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Front Matter

Henry Ford Hospital Medical Journal

No abstract provided.

Quality Of Life: What Does It Mean?, Joyce A. Deshano

Henry Ford Hospital Medical Journal

No abstract provided.

Palliative Care In The 1990s: Special Issues, Derek Doyle

Henry Ford Hospital Medical Journal

No abstract provided.

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.

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 …

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 …

The Department Of Surgery And The Halsted Tradition, Edward R. Munnell

Henry Ford Hospital Medical Journal

No abstract provided.

Back Matter

Henry Ford Hospital Medical Journal

No abstract provided.

Hospice Care: An Overview, Josefina B. Magno

Henry Ford Hospital Medical Journal

No abstract provided.

The Accuracy Of Sonographic Imaging (Dolphintm Digigraph) And Standard Lateral Cephalometric Radiographs : A Comparative Study, Michael D. Teichman

Loma Linda University Electronic Theses, Dissertations & Projects

Radiation due to x-ray exposure is a concern, and the development of the Dolphin™ DigiGraph represents an attempt to limit this exposure. The purpose of this paper was to compare measurements (using Ricketts analysis) obtained from conventional radiographic cephalometric tracings with those obtained by computerized digitizing with the DigiGraph. Forty-six patients from the Loma Linda University School of Dentistry graduate orthodontic clinic were digitized, and the results were compared to the x-ray tracings of these patients. The results showed that seven of the twenty-one variables examined exhibited a statistical similarity between the two methods (DigiGraph and x-ray tracing). An examination …

The Use Of Corrected Occlusal X-Ray For Determination Of Ald : A Comparative Study, Merlin D. Ekvall

Loma Linda University Electronic Theses, Dissertations & Projects

In this study arch length discrepancy or ALD was studied in 50 untreated patients. The measurements obtained from Hilgers' corrected occlusal x-ray using his Occlusal Paralleling Instrument or O.P.I, were compared with those derived by four conventional methods, - "Eye balling," digital caliper determination, conventional mandibular x-ray, and the Rocky Mountain Data Systems computer analysis (31 cases). When using the OPI, results give a higher negative ALD as it takes into consideration the space required to level a curve of Spee.

Measurements were made by the author and 3 faculty members using the above methods. Statistical analysis of the means …

Fulminant Hepatic Failure With Typhoid Fever In Childhood, Z A. Bhutta

Department of Paediatrics and Child Health

Although hepatic dysfunction has been described among adults with typhoid, there are few reports of significant hepatic functional impairment in children with typhoid. Of 355 children with culture proven typhoid seen at the Aga Khan University Hospital, hepatomegaly was noted in 118 (33%) and isolated right hypochondrial tenderness in 30 (8.5%). The liver function tests were normal in 78% and 47% of these children respectively and significant hepatic dysfunction was seen only in 26 (7.3%). However, children with typhoid and significant hepatic dysfunction had higher mortality (P less than 0.001) and two patients presented with a picture of fulminant hepatic …

Successful Eradication Of Flavobacterium Meningosepticum Neonatal Meningitis With Ceftizoxime, Z A. Bhutta, S H. Naqvi

Department of Paediatrics and Child Health

No abstract provided.

Effect Of Delays In Processing On The Survival Of Mycobacterium Avium-M. Intracellulare In The Isolator Blood Culture System., C. Fordham Von Reyn, Stephen Hennigan, Sandra Niemczyk, Nicholas J. Jacobs

Dartmouth Scholarship

Concentrations of Mycobacterium avium-M. intracellulare ranging from 10(-1) to 10(3) CFU/ml were added to blood, placed in Isolator tubes, and held at room temperature for intervals ranging from 4 h to 56 days before being processed (centrifugation and culture on Middlebrook 7H10 agar). At all concentrations tested, M. avium-M. intracellulare was recovered after hold times ranging from 4 h to 7 days; the number of final CFU actually increased progressively for hold times of 8 h or more. Hold times of up to 7 days did not increase the time from processing to the first appearance of visible colonies. At …

