Medicine and Health Sciences Commons^™

Update - June 1988, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- LLU schedules clinical ethics seminar for 1989
-- Humphry and Takken debate California death initiative
-- Jack Provonsha lectureship inaugurated at A.P.C.

[ Settings Medical Limits ]
-- Ethics and Old Age
-- A Response to Fletcher
-- How Old is Too Old?

-- Metaphors and Medicine (Review)

The Development And Application Of A Multiple Regression Equation That Predicts The Sum Of Triceps And Subscapular Skinfolds In Children Ages 10-18, Pamela Luna-Raffy

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to develop a tool to predict the sum of triceps and subscapular skinfolds in children ages 10-18. In addition, school-based weight management programs were reviewed.

Skinfold calipers are often used to assess body fat percentage, particularly in non-clinical settings, test sites recommended by researchers are the triceps and The subscapular skinfolds. Recently, however, educators have reported two concerns about using skinfold calipers in the schools: (1) Specialized training and equipment are required, and (2) individuals must remove their clothing from selected test sites.

For schools where the use of calipers present problems, it seemed …

Decreased Triiodothyronine Binding To The Hepatic Nuclear Thyroid Hormone Receptor In The Diabetic Mouse, Thomas J. Dewind

Loma Linda University Electronic Theses, Dissertations & Projects

The diabetic C57BL/KsJ-db m mouse has abnormal thyroid hormone levels and indications of thyroid hormone resistance. To investigate the basis of these abnormalities, the hepatic nuclear thyroid hormone receptor was extracted with 0.4 M KCl, 1.1 mM MgCl₂, 20 mM Tris/HCl, pH 7.9 from hepatocyte nuclei of normal C57BL/KsJ, heterozygous C57BL/KsJ-db m (db/m), and diabetic C57BL/KsJ-db m (db/db) mice. Normal and heterozygous mice were grouped together as the controls. Triiodothyronine (T₃) binding studies at 4°C using nitrocellulose filtration to separate free T₃ from receptor bound T₃ demonstrated an …

Treatment Of Periodontal Furcation Defects, Michael Martin, Bernard Gantes

Loma Linda University Electronic Theses, Dissertations & Projects

[Note: Three parts in one.]

I. Review of the Literature and Description of a Regeneration Surgical Technique

This report provides an abbreviated review of the literature on treatment and prognosis of periodontal furcation lesions. In addition, it describes a surgical technique designed to accomplish bone regeneration in class II furcation defects, together with the rationale for the development of this procedure. Results of treatment of 30 defects with this technique are presented in a subsequent report (Gantes et al. 1987).

II. Bone Regeneration in Mandibular Class II Defects

A total of 30 mandibular, buccal class II furcation defects were treated …

Sensitivity To Sulfited Foods Among Sulfite-Sensitive Subjects With Asthma, Steve L. Taylor, Robert K. Bush, John C. Selner, Julie A. Nordlee, Matthew B. Wiener, Karen Holden, Jerald W. Koepke, William W. Busse

Department of Food Science and Technology: Faculty Publications

Eight individuals with asthma who had been diagnosed as sulfite sensitive on the basis of double-blind capsule-beverage challenges were subjected to challenges with various sulfited foods, including lettuce, shrimp, dried apricots, white grape juice, dehydrated potatoes (as mashed potatoes), and mushrooms. Four of these patients failed to respond to challenges with any of the sulfited foods. The other four patients experienced a decrease in pulmonary function on double-blind challenges with sulfited lettuce. Two of three of these patients reacted to challenges with dried apricots and white grape juice; the fourth patient has not yet been challenged with these products. Only …

Prediction Of Intellectual Deficits In Children With Acute Lymphocytic Leukemia, Paul Trautman, Candace Erickson, David Shaffer, Patricia O'Connor, Annaliese Sitarz, Antonio Correra, Irvin Sam Schonfeld

Publications and Research

Possible predictors of reported lower cognitive functioning in irradiated children with acute lymphoblastic leukemia (ALL) were investigated. Thirty-four subjects, 5-14 years old, with ALL in continuous complete remission and without evidence of current or past central nervous system disease, were examined 9-110 months after diagnosis, using standard measures of intelligence and academic achievement. Subjects with a history of post-irradiation somnolence syndrome were significantly older at diagnosis than nonsomnolent subjects. Intelligence (IQ) was found to be unrelated to history of somnolence syndrome. IQ and achievement were unrelated to age at irradiation, irradiation-examination interval, and radiation dosages. The strongest predictor of IQ …

