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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.

Leisure Preferences Of The Elderly In Bowling Green Nutrition Programs, Lawrence Prochazka

Masters Theses & Specialist Projects

The objective was to identify the leisure preferences of elderly in Bowling Green Nutrition Programs. This objective was to be accomplished through the utilization of a leisure preference test. Since no leisure preference test was found, the study was significant not only for the results obtained but also to evaluate this new test.

The test was designed after the format utilized in the Edwards Personal Preference Test. Major categories were selected and each was composed of five leisure opportunity statements. Each category was placed in opposition to every other category four times to comprise the test. A test was then …

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.

Length Of Perfusion Time In Cadaver Kidney Transplantation, Krishna D. Valjee, Luis H. Toledo-Pereyra, Stanley G. Dienst, Cosme Cruz, Pedro Cortes, Godofredo Santiago, Nathan W. Levin, Riad Farah, Joseph C. Cerny

Henry Ford Hospital Medical Journal

The results of transplantation survival for 70 consecutive cadaver kidneys preserved under hypothermic pulsatile perfusion at Henry Ford Hospital are reviewed. Pulsatile perfusion for up to 30 hours did not adversely alter the survival rate following transplantation. Thus, kidneys perfused for prolonged periods of time (> 20 hours) can be used for transplantation, if the basic rules for organ retrieval and preservation have been followed. Hypothermic pulsatile perfusion of cadaver kidneys has been demonstrated to be an adequate system for ex-vivo preservation for transplantation.

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.

Noninvasive Techniques In The Evaluation Of Arterial Disease, J. Dennis Baker

Henry Ford Hospital Medical Journal

This paper reviews noninvasive technology currently being applied in clinical peripheral vascular laboratories for the evaluation of obstructive arterial disease in the lower extremities and in the cerebral circulation. Lower extremity, arterial insufficiency can be assessed by pressures measured with a Doppler flowmeter or by oscillometric tracings obtained with a Pulse Volume Recorder. Carotid artery stenosis is studied by: 1) ocular pneumoplethysmography, which indirectly measures ophthalmic artery pressure; 2) oculoplethysmography, which compares pulse arrival time at the two eyes; and 3) the Doppler ophthalmic test, which detects the flow pattern in the ophthalmic artery. The main uses of the tests …

Front Matter

Henry Ford Hospital Medical Journal

No abstract provided.

Distant Metastasis Of Locally Controlled Supraglottic Laryngeal Carcinoma: A Report Of Two Cases, Charles N. Ford, William W. Finch, Roger W. Kwong

Henry Ford Hospital Medical Journal

Two cases of supraglottic laryngeal carcinoma are presented in which distant metastasis occurred after adequate local control had been established. The metastasizing tendency of this lesion is discussed, and the efficacy of combined therapeutic approaches in treating these cases is questioned. Submitted

What's New In Crohn's Disease Treatment, Francis J. Owens

Henry Ford Hospital Medical Journal

Progress in the management of Crohn's disease is limited by our inability to compare different patients. Two methods of evaluating the severity of disease have recently been published. Of these, the National Cooperative Crohn's Disease Study (NCCDS) method has been utilized in a study reported on at several national meetings but still in progress. Antibiotics in intensive prolonged dosage, e.g. ampicillin, 500 mg qid for several months, have recently been reported to benefit greater than 90% of patients not responding to conventional therapy. Metronidazole and dapsone continue to be mentioned in letters to journals. Sulfasalazine has been found useful in …

Refractory Hypercalcemia In Sarcoidosis: Exacerbation By Thiazide Diuretics, Differentiation From Primary Hyperparathyroidism, And Possible Role Of Prolactin, A. M. Parfitt

Henry Ford Hospital Medical Journal

Hypercalcemia in a patient with sarcoidosis was made worse by a thiazide diuretic initially given to control hypercalciuria alone. The hypercalcemia was unusually resistant to corticosteroid treatment during the summer even after the thiazide diuretic had been discontinued. Lack of response to corticosteroid together with decreased tubular reabsorption of phosphate and increased tubular reabsorption of calcium suggested associated primary hyperparathyroidism, but PTH was undetectable by immunoassay, and nephrogenous cyclic AMP excretion was zero. Amenorrhea, galactorrhea and hyperprolactinemia were found to be due to a pituitary tumor which was removed. The experience with this patient suggests that: 1) exacerbation of hypercalcemia …

Effect Of Glucagon And Methylprednisolone On Pancreatectomized Recipients Of Whole Pancreas Allografts, Luis H. Toledo-Pereyra, Michael Zammit, Krishna D. Valjee

Henry Ford Hospital Medical Journal

Glucagon alone or in combination with methylprednisolone was an adequate therapeutic adjuvant for pancreatectomized recipients of whole pancreas allografts. All recipients were minimally immunosuppressed with azathioprine, 5.0 mg/K/day for three days, then 2.5 mg/K/day. The morphological, functional, and survival response after whole pancreas transplantation indicated a trend of improvement in the treated groups. Only the groups of dogs receiving glucagon alone or in combination with methylprednisolone survived more than two weeks after transplantation. This therapy has proven to be effective for whole pancreas transplantation.

