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Echocardiographic Identification Of Left Ventricular Cavity Obliteration, Vidyadhar R. Gandra, Mohsin Alam, Fareed Khaja, Sidney Goldstein, Jeffrey B. Lakier
Echocardiographic Identification Of Left Ventricular Cavity Obliteration, Vidyadhar R. Gandra, Mohsin Alam, Fareed Khaja, Sidney Goldstein, Jeffrey B. Lakier
Henry Ford Hospital Medical Journal
We identified 22 patients with angiographic left ventricular cavity obliteration (LVCO), of whom 15 were available for M-mode and two-dimensional echocardiographic evaluation. All 15 patients had chest pain, and 13 had long-standing hypertension. Electrocardiographic evidence of left ventricular hypertrophy was present in ten patients. The echocardiographic criterion for LVCO was apposition of the left ventricular septum with the left ventricular posterior endocardium during systole as demonstrated by either M-mode or two-dimensional systems. LVCO was demonstrated during systole by M-mode echocardiography in seven of 15 patients and by two-dimensional echocardiography in 14 patients. LVCO could not be demonstrated in ten randomly …
Primary Hyperparathyroidism: The Continuing Saga Of Surgical Problems, Melvin A. Block
Primary Hyperparathyroidism: The Continuing Saga Of Surgical Problems, Melvin A. Block
Henry Ford Hospital Medical Journal
Continuing problems in the management and surgical treatment of primary hyperparathyroidism include the localization of the elusive single tumor, the recognition and management of multiple gland involvement, prompt confirmation and operative treatment for hypercalcemic crisis, delineation of a liberal but selective policy relative to surgery for apparent uncomplicated hyperparathyroidism in the elderly, and recognition of the surgeon's responsibility to determine the extent of the operation on the basis of operative findings, realizing that histologic study may not confirm apparent gross abnormalities despite subsequent clinical recovery. When all four glands are involved in primary hyperparathyroidism, subtotal parathyroidectomy is recommended except for …
Hyperviscosity Syndrome Complicating Rheumatoid Arthritis: Report Of Two Additional Cases And Review Of The Literature, Michael R. Lovy, Mark C. Kranc, Gilbert B. Bluhm, Jeanne M. Riddle, Paul D. Stein
Hyperviscosity Syndrome Complicating Rheumatoid Arthritis: Report Of Two Additional Cases And Review Of The Literature, Michael R. Lovy, Mark C. Kranc, Gilbert B. Bluhm, Jeanne M. Riddle, Paul D. Stein
Henry Ford Hospital Medical Journal
A hyperviscosity syndrome developed in two patients with rheumatoid arthritis. Analytic ultracentrifugation of the sera from one patient demonstrated 22S complexes. Intermediate, 22S, and 31S complexes were found in the second case. Platelet aggregometry and electron microscopy surveys of the platelet reactivity in one patient demonstrated inhibition of platelet reactivity caused by the presence of the high molecular weight complexes. These abnormalities, as well as the clinical bleeding, whole blood, and plasma viscosity, became normal after treatment. In vivo leukocytic function was studied with the Rebuck skin window technique, and phagosomal inclusions were observed in both the polymorphonuclear neutrophils and …
Re: Abbs, Conrad R. Lam
The Measurement Of Human Chorionic Gonadotropin For Pregnancy Testing, Carolyn S. Feldkamp, William H. Pfeffer
The Measurement Of Human Chorionic Gonadotropin For Pregnancy Testing, Carolyn S. Feldkamp, William H. Pfeffer
Henry Ford Hospital Medical Journal
/Among many measurable hormones, human chorionic gonadotropin (FICG) is commonly used for pregnancy testing because it is very sensitive and relatively specific. Pregnancy can be identified shortly after implantation. Because some reagents cross-react with luteinizing hormone (LH), the sensitivity of urine tests has been adjusted to maintain specificity. Radioreceptor assay s on serum are more sensitive than urine tests but similarly lack specificity. The problems of LH cross-reactivity are eliminated by antisera specific for the beta subunit. Quantitation of HCG provides additional information useful in diagnosing ectopic pregnancy, providing a prognosis in threatened abortion, and following neoplasms. Considerations of cost, …
Studies On Porcine Bioprosthetic Heart Valves At Henry Ford Hospital: An Overview, Paul D. Stein
Studies On Porcine Bioprosthetic Heart Valves At Henry Ford Hospital: An Overview, Paul D. Stein
Henry Ford Hospital Medical Journal
No abstract provided.
