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Biomedical subjects

R J Epstein

Publications and source records attributed to R J Epstein.

103 records · Page 6Linked to original sources
PubMed1984

Computed tomography of intraperitoneal malignancy.

A review of 205 abdominal computed tomographic (CT) scans in 83 patients with gastric or ovarian neoplasms was performed in order to assess their contribution to management. Assessment of scan accuracy was based on results of invasive procedures, clinical data, and double-blind re-reporting. Scans appeared to be of greater value in patients with ovarian rather than gastric neoplasms (p less than 0.001), and in patients undergoing clinically-indicated rather than routine scans (p less than 0.001). No clinical benefit accrued from the use of pre-treatment scans. Overall accuracy of scanning was judged to be significantly greater for the ovarian than the gastric group (p less than 0.001), while concordance of scan reports with re-reporting was also greater in the ovarian group (p less than 0.001). The data indicate the inherent limitations of the CT scan and the high degree of subjectivity in its interpretation, particularly when used in the follow-up of patients with known or suspected recurrent gastric cancer. CT scanning remains a potentially useful adjunct to clinical assessment of patients with intraperitoneal malignancy, but should not be regarded as obviating the need for clinical judgement in management decisions.

Adolescent↗
PubMed1981

Lymphocyte-induced corneal neovascularization: a morphologic assessment.

Lymphocytes obtained from mesenteric lymph nodes of rabbits were stimulated in vitro by concanavalin A and injected into the corneas of allogeneic hosts. Controls were nonstimulated, killed, or autogeneic lymphocytes injected into the contralateral corneas. The stimulated cells were significantly better inducers of neovascular growth. Histologic observations of the vascularized corneas showing marked mononuclear reactions at the limbus, coupled with the requirement of allogenicity, suggest that there was immunologic recognition of the implanted cells. Stimulated allogeneic blast cells may amplify this host recognition by their elaboration of lymphokines or enhanced antigenicity. The apparent importance of allogenicity for the induction of vessel growth in these experiments may be significant in the pathogenesis tumor-induced or graft-related corneal neovascularization.

Animals↗
PubMed1980

The diagnostic accuracy of the rectal biopsy in acute graft-versus-host disease: a prospective study of thirteen patients.

We carried out a coded, prospective analysis of sequential rectal biopsies from 13 patients undergoing allogeneic bone marrow transplantation in order to study the accuracy of these biopsies in the diagnosis of acute graft-versus-host disease (GVHD). We also tested the hypothesis that individual crypt cell degeneration is the initial lesion of intestinal GVHD. Pretransplant biopsies were normal. All biopsies taken 7--10 days after transplantation were diffusely abnormal with nuclear atypia and crypt cell degeneration. These changes were due to the conditioning regimen of total body irradiation and chemotherapy and had resolved by day 20 after transplantation. When acute GVHD was present, rectal biopsies were focally abnormal with crypt cell degeneration, crypt dilation, and crypt abscess. Rectal biopsies were normal after day 20 in those patients who did not have clinical evidence of GVHD. The location of cell degeneration at the base of crypts suggests that an immunologic mechanism is responsible for damage to rectal mucosa in GVHD. The rectal biopsy is an accurate way of detecting intestinal involvement with acute GVHD if done after resolution of radiation/chemotherapy effects.

Adolescent↗
PubMedDate not supplied

Anterior segment anomalies associated with the fetal alcohol syndrome.

Anterior segment anomalies were noted in eight children diagnosed as having the fetal alcohol syndrome. Peters' and Axenfeld's anomalies were among the specific defects noted. Four children have maintained clear corneal grafts. A teratogenic action of alcohol during a critical period of development of anterior chamber structures is suggested as an etiologic factor. It is proposed that the varied types and severity of abnormalities noted might result from differences in blood alcohol levels, timing of the insult, and genetic background of the fetus. The observation of various types of malformations thought to share a similar pathogenesis lends additional support to the assumption that there is an interrelationship among these types of congenital segment pathology.

Anterior Chamber↗