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Prad1 (Cyclin D1): A Parathyroid Neoplasia Gene On 11q13, Andrew Arnold, Toru Motokura, Theodora Bloom, Carol Rosenberg, Allen Bale, Henry Kronenberg, Joan Ruderman, Milton Brown, Hyung Goo Kim Sep 1992

Prad1 (Cyclin D1): A Parathyroid Neoplasia Gene On 11q13, Andrew Arnold, Toru Motokura, Theodora Bloom, Carol Rosenberg, Allen Bale, Henry Kronenberg, Joan Ruderman, Milton Brown, Hyung Goo Kim

Henry Ford Hospital Medical Journal

Hyperparathyroidism is a central component of multiple endocrine neoplasia type 1 (MEN 1), and both sporadic and familial forms of parathyroid disease may share certain pathogenetic features. We recently identified a gene that is clonally rearranged with the PTH locus in a subset of sporadic parathyroid adenomas. This candidate oncogene, PRAD1 (previously D11S287), appears to contribute to parathyroid tumorigenesis in a fashion analogous to activation of C-MYC or BCL-2 by rearrangement with tissue-specific enhancers of the immunoglobulin genes in B-lymphoid neoplasia. The PRAD1 gene maps to 11q13 and has been linked to the BCL-1 breakpoint locus, although not to the …


Primary Hyperparathyroidism In Patients With Multiple Endocrine Neoplasia Type 1: Experience By A Single Surgical Team In Japan, Takao Obara, Yoshihide Fujimoto, Yukio Ito Sep 1992

Primary Hyperparathyroidism In Patients With Multiple Endocrine Neoplasia Type 1: Experience By A Single Surgical Team In Japan, Takao Obara, Yoshihide Fujimoto, Yukio Ito

Henry Ford Hospital Medical Journal

Nineteen patients were surgically treated for hyperparathyroidism associated with multiple endocrine neoplasia type 1 syndrome. Fourteen patients (74%) had removal of three or more parathyroid glands at the first operation, and five (26%) by removal of 2 1/2 or fewer glands. Two patients had recurrent hypercalcemia during the mean follow-up period of 65 months. One had a recurrence 10 years after subtotal parathyroidectomy. Reexploration in this patient revealed enlargement of the remaining tissue in the neck and an enlarged supernumerary gland in the aorticopulmonary window. The other patient had persistent hypercalcemia after removal of two hyperplastic parathyroid glands until after …


Expression Of The Ret Proto-Oncogene In Human Medullary Thyroid Carcinomas And Pheochromocytomas Of Men 2a, Akihiro Miya, Masayuki Yamamoto, Hideki Morimoto, Norifumi Tanaka, Esei Shin, Katsu Karakawa, Kumao Toyoshima, Yukihito Ishizaka, Takesada Mori, Shin-Ichiro Takai Sep 1992

Expression Of The Ret Proto-Oncogene In Human Medullary Thyroid Carcinomas And Pheochromocytomas Of Men 2a, Akihiro Miya, Masayuki Yamamoto, Hideki Morimoto, Norifumi Tanaka, Esei Shin, Katsu Karakawa, Kumao Toyoshima, Yukihito Ishizaka, Takesada Mori, Shin-Ichiro Takai

Henry Ford Hospital Medical Journal

We studied the expression of the ret proto-oncogene (proto-ret) in human medullary thyroid carcinomas (MTCs) and pheochromocytomas of multiple endocrine neoplasia type 2A (MEN 2A) by Northern blot analysis. Expression of the normal-sized transcripts was detected in all 12 MTCs and in 6 of 8 pheochromocytomas. In situ localization of proto-ret mRNA revealed that the signal was confined to the cytoplasm of MTC cells. By Southern blot analysis neither amplification nor gross genetic changes of proto-ret were found in the tumors. Although no transcripts were detected in the normal portion of the thyroid from one MEN 2A patient,faint signals were …


