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Full-Text Articles in Life Sciences
New Purine Analogues For The Treatment Of Chronic B-Cell Malignancies, Thomas E. Gribbin
New Purine Analogues For The Treatment Of Chronic B-Cell Malignancies, Thomas E. Gribbin
Henry Ford Hospital Medical Journal
Adenosine deaminase (ADA). a purine salvage pathway enzyme, appears to play a key role in normal lymphocyte growth, development, and differentiation. Three new purine nucleoside analogues, deoxycoformycin, fludarahine, and 2-chlorodeoxyadenosine, affect the normal function of the purine salvage pathway by inhibiting ADA or by acting as analogs of the ADA substrates. These agents show significant activity in the treatment of chronic B-cell leukemias and low-grade lymphomas. The pharmacology, mechanism of action, and clinical usefulness of these agents are discussed.
Chronic Myelogenous Leukemia: Molecule To Man, Robert Peter Gale
Chronic Myelogenous Leukemia: Molecule To Man, Robert Peter Gale
Henry Ford Hospital Medical Journal
Chronic myelogenous leukemia (CML) is the best understood human cancer. The molecular basis of CML involves activation of a cellular proto-oncogene—ABL. The consequence is to increase tyrosine kinase activity. This results in a marked clonal increase in the myeloid mass. Later on, cellular maturation is blocked and the decrease eventuates in acute leukemia. Abnormalities of other proto-oncogenes or antioncogenes, like P53, may be involved in leukemia progression. Treatment of CML involves chemotherapy and, more recently, interferon. Whether this treatment prolongs survival or increases the likelihood of cure is unknown but either result seems unlikely. Bone marrow transplants which cure about …
Application Of The Polymerase Chain Reaction For Detection Of Minimal Residual Disease Of Hematologic Malignancies, Mark S. Roth, Valeri H. Terry
Application Of The Polymerase Chain Reaction For Detection Of Minimal Residual Disease Of Hematologic Malignancies, Mark S. Roth, Valeri H. Terry
Henry Ford Hospital Medical Journal
Current induction therapies for acute and chronic leukemias and the lymphomas have achieved significant complete remission rates. Despite this initial success, disease recurrence remains a major problem. Relapse from clinically undetectable residual malignant cells is the most likely mechanism of recurrence. Of crucial importance to the clinician is the accurate detection of residual malignant cells prior to clinical relapse. Standard approaches to evaluate for this minimal residual disease (MRD) allow detection only when the malignant clone exceeds 1%. Patients in remission, however, may frequently have residual neoplastic cells that are far below this level. Recently, several investigators have adapted the …
Peripheral Blood Stem Cell Transplantation As An Alternative To Bone Marrow Transplantation: An Overview, Nalini Janakiraman
Peripheral Blood Stem Cell Transplantation As An Alternative To Bone Marrow Transplantation: An Overview, Nalini Janakiraman
Henry Ford Hospital Medical Journal
Stem cells capable of restoring hematopoiesis following lethal bone marrow injury circulate in the blood of many animals, including humans. When collected through leukapheresis and reinfused following high-dose chemotherapy, stem cells offer a treatment option not currently open to some patients who are unable to undergo autologous bone marrow transplantation because of tumor involvement in the pelvis, prior pelvic radiation, or intolerance to general anesthesia. After stem cell infusion, hematologic and immunologic recovery are rapid in comparison to that after autologous hone marrow reinfusion: however, in some cases platelet engraftment is slower. There is some evidence that tumor contamination in …
The Department Of Surgery And The Halsted Tradition, Edward R. Munnell
The Department Of Surgery And The Halsted Tradition, Edward R. Munnell
Henry Ford Hospital Medical Journal
No abstract provided.
Current Issues In The Leukemias, Howard R. Terebelo
Current Issues In The Leukemias, Howard R. Terebelo
Henry Ford Hospital Medical Journal
No abstract provided.
