Digital Commons Network^™

An Ischemic Infarct In Medulla And Cervical Cord, Ezzatollah Shivapour, Gilbert B. Solitare

Henry Ford Hospital Medical Journal

This report documents an unusual case of an occlusion of the anterior spinal artery of the medulla oblongata. The patient presented with involvement of the left accessory nerve and weakness of ipsilateral extremities. The diagnosis of an ischemic infarct in the distribution of the left proximal portion of the anterior spinal artery was made. Bulbar weakness, quadriplegia, and respiratory arrest developed. Postmortem examination, 23 days after onset, revealed an old infarct in the medulla which appeared as a more recent hemorrhagic infarct throughout the cervical cord.

Front Matter

Henry Ford Hospital Medical Journal

No abstract provided.

Clinical Notes: 201tl Chloride Uptake By Non-Hodgkins Lymphoma: Radiographic Exhibit, Daniel S. Marks, Keenan L. Carroll

Henry Ford Hospital Medical Journal

This report describes intense uptake of 201Tl in a patient with histiocytic lymphoma. The activity seen was greater than with 67Ga. Use of 201Tl as an alternative imaging agent is advocated.

Mixed Connective Tissue Disease And Systemic Lupus Erythematosus In One Family, Michael R. Lubetsky, Howard Duncan

Henry Ford Hospital Medical Journal

A mother with mixed connective tissue disease (MCTD) and a daughter with systemic lupus erythematosus (SLE) were simultaneously diagnosed and treated in August, 1977. Multiple cases of SLE occurring in the same family are not rare, but the frequency with which systemic lupus erythematosus and mixed connective tissue disease occurs in the same family is not known, and the reports are few. This report describes these two cases and suggests that mixed connective tissue disease may be part of the spectrum of systemic lupus erythematosus.

Letters To The Editor

Henry Ford Hospital Medical Journal

No abstract provided.

Back Matter

Henry Ford Hospital Medical Journal

No abstract provided.

Scanning Electron Microscopy Of The Surface Of Human Duodenum In Patients With And Without Duodenal Ulcer Disease, Bernard M. Schuman, Klaus Ritter, John H. L. Watson, Jessica Goodwin

Henry Ford Hospital Medical Journal

Endoscopic biopsy specimens of normal human duodenum from patients with duodenal ulcer disease were studied by light microscopy and by scanning electron microscopy. For scanning, the tissue was dried by the critical point-drying technique. SEM criteria for both normal and abnormal duodenal surfaces were determined. SEM evidence for the presence of "tuft cells" similar to those found on the surface of rat duodenum was found in both the normal and abnormal human material. Although other reports have described the favorable effects of carbenoxolone sodium treatment on duodenal ulcer disease, our SEM studies of four patients found that this treatment had …

Endoscopic Retrograde Cholangiopancreatography At Henry Ford Hospital: 1972-1977, Bernard M. Schuman, Kian H. Wong, R. Salimi, A. N. Adham

Henry Ford Hospital Medical Journal

Between 7972 and /977, 440 patients underwent endoscopic retrograde cholangiopancreatography (FRCP) at Henry Ford Hospital. The procedure was found to be most useful for identifying the site and nature of an extrahepatic obstruction, the diagnosis of pancreatic cancer, and the preoperative evaluation of chronic pancreatitis. One death occurred as a result of cholangitis in a patient with cancer of the pancreas. Review of the data has led us to refine our indications for FRCP. It has been shown to be a valuable technique with a low incidence of complications in evaluating pancreaticobiliary disease. Based on our study, it would be …

In Vitro And Clinical Studies Of Cefaclor, A New Cephalosporin, Daria Kiani, Tom Madhavan, Keith Burch, Don Pohlod, Evelyn Fisher, Edward L. Quinn

Henry Ford Hospital Medical Journal

In vitro susceptibility studies of 246 clinical isolates demonstrated that this antibiotic was effective against Group A beta hemolytic streptococci, alpha hemolytic streptococci, S. pneumoniae, both penicillinase producing and nonpenicillinase producing Staphylococci, Klebsiella pneumoniae, and Proteus mirabilis. Cephalothin susceptible E. coii were also susceptible to cefaclor. Pseudomonas aeruginosa, Serratia sp., Enterobacter Sp., and Streptococcus faecalis were uniformly resistant to cefaclor. The efficacy and safety of this antibiotic were studied in 27 patients with urinary tract, soft tissue, and respiratory infections. Patients with urinary tract infections became abacteriuric after 48 hours. Patients with soft tissue infections responded well within the first …