Medullary Thyroid Carcinoma: Australian Experience With Genetic Testing, Janet L. Ward, Valentine J. Hyland, David S. Andrew, Debbie J. Marsh, Bruce G. Robinson Sep 1992

Medullary Thyroid Carcinoma: Australian Experience With Genetic Testing, Janet L. Ward, Valentine J. Hyland, David S. Andrew, Debbie J. Marsh, Bruce G. Robinson

Henry Ford Hospital Medical Journal

Linkage analysis has been performed in four pedigrees with multiple endocrine neoplasia type 2A (MEN 2A) or familial medullary thyroid carcinoma (MTC) using pericentromeric chromosome 10 probes. Important information regarding carrier status has been provided in 10 individuals, many of whom would not have been identified by pentagastrin stimulation testing. We have also used pulsed field gel electrophoresis (PFGE) to link the probes H4JRBP and pMCK2 to a 150 kb fragment. Using PFGE, no evidence was found in DNA from lymphocytes of a major DNA rearrangement in two individuals affected with MEN 2A and an individual with MEN 2B compared …


Cutaneous Lesion Associated With Multiple Endocrine Neoplasia Type 2a: Lichen Amyloidosis Or Notalgia Paresthetica?, O. Chabre, F. Labat, N. Pinel, F. Berthod, V. Tarel, I. Bachelot Sep 1992

Cutaneous Lesion Associated With Multiple Endocrine Neoplasia Type 2a: Lichen Amyloidosis Or Notalgia Paresthetica?, O. Chabre, F. Labat, N. Pinel, F. Berthod, V. Tarel, I. Bachelot

Henry Ford Hospital Medical Journal

Three patients of a French family demonstrated an association of multiple endocrine neoplasia type 2A (MEN 2A) with a pruritic scapular skin lesion. The lesions are similar to those described as familial cutaneous lichen amyloidosis in unrelated MEN 2A and medullary thyroid carcinoma families, but histological, immunohistochemical, and ultrastructural analysis of skin biopsies from each patient in the French family did not show amyloid deposition. The topography of the lesion follows dermatomes C8-D3. The patients report not only pruritus but also paresthesia and hyperalgesia, and one showed touch hypoesthesia and pain hyperesthesia in the area of the lesion. Such an …


Unusual Features Of Multiple Endocrine Neoplasia, Andrea Frilling, Heinz Becker, Hans-Dietrich Roeher Sep 1992

Unusual Features Of Multiple Endocrine Neoplasia, Andrea Frilling, Heinz Becker, Hans-Dietrich Roeher

Henry Ford Hospital Medical Journal

In addition to the common presentations of the multiple endocrine neoplasia (MEN) syndromes, unusual organ involvement as rare manifestations of a single disease may occur. Among our patients we have identified four cases in which unusual features of MEN were present. In the first patient, bilateral adrenal cortical adenoma, parathyroid adenoma, multiple pancreatic tumors, and follicular thyroid carcinoma were observed. The second patient suffered from thymic carcinoid, parathyroid hyperplasia, gastrinoma, and pituitary adenoma. Additionally, one family was discovered in which medullary thyroid carcinoma (MTC), Hirschsprung's disease, and pheochromocytoma occurred and another family had MTC and ovarian cancer. Based on these …


Statistical Analysis Of Histomorphological Findings In Medullary Thyroid Carcinoma: Distinction Between The Different Familial Forms Of The Disease, B. Franc, M. Rosenberg-Bourgin, B. Auvert, B. Caillou, N. Dutrieux-Berger, J. Floquet, M. Houcke-Lecomte, E. Justrabo, F. Labat-Moleur, M. F. Le Bodic, A. Pages, M. Patey, G. Viennet, F. Vilde, J. P. Saint-Andre Sep 1992