Natural History Of The Porcine Bioprosthetic Heart Valve, Donald J. Magilligan Jr., Joseph W. Lewis Jr., J. Lancelot Lester Iii, Paul D. Stein, Mohsin Alam, Jeffrey B. Lakier, Julio C. Davilia, David W. Smith
Natural History Of The Porcine Bioprosthetic Heart Valve, Donald J. Magilligan Jr., Joseph W. Lewis Jr., J. Lancelot Lester Iii, Paul D. Stein, Mohsin Alam, Jeffrey B. Lakier, Julio C. Davilia, David W. Smith
Henry Ford Hospital Medical Journal
The porcine bioprosthesis has been the prosthetic valve of choice at Henry Ford Hospital since October 1971. By 1979, 23 cases of degeneration had been seen, and the rate seven years after implantation was 16%. Now, with a ten-year follow-up, there are 41 degenerated valves. After seven years, the percent free of degeneration is 88%, (SE of 2% [standard error]); at eight years, 82% (SE of 2.9%,); at nine years, 80% (SE of 3.4%); and at ten years, the percent free of degeneration is 69% (SE of 6.5%,). There was no difference in degeneration between men and women, between aortic …
Echocardiographic Evaluation Of Porcine Bioprosthetic Valve Degeneration, M. Alam, J. B. Lakier, S. Goldstein
Echocardiographic Evaluation Of Porcine Bioprosthetic Valve Degeneration, M. Alam, J. B. Lakier, S. Goldstein
Henry Ford Hospital Medical Journal
Spontaneous cusp degeneration is one of the most common long-term complications associated with porcine bioprosthetic valves (1-6). Recognition of its occurrence is essential for appropriate management to be instituted. In this report we have reviewed our echocardiographic experience with porcine bioprosthetic valve degeneration (7-8).
Frequency Content Of Heart Sounds And Systolic Murmurs In Patients With Porcine Bioprosthetic Valves: Diagnostic Value For The Early Detection Of Valvular Degeneration, Paul D. Stein, Hani N. Sabbah, Jeffrey B. Lakier, Stephen R. Kemp, Donald J. Magilligan Jr.
Frequency Content Of Heart Sounds And Systolic Murmurs In Patients With Porcine Bioprosthetic Valves: Diagnostic Value For The Early Detection Of Valvular Degeneration, Paul D. Stein, Hani N. Sabbah, Jeffrey B. Lakier, Stephen R. Kemp, Donald J. Magilligan Jr.
Henry Ford Hospital Medical Journal
The frequency content of heart sounds and murmurs in patients with implanted bioprosthetic valves may reveal evidence of degenerative changes before such changes are clinically apparent. An increased dominant frequency of the heart sound caused by a bioprosthetic valve in either the aortic or mitral positions suggests stiffening of the leaflets. While a musical systolic murmur of a bioprosthetic valve in the mitral position suggests flutter from a torn, insufficient leaflet, limited observations of musical systolic murmurs in the aortic position do not seem to indicate a degenerated valve.
