Medicine and Health Sciences Commons^™

Cervicofacial Actinomycosis In Children, Michael E. Friduss, Dennis R. Maceri

Henry Ford Hospital Medical Journal

Actinomycotic infections, once common in humans and cattle, are now rare causes of disease in man. This general group of organisms belongs taxonomically between the true bacteria and the fungi; however, the organisms behave clinically like true anaerobes. The organism, although phagocytized by the host cells, is not killed. Therefore, d is defined as a facultative intracellular parasite of the host. The protean manifestations of actinomycotic infections often mimic infectious processes, such as osteomyelitis or granulomatous disease, as well as neoplasia. It is therefore important for the surgeon to include actinomycosis in the differential diagnosis of cervicofacial masses in children …

Zollinger-Ellison Syndrome: Methods Of Diagnosis And Treatment, Ravi R. Sarin, Ajay K. Sangal, Timothy T. Schubert, Jan Rival

Henry Ford Hospital Medical Journal

Until two decades ago the Zollinger-Ellison syndrome (ZES) was difficult to diagnose and stage accurately. Total gastrectomy was often the ultimate treatment. Improvements in the measurement of serum gastrin and in radiographic imaging have greatly improved the precision of diagnosis and staging. Treatment with histamine-2 receptor antagonists and proton pump blockers have eliminated the need for gastrectomy, and current surgical intervention is directed at cure through removal of the localized gastrinoma. We reviewed the management of eight patients with this diagnosis seen at Henry Ford Hospital from 1983 to 1988. Time from first presentation to diagnosis varied from two months …

A Tribute To Henry Ford Hospital, Jan Rival

Henry Ford Hospital Medical Journal

No abstract provided.

Denker Rhinotomy For Inverted Papilloma Of The Nose And Paranasal Sinuses, Samuel A. Mickelson, Richard D. Nichols

Henry Ford Hospital Medical Journal

Inverted papilloma of the nose and paranasal sinuses is an unusual benign neoplasm that has the propensity for local tissue destruction and an association with malignant degeneration. The tumor represents an inverted growth of epithelium rather than outward proliferation. It most commonly arises from the lateral nasal wall with growth into the nose and paranasal sinuses and only rarely originates from the septum. Presenting symptoms are usually unilateral nasal obstruction and clear rhinorrhea. Surgical excision is the recommended treatment though the aggressiveness ofthe approach has varied. Transnasal local excision has been associated with a high recurrence rate. Lateral rhinotomy with …

Management Of Chronic Staphylococcal Osteomyelitis Of The Temporal Bone: The Use Of Hyperbaric Oxygen, Vanessa G. Schweitzer

Henry Ford Hospital Medical Journal

Hyperbaric oxygen (HBO) is an effective adjunct in the management of selected otolaryngologic problems including radiation-induced necrosis of the temporal hone, malignant external otitis, mandibular osteoradionecrosis and refractory osteomyelitis, soft tissue head and neck necrotizing fasciitis, compromised skin flaps and grafts, acute air or gas embolism, and otologic barotrauma. We describe the management of a patient with insidious Staphylococcus aureus osteomyelitis of the temporal bone by the use of HBO preoperatively and postoperatively in conjunction with surgical debridement. The possible application of angiogenic agents and tetracycline hone-labeling in combination with HBO therapy in the management of refractory neurotologic disease is …

Entry Of The Hearing Impaired Into The Health Care System, Kathleen Yaremchuk, Jonathan Schmidt, Linda Dickson

Henry Ford Hospital Medical Journal

The current system of referral of patients complaining of hearing loss usually requires a dual appointment with otolaryngology and audiology. Most of these patients have sensorineural hearing loss for which there is rarely surgical or medical treatment. This study tests the hypothesis that these patients would receive appropriate treatment and that health care dollars would be saved if an audiological assessment could identify those patients who require medical or surgical care. One hundred consecutive patients whose sole complaint was hearing loss were evaluated using audiograms and "hearing abilities questionnaires" by five audiologists using subjective and objective criteria to determine the …

Metastatic Carcinoma Of The Jaws: Report Of A Case, Jack L. Clark

Henry Ford Hospital Medical Journal

Primary malignant tumors of the mouth and jaws usually do not present a diagnostic challenge to oral surgeons or otolaryngologists. However, recognition of metastatic tumors in the mouth and jaws is much more difficult. A case is presented of metastatic carcinoma from the lung to the soft tissue of the oral cavity. Histopathology of the lesions in the lung and oral cavity as well as the chest x-ray and the Panorex x-ray are presented. The patient refused palliative treatment, became malnourished, and died. A review of the pertinent literature is also presented.