Statistical Analysis Of Histomorphological Findings In Medullary Thyroid Carcinoma: Distinction Between The Different Familial Forms Of The Disease, B. Franc, M. Rosenberg-Bourgin, B. Auvert, B. Caillou, N. Dutrieux-Berger, J. Floquet, M. Houcke-Lecomte, E. Justrabo, F. Labat-Moleur, M. F. Le Bodic, A. Pages, M. Patey, G. Viennet, F. Vilde, J. P. Saint-Andre

Henry Ford Hospital Medical Journal

A multifactorial analysis of morphological findings was performed on 153 cases of medullary thyroid carcinoma (MTC). The aim of the study was to utilize histological criteria to discriminate between MTC associated with multiple endocrine neoplasia type 2A (MEN 2A) and that associated with the inherited MTC only syndrome. The presence of fusiform cells associated with several other markers seemed to he more predictive of MEN 2A. A comparison of inherited MTC only and sporadic MTC only showed fusiform cells to be significantly less common in inherited MTC only. These results suggest that the inherited MTC only syndrome is a distinct …


Surgical Approach Of Synchronous Medullary Thyroid Carcinoma And Pheochromocytoma In Men 2 Syndrome, Georg F. W. Scheumann, Henning Dralle Sep 1992

Surgical Approach Of Synchronous Medullary Thyroid Carcinoma And Pheochromocytoma In Men 2 Syndrome, Georg F. W. Scheumann, Henning Dralle

Henry Ford Hospital Medical Journal

In cases with concurrent medullary thyroid carcinoma (MTC) and pheochromocytoma, discussion regarding a one-stage versus two-stage treatment strategy approach remains open. From 1975 to 1990, 11 of 25 multiple endocrine neoplasia type 2 (MEN 2) patients presented with biendocrinopathies or triendocrinopathies synchronously. All patients were treated surgically and followed subsequently in our hospital. Of the group of nine patients with concurrent MTC and pheochromocytoma, five were treated in one-stage and four in two-stage procedures. No patient had major complications intraoperatively. For the two-stage group, the total hospital stay (preoperatively and postoperatively) averaged 35 days. For the one-stage group, the total …


Somatostatin Acts Via A Pertussis Toxin-Sensitive Mechanism On Calcitonin Secretion In C-Cells, Angela Zink, Hans Scherubl, Friedhelm Raue, Reinhard Ziegler Sep 1992

Somatostatin Acts Via A Pertussis Toxin-Sensitive Mechanism On Calcitonin Secretion In C-Cells, Angela Zink, Hans Scherubl, Friedhelm Raue, Reinhard Ziegler

Henry Ford Hospital Medical Journal

The effect of the somatostatin analog octreotide on cAMP-mediated calcitonin (CT) secretion and cAMP accumulation in C-cells was investigated. Glucagon stimulated cAMP accumulation and CT secretion with a maximal effect at a concentration of 10-6 M. The cAMP antagonist RpcAMPs blocked the glucagon-induced CT secretion down to control levels. Therefore, no other second messengers seem to be involved in glucagon-stimulated CT secretion. Octreotide in increasing doses (10-9 to 10-6 M) inhibited cAMP accumulation and CT secretion with a maximal effect at a concentration of 10-7 (40% and 29% of control values, respectively). Pretreatment of the cells …


Biologic And Cytogenetic Characterization Of Three Human Medullary Thyroid Carcinomas In Culture, R. Pfragner, G. Wirnsberger, A. Behmel, B. Niederle, F. Längle, R. Roka, A. Mandl, P. Pürstner, J. Auner, F. Tatzber Sep 1992

Biologic And Cytogenetic Characterization Of Three Human Medullary Thyroid Carcinomas In Culture, R. Pfragner, G. Wirnsberger, A. Behmel, B. Niederle, F. Längle, R. Roka, A. Mandl, P. Pürstner, J. Auner, F. Tatzber

