Medical Specialties Commons^™

Current Concepts Of Metabolic Functional Imaging With Positron Emitters, John W. Keyes Jr.

Henry Ford Hospital Medical Journal

Positron emitting radionuclides have unique properties that make them nearly ideal as radioactive tracers for in vivo metabolic studies. Using positron emission tomographic (PET) scanning and positron-labeled radiopharmaceuticals, one can study local glucose metabolism in tissues, blood flow, oxygen utilization, protein synthesis, and many other functions noninvasively in normal subjects and patients who have various diseases. A review of some of these techniques and the relative advantages and problems associated with the PET approach is presented.

Back Matter

Henry Ford Hospital Medical Journal

No abstract provided.

The Incidence Of Calculi In Focal Nonshadowing Echogenicity In The Gallbladder, Michael A. Sandler, Eileen M. Biunno, Martin L. Gross, Beatrice L. Madrazo

Henry Ford Hospital Medical Journal

Sonography is valuable in the accurate diagnosis of gallstones. All but the smallest stones attenuate sound, a phenomenon known as acoustic shadowing. However, when small focal nonshadowing opacities are present, the diagnostic question is whether they represent small calculi. In a four-year review of sonographic studies performed at Henry Ford Hospital, 12 patients in whom this sonographic finding was present underwent cholecystectomies, and seven had calculi (58%). If the presence of gallstones is the factor that will determine whether surgery will be performed, we recommend a repeat examination to confirm the presence of the focal opacities and to elicit acoustic …

Applications Of Magnetic Resonance Imaging In Clinical Urology, Barbara A. Demas, Hedvig Hricak

Henry Ford Hospital Medical Journal

During the past two years, the value of magnetic resonance imaging (MRI) in the diagnosis and staging of a variety of urologic neoplasms has been demonstrated, and the ability of MRI to determine sites of renal obstruction and causes of posttransplant renal failure have been reported. Its excellent soft-tissue contrast resolution has allowed accurate delineation of regional anatomy in the kidney, prostate gland, urinary bladder, urethra, uterus, and vagina. The importance of MRI in the urologic diagnosis is expected to increase as clinical imaging systems become widely available.

Cerebral Angiography In Posterior Fossa Revascularization, Roushdy S. Boulos, Suresh Patel, Bharat Mehta, Clifford Jack

Henry Ford Hospital Medical Journal

With advances in microsurgical techniques and refinement of cerebral angiography, many new surgical approaches for the treatment of vertebrobasilar insufficiency (VBI) have been developed. Detailed selective cerebral angiography is essential for confirming the clinical diagnosis, for demonstrating the exact anatomical and topographical vascular pathology, and for deciding on the best surgical procedure. Angiography is recommended to evaluate treated patients both in the early and late postoperative periods. It is an essential element of any future randomized study to assess the value of surgical vs medical treatment of patients with VBI. The benefits of cerebral angiography far outweigh the small risk …

Digital Radiography: A Review, David J. Kastan, Laurens V. Ackerman, Peter J. Feczko, Gordon H. Beute

Henry Ford Hospital Medical Journal

The fully digital radiology department remains a radiologist's dream. The technology necessary for implementation does not yet exist other than in prototype form. When the technology catches up with the radiologist's ideas, many new capabilities will exist. Electronically stored images will be available for viewing wherever a computer terminal exists. The problem of film loss would be nonexistent. Images could be quickly transmitted for interpretation via microwave networks to sites far removed from where they are acquired. Patient radiation exposure would decrease. Computers would help decrease perception errors and would assist in image interpretation. It may be ten years before …

Preliminary Experience With Digital Subtraction Angiography In Cardiac Evaluation, Matthew W. Burke, P. C. Shetty, Rajinder Sharma, James F. Brymer, Fareed Khaja

Henry Ford Hospital Medical Journal

iVe report our initial experience using digital subtraction angiography (DSA) techniques for cardiac evaluation. DSA of the heart may be performed with intravenous or right atrial injection of contrast medium (IVDSA) and with left ventricular or aortic root contrast injection (lADSA). The right ventricle and the atria are best demonstrated by IVDSA, while the left ventricle and coronary arteries are best demonstrated by lADSA. The advantages and disadvantages of DSA ofthe bean are discussed. Present equipment limitations restrict the routine use of cardiac DSA, but these should be overcome with advances in technology.