Management Of Voice Disorders, Alex F. Johnson, Barbara H. Jacobson, Michael S. Benninger

Henry Ford Hospital Medical Journal

Voice disorders are commonly seen in general medical practice. In some cases voice disorders represent the presenting symptom for serious underlying disease. It is important for clinicians from internal medicine, pediatrics, and family practice to be able to identify those factors in the history or observed vocal symptoms which suggest need for referral for comprehensive voice evaluation as well as to understand the distinct but complementary roles of the specific disciplines (otolaryngology and speech-language pathology) involved in diagnosis and treatment of patients with voice disorders.

The Bouveret Syndrome: An Unusual Cause Of Hematemesis, Alaa A. Salah-Eldin, Mostafa A. H. Ibrahim, Ravindra Alapati, Saleh Muslah, Timothy T. Schubert, Bernard M. Schuman

Henry Ford Hospital Medical Journal

Gallstones are usually silent. Less commonly, patients with cholelithiasis develop symptoms and/or complications; biliary fistula occurs in 3% to 5% of the cases. When a large stone is passed and occludes the duodenum, gastric outlet obstruction (the Bouveret syndrome) may result. In reported cases, the stones are usually larger than 2.5 cm. The usual presenting symptoms are those of bowel obstruction: abdominal pain, nausea, and vomiting. Less commonly, the patients experience melena and, rarely, hematemesis. We describe a patient who had the largest stone reported to cause hematemesis rather than bowel obstruction and to be diagnosed endoscopically. The 5 X …

Variability Of Quantitative Sensory Testing: Implications For Clinical Practice, Janice Redmond, Didier Cros, Bhagwan T. Shahani

Henry Ford Hospital Medical Journal

The conventional estimation of motor, sensory, and mixed nerve conduction velocities reflects activity in the fastest conducting, heavily myelinated nerve fibers that are only a small proportion of the total. Unmyelinated and thinly myelinated fibers are not evaluated by this technique and numerically represent the largest group of fibers in human cutaneous nerves. The availability of new quantitative techniques to study this aspect of sensory function is an important addition to standard electrodiagnosis. Patient understanding and cooperation is essential because subjective responses are evaluated. We evaluated a reference range for 20 healthy subjects as well as variability on repeated testing. …

Systemic Dissemination Of Pneumocystis Carinii In A Patient With Acquired Immunodeficiency Syndrome, Mahul B. Amin, Michael P. Abrash, Eugene Mezger, Gary F. Sekerak

Henry Ford Hospital Medical Journal

Pneumocystis carinii is usually considered a respiratory tract pathogen; however, there are reported cases of limited and generalized dissemination of the organism from the lungs of immunocompromised patients. We present the autopsy findings of a 29-year-old male with acquired immunodeficiency syndrome (AIDS) and recurrent Pneumocystis carinii pneumonia who developed abnormal liver function tests. The patient had received aerosolized pentamidine because of toxic reactions to other modes of therapy. The postmortem examination revealed Pneumocystis in the lungs, liver, spleen, kidney, myocardium, thymus, pancreas, thyroid gland, bilateral parathyroid and adrenal glands, gastrointestinal mucosa, perihilar and mesenteric lymph nodes, and bone marrow. A …

Single Coronary Artery, Guo Jingxuan, Mao Jieming, Yan Weidong, Liu Changjiang, Chen Mingzhe

Henry Ford Hospital Medical Journal

No abstract provided.