Assessment Of Methylprednisolone Purging Efficacy On Daudi Burkitt Lymphoma Cells From Normal Bone Marrow, Nalini Janakiraman, Loreen M. Niewenhuis
Assessment Of Methylprednisolone Purging Efficacy On Daudi Burkitt Lymphoma Cells From Normal Bone Marrow, Nalini Janakiraman, Loreen M. Niewenhuis
Henry Ford Hospital Medical Journal
Studies on normal bone marrow and Daudi Burkitt lymphoma cells were performed to determine the efficacy of selective, in vitro chemopurging with methylprednisolone (MP). We found that MP reduces the numher of lymphoma cells without significant damage to bone marrow cells. This information is important because we need to improve the existing in vitro purging regimens used to cleanse autologous marrows of metastatic disease before transplantation into cancer patients who have received high-dose chemotherapy. Normal human bone marrow (NBM) and Daudi lymphoma cells were trealed in parallel with various purging regimens. NBM death was evaluated using soft-agar culture, while Daudi …
Porcine Bioprosthetic Aortic Valve Endocarditis With Ring Abscess And Aortic Stenosis, Reda A. Girgis, Howard Rosman, Ramon Del Busto, Maryann Fitzmaurice, Norman A. Silverman
Porcine Bioprosthetic Aortic Valve Endocarditis With Ring Abscess And Aortic Stenosis, Reda A. Girgis, Howard Rosman, Ramon Del Busto, Maryann Fitzmaurice, Norman A. Silverman
Henry Ford Hospital Medical Journal
Porcine bioprosthetic valve endocarditis is an infrequent but serious complication of valve replacement surgery. Ring (or annular) abscess is a frequent finding in mechanical valve endocarditis. In contrast, porcine valve endocarditis most often involves the cusps, and annular infection is uncommon. Porcine valvular dysfunction secondary to endocarditis usually takes the form of incompetence, whereas stenosis is less frequent. We report a case of a 76-year-old female who developed endocarditis wilh Staphylococcus epidermidis nine months after placement of a Carpenter-Edwards porcine aortic valve. Her initial presentation included complete heart block and moderate aortic stenosis. Transesophageal echocardiography aided the diagnosis by demonstrating …
Antimicrobial Chemotherapy In The Intensive Care Unit, Louis D. Saravolatz
Antimicrobial Chemotherapy In The Intensive Care Unit, Louis D. Saravolatz
Henry Ford Hospital Medical Journal
No abstract provided.
Capsaicin: A Therapeutic Option For Painful Diabetic Neuropathy, Karen M. Basha, Fred W. Whitehouse
Capsaicin: A Therapeutic Option For Painful Diabetic Neuropathy, Karen M. Basha, Fred W. Whitehouse
Henry Ford Hospital Medical Journal
Fifteen patients with diabetes mellitus who had painful diabetic neuropalhy (PDN) were enrolled in a double-blind study to test the safety and efficacy of capsaicin 0.075% (Axsain, Genderm, Northbrook, IL). Twelve of the 15 patients completed the eight-week sludy. Nine of the 12 patients reported symptomatic relief; of these nine, five used the drug and four used the vehicle. The three patients who reported no relief of symptoms applied the vehicle. Capsaicin is potentially effective when burning pain is a major symptom of PDN. The side effects of capsaicin were limited and minimal. This agent should be considered by clinicians …
Primary Hyperparathyroidism And Monoclonal Gammopathy, D. Sudhaker Rao, Rosella Antonelli, Kevin R. Kane, John E. Kuhn, Celina Hetnal
Primary Hyperparathyroidism And Monoclonal Gammopathy, D. Sudhaker Rao, Rosella Antonelli, Kevin R. Kane, John E. Kuhn, Celina Hetnal
Henry Ford Hospital Medical Journal
Coexistent primary hyperparathyroidism and monoclonal gammopathy, although rare, has been reported previously by a number of investigators. We report four patients with such an occurrence who were seen between 1976 and 1988. Another patient with primary hyperparathyroidism also had multiple myeloma and was in remission for 12 years. These patients represent approximately 1% of the 386 patients with primary hyperparathyroidism seen during the same 12-year period. Although several mechanisms have been proposed to explain this concurrence, we believe it is the result of a chance occurrence. A review of the literature, an estimate of the chance occurrence of coincidental monoclonal …
Hyperandrogenemia And Virilization With Simultaneous Pituitary And Adrenal Adenomas, Jeffrey A. Jackson, Raymond C. Mellinger
Hyperandrogenemia And Virilization With Simultaneous Pituitary And Adrenal Adenomas, Jeffrey A. Jackson, Raymond C. Mellinger
Henry Ford Hospital Medical Journal
We describe a postmenopausal woman who presented with virilizing hyperandrogenemia and was found to have an intrasellar tumor and a large left adrenal mass. Pathologic studies showed an undifferentiated hypophyseal adenoma with immunostaining for chromogranin only and a benign adrenocortical adenoma. In light of current understanding of the regulation of adrenal androgen secretion and adrenocortical mitogenesis, we postulate that this case may be explained by secretion of adrenal androgen-stimulating and mitogenic factors by the pituitary tumor.
