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Metastatic Carcinoma Of The Jaws: Report Of A Case, Jack L. Clark

Henry Ford Hospital Medical Journal

Primary malignant tumors of the mouth and jaws usually do not present a diagnostic challenge to oral surgeons or otolaryngologists. However, recognition of metastatic tumors in the mouth and jaws is much more difficult. A case is presented of metastatic carcinoma from the lung to the soft tissue of the oral cavity. Histopathology of the lesions in the lung and oral cavity as well as the chest x-ray and the Panorex x-ray are presented. The patient refused palliative treatment, became malnourished, and died. A review of the pertinent literature is also presented.

Management Of Voice Disorders, Alex F. Johnson, Barbara H. Jacobson, Michael S. Benninger

Henry Ford Hospital Medical Journal

Voice disorders are commonly seen in general medical practice. In some cases voice disorders represent the presenting symptom for serious underlying disease. It is important for clinicians from internal medicine, pediatrics, and family practice to be able to identify those factors in the history or observed vocal symptoms which suggest need for referral for comprehensive voice evaluation as well as to understand the distinct but complementary roles of the specific disciplines (otolaryngology and speech-language pathology) involved in diagnosis and treatment of patients with voice disorders.

The Bouveret Syndrome: An Unusual Cause Of Hematemesis, Alaa A. Salah-Eldin, Mostafa A. H. Ibrahim, Ravindra Alapati, Saleh Muslah, Timothy T. Schubert, Bernard M. Schuman

Henry Ford Hospital Medical Journal

Gallstones are usually silent. Less commonly, patients with cholelithiasis develop symptoms and/or complications; biliary fistula occurs in 3% to 5% of the cases. When a large stone is passed and occludes the duodenum, gastric outlet obstruction (the Bouveret syndrome) may result. In reported cases, the stones are usually larger than 2.5 cm. The usual presenting symptoms are those of bowel obstruction: abdominal pain, nausea, and vomiting. Less commonly, the patients experience melena and, rarely, hematemesis. We describe a patient who had the largest stone reported to cause hematemesis rather than bowel obstruction and to be diagnosed endoscopically. The 5 X …

Variability Of Quantitative Sensory Testing: Implications For Clinical Practice, Janice Redmond, Didier Cros, Bhagwan T. Shahani

Henry Ford Hospital Medical Journal

The conventional estimation of motor, sensory, and mixed nerve conduction velocities reflects activity in the fastest conducting, heavily myelinated nerve fibers that are only a small proportion of the total. Unmyelinated and thinly myelinated fibers are not evaluated by this technique and numerically represent the largest group of fibers in human cutaneous nerves. The availability of new quantitative techniques to study this aspect of sensory function is an important addition to standard electrodiagnosis. Patient understanding and cooperation is essential because subjective responses are evaluated. We evaluated a reference range for 20 healthy subjects as well as variability on repeated testing. …

Systemic Dissemination Of Pneumocystis Carinii In A Patient With Acquired Immunodeficiency Syndrome, Mahul B. Amin, Michael P. Abrash, Eugene Mezger, Gary F. Sekerak

Henry Ford Hospital Medical Journal

Pneumocystis carinii is usually considered a respiratory tract pathogen; however, there are reported cases of limited and generalized dissemination of the organism from the lungs of immunocompromised patients. We present the autopsy findings of a 29-year-old male with acquired immunodeficiency syndrome (AIDS) and recurrent Pneumocystis carinii pneumonia who developed abnormal liver function tests. The patient had received aerosolized pentamidine because of toxic reactions to other modes of therapy. The postmortem examination revealed Pneumocystis in the lungs, liver, spleen, kidney, myocardium, thymus, pancreas, thyroid gland, bilateral parathyroid and adrenal glands, gastrointestinal mucosa, perihilar and mesenteric lymph nodes, and bone marrow. A …

Single Coronary Artery, Guo Jingxuan, Mao Jieming, Yan Weidong, Liu Changjiang, Chen Mingzhe

Henry Ford Hospital Medical Journal

No abstract provided.

Practical Value Of Echo Doppler Evaluation Of Aortic And Mitral Stenosis: A Comparative Study With Cardiac Catheterization, Jihad Bitar, Lori Douthat, Mohsin Alam, Howard S. Rosman, Mark Lebeis, Sidney Goldstein, Fareed Khaja

Henry Ford Hospital Medical Journal

This retrospective analysis compares data derived by echocardiography and cardiac catheterization in the evaluation of aortic and mitral valve stenosis. Sixty-seven patients, aged 69 ± 12 years, underwent 76 catheterization procedures. In all studies the Doppler recording was technically adequate. In 64 studies of patients with aortic stenosis, correlation was good between the gradient obtained at catheterization (peak 51 ± 28 mm Hg, mean 48 ± 24 mm Hg) and the Doppler gradient (peak 73 ± 29 mm Hg, mean 41 ±17 mm Hg) (R = 0.78 peak, 0.77 mean). In 15 studies the aortic valve area, 0.8 ± 0.2 …

C. Paul Hodgkinson, Md, Dorothy Porter

Henry Ford Hospital Medical Journal

No abstract provided.