Magnetic Resonance Imaging Of Oromandibular Limb Hypogenesis Syndrome (Olhs) : Type 1a Congenital Hypoglossia With Micrognathia, Edmond H. Henken

Loma Linda University Electronic Theses, Dissertations & Projects

An eighteen-year old female with Oromandibular Limb Hypogenesis Syndrome Type 1A was imaged with Magnetic Resonance in the sagittal, coronal, and transverse planes with the jaws closed. The intrinsic muscles of the tongue, genioglossus, geniohyoid, mylohyoid, medial and lateral pterygoid muscles were identified and compared with a control of the same age and sex. All the muscles in question were present. Combined with the intrinsic muscles of the tongue, the genioglossus were approximately one-half the size of the control in the sagittal plane. The geniohyoid of the OLHS subject was enlarged most probably due to the hyperactivity of the floor …

Epidemic Non-A Non-B Hepatitis In Urban Karachi, Pakistan, R A Jr Smego, A A. Khaliq

Section of Gastroenterology

An outbreak of icteric non-A non-B (NANB) hepatitis occurred in a residential community of urban Karachi, Pakistan, from August 1986 through October 1986. Of the 114 cases reported from this community during the 1986 calendar year, a clustering of 85 cases was seen during the above period. Twenty-seven percent of 226 households and 9% of 1,250 individuals were affected. Five persons were hospitalized and 1 death occurred in a young pregnant woman. Cases occurred predominantly in the less than or equal to 29-year-old age group (72%), with a male:female ratio of 1.8:1. Thirty-four cases occurred singly within households, while in …

Ua12/2/1 Magazine, Wku Student Affairs

WKU Administration Documents

Special magazine edition of the College Heights Herald.

• Poore, Chris. The Jovial Judge – District Court Judge Tom Lewis
• White, Douglas. Dealing with Death
• White, Douglas. Hospice Eases Death Crisis
• Albrecht, Dana. Friends Forever – short story

Vital Signs, April 1988, Boonshoft School Of Medicine

Vital Signs

A twelve 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, alumni profiles, class notes, and more.

Digest Of The Philadelphia College Of Osteopathic Medicine (Spring 1988), Philadelphia College Of Osteopathic Medicine

Digest

The Spring 1988 issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• First Contact
• DO's in the Arts
• How We Do lt!
• Giving & Receiving
• Alumni Notes
• On Campus
• Class Acts
• In Memoriam
• Calendar

Simple Capsule Pneumograph, Steve S. Kraman

Internal Medicine Faculty Patents

A capsule pneumograph includes an electret microphone connected to a capsule chestpiece attached to a sleeping subject. The output of the microphone is connected to the input of a recorder or monitor in order to provide a system for the detection of respiratory movements in subjects during polysomnographic sleep monitoring. A tube connecting the capsule chestpiece to the microphone functions as a low pass filter to pass only low frequency signals in the range of respiratory movements from the chestpiece to the microphone.

From 'The Help Of Grave And Modest Women' To 'The Care Of Men Of Sense': The Transition From Female Midwifery To Male Obstetrics In Early Modern England, Karen L. Smith Adams

Dissertations and Theses

Until the sixteenth century, childbirth in England was the exclusive domain of women and was orchestrated by the female midwife. By the end of the seventeenth century, university-educated and church-approved male physicians were systematically beginning to usurp the midwife's role in the lying-in room and to gradually assume authority and power over the process of childbirth. Ultimately doctor-dominated childbirth threatened, and in some places accomplished, the displacement of the midwife. No one factor was responsible for the shift in delivery room personnel nor was the transition from female midwives to male obstetricians a "natural" one. This thesis looks at three …

A Mathematical Model Of Lung Static Pressure-Volume Relationships: Comparison Of Clinically Derived Parameters Of Elasticity, William Benish, Peggy Harper, Joseph Ward, John Popovich Jr.

Henry Ford Hospital Medical Journal

We constructed a simple model of lung distensibility in which the relationship between pressure (P) and volume (V) is of the exponential form obtained empirically: V = a+ becP , where a, b, and c are constants, and e is the base of the natural logarithm. The model lung is idealized as a frictionless diaphragm moving in a cylinder. Diaphragm movement is impeded by a variable force (F). By assuming that the rate of change of F is proportional to the inverse of the distance of the diaphragm from a maximal distance, the pressure-volume relationship assumes the above exponential form. …

Anticoagulant And Antithrombotic Therapy In Deep Venous Thrombosis And Pulmonary Embolism, Paul D. Stein

Henry Ford Hospital Medical Journal

No abstract provided.

