Digital Commons Network^™

Cushing's Disease, A Pituitary Disorder: A Hypothesis, M. Saeed Zafar, Raymond C. Mellinger

Henry Ford Hospital Medical Journal

At present, Cushing's disease Is believed to be due to Inappropriate secretion of adrenocorticotropic hormone (ACTH). Associated abnormalities such as disturbed sleep pattern, growth hormone secretion, depressed thyroid hormone levels, and gonadal function are considered by some as manifestations of a generalized central nervous system disturbance, with abnormal ACTH secretion as one of the components. Recognition of microadenomata in Increasing numbers of patients with Cushing's disease, the reversal of hypothalamic abnormalities after adenomectomy, and correction of hypercortisolemia all suggest that the central nervous system disturbances result from Cortisol excess. We hypothesize that the basic abnormality in Cushing's disease is the …

Painless Thyroiditis With Hyperthyroidism Following External Irradiation To The Neck, J. David Fachnie, Sudhaker D. Rao

Henry Ford Hospital Medical Journal

Two months after finishing 60Co external irradiation to treat squamous cell carcinoma of the larynx, a 47-year-old man became hyperthyrold. Although the thyroid gland was not tender, the radioactive iodine uptake was diminished. After subsequent periods of euthyroidism and hypothyroidism, the patient's thyroid function spontaneously returned to normal. The features of this case mimic the syndrome of painless granulomatous thyroiditis. Although hypothyroidism is frequently observed following radiation thyroiditis, hyperthyroidism from external radiation has not been reported. Despite this low frequency, diagnosis is important to permit prompt, symptomatic treatment of the thyrotoxic phase.

Graves' Disease Following The Occurrence Of Hypothyroidism, A. R. Guansing, D. D. Klink, N. Engbring, Y. Leung, J. Chakravarty, S. Wilson

Henry Ford Hospital Medical Journal

Three patients with hypothyroidism of 15-48 months' duration developed Graves' disease while on thyroid hormone replacement therapy. In one patient, the hyperthyrold phase was preceded by ophthalmopathy and nonsuppresslble 24-hour radioactive iodine uptake (RAIU). Eventually, all had hyperthyrold findings with elevated thyroid hormone levels, high 24-hour RAIU, and a diffuse uniform uptake of RAI by the enlarged thyroid. All subjects had negative antithyroglobulin and antimicrosomal antibody titers. Two had demonstrable long-acting thyroid stimulator (LATS) in their sera. All three were followed for 5-36 months while on propylthiouracil therapy prior to surgery or RAI administration. Both LATS-positive patients underwent bilateral subtotal …

Insulin-Resistant Diabetes Mellitus And Insulin Receptor Antibodies: Variable Association With Acanthosis Nigricans, José Goldman

Henry Ford Hospital Medical Journal

Two patients with severe insulin-resistant diabetes mellitus and anti-insulin receptor autoantibodies are reported here. A marked decrease in the number of accessible insulin receptors was found in the monocytes of one patient. Otherwise, the Insulin receptors were of normal affinity compared to those of normal controls. Acanthosis nigricans was not present in one patient, and in the other patient it preceded the diagnosis of diabetes by ten years. We conclude that although acanthosis nigricans and insulin resistance are frequently associated, they probably do not bear a pathogenetic relationship to each other. Therefore, the investigation of anti-insulin receptor antibodies Is advisable …

Dietary And Hormonal Factors In Bone Loss, Richmond W. Smith Jr.

Henry Ford Hospital Medical Journal

No abstract provided.

Back Matter

Henry Ford Hospital Medical Journal

No abstract provided.

Vital Signs, June-July, 1980, Boonshoft School Of Medicine

Vital Signs

A sixteen page newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes a variety of feature articles, a research spotlight, alumni notes, and more.

