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Full-Text Articles in Medicine and Health Sciences

The Role Of Splenectomy In Endocarditis, Donald J. Magilligan Jr., Edward L. Quinn Mar 1983

The Role Of Splenectomy In Endocarditis, Donald J. Magilligan Jr., Edward L. Quinn

Henry Ford Hospital Medical Journal

Five patients with endocarditis, persistent sepsis, and positive liver-spleen scans underwent splenectomy. Three had splenectomy performed concomitantly with cardiac valve replacement, one after valve replacement and one as an isolated procedure. Four of five spleens contained abscesses, and bacterial cultures of two were positive. Histologic study of one spleen revealed splenitis. All patients improved after splenectomy, and all are well two to twenty months postoperatively. An aggressive approach to splenic abscess in endocarditis may lead to reduced mortality from bacterial endocarditis and infected prosthetic valves.


Therapeutic Hemapheresis, Sheikh M. Saeed, B. K. S. Raman Mar 1983

Therapeutic Hemapheresis, Sheikh M. Saeed, B. K. S. Raman

Henry Ford Hospital Medical Journal

No abstract provided.


Editorials Mar 1983

Editorials

Henry Ford Hospital Medical Journal

No abstract provided.


Back Matter Mar 1983

Back Matter

Henry Ford Hospital Medical Journal

No abstract provided.


Front Matter Dec 1982

Front Matter

Henry Ford Hospital Medical Journal

No abstract provided.


Echocardiographic Identification Of Left Ventricular Cavity Obliteration, Vidyadhar R. Gandra, Mohsin Alam, Fareed Khaja, Sidney Goldstein, Jeffrey B. Lakier Dec 1982

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 Dec 1982

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 Dec 1982

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 Dec 1982

Re: Abbs, Conrad R. Lam

Henry Ford Hospital Medical Journal

No abstract provided.


The Measurement Of Human Chorionic Gonadotropin For Pregnancy Testing, Carolyn S. Feldkamp, William H. Pfeffer Dec 1982

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, …


Back Matter Dec 1982

Back Matter

Henry Ford Hospital Medical Journal

No abstract provided.


Front Matter Sep 1982

Front Matter

Henry Ford Hospital Medical Journal

No abstract provided.


Studies On Porcine Bioprosthetic Heart Valves At Henry Ford Hospital: An Overview, Paul D. Stein Sep 1982

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 Sep 1982

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 Sep 1982

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. Sep 1982

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 Sep 1982

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 Sep 1982

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. Sep 1982

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. Sep 1982

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 Sep 1982

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 Sep 1982

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 Sep 1982

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 Sep 1982

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 Sep 1982

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.


Editorials Sep 1982

Editorials

Henry Ford Hospital Medical Journal

No abstract provided.


Front Matter Jun 1982

Front Matter

Henry Ford Hospital Medical Journal

No abstract provided.


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 Jun 1982

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 Jun 1982

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 Jun 1982

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. …