The Phenomenology Of Cushing's Syndrome: One Patient's Account, Andrew Armstrong, J. David Fachnie
The Phenomenology Of Cushing's Syndrome: One Patient's Account, Andrew Armstrong, J. David Fachnie
Henry Ford Hospital Medical Journal
Cushing's syndrome caused by ectopic secretion of adrenocorticotropic hormone (ACTH) is often a serious disease and a diagnostic dilemma. In the reported patient, the source of ACTH proved to he a benign pulmonary carcinoid tumor. The patient describes his trying experiences through the six months from initial diagnosis to definitive therapy.
Cushing's Disease: Dilemmas Of Diagnosis And Management, M. Saeed-Uz-Zafar, Raymond C. Mellinger, Max Wisgerhof
Cushing's Disease: Dilemmas Of Diagnosis And Management, M. Saeed-Uz-Zafar, Raymond C. Mellinger, Max Wisgerhof
Henry Ford Hospital Medical Journal
Determining the cause of Cushing's disease and correcting the abnormality presents a continuing challenge to the clinician despite remarkable advances in diagnostic and therapeutic techniques. We present seven cases to illustrate 1) the classic disorder cured by pituitary adenomectomy: 2) persistence of the disease after adenomectomy: 3) Cushing's disease manifesting in the puerperium and remitting with dopamine agonist therapy: 4) a patient whose disease relapsed at least five times during 20 years of treatment by adrenalectomy, pituitary radiation, mitotane, and pituitary adenomectomy; 5) the Nelson syndrome; 6) the ectopic adrenocorticotropic hormone (ACTH) syndrome in a patient with dexamethasone suppressible urinary …
Human Growth Hormone Treatment: Henry Ford Hospital Experience 1964-1990, David C. Leach
Human Growth Hormone Treatment: Henry Ford Hospital Experience 1964-1990, David C. Leach
Henry Ford Hospital Medical Journal
Treatment with human growth hormone (GH) at Henry Ford Hospital began in 1964 and has included 145 patients. A total of 68 patients were treated with extracted hormone and 77 with recombinant GH. The appearance of Creutzfeldt-Jakob disease, now five cases worldwide, in patients treated with extracted hormone abruptly stopped its use in the United States. The development of recombinant GH in 1985 has resulted in greater availability of treatment. Diagnostic criteria are now more liberal and certain patients without GH deficiency, i.e., those with the Turner syndrome, are now being successfully treated with GH. GH is expensive and its …
A Thyroid Testing Algorithm: Results Of A Pilot Study, Hossam Ibrahim, Malachi J. Mckenna, Carolyn S. Feldkamp
A Thyroid Testing Algorithm: Results Of A Pilot Study, Hossam Ibrahim, Malachi J. Mckenna, Carolyn S. Feldkamp
Henry Ford Hospital Medical Journal
We conducted a pilot study to evaluate an algorithm for thyroid function testing consisting of initial serum thyrotropin values, measured by a sensitive immunoradiometric assay (TSH-IRMA) followed by a computer-directed decision to order further studies. We divided 216 outpatients according to their serum TSH-IRMA values as follows: suppressed (< 0.1 mU/L, group I); low (0.1 to 0.4 mU/L, group II); normal (0.5 to 5.0 mU/L, group III); and high (> 5.0 mU/L, group IV). Thyroxine (T4), resin uptake (RU). and free thyroxine index (FTI) tests on groups I, Il, and IV revealed that T4 and RU were normal for most patients in all groups and FTI was normal in 80% of group 1, 93.4 % of group ll, and 93.3% of …
Disturbances In Lipid Metabolism Associated With Chylothorax And Its Management, Malachi J. Mckenna, Jau-Wen Chu, Dorothy M. Kahkonen
Disturbances In Lipid Metabolism Associated With Chylothorax And Its Management, Malachi J. Mckenna, Jau-Wen Chu, Dorothy M. Kahkonen
Henry Ford Hospital Medical Journal