Lipoprotein Lipase Inhibitor Removal During Ultrafiltration Of Renal Failure Patients, Alisa Minear

Loma Linda University Electronic Theses, Dissertations & Projects

Plasma samples were obtained from seven hypertriglyceridemic (>150 mg/dl) chronic renal failure patients before and after regular hemodialysis. The effect of the plasma on the lipolytic activity of bovine milk lipoprotein lipase was investigated. The lipoprotein lipase activity, as measured by release of C¹⁴-labeled free fatty acid from triglyceride, was decreased 8-67% when incubated with uremic plasma as compared to the control plasma (44 mg/dl triglyceride). The inhibition noted prior to hemodialysis did not appear to be alleviated by the dialysis but subsequent treatment with an isolated ultrafiltration technique did appear to remove an inhibitory substance as …

An Analysis Of The Attitudes Of Unlicensed Personnel In San Bernardino Metropolitan Area Convalescent Hospitals Toward Their Jobs And The Geriatric Patients, Theodore G. Sneed

Loma Linda University Electronic Theses, Dissertations & Projects

In American society, convalescent facility residency is a fact of life for many of the aged. Typically, in these geriatric facilities, eighty to ninety percent of primary patient care services are delivered by unlicensed personnel. Unfortunately, this segment of the convalescent facility employee population tends to be transient, underpaid and overworked, and to feel very low esteem for themselves and their jobs. This situation has produced many service abuses and interaction difficulties in the convalescent facilities. Up until the present there has been little attempt on the part of Sociology to study this portion of the employee population in these …

Vital Signs, May, 1980, Boonshoft School Of Medicine

Vital Signs

An eight page newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes a variety of feature articles, a research spotlight, alumni notes, and more.

Newsletter, Volume 25, Number 03, May - June 1980, John M. Daly Md, Edward M. Copeland Md, Stanley J. Dudrick Md, R. Bruce Bracken Md

Newsletter: A Report to Physicians of Texas Archives

• ACS Representative Explains New Cancer-Related Health Checkup Recommendations
• Intravenous Hyperalimentation Improves Immunocompetence in Cancer Patients, John M. Daly, MD, Edward M. Copeland, MD, and Stanley J. Dudrick, MD
• Computer Center Aids Researchers, Students
• Noteworthy
• Semen “Banking” No Solution for Many Patients, R. Bruce Bracken, MD, and Keith D. Smith, MD
• E.J. Freireich Named President of ASCO
• Brazilian Doctors Observer MDAH Treatment

A Study Of The Physiological And Mental Effects Of Various Shift Patterns On Registered Nurses, Carolyn Taylor Smith

Loma Linda University Electronic Theses, Dissertations & Projects

The effects of shift work on circadian I an rhythms has become a subject of great Interest to many industries, hospitals, and sleep researchers. More and more recognition is being given to the results of these studies, especially the possible adverse effects on those working the night shift or a shift they are unable to adapt to adequately. Only a few of these studies, however, have been conducted on registered nurses, a major group involved with shift work.

The purpose of the present study was to investigate the effects on nurses working the a.m. shift (7 a.m. to 3:30 p.m.), …

Changing Physician Ideologies On The Care Of The Dying: Themes And Possible Explanations, John Macdougall

The Journal of Sociology & Social Welfare

An analysis of changing physician ideologies regarding the care of elderly dying patients, as expressed in technical journals read by American physicians. Markedly more titles concerning terminal care are found in Index Medicus in 1968- 78 than in 1960-67. In one journal, physicians are only after 1964 urged to tell patients openly about their condition and after 1969, to improve cooperation within professional teams. Two explanations of these data are tentatively explored: 1) a Parsonian explanation, whereby medical ideologies reflect professional autonomy and the influence of internalized moral norms; 2) a Marxist explanation, whereby medical ideologies reflect physicians' transformation from …

University Of New England Governance System, University Of New England

Gene Yonuschot, Ph.D. Collection

University of New England Governance System document that details the responsibilities of the board of trustees, faculty, and administration as well as the structure of the university, the University Council, Student Advisory bodies, the grievance process, and amendment procedures.

Vital Signs, April, 1980, Boonshoft School Of Medicine

Vital Signs

An eight page newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes a variety of feature articles, a research spotlight, alumni notes, and more.

