Medical Specialties Commons^™

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.

Ua35/11 Student Honors Research Bulletin, Wku Honors Program

WKU Administration Documents

The WKU Student Honors Research Bulletin is dedicated to scholarly involvement and student research. These papers are representative of work done by students from throughout the university.

• Basham, Penny. The Ritalin Controversy: Hyperactive Children and Medication
• Buote, Kim. The Transmission of Negative Feedback: Obstacles, Effects and Suggestions
• Cowan, James. The 1988 Presidential Primaries: Search for Bandwagons
• Durfey, Suzanne. AIDS: Nutrition and Its Implications
• Felty, Jeff. Gay and Lesbian Couples
• Gilliland, Linda. Muffins and Aspartame or Sucrose
• Graham, Ken. Sudden Infant Death Syndrome
• Grubbs, Morris. Conflicts and Synthesis in Robert Penn Warren's Blackberry Winter
• Medeiros, Lynne. Problems of Democratic Republicism in …

Effects Of Sodium Intake, Furosemide, And Infusion Of Atrial Natriuretic Peptide On The Urinary And Metabolic Clearances Of Arginine Vasopressin In Normal Subjects, Arnold M. Moses, Carol Jones, Carolyn B. Yucha

Nursing Faculty Research

Arginine vasopressin (AVP) and atrial natriuretic peptide (ANP) have important influences on water and electrolyte metabolism, and studies on the interactions between these hormones may have important implications. We have investigated the effects of sodium intake, furosemide, and infusion of ANP on the urinary and metabolic (nonurinary) clearances of AVP in hydrated normal subjects. On a high sodium diet there was an increase in urine volume, sodium excretion, osmolal clearance, plasma ANP concentration, and urinary clearance and fractional excretion of AVP, with a decrease in PRA. The infusion of furosemide increased urine volume, sodium excretion, osmolal clearance, and PRA, but …

The Role Of Small Peptides In Cancer Physiology And Chemotherapy, Bao-Ling Tsay

Theses and Dissertations in Biomedical Sciences

The targeting of proven anticancer drugs specifically to cancer cells would provide a unique opportunity to restrict neoplasms without damaging the cancer patient. The present research utilizes the phenomenon of illicit transport, i.e. the coupling of normally impermeant metabolites to permeant metabolites, in targeting the drug melphalan to mouse Ehrlich ascites tumor cells. The dipeptide beta-alanyl-melphalan was synthesized and tested in vitro for toxicity towards mouse Ehrlich ascites tumor cells, mouse liver cells, and mouse 3T3 embryonic cells. The parent compound, melphalan, was used as a control treatment. In addition, both melphalan and beta-alanyl-melphalan were utilized in in vivo chemotherapeutic …

A Phase Ii Trial Of Murine Monoclonal Antibody 17-1a And Interferon-Γ: Clinical And Immunological Data, Mansoor Saleh, Albert Lobuglio, Richard Wheeler, Kimberly Rogers, Amy Haynes, Jeannette Lee, M B. Khazaeli

Haematology and Oncology, East Africa

A group of 15 patients with metastatic colorectal adenocarcinoma received a combination of interferon γ (0.1 mg/m², days 1–15) and the murine monoclonal antibody 17-1A (400 mg, days 5, 7, 9 and 12). The treatment was tolerated with minimal toxicity. Of the 14 evaluable patients, 13 developed human antibody to murine 17-1A, with 11 patients demonstrating antibody to the variable region of 17-1A (anti-idiotype). Antibody to the variable region was inhibited by 17-1A but not by mouse immunoglobulin. Sera from patients with substantial anti-idiotype reactivity were capable of inhibiting the binding of murine 17-1A to antigen expressing LS174-T …

The Importance Of Screening For Medullary Thyroid Carcinoma In Families Of Patients With Men 2, A. Frilling, P. E. Goretzki, L. Bastian, H. D. Roeher

Henry Ford Hospital Medical Journal

Family .screening for medullary thyroid cancer (MTC) is important for detecting members of multiple endocrine neoplasia type 2 (MEN 2) families who may be gene carriers but show no clinical evidence of the disease. Most members of our MEN 2 families are screened yearly by measuring basal and pentagastrin-stimulated calcitonin (CT) levels. A 15-year-old first-degree relative of an affected member of the D-kindred showed a normal basal and an elevated stimulated CT level. Clinical examination, ultrasonography, and scintigraphy were normal. Thyroidectomy and bilateral neck dissection revealed a multicentric MTC with no lymph node involvement. In the O-kindred we detected elevated …

Men 2a: Update On The Northern Ireland And Australian Family, Patrick J. Morrison, David R. Hadden, Colin J. Russell, Norman C. Nevin