Letters To The Editor

Henry Ford Hospital Medical Journal

No abstract provided.

1977 Publications Of The Staff Of Henry Ford Hospital

Henry Ford Hospital Medical Journal

No abstract provided.

Back Matter

Henry Ford Hospital Medical Journal

No abstract provided.

Commencement Program 1978, Loma Linda University

Commencement Programs

CONTENTS

2 | 1978 Events of Commencement

3 | Conferring of Degrees

7 | Candidates for Degrees

26 | Awards

28 | Academic Costume

A Descriptive Study Of The Relationship Between Age And Problems Expressed By Women Seeking Out-Patient Mental Health Services, Linda M. Rodgers, Joyce Carey

Dissertations and Theses

The purpose of this study is to provide a descriptive analysis of the problems presented by a specific group of women seeking out-patient mental health treatment and to relate these problems to the ontogenetic (age-related) developmental issues presented in a study of the literature. The researcher's involvement in this area developed from interest in current literature on adult development, and a personal commitment to life-long growth and acceptance of the inherent changes. In order to investigate whether developmental issues exist for this group of women, and if so to describe them, two distinct age groups--the decades of the 20's and …

Studies On Uveitis Part Ii: Hypotheses With Case Reports, Philip C. Hessburg

Henry Ford Hospital Medical Journal

A number of patients with and without uveitis are used to show that this study of aqueous microbiology suggests the following hypotheses: 1. Routine techniques currently used in most microbiology laboratories overlook classical and variant bacteria which might be isolated from clinical specimens with improved microbiological techniques. 2. Bacterial forms may be present in other ocular tissue when not present in the aqueous. 3. Polymicrobial infections probably occur rather frequently, especially in chronic or subacute inflammatory states. 4. Alterations in various host factors may subject some persons to a greater incidence of inflammatory episodes including uveitis. 5. Antibiotics used in …

Front Matter

Henry Ford Hospital Medical Journal

No abstract provided.

Effect Of Perfusate Osmolarity On Hearts Preserved Under Hypothermic Pulsatile Perfusion For 24 Hours, Luis H. Toledo-Pereya, Manuel Chee, Richard C. Lillehei

Henry Ford Hospital Medical Journal

Canine hearts preserved under hypothermic pulsatile perfusion (24 hours) with an osmolarity of 340 mOsm/L had better preservation and transplantation response than hearts perfused at an osmolarity of 310 and 270 mOsm/L. The hearts perfused at 340 mOsm /L survived an average of 22.6 days after transplantation. This survival was significantly (p>0.05) better than that observed after fresh transplantation (13.4 days average). Hearts perfused at 270 mOsm /L had a significantly (p>0.05) lower survival after transplantation (5.8 days average) than the fresh allografts or the hearts perfused at 310 or 340 mOsm / L. Similar survival times were …

Retroperitoneal Ganglioneuroma: A Case Report And Review Of Literature, Mohammed R. Ansari, Vellore Ramakrishnan, K. S. Rajan

Henry Ford Hospital Medical Journal

Ganglioneuroma, a tumor of neural crest origin, is a rare neoplasm; to encounter it in an adult over 50 years of age is very rare. This report describes the case of a 56-year-old man who was seen at Henry Ford Hospital with an abdominal mass confirmed as ganglioneuroma on histopathology. Experience at Henry Ford Hospital and the available literature on the subject are reviewed.

The Quantitative Determination Of 3-Oxo-Bile Acids, W. T. Beher, G. J. Lin, J. Sanfield, S. Stradnieks

Henry Ford Hospital Medical Journal

A new method for the rapid quantification of 3-oxo-bile acids has been developed. From 5 to 120 μg of oxo-acid in aqueous or ethanolic media are reduced with sodium borohydride. The resulting 3α- and 3β-hydroxy acids are then oxidized in a reaction catalyzed by 3-hydroxysteroid dehydrogenase, during which nicotinamide adenine dinucleotide (NAD) is reduced to NADH. The absorbance of the reaction mixture is determined at 340 nm and is directly proportional to the amount of 3-oxo-acid in the original sample. The method is fully compatible with that used in determining 3α-hydroxy-bile acids.

Chondrosarcoma: A Report Of 65 Cases, Kent K. Wu, Edwin R. Guise, Harold M. Frost, C. Leslie Mitchell

Henry Ford Hospital Medical Journal

A statistical analysis is presented of 65 cases of chondrosarcoma treated at Henry Ford Hospital from 1916 to 1976, with adequate follow-up data.