Efficient Immortalization Of Luminal Epithelial Cells From Human Mammary Gland By Introduction Of Simian Virus 40 Large Tumor Antigen With A Recombinant Retrovirus, Bartek J, Bartkova J, Kyprianou N, El-Nasir Lalani, Staskova Z, Shearer M, Chang S, Taylor Papadimitriou J

Department of Pathology and Laboratory Medicine

When defined in terms of markers for normal cell lineages, most invasive breast cancer cells correspond to the phenotype of the common luminal epithelial cell found in the terminal ductal lobular units. Luminal epithelial cells cultured from milk, which have limited proliferative potential, have now been immortalized by introducing the gene encoding simian virus 40 large tumor (T) antigen. Infection with a recombinant retrovirus proved to be 50-100 times more efficient than calcium phosphate transfection, and of the 17 cell lines isolated, only 5 passed through a crisis period as characterized by cessation of growth. When characterized by immunohistochemical staining …

Digest Of The Philadelphia College Of Osteopathic Medicine (Spring 1991), Philadelphia College Of Osteopathic Medicine

Digest

The Spring 1991 issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• President’s Perspective
• A Role Model for the Profession
• Founders Day 1991 Highlights
• More News From the Gulf
• A Double Header:
• A Tale of Two
• Team Physicians
• “Tell Me Where It Hurts” - Students Refine Skills
• On Campus
• Alumni News
• Coming Events

Development And Characterization Of Monoclonal Antisperm Antibodies: Potential For Contraception, Dilrowshan H. Haque

Theses and Dissertations in Biomedical Sciences

There is an expressed need to develop a greater variety of safe contraceptive methods which would find acceptance worldwide, particularly in developing countries. Immunization against spermatozoa might be such a method as judged by the accumulated evidence from studies on human females and in a number of female animal species.

Two extraction techniques were used for sperm membrane antigen isolation. The first technique involved NP-40 detergent for antigen extraction from human motile sperm and the second technique employed homogenized human testis for antigen extraction. Using these immunogens, sperm membrane-specific monoclonal antibodies (MAbs) were developed. When these antisperm MAbs were subjected …

Ua12/2/1 Magazine, Wku Student Affairs

WKU Administration Documents

Special magazine edition of the College Heights Herald:

• Poore, Chris. Silent Escape – Amy Deputy, Bulimia

Regulation Vs. The Market: The Case Of Bicycle Safety (Part Ii), Ross D. Petty

RISK: Health, Safety & Environment (1990-2002)

In this part, Professor Petty examines bicycle Risk in detail, comparing the accomplishments of the CPSC's bicycle standard with market forces resulting in, e.g., the development and use of hardshell bicycle helmets. Moreover, he briefly discusses the role of tort liability in managing Risk. Ultimately he concludes that, in the case of bicycle safety, regulation has failed to be as effective as other forces tending to reduce bicycle injuries. [Part I appears at 77.]

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 …

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 …

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 …

Back Matter

Henry Ford Hospital Medical Journal

No abstract provided.

Front Matter

Henry Ford Hospital Medical Journal

No abstract provided.

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 …

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.

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 …

Epidural Spinal Cord Compression From Metastatic Cancer: Clinical Features And Management, H Shaheen, S Abubakar, I Malik, I Altafullah, F Alam, A Khan

Section of Nephrology

We retrospectively analyzed thirty-three patients (21 males, 12 females) with malignancy induced spinal cord compression (SCC). The mean age of the patients was 42.8 years and almost half (51%) of them presented with SCC. Mean duration of symptoms was 4.5 months and the mean interval between the original diagnosis of cancer and the development of SCC was 14.6 months. Back pain was the most frequent (97%) symptom with an equal number of patients having subjective or objective evidence of lower limb weakness. Majority (73%) of the patients were non-ambulatory at the time of diagnosis. Spinal level involvement was mostly thoracic …

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

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 …