Changes in circulating lipid status were studied in a 70-year-old woman during management of chylothorax that included chest drainage, pleuroperitoneal shunting, and a successful thoracic duct ligation. Hypolipidemia with a relative decline in high-density lipoprotein (HDL) cholesterol was apparent at presentation. Following recovery, serum HDL cholesterol rose to the upper limit of normal. Apolipoprotein A-l (Apo A-l) was discordantly raised during the period of pleuroperitoneal shunting. We speculate that diversion of chylomicrons to the liver with subsequent hydrolysis accounted for a release of Apo A-l particles into the circulation at a time when the formation of HDL was compromised by …
An Ambulatory Approach To Self-Care Of Diabetes, Fred W. Whitehouse, Iris J. Whitehouse, Mary Sue Cox, Dorothy M. Kahkonen
An Ambulatory Approach To Self-Care Of Diabetes, Fred W. Whitehouse, Iris J. Whitehouse, Mary Sue Cox, Dorothy M. Kahkonen
Henry Ford Hospital Medical Journal
Managing the insulin-requiring diabetic patient in an ambulatory selling includes metabolic regulation of the diabetes and education in its self-care. Means of achieving these goals include structured group or one-on-one individualized sessions. Third party policies relating to ambulatory care are challenged and their need for fiscal support emphasized. During the coming decade, diabetic patients should 1) have access to ambulatory care programs for metabolic regulation and education in self-care. 2) expect third party support of these programs, and 3) heighten their own priorities on diabetes care to ensure quality management of their diabetes.
Vertebral Compression Fractures At The Onset Of Acute Lymphoblastic Leukemia In A Child, M. Beatriz Oliveri, Carlos A. Mautalen, Carlos A. Rodriguez Fuchs, M. Del Carmen Romanelli
Vertebral Compression Fractures At The Onset Of Acute Lymphoblastic Leukemia In A Child, M. Beatriz Oliveri, Carlos A. Mautalen, Carlos A. Rodriguez Fuchs, M. Del Carmen Romanelli
Henry Ford Hospital Medical Journal
A child with acute lymphoblastic leukemia, spinal osteoporosis with vertebral compression fractures, and hypercalcemia appearing early in the course of the hematologic disease was followed for two and a half years. Bone mineral density (BMD). measured by single photon absorptiometry at the radial shaft. was within normal limits for age and sex. However, x-rays of vertebrae and vertebral BMD. measured by dual photon absorptiometiy, showed marked demineralization. Despite leukemic remission, the spinal osteoporosis became worse and the patient required aggressive treatment for eight months. Treatment included 50 units of calcitonin subcutaneously every other day. 1.000 mg/day of oral calcium, and …
Contemporary Approach To Thyroid Disease Emphasizing Use Of High-Sensitivity Thyrotropin Assays, Carolyn S. Feldkamp, Malachi J. Mckenna
Contemporary Approach To Thyroid Disease Emphasizing Use Of High-Sensitivity Thyrotropin Assays, Carolyn S. Feldkamp, Malachi J. Mckenna
Henry Ford Hospital Medical Journal
Capabilities of new high-sensitivity immunoradiometric assays for thyroid-stimulating hormone (TSH-IRMA) to distinguish among hypothyroid, euthyroid, and hyperthyroid subjects and patient groups with low TSH for nonthyroidal causes suggested an algorithmic approach (directed TSH) to the evaluation of patients with suspected thyroid disease. Utilizing the algorithm, a TSH-IRMA result outside normal limits (0.5 to 5.0 mUlL) generates follow-up tests on the same sample. The interpretation of thyroid function tests (TSH-IRMA, thyroxine, resin uptake, free thyroxine index) and associated studies in the context of different clinical settings is reviewed. The approach is a cost-effective and efficient utilization of laboratory services.
