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Management Of Terminal Illness: The Hospice Concept Of Care, Josefina B. Magno

Henry Ford Hospital Medical Journal

No abstract provided.

Why Palliative Medicine?, Robert G. Twycross

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

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

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 …

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 …

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 …

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 …

Front Matter

Henry Ford Hospital Medical Journal

No abstract provided.

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.

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 …

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.

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

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 …

Molecular Mechanism Of The Stimulation Of Alkaline Phosphatase Activity In Human Bone Cells By 1,25(Oh)2 D3, Eru Kyeyune-Nyombi

Loma Linda University Electronic Theses, Dissertations & Projects

To facilitate this study an in vitro human model system was established that exhibited many aspects of normal osteoblasts. The human osteosarcoma cell line (TE85 cells) expressed a skeletal alkaline phosphatase activity (an accepted bone cell differentiation marker) which was stimulated by 1,25(OH)₂D₃ (a potent differentiating agent), under serum-free conditions in a dose-dependent, time-dependent, and cell density-dependent manner. Cytochemical analysis of the stimulation of ALP activity by 1,25(OH)₂D₃ showed that 1,25(OH)₂D₃ increased the number of TE85 cells that expressed detectable ALP activity, suggesting that 1,25(OH)₂D₃ promoted the process …

Clinical Features And Management Of Malignant Ascites, I Malik, S Abubakar, I Rizwana, F Alam, J Rizvi, A Khan

Section of Cardiology

Retrospective analysis of 45 patients (33 females, 12 males) with cytologically-proven malignant ascites is presented. Abdominal pain was the most frequent symptom (69%). Fiftythree percent cases had low serum albumin. Ascitic fluid was haemorrhagic or serosanguinous in 48% cases, in the rest it was clear or straw-coloured. Peritoneal effusion was exudative in 84% cases. Mean glucose content of ascitic fluid was 95 mg/dl and the mean white cell count of 919 cells/cmm. Vast majority (82%) of the cases had metastatic adenocarcinomas. Primary malignancy was mostly ovarian (47%) followed by non-Hodgkin's lymphoma (11%) and gall bladder carcinoma (9%). Primary site could …

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

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

This part of the article describes events leading to the creation of the Consumer Product Safety Commission - and the on-going debate between those who believe safety regulation is necessary and those who believe that market forces can achieve acceptable levels of Risk. The author also sets the stage for a detailed examination of bicycle Risk. In the next issue, he compares the accomplishments of the CPSC's bicycle standard with, e.g., the development and use of hard-shell bicycle helmets. Moreover, he discusses the role of tort liability in managing Risk and ultimately concludes that, in the case of bicycle safety, …

Southeastern University Of The Health Sciences Catalog 1991-1993, Southeastern University

Health Professions Divisions Course Catalogs and Course Descriptions

No abstract provided.

Oncolog, Volume 36, Issue 02, April-June 1991, Gilbert H. Fletcher M.D., James M. Bowen Phd

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

• Redefining the risks of chemotherapy during pregnancy Renewing the assault on pancreatic cancer
• Significance of cancer volume in radiotherapy

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

Digest

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

• A Master Plan to Grow on: City Avenue Campus
• Emanuel Fliegelman, DO: Reminding Us That to be Human is to be Best
• PCOM's Computer Hospital: High-tech Medical Education
• New Appointments
• On Campus
• Just Published
• Class Acts
• In Memoriam
• Coming Events

Evaluation Of A Patient Education Program For Patients With Non-Insulin Dependent Diabetes (Type Ii), Helen M. Walker

Theses : Honours

The purpose of this study was to evaluate a group outpatient program for patients with non-insulin dependent diabetes (Type II). It endeavoured to establish whether at the completion of a patient education program, and again at the 3 month follow-up period, the patients were complying with : (a) the recommended dietary plan, (b) the exercise program, and (c) were monitoring blood glucose levels at home, as evidenced by weight loss and metabolic control of their diabetes. The study also investigated factors influencing non-compliance. The theoretical rationale used for this study was Pender's Health Promotion Model, which theorises that health-promoting behaviour …

Health And Adjustment In Young Adults: Preliminary Findings From An Epidemiologic Survey, Naomi Breslau, Glenn C. Davis, Patricia Andreski

Henry Ford Hospital Medical Journal

No abstract provided.

Response To Cpap And Uppp In Apnea, Frank J. Zorick, Timothy Roehrs, William Conway, George Potts, Thomas Roth

Henry Ford Hospital Medical Journal

Ninety-two consecutive patients with obstructive sleep apnea syndrome (OSAS) were studied before and six weeks after treatment with either nasal continuous positive airway pressure (CPAP) or uvulopalatopharyngoplasty (UPPP) (n = 46 per group). Assignment of patients to treatment was based on clinical considerations and patient preference. Patients were assessed by nocturnal polysomnography and performance on the Multiple Sleep Latency Test (MSLT) the following day. Before treatment, the CPAP and UPPP groups did not differ in sleep-related respiratory disturbance, oxygenation during sleep, fragmentation of sleep, or the level of excessive daytime sleepiness indicated by the MSLT. Both treatments produced significant improvement …

Nutritional Implications Of Liver Transplantation, Jeanette M. Hasse

Henry Ford Hospital Medical Journal

Malnutrition is a common problem of patients undergoing liver transplantation. To treat malnutrition, it must first be identified through a nutritional assessment. Because many objective nutritional assessment parameters have limitations in end-stage liver disease, subjective nutritional indicators may be used as an alternative. Nutritional needs following transplantation are categorized as short and long term. The short-term nutritional goal, anabolism, can be complicated by the nutritional status of the patient, surgical procedures, and necessary medications. The increased nutrient needs during the early posttransplant phase require particular nutritional support. Nutrition-related problems following transplantation may include obesity, hyperlipidemia. hypertension, diabetes mellitus. hyperkalemia, edema, …

Psychiatry Update: Current Research And Other New Developments, Glenn C. Davis, Naomi Breslau

Henry Ford Hospital Medical Journal

No abstract provided.

Effects Of Age, Neuropsychological Impairment, And Medication On Regional Cerebral Blood Flow In Schizophrenia And Major Affective Disorder, Perry C. Goldstein, Gregory G. Brown, Andrew Marcus, James R. Ewing

Henry Ford Hospital Medical Journal

Reports of abnormalities of regional cerebral blood flow (rCBF) in patients with schizophrenia and major affective disorder are contradictory. To gain a better understanding of the possible sources of these contradictions, the rCBF and neuropsychological functioning of 15 schizophrenics, 15 patients with major affective disorder, and 15 age-matched controls were studied. No group differences in overall rCBF, percent frontal devialion in flow, or rCBF asymmetries were observed. Both overall rCBF and percent frontal deviation of rCBF were reduced with greater age and with increasing neuropsychological impairment. Dosage of neuroleptic medication was associated with reduced whole brain flow, not with percent …

The Ketterer Stress Symptom Frequency Checklist: Anger And The Severity Of Coronary Artery Disease, Mark W. Ketterer

Henry Ford Hospital Medical Journal

Recent research suggests that the most potent feature of the Type A behavior pattern for prospectively predicting cardiac disease is aggravation, irritation, anger, and impatience (AIAI). The present study examines psychometric properties of a new AIAI measure and its relationship to the severity of coronary artery disease (CAD). Subjects included 61 males undergoing coronary angiography. Comparisons were made of mean psychometric scores across groupings, defined by number of vessels occluded. These comparisons showed that the normal or subclinically occluded coronary angiographic group had high levels of depression and anxiety. Higher levels of AIAI were observed in patients with multivessel CAD …