Henry Ford Hospital Medical Journal

Neuroendocrine features and cytogenetic abnormalities of one continuous cell line (MTC-SK) and two long-term cultures (GER, STAH) derived from three sporadic cases of human medullary thyroid carcinomas (MTCs) were studied. Specific neuroendocrine markers (NSE, chromogranins, calcitonin, calcitonin gene-related peptide) were identified by electron microscopy and immunocytochemistry. In situ hybridochemistry and Northern blot analysis confirmed endocrine activity. Cytogenetic studies of the cell line MTC-SK revealed three consistent marker chromosomes, t(3;10), 11p+, and 22p+. Cells of long-term cultures GER and STAH exhibited a consistent translocation t(2;18), a trisomy 7, and two consistent marker chromosomes der3 and 5p+, respectively. Recently, we have isolated …


Back Matter Sep 1992

Back Matter

Henry Ford Hospital Medical Journal

No abstract provided.


Urban Health Care: Solutions For The 1990s, David R. Nerenz, David W. Benfer Mar 1992

Urban Health Care: Solutions For The 1990s, David R. Nerenz, David W. Benfer

Henry Ford Hospital Medical Journal

No abstract provided.


Urban Health Solutions In The 1990s: No Time For False Promises, Seth Foldy Mar 1992

Urban Health Solutions In The 1990s: No Time For False Promises, Seth Foldy

Henry Ford Hospital Medical Journal

No abstract provided.


Health Care Linkage Project: Improving Access To Care, Martha G. Ferguson, Lon Berkeley, Louis Fourcher, Belinda Guyton, Linda Ross Reiner Mar 1992

Health Care Linkage Project: Improving Access To Care, Martha G. Ferguson, Lon Berkeley, Louis Fourcher, Belinda Guyton, Linda Ross Reiner

Henry Ford Hospital Medical Journal

The primary objective of the Health Care Linkage Project, funded by a grant from the Chicago Community Trust, is to develop, implement, and evaluate a primary health care linkage network within the city of Chicago that creates formalized linkages between community health centers, the Chicago Department of Health clinics, and hospitals. Six linkage networks are currently operational, with an additional two sites phased in during 1991. The success of the pilot project has been demonstrated by hundreds of patients receiving primary care and ancillary services on a more timely basis, by greater coordination between the public and private sector, by …


Universal Health Care For Americans, Frank Clemente Mar 1992

Universal Health Care For Americans, Frank Clemente

Henry Ford Hospital Medical Journal

No abstract provided.


Urban Health Care: An Integral Part Of The United States Health Care System, Sander M. Levin Mar 1992

Urban Health Care: An Integral Part Of The United States Health Care System, Sander M. Levin

Henry Ford Hospital Medical Journal

No abstract provided.


Public Health Care Delivery In Five U.S. Municipalities: Lessons And Implications, David G. Whiteis, J. Warren Salmon Mar 1992

Public Health Care Delivery In Five U.S. Municipalities: Lessons And Implications, David G. Whiteis, J. Warren Salmon

Henry Ford Hospital Medical Journal

Increasing pressures on private and public hospitals have necessitated a reassessment of urban health care delivery. Patients left unserved by stressed private hospitals have placed a greater burden on public institutions, which themselves are often old, underfunded, and in danger of closure. As policy analysts consider remedies, primary care in community-based settings has reemerged as an important component of planning. We present results of a comparative analysis of five public health care delivery systems (Boston, Dallas, Denver, Milwaukee, and Seattle), reflecting their economic, political, and cultural dynamics. Although significant differences in the relative centralization of care and reliance on community-based …


Community Health Centers: A Resource For Service And Training, Joan Hedgecock, Maria Castro, William B. Cruikshank Mar 1992

Community Health Centers: A Resource For Service And Training, Joan Hedgecock, Maria Castro, William B. Cruikshank