Henry Ford Hospital Medical Journal

The Northern Ireland/Australian family with multiple endocrine neoplasia type 2A (MEN 2A) originally described in 1987 is presented with a revised and enlarged pedigree. Four members of the first generation studied have died. A seventh member of the second generation studied has developed medullary thyroid carcinoma and has progressed to surgery. None of the third generation members studied has shown any conclusive abnormality in metabolic screening tests. Each member of the third and fourth generations has had genetic counseling and (if appropriate) DNA analysis with gene probes close to the MEN 2A gene locus on chromosome 10. All members of …

Transcriptional Regulation Of The Human Calcitonin Gene: A Progress Report, Sara Peleg, Gilbert J. Cote, Ronald V. Abruzzese, Robert F. Gagel

Henry Ford Hospital Medical Journal

We have applied DNA transfer techniques lo study the transcriptional regulation of the calcitonin (CT) gene in a C-cell line (TT) derived from a human medullary thyroid carcinoma. TT cells were transfected with a fusion gene containing the CT gene promoter and 5' -flanking DNA attached to the promoter-less growth hormone gene (reporter). We quantitated the reporter gene product to monitor transcriptional activation by the CT promoter and deletion mutants of the 5' -flanking DNA. We found that the proximal CT promoter which includes the DNA sequence from +1 to -129 bp upstream from the CT transcription start site did …

Allele Loss On Chromosome 10 And Point Mutation Of Ras Oncogenes Are Infrequent In Tumors Of Men 2 A, Makoto Okazaki, Akihiro Miya, Norifumi Tanaka, Tetsuro Miki, Masayuki Yamamoto, Kazuyoshi Motomura, Akira Miyauchi, Takesada Mori, Shin-Ichiro Takai

Henry Ford Hospital Medical Journal

The multiple endocrine neoplasia type 2A (MEN 2A) gene has been mapped to the centromeric region of chromosome 10 by linkage analysis. We examined 36 medullary thyroid carcinomas (MTCs) (16 hereditary and 20 sporadic) and ten pheochromocytomas (eight hereditary and two sporadic) to detect loss of alleles on chromosome 10 using seven polymorphic DNA markers mapped to this chromosome. Of 20 informative cases, only one (5%) sporadic MTC showed loss of heterozygosity at the locus RBP3. Allele loss at the RBP3 locus was not found in pheochromocytomas from six heterozy gates. All tumors retained constitutional heterozygosity at six other loci …

Screening For Pheochromocytoma In The Men 2 Syndrome, J. Kotzerke, C. Stibane, H. Dralle, H. Wiese, W. Burchert

Henry Ford Hospital Medical Journal

Twenty-two patients with the multiple endocrine neoplasia type 2 (MEN 2) syndrome were screened for pheochromocytoma since it is a major cause of morbidity in MEN 2 families. Clinical symptoms, biochemical parameters, ultrasound, computed tomography or magnetic resonance imaging, and meta-iodo-benzylguanidine (MIBG) scintigraphy were evaluated for detection of adrenal tumors. Clinical symptoms and plasma or urine catecholamines appeared to be nonspecific, whereas MIBG scintigraphy was highly specific and the most sensitive parameter. Patients older than age 30 should be scintigraphically screened at least once despite the radiation exposure. Demonstration of only slight uptake is not an indication for surgery but …

Use Of Somatostatin Analog Sms 201-995 In Medullary Thyroid Carcinoma, Alfonso Libroia, Uberta Verga, Gianleone Di Sacco, Marco Piolini, Fabrizio Muratori

Henry Ford Hospital Medical Journal

We have studied seven subjects with medullary thyroid carcinoma. Each had elevated basal serum calcitonin (CT) levels following total thyroidectomy. After subcutaneous administration of 100 μg of SMS 201-995, blood samples were collected at 60-minute intervals for six hours. Two patients showed a marked decrease of CT levels (patient A: baseline 565 μg/mL, nadir 150 μg/mL; patient B: baseline 1,632 μg/mL, nadir 416 μg/mL). The other five patients showed no significant change in comparison with saline infusion. Two patients were treated with SMS 201-995 (300 μg/day)for 90 days. One of these patients responded to the acute SMS 201-995 test and …

Adrenal Cortex Transplantation After Bilateral Total Adrenalectomy In The Rat, Georg F. W. Scheumann, Wolfgang F. A. Hiller, Soren Schroeder, T. Schurmeyer, Jurgen Klempnauer, Henning Dralle