Practical Value Of Echo Doppler Evaluation Of Aortic And Mitral Stenosis: A Comparative Study With Cardiac Catheterization, Jihad Bitar, Lori Douthat, Mohsin Alam, Howard S. Rosman, Mark Lebeis, Sidney Goldstein, Fareed Khaja

Henry Ford Hospital Medical Journal

This retrospective analysis compares data derived by echocardiography and cardiac catheterization in the evaluation of aortic and mitral valve stenosis. Sixty-seven patients, aged 69 ± 12 years, underwent 76 catheterization procedures. In all studies the Doppler recording was technically adequate. In 64 studies of patients with aortic stenosis, correlation was good between the gradient obtained at catheterization (peak 51 ± 28 mm Hg, mean 48 ± 24 mm Hg) and the Doppler gradient (peak 73 ± 29 mm Hg, mean 41 ±17 mm Hg) (R = 0.78 peak, 0.77 mean). In 15 studies the aortic valve area, 0.8 ± 0.2 …

C. Paul Hodgkinson, Md, Dorothy Porter

Henry Ford Hospital Medical Journal

No abstract provided.

Functional Endoscopic Sinus Surgery: Morbidity And Early Results, Michael S. Benninger, Samuel A. Mickelson, Kathleen Yaremchuk

Henry Ford Hospital Medical Journal

Functional endoscopic sinus surgery is a new alternative to conventional sinus surgery as a means of managing recalcitrant sinus disease. This approach to sinus pathology focuses on the importance of the functional ostiomeatal complex and anterior ethmoid sinuses in the pathogenesis of sinus disease. In an effort lo assess the morbidity and initial results of this procedure, 85 cases were reviewed. A total of 82% of the patients had bilateral maxillary and ethmoid sinusitis, and 45% had pansinusitis, frequently associated with allergic rhinitis (56%) and nasal polyps (58%). A total of 82% of the patients were operated on as outpatients …

Sensorineural Hearing Loss And The Diagnosis Of Acoustic Neuroma, Edwin M. Monsell, Jack P. Rock

Henry Ford Hospital Medical Journal

Sensorineural hearing loss and tinnitus are gradually receiving more attention in medicine due to advances in diagnosis and treatment. Acoustic neuromas can now be detected when they are small, and early microsurgical removal results in the lowest overall morbidity. We examine the historical development of acoustic neuroma management, discuss current diagnosis and treatment, and present illustrative cases from our recent experience. Complaints of tinnitus and hearing loss, especially when unilateral, require appropriate medical evaluation.

Hemangiomas Of The Nasal Septum And Paranasal Sinuses, Lisa Marie Sheppard, Samuel A. Mickelson

Henry Ford Hospital Medical Journal

Hemangiomas of the nasal septum and paranasal sinuses are rare; only 62 cases of septal hemangiomas and 32 cases of maxillary sinus/maxilla hemangiomas have been reported in the English literature. Hemangiomas should be considered in the differential diagnosis of any nasal mass lesion because biopsy may result in profuse bleeding and even death. We report the clinical presentation, differential diagnosis, etiology, and histologic appearance of paranasal sinus hemangiomas occurring in four of our patients.

Abnormal Coagulation Profiles In Tonsillectomy And Adenoidectomy Patients, Jonathan L. Schmidt, Kathleen L. Yaremchuk, Samuel A. Mickelson

Henry Ford Hospital Medical Journal

Preoperative coagulation profile screening is routinely performed in otolaryngology before tonsillectomy and adenoidectomy surgery in the United States. Recently there has been controversy as to whether this routine testing is necessary. To evaluate the need for this testing, we reviewed a series of patients with particular attention to abnormal coagulation profiles. Of 91 consecutive patients undergoing tonsillectomy, adenoidectomy, or both, four had abnormal preoperative coagulation profiles. Of these patients, one had von Willebrand disease, one had hypofibrinoginemia, and two had a transient acquired lupus-like anticoagulant. The latter condition, which causes a temporary prolongation of the activated partial thromboplastin time, is …