Seizures And Brain Tumor In Neurologically Intact Adult Patients: Role Of Computerized Tomography (Ct Scan), Jamshid Seifi, Roushdy S. Boulos, Robert D. Teasdall

Henry Ford Hospital Medical Journal

CT scan of 13 patients with adult onset of seizures who were neurologically intact and otherwise asymptomatic revealed a supratentorial mass in all. Significant EEG abnormalities were recorded in five, and the isotope brain scan was positive in eight. In three patients, both studies were normal. Angiograms confirmed the location of tumor, and histology was established following craniotomy. The value of the CT scan as a screening test for detecting brain tumor in this group of seizure patients is evident.

Bone Erosion In Rheumatoid Arthritis, Howard Duncan, Catharina H. E. Mathews, Michael M. Crouch, A. M. Parfitt

Henry Ford Hospital Medical Journal

A histological study of fully mineralized bone sections was made on thirty joints surgically removed from patients with rheumatoid arthritis. The patterns of bone erosion fell into three groups: 1) that due to multinucleated osteoclasts; 2) areas of apparent bone erosion occupied exclusively by mononuclear cells; and 3) changes produced by an osteocyte which could either enlarge the lacuna space in which it resided or demineralize a region of bone in its immediate vicinity. Tissues taken from knee and hip specimens frequently showed all three cellular patterns of bone erosion, while the sections from finger joints rarely container multinucleated osteoclasts …

Caloric Restriction And Bile Salt Dynamics In Intact And Cholecystectomized Syrian Hamsters, J. Sanfield, W. T. Beher, G. J. Lin, R. Haamen

Henry Ford Hospital Medical Journal

In vivo studies of bile salt absorption and distribution using 14C-taurocholate were made in fed and fasted, intact and cholecystectomized Syrian hamsters. There was no significant difference in the rate of ileal 14C-bile salt absorption or the distribution of 14C-bile salts among the compartments of the enterohepatic circulatory system in any of the animals. The results showed that the sphincter of Oddi is patent in fasting, intact and cholecystectomized hamsters. They also suggested that the diminished bile salt pool seen in fasted, cholecystectomized but not in intact hamsters arises from a) a primary, fasting-induced decrease in liver enzyme activity involved …

Expanded Polytetrafluoroethylene (Ptfe) And External Velour Grafts As Small Artery Substitutes In Dogs, Farouq Samhouri, Luis H. Toledo-Pereyra, Stanley G. Dienst, Roger F. Smith

Henry Ford Hospital Medical Journal

This experimental study compared the clinical patency, angiographic appearance, and histology of 4 mm polytetrafluoroethylene (PTFE) and external double velour grafts which were used as external iliac artery substitutes in dogs. At one week there were no significant differences. However, at two months, none of the PTFE grafts were open, whereas six of the seven external double velour grafts were patent (p<0.05). Thus, in this study the 4 mm PTFE grafts are poor substitutes for canine iliac replacement.

A Comparison Of Two Instructional Methods In Teaching An Introductory Course In Health, Charlotte Mitchell

Masters Theses & Specialist Projects

The purpose of this research was to determine the effectiveness of the independent study method of instruction in promoting health knowledge and health attitude change. The experimental method was compared to the traditional classroom model of instruction.

A random sample of ten subjects was taken for the experimental group and matched control subjects were then selected. Control subjects were chosen based on the demographic variables of age, race, sex, academic classification and grade point average.

A pretest-posttest design using two standardized instruments was employed to measure the health knowledge gain and health attitude change. Data was statistically analyzed by use …

A Comparison Of Kidney Preservation Methods By Oxidative Phosphorylation Studies, Devprakash Samuel, Stanley G. Dienst

Henry Ford Hospital Medical Journal

An oxygen consumption assay using adenosine diphosphonucleotide (ADP) was performed on canine kidneys to measure the efficiency of oxidative phosphorylation. The purpose of the assay was to establish a respiratory control index (RCI) that could be used to evaluate kidneys preserved by different methods. Of the four methods tested, perfusion yielded the best results after 24-hour preservation. Additionally, four pairs of human cadaver kidneys were evaluated with the same assay. Some correlation existed between the RCI values of the nontransplanted kidney in each pair and the clinical viability of its transplanted mate.