A Double-Blind Trial Of Protriptyline In The Treatment Of Sleep Apnea Syndrome, Edward J. Stepanski, William A. Conway, David K. Young, Frank J. Zorick, Robert M. Wittig, Thomas Roth

Henry Ford Hospital Medical Journal

Eight male subjects with sleep apnea syndrome were given placebo and protriptyline in a double-blind crossover design to evaluate the effects of protriptyline on respiration during sleep. Treatment with protriptyline produced significantly better oxygenation and significantly fewer arousals during sleep, but sleep staging was unchanged. The decreased number of respiratory events approached significance and was much greater in six of eight subjects. A rapid eye movement sleep-suppression explanation of the improvement in oxygenation is not supported. Alternative explanations of these findings are discussed.

Sleep-Wake Complaints And Their Relation To Sleep Disturbance, De Ton, Frank J. Zorick, Timothy A. Roehrs, Robert M. Wittig, Jeanne M. Sicklesteel, Thomas Roth

Henry Ford Hospital Medical Journal

This report is a comparison of patients presenting with 1) an insomnia complaint diagnosed as no objective findings. 2) insomnia diagnosed as being associated with a psychiatric disorder, and 3) daytime sleepiness diagnosed as no objective findings. The sleep of patients with insomnia diagnosed as no objective findings is comparable to that of patients with daytime sleepiness diagnosed as no objective findings and is significantly better than that of patients with insomnia associated with a psychiatric disorder. Significant differences were found in sleep induction, sleep maintenance, and overall sleep efficiency. No major differences were found among any of the groups …

A Prospective Randomized Comparison Of A Single Antibiotic (Moxalactam) Versus Combination Therapy (Gentamicin And Clindamycin) In Penetrating Abdominal Trauma, Theodore Fifer, Farouck N. Obeid, H. Mathilda Horst, Victor J. Sorensen, Larry D. Crots, Brack A. Bivins

Henry Ford Hospital Medical Journal

From July 1 to December 31, 1983, 50 consecutive patients undergoing abdominal exploration for penetrating abdominal trauma from stab and gunshot wounds were prospectively randomized to receive postinjury, preoperative antibiotic coverage with moxalactam (2 g intravenously every 12 hours) or a combination of gentamicin (3 to 5 mg/kg/day in three equal doses administered every eight hours) and clindamycin (600 mg intravenously every six hours). No intraabdominal abscesses or wound infections developed, and no direct evidence of toxicity of the antibiotic regimens developed in either group. In the study group, moxalactam therapy was an effective alternative to the combination antibiotic regimen. …

Back Matter

Henry Ford Hospital Medical Journal

No abstract provided.

Clinical Significance Of Sleep Desaturation In Hypoxemic Chronic Obstructive Pulmonary Disease: Studies In 130 Patients, William A. Conway, Meir Kryger, Richard M. Timms, George W. Williams

Henry Ford Hospital Medical Journal

We studied 130 patients with hypoxemic chronic obstructive lung disease to determine if nocturnal desaturation aggravates hypoxia-induced complications. All had tests of neuropsychological and physiological function known to be affected by chronic hypoxia. Of the 130 patients, 25 had complete polysomnography and 105 had their sleep judged visually and arterial oxygen saturation recorded continuously. Severe and mild desaturation groups were defined relative to the mean for both mean and maximal sleep desaturation, and the severity of waking complications were compared. No significant differences were noted between patients with mild and severe mean desaturation or maximal desaturation for hematocrit, neuropsychological tests, …

Front Matter

Henry Ford Hospital Medical Journal

No abstract provided.

Sleep Disorders Medicine, Thomas Roth

Henry Ford Hospital Medical Journal

No abstract provided.

Familial Childhood Sleep Apnea, Robert M. Wittig, Frank J. Zorick, Timothy A. Roehrs, Jeanne M. Sicklesteel, Thomas Roth

Henry Ford Hospital Medical Journal

We report four siblings who had polysomnographically documented sleep apnea. Two presented with the typical clinical picture of sleep apnea syndrome including daytime somnolence and snoring, had repetitive obstructive apneic episodes during sleep, and were effectively treated with upper airway surgery. The other two were asymptomatic and showed infrequent apneic episodes during sleep. This family illustrates the distinction between the sleep apnea syndrome and infrequent apneic episodes during sleep. The sleep apnea syndrome is associated with daytime symptomatology and requires treatment. The presence of apneic episodes during sleep in all four siblings has implications regarding the predisposing factors (eg, upper …

Anticoagulant Therapy, Antithrombotic Therapy, Pulmonary Embolism, And The Henry Ford Hospital Perspective, Paul D. Stein

Henry Ford Hospital Medical Journal

No abstract provided.