The Tube Esophagogram In Cases Of Possible Esophageal Stricture: A Technical Note, Lawrence M. Dubin, Robert D. Halpert, Peter J. Feczko, Sambasiva R. Kottamasu

Henry Ford Hospital Medical Journal

Esophageal strictures can occasionally be underdiagnosed because of the failure to achieve complete and consistent distention of the esophagus. When tube esophagography is performed, a small catheter is positioned in the patient's esophagus, and air is insufflated after the patient drinks barium. This produces maximum, uniform distention of the esophagus with little patient discomfort. This technique is valuable in demonstrating mild or subtle strictures, improving mucosal detail, and evaluating areas suggestive of stricture on routine radiographs.

Nuclear Magnetic Resonance: Current And Future Clinical Applications, Jerry W. Froelich, David O. Hearshen, Robert D. Halpert, Suresh Patel

Henry Ford Hospital Medical Journal

Nuclear magnetic resonance has evolved from a laboratory analytical tool to become a rapidly developing discipline in clinical medicine. We present a brief historical overview, an introduction to the basic principles of the phenomenon, and a statement of the current status of clinical imaging. We have elected to use the traditional terminology nuclear magnetic resonance to refer to the imaging component of the field rather than the American College of Radiology (ACR) modification magnetic resonance. We do this out of respect for the founders of the field.

Percutaneous Nephrolithotomy: Current Methods And The Henry Ford Hospital Experience, P. C. Shetty, Rajinder P. Sharma, Raymond H. Littleton, Gary A. Krasicky, Matthew W. Burke, Brian J. Miles, James H. Thrall, Joseph C. Cerny

Henry Ford Hospital Medical Journal

The combined radiologic/urologic approach to percutaneous renal stone extraction has been practiced at Henry Ford Hospital since November of 1982. This article describes the current methodology and reviews our experience in performing 121 percutaneous nephrolithotomies (PCNL). We conclude that PCNL is a safe, reliable, and cost-effective alternative to open nephrolithotomy in most patients.

Artificial Intelligence And Image Processing, Laurens V. Ackerman, Matthew W. Burke

Henry Ford Hospital Medical Journal

The evolution of artificial intelligence since the 1950s is discussed, especially as it is being applied in radiology to image processing. Developments in artificial intelligence are now being used to provide a new approach to image processing. Initially, the computer dealt with numeric representations using languages such as FORTRAN and BASIC. Now symbolic languages such as LISP and PROLOG have expanded the use of the computer into nonnumeric symbolic reasoning that is just being applied to image understanding. This paper explains the new languages and their application to image understanding.

Front Matter

Henry Ford Hospital Medical Journal

No abstract provided.

The Development Of Multispecialty Group Practice At Henry Ford Hospital Through The Years, Bruce W. Steinhauer

Henry Ford Hospital Medical Journal

No abstract provided.

The Strange Story Of Jay Mclean, The Discoverer Of Heparin, Conrad R. Lam

Henry Ford Hospital Medical Journal

Since 1939, the use of heparin has become widespread in the prevention of postoperative thrombosis and embolism and is the basis for modern open-heart surgery. What is not generally known is the story of Jay McLean, the second-year medical student at Johns Hopkins who is given credit for the original discovery. McLean's first scientific publication concerning the use of heparin does not contain the word "heparin," and not until 25 years later did McLean publish a short paper about heparin. Some personal letters and other research have indicated a checkered career. He was trained as a surgeon in the Halsted …

Adverse Interactions Of Drugs In Critical Care Patients, Barbara Zarowitz, William Conway, John Popovich Jr.

Henry Ford Hospital Medical Journal

No abstract provided.

Central Pontine Myelinolysis In A Patient With Adrenal Insufficiency, John E. Brunner

Henry Ford Hospital Medical Journal

Central pontine myelinolysis is a demyelinating process that has occurred in association with rapid correction of hyponatremia. Presented here is the case of a patient who had adrenal insufficiency and who experienced signs of central pontine myelinolysis after rapid correction of severe hyponatremia (28 mEq/L of sodium administered in the first 24 hours, initial serum sodium level 97mEq/L). Sustained hyponatremia and the use of intravenous contrast material after hyponatremia correction are discussed as possible risk factors in the development of central pontine myelinolysis.

Electron Microscopic Examination Of Various Types Of Ancient Specimens, Jeanne M. Riddle

Henry Ford Hospital Medical Journal

No abstract provided.

Dr Frank J. Sladen: The Osler Connection, Richmond W. Smith Jr.

Henry Ford Hospital Medical Journal

No abstract provided.

In Defense Of The Pickwickian Syndrome, Howard Markel

Henry Ford Hospital Medical Journal

No abstract provided.

Playing With Medicine: A Historical Perspective, William H. Beierwaltes

Henry Ford Hospital Medical Journal

No abstract provided.

