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Clinical Note: Use Of Clonidine To Detoxify Opiate-Addicted Patients, Dennis L. Caffrey, Tai P. Yoo

Henry Ford Hospital Medical Journal

This study investigated the utility of systematically administering clonidine to detoxify opiate-dependent inpatients. Fifteen patients received a 0.1 mg dose of clonidine orally at 8:00 am, 12:00 noon, 4:00 pm, and at bedtime. A 0.1 mg dose was also administered as needed if any withdrawal signs were evidenced, but this additional dose was rarely needed after the second day of treatment. Night sweats were the only significant complaint reported. All 15 patients were successfully detoxified after ten days of treatment.

Echocardiographic Evaluation Of Porcine Bioprosthetic Valve Degeneration, M. Alam, J. B. Lakier, S. Goldstein

Henry Ford Hospital Medical Journal

Spontaneous cusp degeneration is one of the most common long-term complications associated with porcine bioprosthetic valves (1-6). Recognition of its occurrence is essential for appropriate management to be instituted. In this report we have reviewed our echocardiographic experience with porcine bioprosthetic valve degeneration (7-8).

A Morphologic Overview Of The Porcine Bioprosthetic Heart Valve, Jeanne M. Riddle, Paul D. Stein, Donald J. Magilligan Jr.

Henry Ford Hospital Medical Journal

The glutaraldehyde-processed porcine aortic heart valve is similar in its microscopic organization to the human aortic valve (1). It is important to understand the detailed histology of this bioprosthetic valve because distinct components of its leaflets are altered selectively when the valve is initially collected from the pig and stabilized with the commercial glutaraldehyde fixation process. Further structural modifications also occur after the commercially processed valve has been inserted into a patient where it undergoes progressive degeneration.

Observations Suggesting A Possible Link Between Gammacarboxyglutamic Acid And Porcine Bioprosthetic Valve Calcification, Joseph A. Helpern, Stephen J. Mcgee, Jeanne M. Riddle

Henry Ford Hospital Medical Journal

Observations that link gammacarboxyglutamic acid (Gla) peptides with ectopic calcification are accumulating in the literature and may be summarized as follows: 1) Gla peptides selectively bind calcium and hydroxyapatite. 2) The presence of detectable levels of Gla in calcified tissue is concurrent with the onset of mineralization. 3) In an animal model, osteocalcin (a Gla-containing protein) accounts for more than 90% of all the Gla found in the resulting subcutaneously implanted calcified leaflet. 4) Vitamin D stimulates osteocalcin synthesis in cultures of osteosarcoma cells, and in vitamin D deficient rats subcutaneously implanted valve leaflets are not calcified. 5) Gla content …

The Surgeon And The Patient With Cancer: The Development Of Surgical Oncology, Angelos A. Kambouris

Henry Ford Hospital Medical Journal

No abstract provided.

Effects Of Tetracycline On Fecal Bile Acid Pool Composition In A Human: A Preliminary Report, Jerome R. Waldbaum, William T. Beher, Robert J. Priest, Sofia Stradnieks

Henry Ford Hospital Medical Journal

We studied the effect of tetracycline on bile acid pool composition in a human subject. A dosage of 250 mg (qid) of tetracycline for one week completely eliminated deoxycholic and lithocholic acid from the pool. Tetracycline may be of value for limiting the build-up of lithocholic acid in patients who are treated with chenodeoxycholic acid to dissolve gallstones.

Medical Grand Rounds: Open And Closed Loop Insulin Delivery Systems In Diabetes: Current Status, F. John Service

Henry Ford Hospital Medical Journal

No abstract provided.

Editorials

Henry Ford Hospital Medical Journal

No abstract provided.

Medullary Carcinoma Of The Thyroid With Bone Metastasis, Sheldon S. Stoffer, Sidney D. Kobernick, Richard M. Zirkin, Stuart W. Hamburger, Susan E. Harold

Henry Ford Hospital Medical Journal

A woman with medullary carcinoma of the thyroid and a past history of breast cancer was found to have metastatic bone lesions. It was initially assumed that this was due to recurrent breast carcinoma, but bone biopsy revealed medullary carcinoma of thyroid origin. Although clinical bone metastasis is a rare event in patients with medullary carcinoma, quite clearly such an occurrence is possible. Medullary carcinoma should be considered in the differential diagnosis of patients with metastatic bone lesions.

