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Biomedical subjects

D M Epstein

Publications and source records attributed to D M Epstein.

65 records · Page 4Linked to original sources
PubMed1982

Prognosis of pulmonary scar carcinoma.

Eighty-one patients with resectable primary peripheral lung carcinomas were studied to determine the effect of associated scarring on prognosis. Twelve tumors (15%) originated from bronchi. 24 (30%) were associated with scars, and 45 (55%) were not associated with either bronchus or scar (non-scar). Scar carcinomas differed significantly in cell type from bronchogenic and non-scar tumors in that 21 (88%) scar carcinomas were either adenocarcinomas or bronchioloalveolar carcinomas (p less than 0.001). Origin (bronchogenic, scar, non-scar) independent of cell type and tumor stage did not significantly influence survival. Stage of disease independent of cell type or origin affected survival (p less than 0.0001), as did cell type independent of tumor stage or origin (p less than 0.0001). Stage I disease and bronchioloalveolar carcinoma were associated with longer survival, while Stage II or III disease, small cell anaplastic carcinoma, and adenocarcinoma were associated with reduced survival. We conclude that associated scar influences cell type of peripheral lung carcinoma but does not influence patient survival, even among patients with similar cell type and stage of disease.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed1981

CT differentiation of solitary from diffuse bronchioloalveolar carcinoma.

The therapy and prognosis of bronchioloalveolar carcinoma vary greatly with the solitary versus the diffuse form of the disease. Solitary disease demonstrates a high resectability rate with good long term prognosis. This contrasts with the rapidly fatal course associated with the diffuse form. To date, categorization of patients into either the solitary or the diffuse form has been based solely on conventional radiography. Multiple authors have reported cases of disease not demonstrated radiographically but discovered at surgery or autopsy. With the superiority of chest computed tomography (CT) for demonstrating parenchymal abnormalities, we propose that preoperative CT may be crucial in the workup of patients with presumed solitary bronchioloalveolar cell carcinoma. Early identification of diffuse disease or confirmation of the presence of solitary disease by CT may allow the institution of proper therapy and better evaluation of patient prognosis.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed1981

The hypereosinophilic syndrome.

The hypereosinophilic syndrome is a spectrum of clinical disorders characterized by leukocytosis and marked eosinophilia without definable cause. Clinical symptoms and radiographic findings are most often due to congestive heart failure, although parenchymal lung infiltrates from the eosinophilia itself may be seen. Four documented cases with chest radiographs are presented.

Adult↗
PubMed1981

"Semi-invasive" pulmonary aspergillosis: a new look at the spectrum of aspergillus infections of the lung.

A chronic cavitary form of pulmonary aspergillosis may occur with mild immunosuppression or underlying lung disease. In this "semi-invasive" type, the fungus is intermediate between a simple saprophyte and an invasive pathogen. Aspergillus may produce extensive lung destruction despite the lack of vascular invasion. The absence of a previous cavity distinguishes such cases from secondary noninvasive mycetomas. Radiographic features include a chronic infiltrate, progressive cavitation, and subsequent mycetoma formation. Biopsy may be helpful; however, marked squamous metaplasia can produce false-positive Class V cytological findings even though malignancy is excluded. This variety of aspergillosis supports the concept that the traditional allergic, saprophytic, and invasive forms may represent a spectrum of disease dependent on host immune status and lung architecture.

Aged↗
PubMed1981

Progressive systemic sclerosis subgroups: variable pulmonary features.

Evidence has accumulated which enables subdivision of progressive systemic sclerosis (scleroderma) into three categories: (1) classic progressive systemic sclerosis (PSS); (2) the CRST/CREST syndrome; or (3) overlap syndromes. Previous reports of the chest film manifestations of PSS have used only the broad category of scleroderma without subdivision. This study analyzed the chest film manifestations of 73 PSS patients which have been subgrouped. Radiographic abnormalities, either interstitial lung disease or pleural effusion, were present as follows: PSS, 18% (8/44); CRST/CREST, 0% (0/9); and PSS-overlap, 75% (15/20). Interstitial lung diseases in the PSS-overlap group was usually basilar and of mild severity on the initial chest film obtained. While the classic PSS group had a very much lower incidence of lung disease, it was usually more diffuse and severe.

Adult↗
PubMed1979

Immunoglobulin synthesis by cord blood lymphocytes.

The IgG, IgA and IgM synthesis by adult peripheral blood and cord blood lymphocytes incubated alone and with pokeweed mitogen was quantitated. The cord blood lymphocytes produced no immunoglobulin even with mitogen stimulation while the adult peripheral blood lymphocytes responded to the mitogen with a significant (p less than 0.04) increase in immunoglobulin production.

Adult↗