Chronic Pancreatitis Progressing To Duodenal Obstruction In The Absence Of Classic Symptoms, John R. Condit Jr., Dominic K. H. Wong
Chronic Pancreatitis Progressing To Duodenal Obstruction In The Absence Of Classic Symptoms, John R. Condit Jr., Dominic K. H. Wong
Henry Ford Hospital Medical Journal
We report the case of a 34-year-old alcoholic who was initially seen in March 1985 because of acute pancreatitis. A mass was demonstrated in the head of the pancreas. Serial sonogram and computed tomography scans over 4 1/2 years revealed progressive encroachment of the duodenum without symptoms attributable to obstruction. In 1989, three separate endoscopies with multiple biopsies showed chronic inflammation and strictures. Hypotonic duodenography confirmed stricture and obstructed duodenum. Surgical intervention is being considered. Duodenal obstruction secondary to chronic pancreatitis is rare. It may proceed subclinically for several years independent of continued alcohol use. Only when obstruction became severe …
Measurement Of Left Ventricular Ejection Fraction Using Gated 99mtc-Sestamibi Myocardial Planar Images: Comparison To Contrast Ventriculography, David A. Parker, Ramon L. Lloret, Francesco Barilla, Lori Douthat, Mihai Gheorghiade
Measurement Of Left Ventricular Ejection Fraction Using Gated 99mtc-Sestamibi Myocardial Planar Images: Comparison To Contrast Ventriculography, David A. Parker, Ramon L. Lloret, Francesco Barilla, Lori Douthat, Mihai Gheorghiade
Henry Ford Hospital Medical Journal
Using the new myocardial perfusion agent 99mTc-sestamibi and multigated acquisition on a nuclear medicine gamma camera, the left ventricular ejection fraction (LVEF) was derived in 13 patients with coronary artery disease (CAD). Cross-sectional activity profiles were used to measure the left ventricle from end-diastolic and end-.systolic images. Several different geometric methods were then utilized to derive ejection fractions from the nuclear data. Comparison of the resultant ejection fractions to those obtained from contrast ventriculography showed significant correlation for all geometric methods (P < 0.01,S y X x = 6.2 to 9.6). We conclude that in patients with CAD one or more of these simple geometric methods can provide a useful estimate of the LVEF when performing 99mTc-sestamibi multigated myocardial perfusion imaging.
Nutrition Support Of Hiv+ Patients, Johanna T. Dwyer
Nutrition Support Of Hiv+ Patients, Johanna T. Dwyer
Henry Ford Hospital Medical Journal
Case management strategies for the nutritional support of patients infected with the human immunodeficiency virus (HIV) are evolving as the disease becomes less rapidly fatal and more chronic. Nutritional status changes in advanced HIV infection are similar in many respects to protein-calorie malnutrition. Current clinical effort and research focuses on the beneficial effects of preserving lean body mass and keeping asymptomatic patients in good nutritional status by preventing micronutrient deficiencies and by treating preexisting nutritional problems rather than attempting to intervene late in the disease's course, after secondary malnutrition has already developed. Nutrition support and intervention trials only late in …