Effect Of Donor Pretreatment On The Graft Survival Of Human Cadaver Kidneys, Stanley G. Dienst, Krishna D. Valjee, Luis H. Toledo-Pereyra

Henry Ford Hospital Medical Journal

The effect of donor pretreatment on perfused cadaver kidney allografts was evaluated in 40 recipients at Henry Ford Hospital over a two-year period. Ofthe 40,23 received kidneys from donors pretreated with 40 mg/K each of cyclophosphamide and methylprednisolone during the first year of the study and up to 70 mg/K during the second year. Our results indicated that donor pretreatment for five to eight hours did not consistently improve survival rates in pretreated perfused cadaver kidneys following transplantation. The use of cyclophosphamide for donor pretreatment does not prevent the use of continuous perfusion to preserve human kidneys. Dosages up to …

Radionuclide Evaluation Of Renal Transplant Patients, Daniel S. Marks

Henry Ford Hospital Medical Journal

Radionuclide examinations provide considerable information in evaluating patients who have received renal transplants. In the uncomplicated case, baseline data should be obtained so that subsequent changes in renal function can be better documented. In the complicated case, rapid delineation of the problem may result in more effective therapy. Serial examinations with several radiopharmaceuticals represent the best nuclear approach to the transplant patient. This paper describes the application and performance of these tests as currently performed at Henry Ford Hospital.

Treatment Of Uremic Diabetic Patients: Hemodialysis Or Transplantation?, Godofredo Santiago, Cosme Cruz, Francis Dumler, Pedro Cortes, Stanley Dienst, Sandra Parnell, Maxine Uniewski, Nathan W. Levin

Henry Ford Hospital Medical Journal

Eighty-one patients with chronic renal failure associated with or secondary to diabetic nephropathy were treated with dialysis and/or transplant. Twenty-five had juvenile diabetes and 56 had adult onset diabetes. Juvenile diabetics did poorly on hemodialysis with 13 patients having a 19% four-year survival rate, whereas those who had cadaveric transplantation did well with a four-year patient and graft survival rate of 56% in nine patients. The three juvenile diabetics who received related kidney grafts are presently alive with good function. Patients with adult onset diabetes did well on hemodialysis with a four-year survival rate of 63% in 45 patients. In …

Front Matter

Henry Ford Hospital Medical Journal

No abstract provided.

Effect Of Acute Posttransplant Renal Failure On The Survival Of Perfused Cadaver Kidneys, Krishna D. Valjee, Luis H. Toledo-Pereyra, Stanley G. Dienst, Heung K. Oh, Daniel S. Marks, Pedro Cortes, Cosme Cruz, Godofredo Santiago, Nathan W. Levin

Henry Ford Hospital Medical Journal

Between 7973 and 7977 we encountered 22 cases of acute renal failure after transplantation in 70 patients who received perfused cadaver kidneys. Nearly two-thirds of 76 nonfunctioning grafts were lost due to subsequent superimposed rejection, often undetected and, hence, untreated. Thirty-one percent of the 76 recovered function. The recovery rate, we believe, can be improved by earlier diagnosis and treatment of rejection and by avoiding invasive diagnostic procedures in the early postoperative period. If the oliguric period extends beyond two weeks, a closed percutaneous renal biopsy is justified. The diagnosis of rejection and/or other abnormality as well as subsequent treatment …

Histocompatibility Testing In Renal Transplantation, Hajime Hayashi, Jay B. Hunter

Henry Ford Hospital Medical Journal

The effect of HLA matching and other aspects of histocompatibility on renal graft survival were analyzed in 144 patients who received renal transplants at Henry Ford Hospital during the past ten years. Living related transplants with one haplotype match or better demonstrated a higher graft survival rate (at least 88%) at one year than the better matched cadaveric transplant. In cadaveric transplants, the group with fewer than two mismatched antigens appeared to have a higher graft survival rate than those with more than two. The patient population was not large enough to determine the effect of preformed antibodies, ABO grouping, …

Urological Complications In Renal Transplantation, Riad N. Farah, Richard Klugo, Thomas Mertz, Joseph C. Cerny

Henry Ford Hospital Medical Journal

There were 116 renal transplants performed on 108 patients over a five-year period at Henry Ford Hospital with three major urological complications. The rate of 2.6% compares favorably with that reported in other series. Careful preoperative urological evaluation together with technically precise ureteroneocystostomy are factors that minimize the incidence of urological complications.

