The findings indicate that prostate cancer patients under 65 differ markedly in their endogenous hormonal pattern from patients 65 or older. This leads us to propose a "two-disease" theory of prostate cancer, with possible differences in genetic factors and prognosis.

Age Factors↗
PubMed1980

Xanthogranulomatous pyelonephritis: segmental or generalized disease.

Xanthogranul omatous pyelonephritis of the kidney usually occurs in association with urinary tract infection, obstruction and/or calculi. The diagnosis usually is made when a nephrectomy is performed for a non-functioning kidney and/or a mass indistinguishable from carcinoma on radiological as well as gross examination. Segmental excision of the kidney for focal xanthogranulomatous pyelonephritis has been used rarely in the past. Focal involvement of the kidney with xanthogranulomatous pyelonephritis was encountered in 4 instances at our institution. The diagnosis was made incidentally in 3 patients during segmental excision of the involved parenchyma and/or cyst wall. We believe that the xanthogranulomatous process probably starts as a localized involvement in some cases and, if excised during this stage, further destruction of renal parenchyma can be prevented successfully.

Adult↗
PubMed1979

The prevalence and significance of Brunn's nests, cystitis cystica and squamous metaplasia in normal bladders.

The frequency of Brunn's nests, cystitis cystica and squamous metaplasia was studied by multiple histologic sections in 100 grossly normal bladders obtained at postmortem examination. Of the 100 bladders 93 per cent had at least 1 of the 3 proliferative changes. Brunn's nests and cystitis cystica were seen in 89 and 60 per cent of the bladders, respectively, most often at the bladder neck and trigone. Non-keratinizing squamous metaplasia of the vaginal type was seen almost exclusively on the trigone and bladder neck in 46 per cent of the premenopausal and postmenopausal women but in only 7 per cent of the men. There was no satisfactory evidence that inflammation was casually associated with these changes. These findings suggest that Brunn's nests, cystitis cystica and squamous metaplasia of the vaginal type in women are normal variants of bladder urothelium and have no precancerous potential.

Adolescent↗
PubMed1978

Effect of flutamide on cortisol metabolism.

The effect of flutamide on cortisol metabolism was studied in eight patients with prostate cancer. Flutamide markedly decreased the formation of 3 alpha, 17,21-trihydroxypregnane-11,20-dione (THF), and the 11-oxy-17-ketosteroid metabolites by 72%, 50%, and 46% respectively; however, 3 alpha, 11 beta, 17,21-tetrahydroxy-5 alpha- pregnan-20-one was increased by 46%. The 24-h mean plasma cortisol concentration was not altered. The cortisol production rate decreased by an average of 53% (from 32.7 to 15.5 mg/24 h). The effect of the drug on plasma cortisol kinetics was studied in three patients. This showed that flutamide increased the t1/2 (from 80 to 108 min) but decreased the distribution volume (from 17.8 to 13.8 liters) and the MCR (from 222 to 130 liters/24 h). The changes in THE and THF formation and in the t1/2 and MCR of [C]cortisol are similar to the effects observed in patients with intrahepatic cholestasis. It is suggested that in the case of flutamide these changes were also due to a cholestasis-producing effect of the drug on the liver. As the clinical response to the drug did not correlate with the cortisol metabolic changes, its therapeutic effect was probably not mediated by its effects on cortisol metabolism.

Aged↗
PubMed1978

Attempted ureteral replacement and urinary conduit using bovine artery graft.

Ureteral replacement and urinary diversion using bovine carotid artery heterograft were attempted in dogs. The graft failed for several reasons: stasis proximal to an aperistaltic segment, anastomotic stricture, and fibrotic narrowing of the graft. The disease entities and criteria for successful ureteral replacement and diversion are reviewed.

Animals↗
PubMed1977

Nonpapillary carcinoma in situ and atypical hyperplasia in cancerous bladders: further studies of surgically removed bladders by mapping.

Complete mapping of epithelium has been performed in 10 bladders surigcally removed for cancer. In all cases, in areas adjacent to or distant from the visible tumors, nonpapillary carcinoma in situ and related lesions such as atypical hyperplasia could be demonstrated. More importantly, in 5 of the 10 bladders, areas of occult invasive carcinoma derived from such abnormal epithelia have been recorded. These findings fully confirm prior observations and raise the number of totally mapped bladders to 20. The histologic findings in the entire series of 20 cases are discussed and the distribution of cancer and precancerous lesions tabulated. It is suggested that the areas of the bladder most frequently affected by precancerous lesions are the left and right lateral walls and the posterior wall. The trigone and the dome are less frequently involved. The need for aggressive assessment of bladder epithelium in patients with tumors of the bladder and/or early radical treatment for patients with non papillary carcinoma in situ is discussed in light of these observations.

Aged↗
PubMed1977

Follow-up of patients after nephrectomy for renal cell carcinoma.

Follow-up of patients after nephrectomy for renal cell carcinoma is often inadequate. The sooner secondary lesions are identified and treated the better. Routine annual admission of these patients is urged for abdominal angiography, bone scan, chest roentgenograms, and specialized diagnostic procedures as indicated.

Adenocarcinoma↗
PubMed1977

Nephrectomy for renal cell carcinoma with metastases.

The percentage of patients with renal cell carcinoma who also have identifiable metastases when first seen is increasing. In the past metastases were considered justification for excluding nephrectomy in the management of the patient. However, numerous opportunities for therapy which are abetted by removal of the primary tumor are presented. It is concluded, depending on several variables, that the advantages of nephrectomy usually justify the procedure.

Adenocarcinoma↗
PubMed1977

Infundibulopyelostomy for vascular obstruction of a middle infundibulum.

The syndrome of nephralgia caused by vascular compression of a superior infundibulum of the kidney and its surgical resolution are reported. A case is presented to demonstrate that this syndrome also can involve a middle infundibulum, which can be treated by the same surgical technique.

Adult↗
PubMed1977

Idiopathic regression of metastases from renal cell carcinoma.

Herein we review 48 acceptable cases of idiopathic regression of metastases from renal cell carcinoma culled from the literature and present 3 additional cases. The data are analyzed and the issue of organ specificity in coping with metastases is discussed.

Adenocarcinoma↗
PubMed1976

Complications of renal cyst puncture.

One hundred nineteen renal cyst punctures have been reviewed. There have been four complications (3.4 per cent), three requiring surgery. This should be expected, as all invasive diagnostic procedures are accompanied by some morbidity. The relative benefit of nonoperative diagnostic procedures in differentiating benign renal cyst from adenocarcinoma is discussed.

Aged↗