Fluid Dynamic Stresses In The Region Of A Porcine Bioprosthetic Valve, Hani N. Sabbah, Paul D. Stein
Fluid Dynamic Stresses In The Region Of A Porcine Bioprosthetic Valve, Hani N. Sabbah, Paul D. Stein
Henry Ford Hospital Medical Journal
Mechanical forces caused by the dynamics of blood flow in the region of porcine bioprosthetic valves may directly injure the valve as well as formed elements of the blood. Previous in vitro studies in our laboratory evaluated quantitatively the fluid dynamic stresses in the region of such valves. In this paper we discuss our results in relation to fluid dynamic stresses found in patients with normal and diseased natural aortic valves. The levels of fluid dynamic stresses that may produce mechanical injury to erythrocytes and platelets are reviewed. These may indicate the extent to which fluid dynamic stresses may activate …
Observations Suggesting A Possible Link Between Gammacarboxyglutamic Acid And Porcine Bioprosthetic Valve Calcification, Joseph A. Helpern, Stephen J. Mcgee, Jeanne M. Riddle
Observations Suggesting A Possible Link Between Gammacarboxyglutamic Acid And Porcine Bioprosthetic Valve Calcification, Joseph A. Helpern, Stephen J. Mcgee, Jeanne M. Riddle
Henry Ford Hospital Medical Journal
Observations that link gammacarboxyglutamic acid (Gla) peptides with ectopic calcification are accumulating in the literature and may be summarized as follows: 1) Gla peptides selectively bind calcium and hydroxyapatite. 2) The presence of detectable levels of Gla in calcified tissue is concurrent with the onset of mineralization. 3) In an animal model, osteocalcin (a Gla-containing protein) accounts for more than 90% of all the Gla found in the resulting subcutaneously implanted calcified leaflet. 4) Vitamin D stimulates osteocalcin synthesis in cultures of osteosarcoma cells, and in vitamin D deficient rats subcutaneously implanted valve leaflets are not calcified. 5) Gla content …
Assessment Of The Orifice Area Of Bioprosthetic Valves By Orifice-View Roentgenography, Paul D. Stein, James F. Brymer, Daniel T. Anbe, Hani N. Sabbah, Gordon M. Folger Jr.
Assessment Of The Orifice Area Of Bioprosthetic Valves By Orifice-View Roentgenography, Paul D. Stein, James F. Brymer, Daniel T. Anbe, Hani N. Sabbah, Gordon M. Folger Jr.
Henry Ford Hospital Medical Journal
Orifice-view angiography permits us to visualize en face the orifice of the aortic or mitral valve. The radiopaque annulus of bioprosthetic valves assists in permitting the angiographer to position the patient exactly, so that the valve can be seen as if looking directly into the orifice. Orifice-view angiography of porcine bioprosthetic valves has been useful in assessing the size and configuration of the valve orifice. It can reveal a failure of leaflet opening that would indicate degeneration, even when hemodynamic measurements remain equivocal.
A Morphologic Overview Of The Porcine Bioprosthetic Heart Valve, Jeanne M. Riddle, Paul D. Stein, Donald J. Magilligan Jr.
A Morphologic Overview Of The Porcine Bioprosthetic Heart Valve, Jeanne M. Riddle, Paul D. Stein, Donald J. Magilligan Jr.
Henry Ford Hospital Medical Journal
The glutaraldehyde-processed porcine aortic heart valve is similar in its microscopic organization to the human aortic valve (1). It is important to understand the detailed histology of this bioprosthetic valve because distinct components of its leaflets are altered selectively when the valve is initially collected from the pig and stabilized with the commercial glutaraldehyde fixation process. Further structural modifications also occur after the commercially processed valve has been inserted into a patient where it undergoes progressive degeneration.
Immunological Involvement In Porcine Bioprosthetic Valve Degeneration: Preliminary Studies, Rollin H. Heinzerling, Paul D. Stein, Jeanne M. Riddle, Donald J. Magilligan Jr., John J. Jennings
Immunological Involvement In Porcine Bioprosthetic Valve Degeneration: Preliminary Studies, Rollin H. Heinzerling, Paul D. Stein, Jeanne M. Riddle, Donald J. Magilligan Jr., John J. Jennings
Henry Ford Hospital Medical Journal
Preliminary animal model studies have indicated that porcine bioprosthetic valves can be recognized by the immune system. This report presents the results of a preliminary investigation on the implanted valves of 27 patients. While none of the 27 demonstrated an immune response to porcine serum proteins, five patients developed antibodies against the implanted valve leaflets. Cells were enzymatically eluted from a degenerated bioprosthetic valve and were classified by means of monoclonal antibodies. Although these cells were not found to be of T-lymphocyte lineage, they did express la determinants and had the morphologic appearance of plasma cells. We therefore conclude that …
The Surgeon And The Patient With Cancer: The Development Of Surgical Oncology, Angelos A. Kambouris
The Surgeon And The Patient With Cancer: The Development Of Surgical Oncology, Angelos A. Kambouris
Henry Ford Hospital Medical Journal
No abstract provided.