Clinical Manifestations Of Acute Pulmonary Embolism: Henry Ford Hospital Experience, A Five-Year Review, Kenneth V. Leeper Jr., John Popovich Jr., Deborah Adams, Paul D. Stein

Henry Ford Hospital Medical Journal

Clinical findings of 112 patients with angiographically proven pulmonary embolism over a five-year period were analyzed. Recent immobilization, chronic heart disease, deep venous thrombosis, malignancy, and recent surgery were the most frequent predisposing factors. Only 5% had no identifiable risk factors. Presenting syndromes were circulatory collapse (25%), pulmonary infarction (59%), and uncomplicated pulmonary embolism (18%). Dyspnea and pleuritic chest pain were the predominant symptoms. The combination of dyspnea, pleuritic chest pain, and hemoptysis occurred in 23% of the patients. The most frequent signs were tachypnea, tachycardia, and rales. Most of the patients demonstrated arterial oxygen tension (PaO2) between 50 and …

Disseminated Strongyloides Stercoralis And Aspergillus Fumigatus Presenting As Diffuse Interstitial Pneumonitis In A Steroid-Dependent Chronic Obstructive Pulmonary Disease Patient, Larry Tankanow, Michael S. Eichenhorn

Henry Ford Hospital Medical Journal

We describe a patient with long-standing steroid-dependent chronic obstructive pulmonary disease who was admitted with new diffuse interstitial pulmonary infiltrates. Strongyloides stercoralis was present in the sputum and stool and responded to treatment. However, complicating disseminating Aspergillus fumigatus infection eventuated in the patient's death. Strongyloides stercoralis infection should be considered in patients with relevant exposure history, and complicating fungal and gram-negative bacterial infections which such patients may develop should be suspected.

Cancer Mortality Among Residents Of Huron, Sanilac, And Tbscola Counties As Compared To Other Michigan Residents, 1971-1985, Jennifer A. Booms, William Benish

Henry Ford Hospital Medical Journal

Age-adjusted cancer mortality rates in the "Thumb" area of Michigan (Huron, Sanilac, and Tuscola counties) were compared with those for the rest of the state from 1971 to 1985. Comparisons were made after partitioning the mortality data on the basis of the patient's sex, year of death (1971 to 1975, 1976 to 1980, or 1981 to 1985), and site of primary tumor. International Classification of Diseases categories were combined to define 29 cancer site groups. The analysis was limited to the white population. The major observation was a consistently lower mortality rate of lung cancer in the Thumb area than …

Enteric-Coated Fenoprofen In Large-Joint Osteoarthritis, Gilbert B. Bluhm, Harris H. Macilwain, Walter W. Offen

Henry Ford Hospital Medical Journal

Enteric-coated fenoprofen was compared with standard fenoprofen (Nalfon, Dista, Indianapolis, IN) in a randomized, double-blind, parallel, three-month trial of 113 outpatients (mean age, 64 years) with large-joint osteoarthritis. A previous study showed that enteric coating of fenoprofen reduces gastrointestinal microbleeding and may offer a safety advantage. Both treatments provided statistically significant improvement in pain measures (tenderness on pressure, pain at rest, pain with weight-bearing activity, and pain on passive motion). Adverse experiences were similar with both treatments and of an expected type, severity, and incidence for nonsteroidal anti-inflammatory drugs. Enteric-coated fenoprofen was found to be as effective and safe as …

Malignant Lymphoma Presenting In Gluteal Muscles: Case Report And Brief Review Of The Literature, Roberta Sonnino, Angelos A. Kambouris

Henry Ford Hospital Medical Journal

No abstract provided.

Potency Of Current Levothyroxine Preparations Evaluated By High-Performance Liquid Chromatography, Sheldon S. Stoffer, Walter E. Szpunar

Henry Ford Hospital Medical Journal

Ten different levothyroxine products manufactured by six companies were analyzed by high-performance liquid chromatography. Although nine products met the United States Pharmacopeia requirements, one product was found to have only 47% of expected potency. Until these products become more uniform, we would not recommend interchangeability of levothyroxine preparations.