Henry Ford Hospital Medical Journal

The American Medical Student Association (AMSA) Foundation is assisting the U.S. Public Health Service in increasing the number of primary care physicians trained and committed to practice in medically underserved areas. In collaboration with the American Academy of Family Physicians, the Ambulatory Pediatrics Association, and the Society of General Internal Medicine, AMSA conducted an assessment of federally-funded residency programs to identify and describe their affiliations with federally-funded community and migrant health centers (CIMHCs). Of the 260 programs assessed and the 147 responses, 125 offer community-based training. Of these, 73 offer training in primary care centers and 39 offer training in …


The Structure And Function Of Urban Pharmacies: Visits To Community Pharmacies In Inner-City Chicago, Thomas J. Reutzel, Laura A. Wilson Mar 1992

The Structure And Function Of Urban Pharmacies: Visits To Community Pharmacies In Inner-City Chicago, Thomas J. Reutzel, Laura A. Wilson

Henry Ford Hospital Medical Journal

Visits were made to 21 pharmacies in two poor neighborhoods on the west side of Chicago and interviews conducted with pharmacists-in-charge. The objective of the study was to provide a comprehensive description of the function, capabilities, and problems of urban pharmacy. We present results on the structure and function of these inner-city pharmacies. The pharmacies fit one of three structural forms: chain, independent, or medical center. The majority of respondents viewed the function of the inner-city pharmacy as patient-centered but also identified several barriers to effective patient communication. The results suggest that inner-city physicians and pharmacists should communicate with patients …


Urban Health And The Social Contract: Poverty, Race, And Death, H. Jack Geiger Mar 1992

Urban Health And The Social Contract: Poverty, Race, And Death, H. Jack Geiger

Henry Ford Hospital Medical Journal

No abstract provided.


Moving From Health Care Research To Action, Claudia R. Baquet, Katherine Marconi, George Alexander Mar 1992

Moving From Health Care Research To Action, Claudia R. Baquet, Katherine Marconi, George Alexander

Henry Ford Hospital Medical Journal

Although the United States spends more on health care than any country in the world, access to that care is becoming increasingly difficult. The National Cancer Institute and other federal agencies are sponsoring innovative research for delivering effective medical services, particularly to underserved populations. Models of successful collaboration between private and public sectors concerned with health care can be adapted and implemented at the national, state, and local levels. However, other measures are needed to ensure access to adequate health care for all Americans. Minimal but effective regulations are needed to ensure quality control, reduce duplication of services, and minimize …


Mount Sinai: A Special Hospital For A Special Community, Benn Greenspan Mar 1992

Mount Sinai: A Special Hospital For A Special Community, Benn Greenspan

Henry Ford Hospital Medical Journal

No abstract provided.


Urban Hospitals: Their Plight And Mission, Jeffrey C. Merrill, Elliott C. Roberts, Mary Corita Heid Mar 1992

Urban Hospitals: Their Plight And Mission, Jeffrey C. Merrill, Elliott C. Roberts, Mary Corita Heid

Henry Ford Hospital Medical Journal

No abstract provided.


Adenocarcinoma Of The Prostate: Overview Ii, Joseph C. Cerny Mar 1992

Adenocarcinoma Of The Prostate: Overview Ii, Joseph C. Cerny

Henry Ford Hospital Medical Journal

No abstract provided.


Radical Surgery In The Treatment Of Localized Carcinoma Of The Prostate, Dinesh J. Telang, Brian J. Miles, Riad N. Farah, Ray H. Littleton, Aaron K. Kirkemo, James O. Peabody, David A. Burks, Caleb Fleming, Joseph C. Cerny Mar 1992

Radical Surgery In The Treatment Of Localized Carcinoma Of The Prostate, Dinesh J. Telang, Brian J. Miles, Riad N. Farah, Ray H. Littleton, Aaron K. Kirkemo, James O. Peabody, David A. Burks, Caleb Fleming, Joseph C. Cerny

Henry Ford Hospital Medical Journal

New methods of early detection combined with recent advances in surgical techniques have resulted in more patients undergoing radical surgery for treatment of localized carcinoma of the prostate. Over 350 radical prostatectomies have been performed by our group since January 1987. We review the role of radical prostatectomy in the treatment of prostate cancer and our experience with 100 patients undergoing radical retropubic prostatectomy since the advent of nerve-sparing techniques to preserve potency.


