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Henry Ford Hospital Medical Journal

1990

Articles 61 - 76 of 76

Full-Text Articles in Medicine and Health Sciences

Management Of Voice Disorders, Alex F. Johnson, Barbara H. Jacobson, Michael S. Benninger Mar 1990

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.


Cocaine-Induced Hepatonephrotoxicity: A Case Report, Guillermo P. Gubbins, Rhett M. Schiffman, Ravindra S. Alapati, Surinder K. Batra Mar 1990

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.


Zollinger-Ellison Syndrome: Methods Of Diagnosis And Treatment, Ravi R. Sarin, Ajay K. Sangal, Timothy T. Schubert, Jan Rival Mar 1990

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 …


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 Mar 1990

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.


Computerized Literature Searching In The Ambulatory Setting Using Paperchase®, Byron K. Wolffing Mar 1990

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 …


Systemic Dissemination Of Pneumocystis Carinii In A Patient With Acquired Immunodeficiency Syndrome, Mahul B. Amin, Michael P. Abrash, Eugene Mezger, Gary F. Sekerak Mar 1990

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 …


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 Mar 1990

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 Mar 1990

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. …


Single Coronary Artery, Guo Jingxuan, Mao Jieming, Yan Weidong, Liu Changjiang, Chen Mingzhe Mar 1990

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

Henry Ford Hospital Medical Journal

No abstract provided.


Surgical Removal Of Metastatic Renal Adenocarcinoma To The Midbrain Tectum: A Case Report, Frank J. Tomecek, James I. Ausman, Ghaus M. Malik Mar 1990

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.


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 Mar 1990

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 …


Management Of Advanced Endodermal Sinus Tumor Of The Ovary With Preservation Of Reproductive Function, Michael L. Hicks, Shari L. Maxwell, Wooshin Kim Mar 1990

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 …


C. Paul Hodgkinson, Md, Dorothy Porter Mar 1990

C. Paul Hodgkinson, Md, Dorothy Porter

Henry Ford Hospital Medical Journal

No abstract provided.


A Tribute To Henry Ford Hospital, Jan Rival Mar 1990

A Tribute To Henry Ford Hospital, Jan Rival

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 Mar 1990

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 …


Back Matter Mar 1990

Back Matter

Henry Ford Hospital Medical Journal

No abstract provided.