Digest Of The Philadelphia College Of Osteopathic Medicine (Spring 1980), Philadelphia College Of Osteopathic Medicine

Digest

The Spring 1980 issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• The President's Page
• 4190 Renovations Begin
• Meet the Board of Trustees
• New Appointments
• Laporte Physician Helps Restore Sight
• What is a D.O.?
• Faculty Notes
• News from the Hospital and Health Care Centers
• News from the College
• Nursing Alumnae
• Sports Wrap-up
• Come to the Fair! – The Philadelphia Fair
• Alumni News Briefs
• From the Alumni Office
• In Memoriam

Body Adiposity Measurement By Differential Absorptiometry, Luther E. Preuss, Frank P. Bolin

Henry Ford Hospital Medical Journal

A scanning principle utilizing a dual beam of penetrating radiation and a new instrument designed to measure the fat to fat-free ratio of the soft tissue of the upper arm by differential absorptiometry were tested in 24 volunteers for short and long-term precision. Reproducibility of the adiposity measurements was generally good, and positive correlations were obtained with other variables such as weight and skinfold. Regional adiposity measurement by absorptiometry shows promise for clinical application.

The Pulmonary Component Of The Second Sound In Right Ventricular Failure, Paul D. Stein, Hani N. Sabbah, Daniel T. Anbe, Mario Marzilli

Henry Ford Hospital Medical Journal

Sound within the pulmonary artery was measured in 24 patients to determine if right ventricular failure modifies the amplitude of the pulmonary component of the second sound (P2). The amplitude of P2 in eight patients with right ventricular failure secondary to pulmonary hypertension (2610 ± 370 dynes/cm2) did not differ from P2 in eight patients with pulmonary hypertension not accompanied by right ventricular failure (3120 ± 710 dynes/cm2). In both groups, the amplitude of P2 exceeded control subjects (520 ± 70 dynes/cm2) (P < .001 and P < .01, respectively). The maximal rate of development of the pressure gradient across the closed pulmonary valve was higher in patients with right ventricular failure (580 ± 100 mm Hg/sec) than in control subjects (150 ± 30 mm Hg/sec) (P < .001) and maximal negative dp/dt was also higher in patients with failure (750 ± 70 mm Hg/sec vs 190 ± 20 mm Hg/sec) (P < .001). The maximal rate of change of the diastolic pressure gradient correlated linearly with maximal negative dp/dt (r=.89). These observations indicate that P2 is accentuated in patients with right ventricular failure secondary to pulmonary hypertension. The accentuation results from the augmented rate of development of the diastolic pressure gradient, which reflects an augmented right ventricular negative dp/dt. Therefore, an accentuated P2 remains valid as a clinical sign of pulmonary hypertension whether or not right ventricular failure occurs.

Persistent Obstructive Jaundice Associated With Chronic Pancreatitis, C. Grodsinsky, M. A. Block

Henry Ford Hospital Medical Journal

Persistent obstructive jaundice due to stenosis of the distal common bile duct by chronic pancreatitis has been documented in 13 patients of 253 for whom the diagnosis of chronic pancreatitis has been established. All 13 cases required operation; obstructive jaundice was present at surgery in nine; four had recurring jaundice for prolonged periods. None had associated biliary lithiasis. All cases showed evidence of excess alcohol intake. The jaundice, often associated with mild to moderate pain, was disabling and life-endangering and was relieved by operation. In these patients carcinoma must always be ruled out by diagnostic studies, operation, and the elapse …

Intrahepatic-Cutaneous Biliary Fistulas Secondary To Trauma, Farouq Samhouri, James C. Gruenberg, Robert S. Brown

Henry Ford Hospital Medical Journal

Biliary fistula is an unusual complication after operations for hepatic trauma, but only scant information is available concerning its management. This report describes biliary fistulas and presents two cases of their successful resolution, by external drainage in one case and internal drainage in the other. These cases illustrate aspects of fistula management and prevention described in the literature and suggest individualized approaches.

Herpes Zoster Encephalitis: Successful Therapy With Vidarabine, Steve J. Wees, Tom Madhavan

Henry Ford Hospital Medical Journal

A 77-year-old woman was seen who had encephalitis complicating trigeminal herpes zoster. Diagnosis was made by clinical and cerebrospinal fluid findings and electroencephalogram. As a result of parenteral vidarabine therapy, the patient recovered.