Hemoptysis Complicating Mitral Stenosis: Case Report With Attention To Differential Diagnosis And A Review Of The Literature, Michael S. Eichenhorn, John Popovich Jr., Jan R. Radke

Henry Ford Hospital Medical Journal

The differential diagnosis of hemoptysis in patients with mitral stenosis includes many primary pulmonary problems besides those peculiar to mitral stenosis. We describe the case of a 40-year-old woman with a 40-pack-year smoking history whose presenting symptom of hemoptysis was wrongly ascribed to pulmonary embolus and infarction, based on a presumably positive angiogram, and to chronic bronchitis, based on endoscopic findings at fiberoptic bronchoscopy, as provided by the referring physician. The features differentiating between cardiac and primary pulmonary disease are described, and the pathophysiology of hemoptysis in mitral stenosis is reviewed. In a case like the one we describe, hemoptysis …

Isoenzyme Update: Creatine Kinase And Lactate Dehydrogenase, Craig C. Foreback

Henry Ford Hospital Medical Journal

Creatine kinase (CK) and lactate dehydrogenase (LD) are isoenzymes that have been measured in clinical laboratories for over 20 years; their separation has proved valuable in the diagnosis of myocardial infarction and other cardiac-related diseases. Although, historically, electrophoresis was the preferred method to measure both isoenzymes, there has been controversy over the best method for separating the CK isoenzyme. lon exchange chromatography has been used successfully to isolate CK isoenzymes, and the procedure was adapted to determine CK-MB activity in serum. New methods to quantify CK-MB have also been tested, including an automated column technique, the immunoinhibidon/ immunoprecipitadon technique, and …

Front Matter

Henry Ford Hospital Medical Journal

No abstract provided.

Familial Hypokalemic Periodic Paralysis In Blacks, Jack M. Bernstein, Michael Kleerekoper

Henry Ford Hospital Medical Journal

Hypokalemic periodic paralysis is an uncommon disease that has rarely been reported in blacks. Historical, clinical, and pathological findings in three black patients, in addition to those previously reported in the literature, suggest that the spectrum of the disease is identical in both blacks and whites. Considering the disease as either different or unknown in the black population is probably not justified.

Chronic Idiopathic Thrombocytopenic Purpura: Effective Preoperative Preparation And Long-Term Results Of Splenectomy, James C. Gruenberg, Melvin A. Block, Ellis J. Van Slyck, Joseph P. Abraham

Henry Ford Hospital Medical Journal

A retrospective review of 98 patients seen at Henry Ford Hospital from 1953 through 1977 demonstrated that splenectomy for chronic idiopathic thrombocytopenic purpura provided a good response which usually was sustained on long-term follow-up (72% at 15 years). Although splenectomy for this condition had a low mortality, morbidity was significant in patients older than 40 years. When compared to patients whose response to splenectomy was sustained, patients who relapsed had significantly lower platelet counts preoperatively both when they were untreated (mean: 9,194 per cc versus 18,524 per-cc) and/or when they were treated with steroids (mean: 85,647 per cc versus 142,590 …

Effect Of Levamisole On The Incidence Of Spontaneous Mammary Tumors In C3h Mice, Robert H. Page, Duilio A. Valdivia, Robert W. Talley, Robert A. Huseby

Henry Ford Hospital Medical Journal

Spontaneous mammary carcinoma in C3H mice is preceded by premalignant hyperplastic alveolar nodules. When a primary tumor is evident, examination of the other mammae will reveal a number of microscopic precancerous lesions in various stages of transformation to overt malignant tumors. In an effort to inhibit the development of additional malignant tumors after surgical removal of the first apparent tumor, we treated female C3H/HeJ mice with subcutaneous injections of levamisole (0.6 mg per kg of body weight) on a twice weekly regimen. All further tumors were surgically excised when they became palpable. The surgical excision of bulk tumor burden, immunorestoration …

Acid Phosphatase: Clinical Utility Of The First Tumor Marker, Christopher J. Dipaolo, Jan Rival