Functional Endoscopic Sinus Surgery: Morbidity And Early Results, Michael S. Benninger, Samuel A. Mickelson, Kathleen Yaremchuk

Henry Ford Hospital Medical Journal

Functional endoscopic sinus surgery is a new alternative to conventional sinus surgery as a means of managing recalcitrant sinus disease. This approach to sinus pathology focuses on the importance of the functional ostiomeatal complex and anterior ethmoid sinuses in the pathogenesis of sinus disease. In an effort lo assess the morbidity and initial results of this procedure, 85 cases were reviewed. A total of 82% of the patients had bilateral maxillary and ethmoid sinusitis, and 45% had pansinusitis, frequently associated with allergic rhinitis (56%) and nasal polyps (58%). A total of 82% of the patients were operated on as outpatients …

Sensorineural Hearing Loss And The Diagnosis Of Acoustic Neuroma, Edwin M. Monsell, Jack P. Rock

Henry Ford Hospital Medical Journal

Sensorineural hearing loss and tinnitus are gradually receiving more attention in medicine due to advances in diagnosis and treatment. Acoustic neuromas can now be detected when they are small, and early microsurgical removal results in the lowest overall morbidity. We examine the historical development of acoustic neuroma management, discuss current diagnosis and treatment, and present illustrative cases from our recent experience. Complaints of tinnitus and hearing loss, especially when unilateral, require appropriate medical evaluation.

Hemangiomas Of The Nasal Septum And Paranasal Sinuses, Lisa Marie Sheppard, Samuel A. Mickelson

Henry Ford Hospital Medical Journal

Hemangiomas of the nasal septum and paranasal sinuses are rare; only 62 cases of septal hemangiomas and 32 cases of maxillary sinus/maxilla hemangiomas have been reported in the English literature. Hemangiomas should be considered in the differential diagnosis of any nasal mass lesion because biopsy may result in profuse bleeding and even death. We report the clinical presentation, differential diagnosis, etiology, and histologic appearance of paranasal sinus hemangiomas occurring in four of our patients.

Abnormal Coagulation Profiles In Tonsillectomy And Adenoidectomy Patients, Jonathan L. Schmidt, Kathleen L. Yaremchuk, Samuel A. Mickelson

Henry Ford Hospital Medical Journal

Preoperative coagulation profile screening is routinely performed in otolaryngology before tonsillectomy and adenoidectomy surgery in the United States. Recently there has been controversy as to whether this routine testing is necessary. To evaluate the need for this testing, we reviewed a series of patients with particular attention to abnormal coagulation profiles. Of 91 consecutive patients undergoing tonsillectomy, adenoidectomy, or both, four had abnormal preoperative coagulation profiles. Of these patients, one had von Willebrand disease, one had hypofibrinoginemia, and two had a transient acquired lupus-like anticoagulant. The latter condition, which causes a temporary prolongation of the activated partial thromboplastin time, is …

Infant Hearing Screening 1984 To 1989: The Henry Ford Hospital Experience, Gary P. Jacobson, Mary Jo Burtka, Jeanne A. Wharton, Craig W. Newman, Neil Shepherd, Robert G. Turner

Henry Ford Hospital Medical Journal

From 1984 to 1989 the Infant Hearing Screening (IHS) program at Henry Ford Hospital identified 1,300 infants as being "at risk" for hearing loss. The prevalence of significant sensorineural hearing loss in this sample was 1.4%. Additionally, 80 infants who passed the IHS program and reached 3 years of age were found to have normal hearing sensitivity by conventional audiometric techniques (ie, no false-negative predictions). There were three false-positive predictions. It was discovered that infants of low birthweight (ie, < 1,500 g) were three times more likely to fail IHS than those whose weight exceeded 1,500 g. A higher return rate was found for infants failing an initial hearing screening conducted in the neonatal intensive care unit in comparison to those screened as outpatients one week postdischarge. The sensitivity and specificity of behavioral observation audiometry were 43% and 92%, respectively, when brainstem auditory-evoked potentials was used as the criterion validity measure.

