Medicine and Health Sciences Commons^™

Radiographic Features Of Anterior Cruciate Ligament Reconstruction, Mark I. Burnstein, Burton I. Ellis, Robert A. Teitge, Martin L. Gross, Christopher K. Shier

Henry Ford Hospital Medical Journal

Anterior cruciate ligament disruption is a common injury that occurs in contact sports such as football. The treating orthopedic surgeon may elect any of a variety of therapeutic options. Surgical management may consist of primary repair of the torn ligament or replacement of the torn ligament with graft material, known as anterior cruciate ligament reconstruction (ACER). Many physicians, including radiologists, are unfamiliar with the surgical procedure or the expected postoperative radiographic appearance of ACER. Assessment of radiographs following ACER, as with many surgical procedures, requires understanding of the surgical procedure. We present our experience in assessing the postoperative radiographs of …

The First-Bite Syndrome, William S. Haubrich

Henry Ford Hospital Medical Journal

Patients presenting with esophageal disorders often describe what can be called a "first-bite syndrome." The condition can be discerned by its characteristic clinical features. It may be a variant of diffuse esophageal spasm. While in a majority of patients it is a benign functional disturbance, it can be a harbinger of carcinoma. When of functional origin, it is amenable, in most cases, to relatively simple medical management.

Characteristics, Mortality, And Outcome Of Infants Weighing Over 2500 Grams Who Require Intensive Care, Anthony Udo-Inyang, Chang Y. Lee

Henry Ford Hospital Medical Journal

Documentations of morbidity and mortality of infants weighing over 2500 g who require intensive care, along with research to improve their outcome, have not received adequate emphasis in the literature. From 1981 to 1984 these infants accounted for 495 (40.1%) admissions and 16 (9.8%) deaths in Henry Ford Hospital's neonatal intensive care unit. The most common diagnoses were hematologic diseases (24.6%), meconium aspiration (20.4%), respiratory distress/asphyxia (17.2%), congenital anomalies (13.8%), and infants of diabetic mothers (10.7%). Infant mortality was 56.2% from congenital anomalies. 25% from meconium aspiration, 6.2% from infection, 6.2% from maternal accident, and 6.2% from accidental neonatal asphyxia. …

Clinical And Laboratory Study Of Sickle Cell/Β-Thalassemia, Koichi Maeda, Ellis J. Van Slyck, Robert C. Hawley

Henry Ford Hospital Medical Journal

We have studied 39 patients doubly heterozygous for sickle cell/β-thalassemia, 12 with sickle cell/β^o- thalassemia and 27 with sickle cell/β⁺-thalassemia. Generally, sickle cell/β^o-thalassemia is considered more severe than sickle cell/β⁺-thalassemia. In our study, however clinical complications in the group with sickle cell/β⁺-thalassemia were seen almost as frequently as in the group with sickle cell/β^o-thalassemia. A wide variety of clinical manifestations were seen in both groups of patients.

Small Cell Carcinoma Of The Lung In The Intensive Care Unit, Paul Harkaway, Cynthia Glines, Michael Eichenhorn, Paul Kvale, Robert Chapman, John Popovich Jr.

Henry Ford Hospital Medical Journal

The outcome of 29 patients with a diagnosis of small cell carcinoma of the lung admitted to the medical intensive care unit (MICU) from 1980 through 1984 was reviewed retrospectively. Respiratory failure was the most common admitting diagnosis (23 patients [80%]). followed by cardiopulmonary arrest (three patients [10%]), and hypotension (three patients [10%] ). Only five patients survived to leave the MICU, and only two of these patients lived longer than two months after MICU discharge. Of the features examined, the absence of sepsis was the only statistically significant predictor of MICU survival. Treatment of the malignancy did not appear …

Robert K. Nixon, Md, Robert J. Priest

Henry Ford Hospital Medical Journal

No abstract provided.

Back Matter

Henry Ford Hospital Medical Journal

No abstract provided.