The Current Role Of Prostatic Acid Phosphatase And Prostate-Specific Antigen In The Management Of Prostate Cancer, Sugandh D. Shetty, Joseph C. Cerny Mar 1992

The Current Role Of Prostatic Acid Phosphatase And Prostate-Specific Antigen In The Management Of Prostate Cancer, Sugandh D. Shetty, Joseph C. Cerny

Henry Ford Hospital Medical Journal

No abstract provided.


Management Of Impotence After Treatment Of Carcinoma Of The Prostate, Dinesh J. Telang, Riad N. Farah Mar 1992

Management Of Impotence After Treatment Of Carcinoma Of The Prostate, Dinesh J. Telang, Riad N. Farah

Henry Ford Hospital Medical Journal

Impotence commonly occurs as a result of treatment of carcinoma of the prostate. We review the etiology, evaluation, and treatment options available for these patients as well as our experience with fifty prostate cancer patients who underwent placement of penile prostheses. Several excellent alternatives are available for patients with impotence resulting from treatment of carcinoma of the prostate.


An Update On The Role Of Ploidy In Prostate Carcinoma, Jill M. Peters-Gee Mar 1992

An Update On The Role Of Ploidy In Prostate Carcinoma, Jill M. Peters-Gee

Henry Ford Hospital Medical Journal

One of the characteristic features of prostate carcinoma is its marked variation in biologic behavior. DNA quantitation has been studied in prostate carcinoma using a variety of techniques. Evaluation of tumor ploidy suggests that this may be the best predictor of the biologic behavior of prostate cancer in individual patients. This comprehensive review addresses the current studies, stage by stage, to clarify the clinical significance of these findings.


Maximal Androgen Ablation: A Review, Brian J. Miles, Joseph Babiarz Mar 1992

Maximal Androgen Ablation: A Review, Brian J. Miles, Joseph Babiarz

Henry Ford Hospital Medical Journal

Primary management of advanced (stage D) adenocarcinoma of the prostate is androgen ablation. Since this principle was discovered in the early 1940s, therapeutic alternatives and "progress" have centered around different ways to obtain castrate levels of androgens. The role of adrenal androgens in supporting prostate or prostatic cancer growth has been debated for decades and until recently was believed to be minimal. In the 1980s the concept of maximum androgen suppression, involving both the testes and adrenal glands, was reintroduced with some investigators claiming exceptional results. We review studies that have examined this concept, with emphasis on the largest trial …


Megakaryoblastic Termination Of Myeloproliferative Disorders, Mahul B. Amin, Koichi Maeda, John L. Carey, Ramesh V. Babu, B. K. S. Raman Mar 1992

Megakaryoblastic Termination Of Myeloproliferative Disorders, Mahul B. Amin, Koichi Maeda, John L. Carey, Ramesh V. Babu, B. K. S. Raman

Henry Ford Hospital Medical Journal

Megakaryoblastic termination of myeloproliferative disorders is rare. The morphology of megakaryoblastic transformation can be subtle and is often mistaken for myeloid or lymphoid proliferations. Previously reported observations suggest a relatively poor prognosis for this category of patients, making precise diagnosis imperative. A multifaceted approach using morphology, ultrastructure, cytochemistry, and immunological membrane analysis may be helpful. We present two cases of myeloproliferative disorder with aggressive megakaryoblastic phases (myelofibrosis with agnogenic myeloid metaplasia and chronic myeloid leukemia with blast crisis). The clinical course is described and the results of the morphological, cytochemical, ultrastructural, and cytogenetic studies of both cases are presented. In …