Cocaine-Induced Hepatonephrotoxicity: A Case Report, Guillermo P. Gubbins, Rhett M. Schiffman, Ravindra S. Alapati, Surinder K. Batra

Henry Ford Hospital Medical Journal

Hepatotoxicity due to cocaine has been well described in animal models. There are few reports on cocaine-induced hepatic injury in humans; however, its link to rhabdomyolysis and renal failure is better known. We report a case of reversible acute hepatonephrotoxicity associated with recreational cocaine use. The proposed mechanisms responsible for its hepatic and renal toxicity are reviewed.

Computerized Literature Searching In The Ambulatory Setting Using Paperchase®, Byron K. Wolffing

Henry Ford Hospital Medical Journal

PaperChase®, a self-service computerized literature search (SSCLS) service, was compared to conventional resources for accessing recent medical information by assessing user attitudes, search costs, and number of searches performed. The study was designed as a randomized controlled trial using survey instruments before and after the intervention. Accounting of PaperChase searches was monitored electronically, and costs of librarian searches were provided by the hospital library. Participants included 57 physicians in several specialties who were members of a group practice located in a suburban ambulatory care center. Responses were received from 67%. The experimental group received free, unlimited access to PaperChase over …

Surgical Removal Of Metastatic Renal Adenocarcinoma To The Midbrain Tectum: A Case Report, Frank J. Tomecek, James I. Ausman, Ghaus M. Malik

Henry Ford Hospital Medical Journal

A patient with adenocarcinoma of the kidney metastatic lo the quadrigeminal plate of the midbrain presented with acute obstructive hydrocephalus and early tonsillar herniation. Because the majority of these carcinomas are resistant to radiation therapy, only limited treatment choices were available. Initially, a ventriculoperitoneal shunt relieved the hydrocephalus and neurologic symptoms. After a short course of improvement, with decompressed ventricles demonstrated by postoperative computed tomography, the patient developed additional neurologic signs, leading to the decision to excise the metastatic tumor. Convalescence was complicated but the patient survived for six months, succumbing to respiratory failure presumably caused by lung metastases.

Management Of Advanced Endodermal Sinus Tumor Of The Ovary With Preservation Of Reproductive Function, Michael L. Hicks, Shari L. Maxwell, Wooshin Kim

Henry Ford Hospital Medical Journal

Endodermal sinus tumor of the ovary occurs primarily in children and young adults. This tumor is classified as a germ cell tumor which comprises approximately 5% of all ovarian tumors. In the past, patients with this highly malignant tumor had low survival. However, with the evolution of effective adjunctive chemotherapeutic regimens, specifically vincristine, actinomycin D, and cyclophosphamide, survival rates have improved. In an attempt to continuously improve survival rates, other combination chemotherapeutic regimens are currently under investigation. Unlike epithelial ovarian malignancies, endodermal sinus tumor can be monitored by a specific tumor marker, alpha-fetoprotein (AFP). Serum levels of AFP can be …

Evaluation Of The Predictive Power Of Progesterone Receptor Levels In Primary Breast Cancer: A Comparison With Other Criteria In 559 Cases With A Mean Follow-Up Of 74.8 Months, Robert A. Huseby, Helen E. Ownby, Sam Brooks, Jose Russo

Henry Ford Hospital Medical Journal

A total of 559 women with primary breast cancer treated by modified radical mastectomy were followed for a mean of 74.8 months to evaluate the relationship of sex hormone receptor content in the tumor with time to first recurrence and to death due to breast cancer. The prognostic significance of progesterone receptor (PgR) status was evaluated in terms of estrogen receptor (ER) status, age (< 49 years, > 50 years), extent of lymph node involvement, tumor size, and morphologic characteristics. Overall, patients with PgR positive (> 9 femtomoles/10 mg wet weight tissue) tumors experienced a significantly longer period to both first recurrence and …

Back Matter

Henry Ford Hospital Medical Journal

No abstract provided.

Plasma Native And Peptidase-Derivable Met-Enkephalin Responses To Restraint Stress In Rats. Adaptation To Repeated Restraint, K. Pierzchala, G. R. Van Loon

Internal Medicine Faculty Publications

Met-enkephalin and related proenkephalin A-derived peptides circulate in plasma at picomolar concentration as free, native pentapeptide and at nanomolar concentration in cryptic forms. We have optimized conditions for measurement of immunoreactive Met-enkephalin in plasma and for generation by trypsin and carboxypeptidase B of much greater amounts of total peptidase-derivable Met-enkephalin in plasma of rats, dogs, and humans. Free Met-enkephalin (11 pM) is constituted by native pentapeptide and its sulfoxide. Characterization of plasma total Met-enkephalin derived by peptidic hydrolysis revealed a small amount (38 pM) of Met-enkephalin associated with peptides of molecular mass less than 30,000 D, and probably derived from …

Pms And Eosinophilia-Myalgia Syndrome, Mary Guinan

School of Public Health Faculty Research

No abstract provided.