Medical Grand Rounds: Open And Closed Loop Insulin Delivery Systems In Diabetes: Current Status, F. John Service
Medical Grand Rounds: Open And Closed Loop Insulin Delivery Systems In Diabetes: Current Status, F. John Service
Henry Ford Hospital Medical Journal
No abstract provided.
Effects Of Tetracycline On Fecal Bile Acid Pool Composition In A Human: A Preliminary Report, Jerome R. Waldbaum, William T. Beher, Robert J. Priest, Sofia Stradnieks
Effects Of Tetracycline On Fecal Bile Acid Pool Composition In A Human: A Preliminary Report, Jerome R. Waldbaum, William T. Beher, Robert J. Priest, Sofia Stradnieks
Henry Ford Hospital Medical Journal
We studied the effect of tetracycline on bile acid pool composition in a human subject. A dosage of 250 mg (qid) of tetracycline for one week completely eliminated deoxycholic and lithocholic acid from the pool. Tetracycline may be of value for limiting the build-up of lithocholic acid in patients who are treated with chenodeoxycholic acid to dissolve gallstones.
Clinical Note: Use Of Clonidine To Detoxify Opiate-Addicted Patients, Dennis L. Caffrey, Tai P. Yoo
Clinical Note: Use Of Clonidine To Detoxify Opiate-Addicted Patients, Dennis L. Caffrey, Tai P. Yoo
Henry Ford Hospital Medical Journal
This study investigated the utility of systematically administering clonidine to detoxify opiate-dependent inpatients. Fifteen patients received a 0.1 mg dose of clonidine orally at 8:00 am, 12:00 noon, 4:00 pm, and at bedtime. A 0.1 mg dose was also administered as needed if any withdrawal signs were evidenced, but this additional dose was rarely needed after the second day of treatment. Night sweats were the only significant complaint reported. All 15 patients were successfully detoxified after ten days of treatment.
Chronic Idiopathic Thrombocytopenic Purpura: Effective Preoperative Preparation And Long-Term Results Of Splenectomy, James C. Gruenberg, Melvin A. Block, Ellis J. Van Slyck, Joseph P. Abraham
Chronic Idiopathic Thrombocytopenic Purpura: Effective Preoperative Preparation And Long-Term Results Of Splenectomy, James C. Gruenberg, Melvin A. Block, Ellis J. Van Slyck, Joseph P. Abraham
Henry Ford Hospital Medical Journal
A retrospective review of 98 patients seen at Henry Ford Hospital from 1953 through 1977 demonstrated that splenectomy for chronic idiopathic thrombocytopenic purpura provided a good response which usually was sustained on long-term follow-up (72% at 15 years). Although splenectomy for this condition had a low mortality, morbidity was significant in patients older than 40 years. When compared to patients whose response to splenectomy was sustained, patients who relapsed had significantly lower platelet counts preoperatively both when they were untreated (mean: 9,194 per cc versus 18,524 per-cc) and/or when they were treated with steroids (mean: 85,647 per cc versus 142,590 …
Familial Hypokalemic Periodic Paralysis In Blacks, Jack M. Bernstein, Michael Kleerekoper
Familial Hypokalemic Periodic Paralysis In Blacks, Jack M. Bernstein, Michael Kleerekoper
Henry Ford Hospital Medical Journal
Hypokalemic periodic paralysis is an uncommon disease that has rarely been reported in blacks. Historical, clinical, and pathological findings in three black patients, in addition to those previously reported in the literature, suggest that the spectrum of the disease is identical in both blacks and whites. Considering the disease as either different or unknown in the black population is probably not justified.
