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Prospects For Clinical Research, G. Donald Whedon

Henry Ford Hospital Medical Journal

No abstract provided.

Transiliac Bone Biopsy: Complications And Diagnostic Value, Sudhaker D. Rao, Velimir Matkovic, Howard Duncan

Henry Ford Hospital Medical Journal

This article reviews the experience of 101 transiliac bone biopsies performed in one year at Henry Ford Hospital and discusses the possible diagnostic value ofthe procedure in evaluating generalized metabolic bone disease. In 50 of the 101 cases, we used a pain scoring method to evaluate the acceptability of the procedure to patients. Data from our study and 18 other clinical centers were then analyzed for: 1) demographic distribution of patients who had a bone biopsy; 2) its acceptability to patients; 3) quality of the specimen and its relationship to the physician performing the procedure; 4) diagnostic yield of bone …

Osteoporosis And Epidemiology Of Fractures In Croatia: An International Comparison, Velimir Matkovic, Marija Ciganovic, Cedomil Tominac, Krista Kostial

Henry Ford Hospital Medical Journal

We examined the epidemiology of osteoporotic fractures in Croatia and correlated the results with data from other countries. We analyzed annual rates of wrist fractures in the large urban community of Zagreb and hip fractures in the Republic of Croatia. In addition, we determined mortality data and measured metacarpal bone mass In patients with hip fractures. There were age and sex differences in the incidence of both types of fracture. The incidence of wrist fractures is the same as in some Northwestern European countries, but the incidence of hip fractures is much lower. The mortality after hip fractures is high …

The Acute Effect Of Piretanide Upon Serum And Urinary Calcium In Normal Subjects, Cristina Casco, Patricia Fainstein Day, Carlos Mautalen

Henry Ford Hospital Medical Journal

We gave piretanide, a new diuretic, at two dose levels to six normal subjects. Sodium excretion increased six to eightfold in the first two hours, and diuresis was completed within four hours. There was a simultaneous increase in the excretion of calcium which exceeded the amount present In the mobilized extracellular fluid. The resulting deficit of calcium produced a small but significant fall in serum calcium corrected for protein. After diuresis ended, calcium was retained but not sodium, when compared to basal values on the previous day. The fall in urinary calcium and the failure to correct the sodium deficit …

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.

The Effect Of Nursing Discharge Counseling Sessions On The Pre-Discharge Anxiety Level Of The Neurotically-Depressed Female In A Community Hospital Setting, Deborah Snyder Galasso

Loma Linda University Electronic Theses, Dissertations & Projects

Discharge from the hospital has been identified as a time when patients are in need of additional nursing support. The prospect of leaving the protective hospital environment to return to the home environment with its life stresses can cause anxiety. This study was designed to test the effect of a nursing intervention, discharge counseling sessions, on the anxiety level of the neurotically-depressed female prior to discharge.

The null hypothesis guiding this study was: nursing discharge counseling sessions will have no significant (α=0.05) effect on the pre-discharge anxiety level of the neurotically-depressed female in a community hospital setting. The State-Trait Anxiety …

Public Health And Public Wealth: Social Costs As A Basis For Restrictive Policies, David T. Courtwright

History Faculty Research and Scholarship

Historically, the most important rationale for coercive public health measures has been the prevention of disease and injury to others. However, as noncommunicable diseases and accidents have assumed increased importance as causes of morbidity and mortality, and as the connection between noncommunicable diseases and accidents and individual practices such as smoking and drinking has become more apparent, a new line of argument based on social costs has emerged. My purpose is both to describe and evaluate the social-costs argument, to explain why it has become so popular, and to show what must be done to make it consistent with its …

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.

Hypomagnesemia-Lnduced Cardiac Arrhythmia, Robert Chapman, Jan Rival

Henry Ford Hospital Medical Journal

A case of life-threatening cardiac arrhythmia associated with magnesium deficiency is described. The patient had no history of any cardiac disease, was not taking any medication and had no other accompanying electrolyte disorder. His arrhythmia was refractory to conventional treatment but responded to parenteral magnesium therapy. The role of hypomagnesemia in the predisposition to cardiac arrhythmia is discussed. To our knowledge, there are only two well-documented cases of ventricular irritability which responded to magnesium as the sole treatment. As awareness of such a relationshp increases and magnesium determinations become more available, this entity may be more commonly recognized, and the …

Dissecting Aneurysm Of Aorta Complicating Coarctation Of The Aorta: Case Report And Brief Literature Review, Remigio Garcia, Julius M. Ohorodnik, Donald J. Magilligan Jr.

Henry Ford Hospital Medical Journal

The incidence of dissecting thoracic aorta aneurysm complicating coarctation of the aorta ranges from 1.7 to 23% in large series of coarctation of the aorta reported. In a review of 95 cases of dissection of the aorta, we found only one case with associated coarctation of the aorta. The presence of this anomaly, although rare, should be suspected and searched for in younger patients with dissection, in view of the surgical implications at the time of correction.

Use Of The Intraocular Lens In The Aphakic Eye - Part 1: The Anterior Chamber Intraocular Lens, Philip C. Hessburg

Henry Ford Hospital Medical Journal

Th;s paper reviews some reasons why many ophthalmic surgeons do not implant intraocular lenses. It presents some parameters of a theoretically "ideal" lens, some of the disadvantages and advantages of the currently available anterior chamber intraocular lenses, and lastly, it offers designs for a new anterior chamber intraocular lens. While preserving the advantages of currently available anterior chamber intraocular lenses, the new designs may have certain advantages. Currently under investigation, the new lenses may be available for use in man within the next year.

Back Matter

Henry Ford Hospital Medical Journal

No abstract provided.