Henry Ford Hospital Medical Journal

Acid phosphatase was the first tumor marker to be measured in blood. Although it is used as a marker of prostatic carcinoma, serum levels are also elevated in many diseases of prostate, bone, and hematologic tissue. While serum acid phosphatase concentration is elevated in patients with prostatic carcinoma or infarction, it may also be increased merely with benign hypertrophy and after prostate massage. Recent studies demonstrate that levels are not significantly increased after routine rectal examination. Although of limited use as a screening test, the assay may be useful in staging, prognostication during hormonal therapy, and in making clinical decisions. …

The Central Surgical Association Turns Forty: Some Highlights Of The First Twenty Years, Conrad R. Lam

Henry Ford Hospital Medical Journal

The Central Surgical Association assembled for the first time in Detroit and Ann Arbor, Michigan in February, 1941. On the 40th anniversary of this meeting, the Association met again in the same geographical region, in Dearborn. Selected papers from the first twenty years have been chosen as highlights. Criteria for choosing a few from many significant papers were the originality of the material, its time-proven value, and the subsequent impressive careers of the authors. Appropriate credit is given to Dr. Roy D. McClure for his concept of an organizadon of surgeons in the central geographical area and for his efficient …

Compression Of The Duodenum By The Root Of The Mesentery, Peter A. Haas, Jawaid Akhtar, Lester Kobylak

Henry Ford Hospital Medical Journal

Compression of the duodenum by the root of the mesentery is a rare pathological entity that has caused much controversy because it has been mistakenly identified as the "superior mesenteric artery syndrome" or the "vascular compression of the duodenum." We discuss the pathological anatomy and the diagnosis of the disease, and report an illustrative case. Some authors report many cases of the syndrome, while others doubt its existence. Before surgery is considered, the diagnosis should be established beyond doubt and a prolonged period of observation, medical treatment, and nutritional support should be provided. The barium contrast swallowing test combined with …

Rupture Of Mycotic Aneurysm During Pregnancy: Another Hazard Of Drug Abuse, Jayanta Kumar Dirghangi, Mohammed R. Ansari

Henry Ford Hospital Medical Journal

Widespread parenteral drug abuse has led to an increase in mycotic aneurysms in the area of drug injection. We report an unusual case of ruptured mycotic aneurysm of the right external iliac artery in a pregnant woman who was a heroin addict. In the third trimester, she developed a large hematoma that resulted in intra-uterine fetal death, premature labor, and hypovolemic shock. This case presented a difficult diagnostic and therapeutic dilemma that was confused with the syndrome of ruptured utero-ovarian veins.

Letters To The Editor

Henry Ford Hospital Medical Journal

No abstract provided.

Editorials, Raymond H. Kahn, Michael Kleerekoper, Irwin K. Rosenberg

Henry Ford Hospital Medical Journal

No abstract provided.

Back Matter

Henry Ford Hospital Medical Journal

No abstract provided.

Observation Of Bone Formation In The Mandibular Symphysis Following Surgical Separation And Slow Mechanical Expansion In A Baboon, Robert J. Homer

Loma Linda University Electronic Theses, Dissertations & Projects

Mechanical expansion of the maxilla, at the midline suture, is a widely accepted orthodontic procedure used to gain arch width in certain types of maxillary deficient arches.

In animal research on the mandible, techniques using surgical separation at the symphysis with immediate expansion up to 12 mm, fixation with a metal splint, and autogenous bone transplanted into the expanded area, have been reported to be successful.

To date, no experiment utilizing slow mechanical expansion of the mandible at the symphysis has been reported.

In this pilot study, the mandible of a female baboon was surgically separated A-P at the symphysis. …

The Immunology Of Inflammatory Bowel Disease, Hugh L. N. Mackechnie

Henry Ford Hospital Medical Journal

Although several measurements of both cellular and humoral immunity are altered in inflammatory bowel disease (IBD), no direct pathogenic role can be confirmed in either ulcerative colitis (UC) or Crohn's disease (CD). No clear role has been shown for allergic, microbiological, or psychogenic factors, and no specific genetic susceptibility has been demonstrated. Several studies have shown some benefit from using immunosuppressive drugs to treat inflammatory bowel disease, such as sulfasalazine to treat ulcerative colitis and corticosteroids to treat Crohn's disease. Whether these benefits derive from the anti-inflammatory activity of these drugs or from their immunological effects is uncertain.