Amwa Endorses Uniform Mammography Screening, Mary Guinan

School of Public Health Faculty Research

Breast cancer is gaining on us at an increasing rate each year. In 1990 in the United States alone we expect about 145,000 new cases and 45,000 breast cancer deaths in women. What are we doing about it? What is AMWA doing, and what are women physicians doing- for themselves and their patients? Can we do anything? The answer is yes, we can. We can reduce mortality considerably if the cancer is detected early. The five-year survival rate for women with breast cancer diagnosed in its early (localized) stages is 90%, but for women with cancer diagnosed after it has …

Ua35/11 Student Honors Research Bulletin, Wku Honors Program

WKU Administration Documents

The WKU Student Honors Research Bulletin is dedicated to scholarly involvement and student research. These papers are representative of work done by students from throughout the university.

• Basham, Penny. The Ritalin Controversy: Hyperactive Children and Medication
• Buote, Kim. The Transmission of Negative Feedback: Obstacles, Effects and Suggestions
• Cowan, James. The 1988 Presidential Primaries: Search for Bandwagons
• Durfey, Suzanne. AIDS: Nutrition and Its Implications
• Felty, Jeff. Gay and Lesbian Couples
• Gilliland, Linda. Muffins and Aspartame or Sucrose
• Graham, Ken. Sudden Infant Death Syndrome
• Grubbs, Morris. Conflicts and Synthesis in Robert Penn Warren's Blackberry Winter
• Medeiros, Lynne. Problems of Democratic Republicism in …

Oncolog, Volume 35, Number 04, October-December 1990, Staff

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Search Continues for the Cause of Cervical Cancer
• Clinical Applications of Fine Needle Aspiration Increase
• The Uncertain Role of Adjuvant Systemic Therapy
• Breast Conservation Should Be the Patient's Choice

Department Of Radiology-Annual Executive Summary Report-July 1, 1989 To June 30, 1990, David C. Levin, M.D.

Department of Radiology Administrative Documents and Reports

Department of Radiology

Chairman, Vice Chairman 1

Divisions and Directors 1

Committees and Chairmen 1

Department Full Time Faculty 2

Faculty with Secondary Appointments 3

Adjunct Faculty 3

Radiology Residents and Fellows 4

Department Organization Charts 5

State of the Department 7

Teaching Programs

Introduction 17

A. Teaching Programs for Medical Students 17

B. Residency Program 18

C. Training Programs for Fellows 19

D. Continuing Medical Education (CME) Programs . 20

Radiology Grand Rounds 21

Radiology Research Conferences 23

Publications

Publications 25

Abstracts 34

Presentations

Scientific Presentations 43

Exhibits and Poster Presentations 66

Honors, Editorial Activities, Service for National or …

Oncolog, Volume 35, Number 03, July-September 1990, Staff

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Treatment Team Addresses Needs of the Dying Patient
• Fludarabine Opens a New Dimension in Chronic Lymphocytic Leukemia Research

Oncolog, Volume 35, Number 02, April-June 1990, Staff

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Chemotherapy for Brain Metastasis Sees Progress in the Last Decade
• Researchers Hope Chemoprevention Will Reverse Tumorigenic Process
• Immunocytochemical Assays for Steroid Receptors: A New Application for Fine Needle Aspiration

Oncolog, Volume 35, Number 01, January-March 1990, Staff

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Is Malpractice Litigation Undermining Informed Consent?
• Total Parenteral Nutrition: The Double-Edged Sword
• Expandable Stents Provide Relief for Patients with Tumor-Compressed Tissue

Digest Of The Philadelphia College Of Osteopathic Medicine (Winter 1990), Philadelphia College Of Osteopathic Medicine

Digest

The Winter 1990 issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• President's Perspective
• Pioneer, Mover, Shaker & Builder
• Loud & Clear Alumni Voices
• The Osteopathic Phoenix
• On Campus
• Class Acts
• In Memoriam
• Calendar

Human Fetal Tissue: Scientific Uses And Ethical Concerns, Carol A. Tauer Ph.D.

Journal of the Minnesota Academy of Science

Human fetal tissue has been used in research for decades, but recent attempts to implant fetal neural tissue as therapy for Parkinson's disease have stimulated discussion of ethical and policy issues. In late 1989 a moratorium on federal support of fetal tissue transplantation research was indefinitely extended, based on the connection between this research and elective abortion. Four abortion-related objections to the use of fetal tissue can be identified: 1. The procedures of abortion and tissue procurement are linked in practice; 2. One who uses fetal tissue is complicit with the abortions which provided the tissue; 3. The prospect of …