Intravenous Methylprednisolone For Kidney Transplantation, Krishna D. Valjee, Luis H. Toledo-Pereyra

Henry Ford Hospital Medical Journal

The effect of different dosage levels (0-100 mg/k/day x 3)of intravenous methylprednisolone was tested in canine kidney autografts undergoing immediate contralateral nephrectomy. Intravenous methylprednisolone was safely administered in doses up to 40 mg/k/day for three days after kidney transplantation. Higher doses ( 40 mg/k/day x 3) were functionally and structurally harmful to canine kidney autografts.

Prolonging Kidney Graft Survival With Concanavalin A: Effects Of Temperature, Perfusate Composition, Ph, And Different Manufacturing Lots, Luis H. Toledo-Pereyra, Richard L. Simmons

Henry Ford Hospital Medical Journal

This study analyzes the effect of temperature, perfusate composition, pH, and variable manufacturing lots in prolonging kidney allograft survival with Concanavalin A (Con A). Cold temperature (4°C), crystalloid composition of the perfusates, and neutral or mildly alkaline pH were important factors in the effect of Con A on prolonging allograft survival. Also, different lots of Con A from the same manufacturer produced variable results in prolonging survival. Thus, multiple factors should be considered if Con A is to be used to prolong kidney allograft survival.

Reevaluation Of A New Colloid Hyperosmolar Solution For Hypothermic Storage Of Ischemic Canine Kidneys, Manuel Chee, Luis H. Toledo-Pereyra, Richard M. Condie

Henry Ford Hospital Medical Journal

This paper describes the results of experiments designed to test the effectiveness of a new colloid hyperosmolar solution (Toledo-Pereyra) for renal hypothermic storage. Three experimental conditions were employed: 60 minutes of warm ischemia (37 C), 24 hours of hypothermic storage, and a combination of warm ischemia and hypothermic storage. Canine kidneys tolerated either one of the first two procedures when flushed with the colloid hyperosmolar solution before storage or transplantation. If warm ischemia was applied before 24 hours of hypothermic storage, four of six dogs survived more than 20 days after transplantation, while the other two died of uremia. Thus, …

Back Matter

Henry Ford Hospital Medical Journal

No abstract provided.

Nutritional Aspects In The Care Of The Child With Cleft Lip And Palate, Mary E. Keitel

Henry Ford Hospital Medical Journal

Proper nutrition is essential in the care of the infant with cleft lip or palate, as these infants are often plagued with feeding difficulties from birth. This paper reviews recent literature on the many feeding practices in use today and discusses the current trend toward a multidisciplinary approach to treatment for the cleft lip/palate child. It also presents a brief review of experimental animal studies which have implicated nutritional deficiences in the causation of cleft lip/palate.

Intracardiac Phonocardiography In Subaortic Stenosis, Paul D. Stein, Hani N. Sabbah, Daniel T. Anbe, Fareed Khaja, Gordon M. Folger Jr.

Henry Ford Hospital Medical Journal

The purpose of this study is to explore the value of intracardiac sound recordings for the verification of subaortic stenosis. Intracardiac sound was measured in ten patients with subaortic obstructions. Seven had idiopathic hypertrophic subaortic stenosis, two had a subvalvular membrane, and one had a subvalvular tunnel. In each patient, a systolic murmur was recorded within the left ventricle distal to the obstruction. The murmur was of lower amplitude distal to the aortic valve, and it was of even lower amplitude or absent proximal to the obstruction. In the presence of entrapment, no intraventricular murmur occurred although an apparent subvalvular …

Clinical Notes: Bacteremia Associated With Colonoscopy, A. Suarez, B. Schuman, E. Quinn, T. Neblett

Henry Ford Hospital Medical Journal

Twenty-eight patients had a total of 168 blood cultures before and at regular intervals during colonoscopy. No bacteremia was found. Based on our results and other reports, we recommend antibiotic prophylaxis during colonoscopy only for those patients with prosthetic heart valves and for those with valvular heart disease who also have advanced liver disease.

Emergency Transvenous Cardiac Pacing, Carl E. Bartecchi

Henry Ford Hospital Medical Journal

A single pacemaker electrode catheter placement procedure, using the subclavian route and a semi-floating pacemaker catheter, was utilized in 120 consecutive patients who required emergency cardiac pacing. Stable pacing was achieved in a high percentage with few complications.