Biomedical subjects
J M Reich
Publications and source records attributed to J M Reich.
Sarcoidosis and agnogenic myeloid metaplasia.
Agnogenic myeloid metaplasia (AMM) was recognized 3 years after a diagnosis of sarcoidosis in a 45-year-old man. This is the second reported instance of that association, and the 15th reported case in which systemic granulomata have been associated with a myeloproliferative disorder (MPD). In the client population at risk, this connection would be expected to occur by chance once in 1700 years. Therefore, it is unlikely that the association is fortuitous. Systemic granulomata may represent an immunologic response to antigens of neoplastic origin in MPD.
Convulsion of the lung: an historical analysis of the cause of Dr Johnson's fatal emphysema.
Of Johnson's fatal emphysema, it appears probable, on available historical and anatomic evidence, that it resulted from bronchiectasis, a diagnosis favoured by the pattern of illness: a protracted and severe respiratory infection succeeded by annual episodes of severe winter bronchitis, remitting in summer, and culminating in respiratory insufficiency; and by the findings of pleural adhesion and cor pulmonale at necropsy. That is resulted from chronic bronchitis is a proposition both plausible and irrefutable without the specimen.
Dysutility of screening chest roentgenograms for lung cancer: the Ulysses syndrome.
Explore the source record for details and available documents.
Pulmonary gangrene and the air crescent sign.
BACKGROUND: A study was carried out to increase familiarity with the aetiology, pathogenesis, and radiographic features that characterise pulmonary gangrene. PATIENTS: Four patients with one of the disorders vasoinvasive aspergillosis, infarcted tuberculous cavity, chronic necrotising aspergillosis, and gangrene due to Pseudomonas aeruginosa were selected because they showed the variations of the typical radiographic pattern and illustrated the pathogenesis. A fifth case is also presented, in which pulmonary gangrene was simulated by the invagination of a loculated pleural effusion into the wall of a contiguous lung abscess. CONCLUSIONS: Evolution of a crescent or rim of air within a homogeneous shadow is the feature that both heralds the development and facilitates the recognition of pulmonary gangrene. It is most often the result of vascular thrombosis induced by the infecting organism. The outcome of treatment is often unfavourable, principally because of the severity of the predisposing systemic or local underlying disorder, although a delay in diagnosis, possibly due to unfamiliarity with the radiographic pattern, may have contributed to the adverse outcome in some instances.
Aspergillus epidural abscess and cord compression in a patient with aspergilloma and empyema.
Explore the source record for details and available documents.
Chirping rales in bird-fancier's lung.
Explore the source record for details and available documents.
Acute myeloblastic leukemia and sarcoidosis.
A protracted unexplained blood dyscrasia, and late age of onset were peculiar features observed in several of the nine reported instances of sarcoidosis in which acute myeloblastic leukemia evolved. These characteristics, in combination with the observed frequency with which the two disorders have been linked, and numerous previous reports of malignancy-associated sarcoidosis, suggest that the conjunction in non-fortuitous. Seven criteria are proposed which might be employed to support a causal relationship between sarcoidosis and malignancy. A systemic granulomatous response to tumor antigen, analogous to regional sarcoid reactions, is offered as a possible explanation for this association.
Primary pulmonary disease due to Mycobacterium avium-intracellulare.
Explore the source record for details and available documents.
Mycobacterium avium complex pulmonary disease presenting as an isolated lingular or middle lobe pattern. The Lady Windermere syndrome.
BACKGROUND: Pulmonary disease due to Mycobacterium avium complex (MAC-PD) radiographically resembles that due to tuberculosis; it preferentially affects elderly white men with predisposing pulmonary disorders (PDPD). METHODS: Twenty-nine patients with MAC-PD were identified from a community-based population, and the medical records and chest roentgenograms (CRs) of six with a previously undescribed pattern of MAC-PD were reviewed. The distinctive clinical and demographic features of these six patients were identified and summarized. RESULTS: All were women who tended to be elderly. None had clinically evident PDPD. The dependent portion of the lingula or its counterpart, the middle lobe, was initially affected. Hilar adenopathy, volume loss, and cavitary disease were uniformly absent. CONCLUSIONS: To account for the distinctive features of this syndrome, we offer the hypothesis that habitual voluntary suppression of cough may have led to the development of nonspecific inflammatory processes in these poorly draining lung regions, upon which MAC-PD engrafted. We offer the term, Lady Windermere's syndrome, to describe this pattern among elderly women and to suggest that their fastidiousness may be its root cause.
Pneumothorax due to pleural perforation of a pseudocavity containing aspergillomas in a patient with allergic bronchopulmonary aspergillosis.
Explore the source record for details and available documents.
Pulmonary lymphangioleiomyomatosis.
Explore the source record for details and available documents.
Mycobacterium avium complex pulmonary disease. Incidence, presentation, and response to therapy in a community setting.
The experience with pulmonary disease caused by Mycobacterium avium complex (MAC-PD) was examined over a 12-yr period in a nonreferral setting. The 29 patients with the disease constituted 30% of all pleuropulmonary mycobacterioses. The mean annual incidence rate was 1/100,000. Sixty-two percent of patients were female, the majority of whom had no discernible preexisting pulmonary disorder to account for their susceptibility. A short- and long-term favorable response to therapy was observed in more than 90% of the 16 patients treated with intent to cure. Suggested as plausible explanations for the favorable response rate compared with previous studies originating in referral settings were: absence of adverse selection as shown by a smaller proportion of patients with far-advanced cavitary disease or with previous treatment failure, and a larger proportion of female patients. A previously unreported pattern of MAC-PD was observed: disease limited to the lingula or middle lobe occurred in 21% of the patients, all female. A rarely identified pattern, primary disease in a 3-yr-old exposed to pet birds, is reported.
Acute myeloblastic leukemia and sarcoidosis. Implications for pathogenesis.
A disorder characterized by anemia and neutropenia due to impaired bone marrow function and a multisystem noncaseating granulomatous (NCG) disorder typical of sarcoidosis, culminated in acute myeloblastic leukemia (AML) in a patient after 6 years of observation. Linkage between the leukemia and sarcoidosis is suggested by a precedent case report, by the statistical remoteness of a fortuitous concurrence, by numerous reported instances of regional or systemic NCG accompanying a variety of malignancies, and by evidence of AML immunogenicity. It appears possible that the sarcoidosis in this patient represented a tissue reaction to the AML.
Course and prognosis of sarcoidosis in a nonreferral setting. Analysis of 86 patients observed for 10 years.
Analysis of the course and prognosis of 86 patients with sarcoidosis over a 10-year period of observation in a nonreferral setting (Kaiser-Permanente Medical Care Program), a prepaid health maintenance organization, revealed no deaths or severe disability due to respiratory failure or cor pulmonale among 12 patients in whom pulmonary fibrosis either was present or developed during the period of observation. The prognosis by stage and overall was not influenced by race. Because of the method of disease identification that was chosen, it is believed the favorable outcome observed more closely approximates the course and prognosis of sarcoidosis as it occurs in the population in general than do series emanating from institutional settings.