Henry Ford Hospital Medical Journal

An experimental animal model with adrenal cortex transplantation was developed to study adrenal cortex replacement therapy in patients with multiple endocrine neoplasia type 2 who have had bilateral adrenalectomy for pheochromocytomas. Adrenal cortex of syngenetic rats was isolated from the medulla by collagenase digestion and a defined sedimentation. The cell suspension of the cortical cells was implanted under the kidney capsule of untreated syngenetic rats. After two weeks the recipients were bilaterally adrenalectomized. Serum corticosterone levels were measured as an estimate of function of the grafts. All recipients were healthy throughout the observation period, whereas all adrenalectomized controls died within …

Living With A Hereditary Form Of Cancer: Experiences And Needs Of Men 2 Patients And Their Families, Marc P. H. D. Cleiren, Wil Oskam, Cornelis J. M. Lips

Henry Ford Hospital Medical Journal

Unlike the purely medical research done in multiple endocrine neoplasia type 2 (MEN 2) families, little work has been done on the psychosocial aspects of the disease. To assess the severely stressful influences and the consequences of that stress on the family network, a small-scale survey was carried out during a national meeting. The goal of the study was to obtain more information about the experiences and needs of MEN 2 patients and their relatives. Of the 59 respondents, 85% were satisfied with the medical information provided, 81% were satisfied with the medical knowledge of the specialist, but only 12% …

A Novel Parathyroid Hormone-Related Gene Product, T. J. Martin, J. A. Danks

Henry Ford Hospital Medical Journal

A parathyroid hormone-related protein (PTHrP) has been invoked as being responsible for the humoral hypercalcemia of malignancy. Eight of the first 13 amino acids of PTHrP are identical with those in PTH, but there is no other significant homology. The PTHrP gene is located on chromosome 12, whereas that for PTH is on chromosome 11, and the two genes are probably related by a duplication process. Antisera against PTHrP(1-34), which cross-read poorly or not at all with PTH, and antisera against other parts of PTHrP not homologous to PTH were used in immunocytochemistry, using a peroxidase-antiperoxidase method, to identify PTHrP …

Evolutionary Pathways Of The Calcitonin (Calc) Genes, Cornelis J. M. Lips, Rolf A. Geerdink, Maria G. Nieuwenhuis, Jaap Van Der Sluys Veer

Henry Ford Hospital Medical Journal

Recombinant DNA techniques have made it possible to establish the structure of various genes encoding polypeptide hormones. Comparison of nucleotide sequences of the calcitonin (CALC) genes in man has revealed surprising similarities and variations. These findings and the homologies among the sequences in different species offered an opportunity for speculation about relationships between these genes and about their evolutionary origin. The first gene (CALC-I) directing the synthesis of calcitonin (CT) or CT gene-related peptide (CGRP) comprises six exons and gives rise to two mRNAs by an alternative RNA-processing mechanism. The homology between CGRP and CT reflects their common origin. The …

Abstracts From The Third International Workshop On Men 2

Henry Ford Hospital Medical Journal

No abstract provided.

Front Matter

Henry Ford Hospital Medical Journal

No abstract provided.

The Third International Workshop On Multiple Endocrine Neoplasia Type 2 Syndromes, Friedhelm Raue, Charles E. Jackson

Henry Ford Hospital Medical Journal

No abstract provided.

Multiple Endocrine Neoplasia Type 2 Syndromes: Nomenclature Recommendations From The Workshop Organizing Committee, Robert F. Gagel, Charles E. Jackson, Bruce A. J. Ponder, Friedhelm Raue, Nancy E. Simpson, Reinhard Ziegler

Henry Ford Hospital Medical Journal

No abstract provided.

Closing In On The Men2a Locus, Nancy E. Simpson, Kenneth K. Kidd

Henry Ford Hospital Medical Journal

The mapping of the locus for multiple endocrine neoplasia type 2A (MEN 2A) to chromosome 10 using linkage is briefly reviewed including a discussion of linkage strategy and reference to some of the exclusions before the assignment. The subsequent development of the map of the centromeric region of the chromosome and the linking of what appear to be the four closest flanking markers and the centromeric alphoid sequence to the disease locus are reviewed. To date no recombination has been observed between the centromeric marker and the MEN2A locus among, at least, 26 informative meioses, 11 of which are phase …

Hereditary Medullary Thyroid Carcinoma: Genetic Analysis Of Three Related Syndromes, Hagay Sobol, Steven A. Narod, Isabelle Schuffenecker, Chris Amos, R. Alan B. Ezekowitz, Gilbert M. Lenoir

Henry Ford Hospital Medical Journal

Hereditary medullary thyroid carcinoma (MTC) appears in three forms: 1) in association with pheochromocytomas and parathyroid hyperplasia (multiple endocrine neoplasia type 2 A [MEN 2A]); 2) with pheochromocytomas, neuromas of the mucous membranes, and a marfanoid appearance (MEN 2B): and 3) without pheochromocytoma. Despite these differences in presentation, age of onset, and clinical severity, limited genetic studies suggest that the three MTC variants may be due to inherited mutations at the same gene locus. We present further data in support of the hypothesis that allelic variation may underlie the diversity of these endocrine neoplasia syndromes.

