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Biomedical subjects

D N Ostrow

Publications and source records attributed to D N Ostrow.

13 recordsLinked to original sources
PubMed1991

Outcome of hepatitis B virus infection in homosexual men and its relation to prior human immunodeficiency virus infection.

To investigate the effect of human immunodeficiency virus type 1 (HIV-1) infection on subsequent hepatitis B virus (HBV) infection, HIV antibody was sought in homosexual men who developed HBV infection during a hepatitis B vaccine trial. Among 134 unvaccinated HIV-1-negative men, 7% became HBV carriers, 64% had viremia, and 42% had clinical illness. Among vaccinated HIV-1-negative men, HBV infection severity decreased with number of vaccine doses administered. When adjusted for prior hepatitis B vaccination status, persons with HIV-1 infection preceding HBV infection had a significantly higher risk of developing HBV carriage, viremia, prolonged ALT elevation, and clinical illness. Among HIV-1-infected men, the risk of HBV carriage was increased in unvaccinated persons (21%) and those who failed to respond to vaccination (31%) and further increased in those who received vaccine doses at the time they developed new HBV infection (56%-80%), suggesting inactivated hepatitis B vaccine may temporarily impair the immune response to HBV infection in HIV-1-infected persons. HIV-1 infection was also associated with reduced alanine aminotransferase elevations during the first 36 months of follow-up of men who became HBV carriers.

Alanine Transaminase↗
PubMed1991

High-resolution computed tomography of chronic interstitial lung disease.

The absence of superimposition of parenchymal structures on HRCT permits better assessment of the pattern and distribution of disease than is possible on the radiograph. Several studies have shown that HRCT is superior to the chest radiograph in the diagnosis and management of patients with chronic interstitial lung disease. High-resolution studies may demonstrate extensive parenchymal disease when the radiograph is normal and allow for a confident diagnosis when the radiographic findings are nonspecific. It is superior to the chest radiograph in determining whether transbronchial or open lung biopsy is indicated, and it is essential in selecting the optimal biopsy site. Although further studies are required to determine the precise role of HRCT in interstitial lung disease, current indications for HRCT include: (1) assessment of patients with symptoms suggestive of infiltrative lung disease but normal or nonspecific findings on the radiograph; (2) further evaluation of the lung parenchyma in patients in whom the radiographic findings are not in keeping with the clinical history or symptomatology; (3) as a guide to the optimal biopsy site in all patients undergoing open or transbronchial biopsy; and (4) assessment of suspected complications (e.g., infection) in patients with diffuse lung disease.

Biopsy↗
PubMed1989

Sarcoidosis: correlation of extent of disease at CT with clinical, functional, and radiographic findings.

Computed tomography (CT) was compared with chest radiography in the assessment of disease severity in 27 patients with sarcoidosis. The CT scans and radiographs were each read twice by two independent observers. Disease extent was assessed on CT scans by visual scoring (0%-100% involvement of the lung parenchyma) and on radiographs by using an adaptation of the International Labour Office classification. The severity of parenchymal changes on the CT scan and on the radiograph was significantly correlated with the severity of dyspnea (r = .61 and .58, respectively; P less than .001), diffusing capacity (r = -.62 and -.52, P less than .01), and vital capacity (r = -.49 and -.51, P less than .01). Patients with predominantly irregular opacities had more severe dyspnea and lower lung volumes than patients with predominantly nodular opacities (P less than .05). The authors conclude that in patients with sarcoidosis, the radiographic and CT assessments of disease severity show similar correlation with clinical and functional impairment.

Adult↗
PubMed1989

Multicentricity of adenocarcinoma of the lung.

In a consecutive series of 62 lung resections for bronchogenic adenocarcinoma, 12 patients (19 percent) were found to have two or more adenocarcinomas on careful pathologic examination. These tumors all met the criteria for separate primary malignancy. In only two of the patients were the additional lesions suspected preoperatively. This incidence of multiple primary lung adenocarcinomas in apparently operable patients is several fold higher than would be anticipated from the literature. The phenomenon has important implications for preoperative radiologic evaluation, postoperative pathologic examination, assignment of TNM stage, and clinical follow-up of patients undergoing successful resection.

Adenocarcinoma↗
PubMed1988

Glandular neoplasia of the lung. A proposed analogy to colonic tumors.

In 62 consecutive resections for adenocarcinoma of the lung, 50 cases (81%) had single adenocarcinomas and 12 (19%) had multiple adenocarcinomas. In seven of these 12 patients, two adenocarcinomas were found. In the other five patients, the specimen contained a dominant adenocarcinoma and several 0.1- to 1-cm nodules of similar histologic appearance. In four of the 50 single tumor patients and one of seven double tumor patients, 1- to 2-mm nodules were found along with adenocarcinomas that we interpreted as being bronchioloalveolar tumors of uncertain malignant potential. An analogy is drawn between these four types of findings and single tumors of the colon, double tumors of the colon, polyposis syndromes, and tubular adenomas of the colon, respectively.