Infant Hearing Screening 1984 To 1989: The Henry Ford Hospital Experience, Gary P. Jacobson, Mary Jo Burtka, Jeanne A. Wharton, Craig W. Newman, Neil Shepherd, Robert G. Turner

Henry Ford Hospital Medical Journal

From 1984 to 1989 the Infant Hearing Screening (IHS) program at Henry Ford Hospital identified 1,300 infants as being "at risk" for hearing loss. The prevalence of significant sensorineural hearing loss in this sample was 1.4%. Additionally, 80 infants who passed the IHS program and reached 3 years of age were found to have normal hearing sensitivity by conventional audiometric techniques (ie, no false-negative predictions). There were three false-positive predictions. It was discovered that infants of low birthweight (ie, < 1,500 g) were three times more likely to fail IHS than those whose weight exceeded 1,500 g. A higher return rate was found for infants failing an initial hearing screening conducted in the neonatal intensive care unit in comparison to those screened as outpatients one week postdischarge. The sensitivity and specificity of behavioral observation audiometry were 43% and 92%, respectively, when brainstem auditory-evoked potentials was used as the criterion validity measure.

Cocaine-Induced Hepatonephrotoxicity: A Case Report, Guillermo P. Gubbins, Rhett M. Schiffman, Ravindra S. Alapati, Surinder K. Batra

Henry Ford Hospital Medical Journal

Hepatotoxicity due to cocaine has been well described in animal models. There are few reports on cocaine-induced hepatic injury in humans; however, its link to rhabdomyolysis and renal failure is better known. We report a case of reversible acute hepatonephrotoxicity associated with recreational cocaine use. The proposed mechanisms responsible for its hepatic and renal toxicity are reviewed.

Computerized Literature Searching In The Ambulatory Setting Using Paperchase®, Byron K. Wolffing

Henry Ford Hospital Medical Journal

PaperChase®, a self-service computerized literature search (SSCLS) service, was compared to conventional resources for accessing recent medical information by assessing user attitudes, search costs, and number of searches performed. The study was designed as a randomized controlled trial using survey instruments before and after the intervention. Accounting of PaperChase searches was monitored electronically, and costs of librarian searches were provided by the hospital library. Participants included 57 physicians in several specialties who were members of a group practice located in a suburban ambulatory care center. Responses were received from 67%. The experimental group received free, unlimited access to PaperChase over …

Surgical Removal Of Metastatic Renal Adenocarcinoma To The Midbrain Tectum: A Case Report, Frank J. Tomecek, James I. Ausman, Ghaus M. Malik

Henry Ford Hospital Medical Journal

A patient with adenocarcinoma of the kidney metastatic lo the quadrigeminal plate of the midbrain presented with acute obstructive hydrocephalus and early tonsillar herniation. Because the majority of these carcinomas are resistant to radiation therapy, only limited treatment choices were available. Initially, a ventriculoperitoneal shunt relieved the hydrocephalus and neurologic symptoms. After a short course of improvement, with decompressed ventricles demonstrated by postoperative computed tomography, the patient developed additional neurologic signs, leading to the decision to excise the metastatic tumor. Convalescence was complicated but the patient survived for six months, succumbing to respiratory failure presumably caused by lung metastases.

Management Of Advanced Endodermal Sinus Tumor Of The Ovary With Preservation Of Reproductive Function, Michael L. Hicks, Shari L. Maxwell, Wooshin Kim

Henry Ford Hospital Medical Journal

Endodermal sinus tumor of the ovary occurs primarily in children and young adults. This tumor is classified as a germ cell tumor which comprises approximately 5% of all ovarian tumors. In the past, patients with this highly malignant tumor had low survival. However, with the evolution of effective adjunctive chemotherapeutic regimens, specifically vincristine, actinomycin D, and cyclophosphamide, survival rates have improved. In an attempt to continuously improve survival rates, other combination chemotherapeutic regimens are currently under investigation. Unlike epithelial ovarian malignancies, endodermal sinus tumor can be monitored by a specific tumor marker, alpha-fetoprotein (AFP). Serum levels of AFP can be …

