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Biomedical subjects

B R Marsh

Publications and source records attributed to B R Marsh.

34 records · Page 2Linked to original sources
PubMed1981

Transbronchial needle aspiration for diagnosis of lung cancer.

Thirty-two consecutive patients with mediastinal lesions suggestive of bronchogenic carcinoma underwent transbronchial needle aspiration. Eighteen of 20 patients (90 percent) with proved bronchogenic carcinoma had malignant cytology specimens or tissue fragments. Of 12 patients with normal cytology specimens, six were subsequently proved to have nonneoplastic disease. Transbronchial needle aspiration appears to offer a sensitive and specific alternative to more invasive surgical techniques used in the diagnosis of malignancies with mediastinal involvement.

Biopsy, Needle↗
PubMed1976

New horizons in lung cancer diagnosis.

Lung cancer is rarely diagnosed and treated while still localized. Sputum cytology allows detection of radiologically occult tumors but conventional endoscopic procedures frequently prove inadequate for localization. It is the purpose of this report to outline the endoscopic observations and methods we have developed in successfully localizing 17 consecutive, radiologically occult carcinomas discovered in the sputum of 15 patients. A detailed examination of the upper respiratory tract demonstrated occult tumors in two patients. A segment by segment fiberbronchoscopic study under anesthesia allows multiple brushings and meticulous handling of specimens. Lesion localization is provided as well as identification of synchronous second primary tumors. Biopsies at the lobar spur and carina assist in determining the proximal extent of carcinoma in situ at potential surgical margins. Newer methods should enhance our recognition of inapparent carcinoma in situ allowing more efficient and more accurate tumor localization and a better appreciation of its extent.

Bronchi↗
PubMed1976

Relationships of morphology to clinical presentation in ten cases of early squamous cell carcinoma of the lung.

The morphologic changes in 10 patients who were found to have squamous cell carcinoma of the lung before they became evident on chest x ray are discussed. It is suggested that these cases have a long preclinical course as invasive carcinomas that ranges from a microscopic focus of microinvasion (possibly originating from in situ carcinoma in submucosal gland epithelium) to a large concentric carcinoma which may have metastasized to regional lymph nodes. Although the duration of the in situ phase of squamous cell carcinoma of the bronchus in not known, it was evident that the expanse of in situ carcinoma frequently far exceeded that of the invasive carcinoma, and usually extended proximal to the invasive lesion. It is important that the extent of the in situ lesion is determined preoperatively. Finally, multifocal in situ (or invasive) carcinoma was found in at least two of the cases, either synchronously or metachronously.

Adult↗
PubMed1975

The clinical assessment of selected patients with bronchogenic carcinoma.

This paper describes the clinical management of patients with malignant cells in their sputum and a normal chest roentgenogram and those with asymptomatic peripheral pulmonary masses. The source of malignant cells in the sputum of patients with no roentgenographic abnormalities can be localized by tantalum bronchography and fiberoptic bronchoscopy. Peripheral pulmonary masses can be diagnosed preoperatively by needle biopsy or transbronchial fiberoptic bronchoscopy with little morbidity and no mortality. These procedures are not necessary, however, if there is firm clinical and roentgenographic evidence of malignancy. Bronchogenic carcinomas presenting as asymptomatic circumscribed peripheral pulmonary masses have a 25% incidence of occult mediastinal lymph node metastases. In view of this relatively high incidence of metastasis, we think mediastinoscopy should routinely be performed prior to thoracotomy is asymptomatic patients with a peripheral pulmonary mass and no roentgenographic evidence of mediastinal widening.

Biopsy, Needle↗
PubMedDate not supplied

The problem of the open safety pin.

The open safety pin lodged in the stomach or esophagus presents a challenge to surgical judgment and technical skill. Most foreign bodies causing trouble lodge in the esophagus. Once in the stomach, uneventful passage can be expected in 80 to 90% of cases. Active intervention is reserved for those where intestinal performation is likely or where there is failure to progress. We have used the fiberesophagoscope to remove three open safety pins from the stomachs of two patients whose symptoms and threat of perforation required intervention. The microbiopsy forceps was used successfully to retrieve the open pins, but a newly developed grasping forceps for use with the fiberesophagoscope now provides a more secure hold on such foreign bodies. Rigid instruments retain their value for selected cases, but the flexible equipment now provides an important advance in the management of the open safety pin in the stomach.

Adult↗
PubMedDate not supplied

Infantile subglottic hemangiomas. An update.

Between 1913 and 1985, 323 cases of infantile subglottic hemangiomas have been reported in the English language literature. The purpose of this study is to review these cases, to report The Johns Hopkins Hospital experience with ten additional cases, and to compare the various methods of treatment in an attempt to identify the regimens associated with the best outcome. The majority of the patients presented before the age of 6 months with respiratory distress, most commonly inspiratory stridor. There was a 2:1 female to male preponderance. The diagnosis was established by endoscopy in the majority and confirmed by biopsy in one third, without serious bleeding complications. A plethora of treatment methods have been described, including the following: corticosteroids, tracheotomy, radiation therapy, radioactive implant therapy, surgical excision, cryotherapy, and carbon dioxide laser. These methods were reviewed and their results compared to our own. We conclude that several methods are effective, each having its advantages and disadvantages. We believe that immediate tracheotomy should be performed in cases with severe airway obstruction. Smaller lesions may be vaporized with the carbon dioxide laser without tracheotomy if postoperative care is provided in a pediatric intensive care unit. Corticosteroids may be used alone or in combination with other modalities. External radiation therapy and injection of sclerosing agents are not advised.

Female↗
PubMedDate not supplied

A simple lavage method for the cytologic sampling of DMBA-induced carcinomas of the hamster cheek pouch.

An effective, simple sampling device was developed to obtain improved cytologic specimens from the cheek pouches of hamsters; it was tested in the sampling of squamous-cell carcinomas induced with 9,10-dimethyl-1,2-benzanthracene (DMBA). Cellular samples collected by this modified syringe lavage-aspirator using Hanks' balanced salt solution contained an average of 1.3 X 10(5) cells per milliliter. Of the heterogeneous contents of the cheek pouch (food, debris, erythrocytes, leukocytes, macrophages, squamous cells, atypical cells and cancer cells), the cells of diagnostic significance from cancer and dysplasia were increased by this procedure to 3.7% of the cells recovered, as compared to 2.5% of the cells obtained by direct scraping of the same pouches. The inexpensive, disposable device allowed repeated sampling of cheek pouches without causing injury to the animals.

9,10-Dimethyl-1,2-benzanthracene↗