Acute Burkitt's Leukemia: Case Report And Literature Review, S. Raman, S. M. Saeed, K. R. Kini

Henry Ford Hospital Medical Journal

The occurrence of leukemia in Burkitt's lymphoma, with or without visceral or nodal tumefaction is uncommon, and its initial presentation as leukemia is even more unusual. Because it has a poor chemotherapeutic response and a grave prognosis, it is important to recognize this unusual leukemia correctly. Our report describes the clinical and pathologic findings of Burkitt's lymphoma cell leukemia in a five-year-old white boy who presented with abdominal distension, hepatosplenomegaly, and lymphadenopathy. Blood examination revealed normocytic normochromic anemia, erythroblastosis, slight leukocytosis, and the presence of numerous (24%) blasts. A diagnosis of Burkitt's lymphoma was established on the basis of morphologic, …

Front Matter

Henry Ford Hospital Medical Journal

No abstract provided.

Zoonoses In Modern Medical Practice, Tom Madhavan

Henry Ford Hospital Medical Journal

Zoonoses are infections transmitted by animals to man. Of the more than 50 such infections that are clinically significant, several are discussed in the articles by McIntosh and Madhavan and by Meyer and Adar in this issue of the Journal (pp. 7-13). These include brucellosis, leptospirosis, relapsing fever, Colorado tick fever, toxoplasmosis, psittacosis, and echinococcosis. The McIntosh and Madhavan article reviews the experience at Henry Ford Hospital with 60 patients, while the article by Meyer and Adar reports on an unusual case of echinococcosis of the spine and retroperitoneum that occurred at Haim Sheba Medical Center in Israel.

Zoonoses At Henry Ford Hospital: Clinical, Epidemiologic, And Therapeutic Aspects, Nancy Mcintosh, Tom Madhavan

Henry Ford Hospital Medical Journal

Zoonoses are diseases of animals that can be transmitted to humans. We reviewed the experience with zoonotic illnesses treated at Henry Ford Hospital in the past ten years. Included in this report are cases of brucellosis, leptospirosis, relapsing fever, Colorado tick fever, toxoplasmosis, psittacosis, and pasteurellosis. This report describes the clinical and epidemiologic aspects of zoonoses in 60 patients in a large urban general hospital.

Echinococcosis Of The Spine And Retroperitoneum: Case Report And Review Of The Literature, Eugene Meyer, Raphael Adar

Henry Ford Hospital Medical Journal

Echinococcosis is a zoonosis transmitted from sheep dogs to humans. It occurs most frequently in sheep and cattle-raising countries, and children who come in contact with sheep dogs are the most likely victims. The liver and the lungs are the most common sites of the hydatid cysts. Their presence in other organs is less common, and primary hydatidosis of the retroperitoneum is extremely rare. In the case reported here, a 65-year-old man had secondary retroperitoneal echinococcosis that recurred three times in 23 years. On the third occasion, marsupialization was performed on a large cyst found in the right retroperitoneum.

Racial Differences In The Incidence Of Steroid Diabetes In Renal Transplant Patients, Francis Dumler, Hajime Hayashi, Jay Hunter, Nathan W. Levin

Henry Ford Hospital Medical Journal

We have studied the development of steroid-induced diabetes in a population of 143 renal allograft recipients who were nondiabetic before transplantation. Steroid-induced diabetes developed In 9.8% of patients. However, in blacks its incidence was significantly higher than in whites (17.3% vs 5.5% respectively; p < .01). The development of steroid-induced diabetes was not associated with a higher frequency of HLA-B8 or HLA-Bw15 in either race. In black graft recipients, HLA-B14 was significantly more frequent (p < .001) among those who developed steroid-induced diabetes than in insulin-dependent diabetic (Type I) and nondiabetic recipients. The clinical course of patients with steroid-induced diabetes has been similar to that of noninsulin-dependent diabetics (Type II).