Ards And Cerebral Infarction Complicating Mycoplasma Pneumonia In Sickle Cell Trait, Mark I. Pensler, Jan R. Radke

Henry Ford Hospital Medical Journal

A patient with Down's syndrome and sickle cell trait developed the adult respiratory distress syndrome and cerebral infarction during infection with Mycoplasma pneumoniae. The slow recovery of pulmonary function was unrelated to antimicrobial therapy. Sickle cell trait may be a risk factor for severe M. pneumoniae infection. The possible underlying mechanism for this relationship is explored, and the relationship between sickle cell trait, cold agglutinins, and the cerebral infarction is discussed.

Front Matter

Henry Ford Hospital Medical Journal

No abstract provided.

1980 Beaumont Lecture: Restriction Enzymes As Tools For Genetic Research, Hamilton O. Smith

Henry Ford Hospital Medical Journal

No abstract provided.

Systematic Treatment Of Chronic Pain With Antidepressants, Dietrich Blumer, Mary Heilbronn, Edgard Pedraza, Gerald Pope

Henry Ford Hospital Medical Journal

Patients with chronic pain who do not have significant physical symptoms present a characteristic clinical-psychological profile and show a high incidence of depressive traits (inactivity, depressive mood, anhedonia, and insomnia). This syndrome is termed pain-prone disorder and represents a form of masked depression par excellence. A series of 129 patients with pain of 6.9 years' duration was divided into three treatment groups. Two psychiatrists prescribed antidepressants systematically by promptly increasing doses and by alternating antidepressants if indicated. Significant improvement or freedom from pain was achieved in most patients who complied with treatment.

The third psychiatrist did not follow the systematic …

The Recognition Of Active Retrolental Fibroplasia, R. Michael Nisbet

Henry Ford Hospital Medical Journal

As the incidence of retrolental fibroplasia increases, physicians must become familiar with its appearance. This report describes the examination techniques and morphology of the active and regressive stages of retrolental fibroplasia.

The Efficacy Of Biliary Diversion For Benign Disease: Long-Term Follow-Up, Farouq Samhouri, Carlos Grodsinsky, Hubert Allen

Henry Ford Hospital Medical Journal

Retrospective analysis of 70 patients who underwent biliary bypass operations for benign disease over an eight-year period was undertaken to evaluate long-term complications. Operative procedures included choledochoduodenostomy in 60 patients, choledochojejunostomy in four, and cholecystoduodenostomy, cholecystojejunostomy and hepaticojejunostomy in two patients each. The most common indication for surgery was choledocholithiasis, with or without hepatic stones, viscid bile, and ampullary stenosis (61 to 70 patients). Other indications included chronic pancreatitis, choledochal cyst, and sclerosing cholangitis. One patient died postoperatively from hemorrhage, and two others died from causes unrelated to surgery. Two patients developed cholangitis without reflux and demonstrated anastomotic stenosis at …

Danazol Therapy In Hereditary Angioedema, Lawrence C. Sweet, Charles E. Jackson, Sam S. Yanari, J. B. Yott

Henry Ford Hospital Medical Journal

Herditary angioedema (HAE) is an autosomal dominantly inherited condition in which a deficiency of the inhibitor (C1lnh) of the activated first component of complement is associated with recurrent episodes of edema of the skin, gastrointestinal tract, and larynx. The pituitary gonadotropin inhibitor, danazol, has been reported to be effective in preventing attacks and increasing C1lnh levels. Our experience with 11 patients from five kindreds corroborated those results and has revealed that most patients can be maintained symptom-free on 100-200 mg of danazol daily Side effects were minimal, although one young woman discontinued therapy because it aggravated her acne. The elevation …

Henry Ford Hospital Clinicopathological Conference: Metamorphosis In Chronic Granulocytic Leukemia In A 60-Year-Old Man

Henry Ford Hospital Medical Journal

No abstract provided.

Skin Lesions Associated With E. Coli Sepsis In A Patient With Acute Leukemia, Robert A. Chapman, Ellis J. Van Slyck, Tom Madhavan

Henry Ford Hospital Medical Journal

The clinical course of a patient with acute leukemia and metastatic intradermal abscesses secondary to Escherichia coli sepsis is described. E. coli organisms, cultured first from the blood and later from the lesions, had an identical antibiotic susceptibility and biotyping profile. This complication has not been previously described. Granulocytopenia and varicose veins may have been critical predisposing factors. With more widespread use of progressive immunosuppressive regimens, unusual manifestations of common infections will be recognized more frequently.