Digest Of The Philadelphia College Of Osteopathic Medicine (Winter 1986), Philadelphia College Of Osteopathic Medicine

Digest

The Winter 1986 issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• O. J. Snyder Award Laureate, David Heilig, DO
• Spunk Smooths Tough Path
• Elliot Ames, DO, Bringing a New Subspecialty to OMCP
• Ben Rubin, PhD - Protagonist in the Victory over Smallpox
• On Campus
• Something of Honor
• Class Acts
• In Memoriam
• Coming Events

Pre-Orthodontic Radiography Of The Temporomandibular Joint, Stephen G. Tracey

Loma Linda University Electronic Theses, Dissertations & Projects

The dental profession has given increased attention to temporomandibular joint problems in recent years. Many orthodontists have shown professional concern by taking pretreatment lateral tomograms to assess developmental abnormalities, previous injury, pathology, and condylar position. The purpose of this study was to determine the consistency of orthodontists in evaluating lateral tomograms and panoramic films, particularly when used prior to treatment. Lateral tomograms and panoramic films of 60 single joints were evaluated by 4 orthodontists on two separate occasions. A questionnaire was completed for each radiograph observed and responses were compared for interobserver and intraobserver [aggreement]. Statistically, results showed little to …

Prevalence Of Sensitivity To Sulfiting Agents In Asthmatic Patients, Robert K. Bush, Steve L. Taylor, Karen Holden, Julie A. Nordlee, William S. Busse

Department of Food Science and Technology: Faculty Publications

Ingestion of sulfiting agents can induce wheezing in some asthmatic patients. However, neither the prevalence of sulfite sensitivity nor the clinical characteristics of the affected asthmatic population are known. In a prospective single-blind screening study, 120 non-steroid-dependent and 83 steroid-dependent asthmatic patients underwent challenge with oral capsules of potassium metabisulfite. Five non-steroid-dependent and 16 steroid-dependent asthmatic patients experienced a greater than 20 percent reduction in their one-second forced expiratory volume within 30 minutes following the oral challenge. Twelve of these sulfite reactors were rechallenged with metabisulfite capsules in a double-blind protocol. Under these conditions, only three of seven steroid-dependent patients …

Digest Of The Philadelphia College Of Osteopathic Medicine (Fall 1986), Philadelphia College Of Osteopathic Medicine

Digest

The Fall 1986 issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• Making Them Comfortable
• John J. Fernandes, DO
• Pathology Department to be Computerized
• O.J. Snyder Award Recipient
• In the Land of Shoo-fly Pie
• Class Acts
• In Memorium
• How Sweet It Is
• On Campus
• Calendar

Vital Signs, Fall 1986, Boonshoft School Of Medicine

Vital Signs

A thirty four 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.

Multiple Function Intubation Apparatus And Method, Jane A. Norton, Diana L. Twyman, A. Byron Young, Robert Rapp

Surgery Faculty Patents

An apparatus and its method of use are provided allowing lavage, sump and enteral feeding operations with only one intubation. The apparatus includes a first tube having two distinct passageways. One of these passageways completely contains a second, feeding tube during intubation. Once the first tube is in place in the patient, the second tube is extended from the first tube so as to enter the stomach. The extension of the second tube opens ports in the first passageway of the first tube, thereby allowing sump or lavage treatment with the second passageway of the first tube serving as an …

Barium Granuloma Mimicking Rectal Carcinoma, Freda L. Arlow, Diane M. D'Angelo

Henry Ford Hospital Medical Journal

No abstract provided.

Front Matter

Henry Ford Hospital Medical Journal

No abstract provided.

Restrictive Cardiomyopathy, Remigio Garcia, Mohsin Alam

Henry Ford Hospital Medical Journal

Restrictive obliterative cardiomyopathy, with emphasis on amyloid infiltration of the heart, is discussed. The presence of right-sided failure associated with low-voltage electrocardiographic complexes may simulate constrictive pericarditis. Intractable congestive heart failure is the most frequent presentation of amyloid heart disease, and the average survival from diagnosis is 14 months. Digitalis sensitivity and fatal arrhythmias are notoriously common. Other important, although less common, restrictive cardiomyopathies include 1) hemochromatosis, which is the only reversible cause of heart failure in this group: and 2) endomyocardial fibrosis, which is rarely seen in temperate zones but which is amenable to surgical palliation. Many questions regarding …

Potassium And Heart Failure, Howard S. Rosman, Mihai Gheorghiade, Sidney Goldstein

Henry Ford Hospital Medical Journal

No abstract provided.