Acid Phosphatase: Clinical Utility Of The First Tumor Marker, Christopher J. Dipaolo, Jan Rival
Acid Phosphatase: Clinical Utility Of The First Tumor Marker, Christopher J. Dipaolo, Jan Rival
Henry Ford Hospital Medical Journal
Acid phosphatase was the first tumor marker to be measured in blood. Although it is used as a marker of prostatic carcinoma, serum levels are also elevated in many diseases of prostate, bone, and hematologic tissue. While serum acid phosphatase concentration is elevated in patients with prostatic carcinoma or infarction, it may also be increased merely with benign hypertrophy and after prostate massage. Recent studies demonstrate that levels are not significantly increased after routine rectal examination. Although of limited use as a screening test, the assay may be useful in staging, prognostication during hormonal therapy, and in making clinical decisions. …
Effect Of Levamisole On The Incidence Of Spontaneous Mammary Tumors In C3h Mice, Robert H. Page, Duilio A. Valdivia, Robert W. Talley, Robert A. Huseby
Effect Of Levamisole On The Incidence Of Spontaneous Mammary Tumors In C3h Mice, Robert H. Page, Duilio A. Valdivia, Robert W. Talley, Robert A. Huseby
Henry Ford Hospital Medical Journal
Spontaneous mammary carcinoma in C3H mice is preceded by premalignant hyperplastic alveolar nodules. When a primary tumor is evident, examination of the other mammae will reveal a number of microscopic precancerous lesions in various stages of transformation to overt malignant tumors. In an effort to inhibit the development of additional malignant tumors after surgical removal of the first apparent tumor, we treated female C3H/HeJ mice with subcutaneous injections of levamisole (0.6 mg per kg of body weight) on a twice weekly regimen. All further tumors were surgically excised when they became palpable. The surgical excision of bulk tumor burden, immunorestoration …
Medullary Carcinoma Of The Thyroid With Bone Metastasis, Sheldon S. Stoffer, Sidney D. Kobernick, Richard M. Zirkin, Stuart W. Hamburger, Susan E. Harold
Medullary Carcinoma Of The Thyroid With Bone Metastasis, Sheldon S. Stoffer, Sidney D. Kobernick, Richard M. Zirkin, Stuart W. Hamburger, Susan E. Harold
Henry Ford Hospital Medical Journal
A woman with medullary carcinoma of the thyroid and a past history of breast cancer was found to have metastatic bone lesions. It was initially assumed that this was due to recurrent breast carcinoma, but bone biopsy revealed medullary carcinoma of thyroid origin. Although clinical bone metastasis is a rare event in patients with medullary carcinoma, quite clearly such an occurrence is possible. Medullary carcinoma should be considered in the differential diagnosis of patients with metastatic bone lesions.
The Central Surgical Association Turns Forty: Some Highlights Of The First Twenty Years, Conrad R. Lam
The Central Surgical Association Turns Forty: Some Highlights Of The First Twenty Years, Conrad R. Lam
Henry Ford Hospital Medical Journal
The Central Surgical Association assembled for the first time in Detroit and Ann Arbor, Michigan in February, 1941. On the 40th anniversary of this meeting, the Association met again in the same geographical region, in Dearborn. Selected papers from the first twenty years have been chosen as highlights. Criteria for choosing a few from many significant papers were the originality of the material, its time-proven value, and the subsequent impressive careers of the authors. Appropriate credit is given to Dr. Roy D. McClure for his concept of an organizadon of surgeons in the central geographical area and for his efficient …
Compression Of The Duodenum By The Root Of The Mesentery, Peter A. Haas, Jawaid Akhtar, Lester Kobylak
Compression Of The Duodenum By The Root Of The Mesentery, Peter A. Haas, Jawaid Akhtar, Lester Kobylak
Henry Ford Hospital Medical Journal
Compression of the duodenum by the root of the mesentery is a rare pathological entity that has caused much controversy because it has been mistakenly identified as the "superior mesenteric artery syndrome" or the "vascular compression of the duodenum." We discuss the pathological anatomy and the diagnosis of the disease, and report an illustrative case. Some authors report many cases of the syndrome, while others doubt its existence. Before surgery is considered, the diagnosis should be established beyond doubt and a prolonged period of observation, medical treatment, and nutritional support should be provided. The barium contrast swallowing test combined with …