Adenocarcinoma↗
PubMed1988

Pulmonary lymphangitic carcinomatosis: CT and pathologic findings.

The authors retrospectively reviewed the computed tomographic (CT) scans, biopsy specimens, autopsy results, and lobectomy specimens of 21 patients who had lymphangitic carcinomatosis. Ten-millimeter collimation CT scans were obtained from all patients, and selected 1.5-mm CT scans were obtained from ten patients. In five patients, the diagnosis was established with open lung biopsy, lobectomy, or autopsy; in nine, with bronchial biopsy or transbronchial biopsy; and in seven, with clinical and radiologic criteria. Certain characteristic findings on CT scans were evident: uneven thickening of bronchovascular bundles, thickening of isolated interstitial lines, and the presence of polygonal lines. These findings may be seen on CT scans even if the findings on chest radiographs are normal or nonspecific. The pathologic basis for these characteristic CT findings may relate to tumor thrombi in lymphatic vessels rather than edema and fibrosis, at least in the early stages of disease.

Adult↗
PubMed1986

Seeding of malignant cells into the needle track after lung and pleural biopsy.

Transthoracic needle biopsy is frequently performed for the diagnosis of pulmonary and pleural disease. Seeding of malignant cells is a potential complication but is extremely uncommon. We report the second patient with malignant seeding after fine-needle aspiration biopsy of a bronchogenic carcinoma. We also report a patient with seeding of bronchogenic carcinoma after a pleural biopsy. Because seeding is a rare complication, it does not affect the indications for biopsy.

Adenocarcinoma, Papillary↗
PubMed1985

Managing chronic airflow obstruction: Part II.

The results of a well-controlled international study have shown no benefit in life expectancy, rate or duration of hospitalizations, lung function, or quality of life when intermittent positive pressure breathing is compared with an air compressor to deliver aerosol bronchodilators. Patients who are accepted on a home oxygen program should be vigorously managed with standard treatment, and only if hypoxemia persists after a month of such therapy should ambulatory oxygen be considered.

Adrenal Cortex Hormones↗
PubMed1978

Professional patient-instructors in the teaching of the pelvic examination.

A class of 100 second-year medical students was randomly divided into two groups for instruction in the techniques of the gynecologic examination. Each group received a lecture and a demonstration film. The control group then had practical instruction on office or clinic patients. The study group was instructed by specially trained clinical teaching associates who acted both as professional patients and as teachers. After practice in clinics and offices, both groups received a common evaluation by gynecologists and teaching associates. Students who were instructed by clinical teaching associates performed better on subsequent pelvic examinations and demonstrated superior communications skills compared with the control group.

Educational Measurement↗
PubMed1978

Alpha1-antitrypsin phenotypes and lung function in a moderately polluted northern Ontario community.

To determine whether persons with intermediate value alpha1-antitrypsin phenotypes living in a polluted environment manifest significant abnormalities in lung function, a study was undertaken of an age-, sex- and smoking-stratified sample of 391 persons from the town of Fort Frances, Ont., which has elevated values of total dustfall, suspended particulates and hydrogen sulfide. Indices of pulmonary function were derived from the maximum expiratory flow and the single breath expiratory flow and the single breath expiratory nitrogen washout curves. The percentage frequency of the M, MS and MZ pheontypes was 91.7, 7.3 and 0.8, respectively. There was no significant difference between the M and MS groups as indicated by the nitrogen washout curve and maximum expiratory flow curve. There was no significant difference between the three MZ subjects and the M group. In both M and MS groups smokers displayed evidence of airflow obstruction when compared with nonsmokers. It would appear that, when compared with M subjects, persons with the MS phenotype living in a moderately polluted area show no changes in indicators of pulmonary function, including tests of early airway disease, that cannot be attributed to their smoking habit.

Adult↗
PubMed1975

Learning pulmonary function interpretation: deductive versus inductive methods.

Volunteer undergraduate medical students were randomly divided into 2 groups. One group were given pulmonary function data and the correct diagnoses from 18 patients. They were told to try to derive the rules by which the diagnoses were made. The other group were given the data from the same 18 patients, but were required to use a computer-assisted instructional program to arrive at the diagnoses in a deductive fashion. Both groups were pre- and post-tested. The deductive method provided higher post-test results. The inductive method took longer and produced more dropouts from the study.

Analysis of Variance↗