Beta-Adrenergic Blocking Agents In Congestive Heart Failure, Sidney Goldstein

Henry Ford Hospital Medical Journal

Although recent physiologic studies suggest that increased catecholamine release in humans may in the long run represent an adverse homeostatic mechanism, this catecholamine release is acutely important in permitting human response to stress. Clinical interventions with beta-adrenergic blocking agents have showed a salutary effect on cardiac function in patients with severe heart failure: in patients with heart failure associated with myocardial infarction, these agents may help improve mortality rates. These studies indicate that the drugs are well tolerated when used carefully in these high-risk patients.

New Positive Inotropic Agents, Syed M. Jafri, James A. Bristol

Henry Ford Hospital Medical Journal

Current therapy for heart failure remains inadequate. New positive inotropic agents that augment myocardial contractility have been introduced. The positive inotropic effects of these nonglycoside, nonsympathomimetic agents are due, at least in part, to inhibition of cardiac phosphodiesterase activity and hence to an increase in myocardial cyclic AMP levels. These agents also have vasodilator properties through their effects on the enzyme phosphodiesterase in the vascular smooth muscle. Recent developments in the preclinical pharmacology, mechanism of action, and clinical experience with these new inotrope vasodilators are presented in this review. The role these drugs will play in revising our therapeutic strategy …

Azathioprine-Lnduced Reversible Severe Dyserythropoiesis As A Cause Of Anemia, Sundara B. K. Raman, Joseph P. Abraham, Sheikh M. Saeed, Maria Sawdyk

Henry Ford Hospital Medical Journal

A 43-year-old woman with a 20-year history of systemic lupus erythematosus was treated with azathioprine for progressive complications of the disease. She developed pancytopenia within four weeks after starting azathioprine therapy. Bone marrow examination showed marked dyserythropoiesis and varying degrees of marrow hypoplasia. Changes seen in normoblasts consisted of nuclear buds, multinucleation, Howell-Jolly bodies, and abnormal mitoses. Azathioprine was discontinued. Peripheral blood counts improved in the next four weeks. A progress bone marrow examination six weeks later showed marked improvement in red blood cell abnormalities. An additional bone marrow examination performed four months after discontinuation of azathioprine showed complete disappearance …

Bilateral Dislocation Of The Crystalline Lens In A Patient With Presumed Syphilitic Uveitis, Jeffrey S. Rapkin, David D. Bogorad

Henry Ford Hospital Medical Journal

Dislocation of the crystalline lens has been described in association with numerous systemic disorders and as a complication of ocular trauma. We present a case of bilateral lens dislocation in a patient with presumed syphilitic uveitis. The mechanism of lens dislocation is related to humoral and cellular effects of inflammation, although the role of trauma cannot be ignored. Persistent uveitis should be considered as a sign of active infection.

Back Matter

Henry Ford Hospital Medical Journal

No abstract provided.

Heart Failure: New Questions And Insights About An Old Foe, Jeffrey B. Lakier

Henry Ford Hospital Medical Journal

No abstract provided.

Indications For Acute And Chronic Digitalis Administration In Heart Failure, Mihai Gheorghiade

Henry Ford Hospital Medical Journal

No abstract provided.

Pathophysiology Of Heart Failure, Mihai Gheorghiade, Jeffrey B. Lakier

Henry Ford Hospital Medical Journal

Heart failure occurs when the heart is unable to maintain a cardiac output sufficient to satisfy the oxygen requirements of the body despite adequate blood volume and hemoglobin content. Regardless of the initial cause of heart failure and in spite of compensatory mechanisms, patients often follow a course of worsening heart failure that is characterized by a low cardiac output, high filling pressures, and increased peripheral vascular resistance. In addition to persistence of the initiating event, cardiac deterioration may be caused or aggravated by a variety of factors including depletion of cardiac norepinephrine stores, down-regulation of myocardial beta-adrenergic receptors, microvascular …