Evaluation Of The Predictive Power Of Progesterone Receptor Levels In Primary Breast Cancer: A Comparison With Other Criteria In 559 Cases With A Mean Follow-Up Of 74.8 Months, Robert A. Huseby, Helen E. Ownby, Sam Brooks, Jose Russo

Henry Ford Hospital Medical Journal

A total of 559 women with primary breast cancer treated by modified radical mastectomy were followed for a mean of 74.8 months to evaluate the relationship of sex hormone receptor content in the tumor with time to first recurrence and to death due to breast cancer. The prognostic significance of progesterone receptor (PgR) status was evaluated in terms of estrogen receptor (ER) status, age (< 49 years, > 50 years), extent of lymph node involvement, tumor size, and morphologic characteristics. Overall, patients with PgR positive (> 9 femtomoles/10 mg wet weight tissue) tumors experienced a significantly longer period to both first recurrence and …

Back Matter

Henry Ford Hospital Medical Journal

No abstract provided.

Home Safety-The Challenge To Public Health, Ray Ranson

The Journal of Sociology & Social Welfare

Home accidents are now a leading cause of death and injury particularly in young children and the elderly. For example, 3.1 million accidents occur in the home every year in the United Kingdom with no signs of diminishment. More effective systems of accident recording, monitoring, investigation, intercollaboration and education are urgently needed to redress this epidemic. More attention needs to be given to preventive safety design in architect training and adoption of home safety design standards and legislation. The major threat to public health which home accidents represent must not go unchallenged.

Pms And Eosinophilia-Myalgia Syndrome, Mary Guinan

School of Public Health Faculty Research

No abstract provided.

Ua12/2/1 College Heights Herald, Vol. 65, No. 34, Wku Student Affairs

WKU Administration Documents

WKU campus newspaper reporting campus, athletic and Bowling Green, Kentucky news. This issue contains articles:

• Poynter, Chris. Pearce-Ford Tower Dwellers Asking for Breath of Fresh Air
• Howard, Laura. Still Here, Paul Cook’s Duties Mount
• Lockert, Anya. Officials Blame ’83 Act for Low Ratio of Blacks – Desegregation Plan
• Regents Ask for Students’ Opinions
• Bricking, Tanya. More Cooks to Stir Recipe for Budget – Thomas Meredith
• Committee Will Study Athletic Reports
• Rubber Ducky Business Has Holiday Boom
• Wessling, Susan. Group Works to Ban Public Smoking
• Students Need AIDS Education
• Chattin, John. Editorial Cartoon – AIDS Skeleton
• Bright Ideas Projecting New Image …

A Baseline Case: The Woburn Wells G And H Superfund Site, Steven Konkel

Environmental Health Science Faculty and Staff Research

This section profiles the types of disputes which arose at the Woburn Wells G and H Superfund site in Woburn, Mass. The Woburn Wells G and H case serves as a baseline because it demonstrates how obstacles cause delays and impasses. This section contains an overview of what has transpired since the discovery of contaminants in two of the town municipal wells, Well G and H.

Management Of Swallowing Disorders: A Program For Professionals Working In Rural Areas, Kathleen D. Sims Mcsd/Ccc-Slp, Sue Reinsel-Garcia Otr/L, Kathy M. Love Ma/Ccc-Slp, Elizabeth Kohler Ed.D., O.T.R., University Of Montana Rural Institute

Health and Wellness

Research indicates that 74% of all nursing home patients experience eating difficulties sometime during their stay (Trupe, Siebens, & Siebens, 1984). Additionally, 59% of patients suffering from stroke experience some degree of dysphagia and aspiration difficulties (Echelard, Thoppil, & Melvin 1984). A significant number of the high risk dysphagia patients described above suffer from life threatening aspiration pneumonia. Consequently the management of swallowing disorders (Dysphagia) is of critical concern to hospital and nursing home personnel. Patients specficially at risk for dysphagia, according to recent studies, include those with head injury, stroke (CVA), and cerebral palsy. Also, patients experiencing cancer of …