Screening For Medullary Thyroid Cancer In France: A National Effort, Claude Calmettes, A. Chaventre, Nicole Feingold, Brigitte Franc, J. M. Guliana

Henry Ford Hospital Medical Journal

Screening for medullary thyroid cancer (MTC) in France is based on a protocol that has been widely distributed nationally. A network of coordinators utilizing a common questionnaire provides for an effective national screening program. Calcitonin stimulation procedures are systematically used for all first-degree relatives of MTC patients. Pathological studies utilize special immunopathologic techniques. Genealogic information is obtained on all index cases, and blood specimens are collected for establishing permanent cell lines. The data collected are used not only to establish the diagnosis of the hereditary or sporadic form of the disease but also to expand the screening as appropriate. This …

Results Of A Screening Program For Multiple Endocrine Neoplasia Type 2a: A Clinical Study Of A Japanese Family, Takashi Shimotake, Naomi Iwai, Jun Yanagihara, Tetsuro Kobayashi, Shin-Ichiro Sakai

Henry Ford Hospital Medical Journal

A Japanese family of 87 members in five generations with multiple endocrine neoplasia type 2A (MEN 2A) is described regarding the utility of screening tests for early detection of medullary thyroid carcinoma and the potential for DNA diagnosis of MEN 2A gene carriers. The screening programs for family members in this series include measurements of plasma calcitonin concentrations after intravenous injection of pentagastrin (0.5 μg/kg/5 sec) and 24-hour urinary excretion of catecholamines. While 18 MEN 2A patients had been previously diagnosed, these screening programs revealed five additional patients with MEN 2A (aged 16, 19, 35, 37, and 57). Prediction of …

Diagnosis, Management, And Pathogenetic Studies In Medullary Thyroid Carcinoma Syndrome, Naguib A. Samaan, Kuo-Pao Paul Yang, Pamela Schultz, R. C. Hickey

Henry Ford Hospital Medical Journal

A retrospective study of 224 patients with medullary thyroid carcinoma (MTC) diagnosed between 1963 and 1988 was performed to 1) establish the diagnosis of MTC in early childhood, 2) establish the role of prophylactic regional lymphadenectomy in patients with MTC, 3) study the effect of chemotherapy on MTC patients with metastatic disease, 4) study the effect of somatostatin analog 201-995 (Sandoz Pharmaceuticals) on the frequency of diarrhea in MTC, and 5) locate the common region(s) of gene deletion on chromosome 1 and examine the loss of heterozygosity on chromosome 10 in tumors. Our data indicated that a progressive rise of …

Postoperative Pentagastrin-Stimulated Serum Calcitonin Concentrations In Patients With Medullary Thyroid Carcinoma: Reoperations In Patients With Concentrations Bordering The Detection Limit, Hinrich Meybier, Heinrich Schmidt-Gayk, Heinz Buhr, Friedhelm Raue

Henry Ford Hospital Medical Journal

The case reports on two patients with medullary thyroid carcinoma show that even postoperatively stimulated serum calcitonin (CT) concentrations near the detection limit (using a polyclonal antibody against synthetic CT) can demonstrate persistent disease. Stimulated CT concentrations can be lowered to nondetectable levels by a second and third operation if a meticulous technique is used for dissection of the lymph compartments. The patient can then be assumed lo be cured. Diagnostic accuracy at very low CT concentrations can be improved by selective venous catheterization with blood sampling for CT after stimulation.

Comparison Of Sporadic And Hereditary Forms Of Medullary Thyroid Carcinoma, M. Rosenberg-Bourgin, P. Gardet, R. De Sahb, M. Schlumberger, B. Caillou, M. Guilloud-Bataille, J. P. Travagli, N. Feingold, C. Parmentier

Henry Ford Hospital Medical Journal

Between 1960 and 1988, 185 patients with medullary thyroid carcinoma (MTC) were followed at the Institut Gustave Roussy in France. The screening of the family members by calcitonin measurement (basal or after pentagastrin stimulation) has led lo the characterization of 38 sporadic cases and 44 hereditary cases. Among the hereditary cases are seven families with MTC only and two families with multiple endocrine neoplasia type 2A (MEN 2A). MTC only cases and MEN 2B cases are present as apparently sporadic forms. Hereditary cases consisted of 26 females and 18 males; the male-female ratio was 21:17 in sporadic cases. Ten of …