Altered Platelet Function In Patients With Severe Congestive Heart Failure, Syed M. Jafri, Jeanne M. Riddle, Sundara B. K. Raman, Sidney Goldstein

Henry Ford Hospital Medical Journal

Platelet function was assessed in 15 patients with severe congestive heart failure (CHF) and in 26 control subjects of similar ages. The platelet count (mm³), surface reactivity, aggregometry studies, release factors, and circulating aggregates were investigated. The mean number of circulating platelets was normal, but a hyperactive platelet response was found in 53% of the CHF patients. CHF patients had a 42% mean for the spread type platelet, and the average number of aggregates was 64: control subjects had a 12% mean for the spread type platelet, and the average number of aggregates was 40 (p < 0.05). Aggregation with all of the inducers was normal, although 27% of CHF patients showed spontaneous aggregation. The mean plasma levels of both platelet factor 4 and betathromboglobulin were abnormally elevated. No circulating platelet aggregates were detected. Our studies indicate that platelet function is abnormal in patients with CHF. The abnormal platelet reactivity found might contribute to the increased incidence of thromboembolic events observed in CHF patients.

"Congestion": An Infrequent Feature In Patients With Chronic Heart Failure On Therapy, Syed M. Jafri, Jeffrey B. Lakier, Howard S. Rosman, Sidney Goldstein

Henry Ford Hospital Medical Journal

The clinical presentation of chronic heart failure has changed with advances in therapy, and the physical findings of congestion are now inconsistently present. To determine the clinical signs of congestion, we studied the clinical findings of 44 patients who had chronic heart failure and abnormal left ventricular ejection fractions (23 ± 10%). Signs of pulmonary edema manifested as rales were absent in all patients in New York Heart Association (NYHA) classes I and II, in 66% of patients in NYHA class III, and in 14% of patients in NYHA class IV. Signs of right heart failure manifested as elevated jugular …

Echocardiographic Evaluation Of Patients With Congestive Heart Failure, Mohsin Alam

Henry Ford Hospital Medical Journal

Echocardiography is a useful noninvasive test for evaluating patients with suspected heart failure and enlarged cardiac silhouette. This test can obtain the dimensions and wall thickness of all four cardiac chambers and can evaluate left ventricular function. The test results are reproducible, and in many instances the etiology of heart failure can be determined.

The Effect Of Aortic Valve Replacement On Left Ventricular Function In Patients With Aortic Valvular Disease, Tennyson Lee, Cathy L. Glick, Jeffrey B. Lakier, Sidney Goldstein

Henry Ford Hospital Medical Journal

Despite improved surgical techniques and survival in patients following aortic valve replacement for aortic stenosis and aortic insufficiency, the proper timing for surgery remains controversial. The incomplete reversibility of left ventricular dysfunction remains a concern, and postoperative improvement of left ventricular function is not consistently demonstrated. We studied 11 patients with aortic stenosis and nine patients with aortic insufficiency using angiographic and radioisotope assessment of left ventricular function preoperatively. Postoperative left ventricular function was assessed over nine to 13 months by radioisotope multiple-gated acquisition (MUGA) scan. All patients with impaired left ventricular function preoperatively showed slow but significant recovery toward …

Status Of Cardiac Transplantation With A Report Of The First Year's Experience At Henry Ford Hospital, Fraser M. Keith, Donald J. Magilligan Jr., Jeffrey B. Lakier, Conrad Drost

Henry Ford Hospital Medical Journal

Cardiac transplantation is now widely accepted as effective treatment for selected patients with end-stage heart disease. Improvements in immunosuppressive treatment and monitoring in the past 15 years have resulted in impressive one-year and five-year survival rates of 80% and 60%. In general, survivors have enjoyed a considerably improved quality of life. A cardiac transplantation program was initiated at Henry Ford Hospital in 1985, and a total of 15 patients received heart transplants in the first 12 months. Fourteen patients are currently alive and well at various stages posttransplant. This early clinical success has prompted the consideration of both combined heart-lung …