A Graphical Aid To Medical Decision Making, William A. Benish

Henry Ford Hospital Medical Journal

Given knowledge of a test's sensitivity and specificity, physicians may use Bayes' theorem to appropriately modify their initial assessment of the likelihood of disease subsequent to obtaining a positive or negative test result. A graphical representation of Bayes' theorem was constructed in order to provide a simple tool to aid in the selection and interpretation of diagnostic tests.

Diagnosis Of Hepatic Portal Venous Gas By Computed Tomography: Role Of Intravenous Contrast Material, Allan M. Haggar, Michael A. Sandler, Martin L. Gross, Beatrice L. Madrazo

Henry Ford Hospital Medical Journal

We describe a case of hepatic portal venous (HPV) gas. The diagnosis was assisted by findings of computed tomography (CT). The HPV gas resulted from a diverticular abscess in a patient who had a stable clinical course. If the possibility of HPV gas exists, scanning without intravenous administration of contrast material should be performed. If postcontrast scans alone are obtained, the opacified portal blood may mask small amounts of HPV gas, as was true in this case. Also, postcontrast scans can easily distinguish HPV gas from air within the biliary tree if findings of precontrast scans are equivocal.

Metastatic Bronchogenic Carcinoma Simulating Osteoarthritis, David Wendt, Paul Kvale

Henry Ford Hospital Medical Journal

No abstract provided.

Leiomyosarcoma Of The Heart: A Twenty-Year Cure, Gerald Fine, B. Usha Raju

Henry Ford Hospital Medical Journal

Excision of a predominantly intracavitary right atrial tumor, which mimicked a number ofother clinical disorders, effected a 20-year cure. Microscopic, ultrastructural, and immunocytochemical characteristics of the tumor were those of smooth muscle; cellular anaplasia, mitotic activity and tumor infiltration of the auricular myocardium indicated malignant neoplasia, a leiomyosarcoma. Distribution of the tumor was consistent with its origin from the auricular endocardium.

The Invalidity Of Monitoring Transcutaneous Oxygen Tension In Patients Who Have Chronic Renal Failure, John R. Armstrong, Thomas W. Kreps, William A. Conway, Francis Dumler, John Popovich Jr.

Henry Ford Hospital Medical Journal

We assessed accuracy of monitoring transcutaneous oxygen tension (PtcO2) in patients with chronic renal failure (CRF). Sixteen stable individuals undergoing chronic maintenance hemodialysis were studied. Correlations between simultaneously determined PtcO2 and arterial oxygen tension (PaO2) were made both before and during dialysis. Comparisons were made with a group of 22 consecutive patients in whom respiration was mechanically assisted, who were hemodynamically stable (urine output greater than 30 mL/hour, pulse less than 130 beats/min, and mean arterial blood pressure greater than 80 mm Hg in the absence of pressor agents), and who had normal renal function.

Among CRF patients, the correlation …

Editorial: In Defense Of Historians, Conrad R. Lam

Henry Ford Hospital Medical Journal

No abstract provided.

Back Matter

Henry Ford Hospital Medical Journal

No abstract provided.

Linkage Data Excluding A Locus For Multiple Endocrine Neoplasia Type 2 Syndromes From The Distal Part Of The Short Arm Of Chromosome 11, Kenneth K. Kidd, Susan D. Kruger, Daniela S. Gerhard, Judith R. Kidd, David Housman, Joseph M. Gertner

Henry Ford Hospital Medical Journal

A study designed to identify the location of a gene for multiple endocrine neoplasia type 2 (MEN-2) is being performed using a single large family segregating for MEN-2A. Here we report our initial results using a set of DNA restriction fragment length polymorphisms spanning a 40 cM segment of the short arm of human chromosome 11. The locus for MEN-2 in this family is excluded from this entire region which includes an oncogene, c-Ha-ras-1, two hormone loci, insulin and parathyroid, and the five hemoglobin genes in the beta hemoglobin gene duster. This is the first exclusion of such a large …

The First International Workshop On Multiple Endocrine Neoplasia Type 2 Syndromes, Charles E. Jackson

Henry Ford Hospital Medical Journal

No abstract provided.

Impact Of Screening On Prognosis In The Multiple Endocrine Neoplasia Type 2 Syndromes: Natural History And Treatment Results In 105 Patients, Margareta Telenius-Berg, Bertel Berg, Bertil Hamberger, Sten Tibblin, Lars-Erik Tisell, Lars Ysander, Gunnar Welander

Henry Ford Hospital Medical Journal

We evaluated the effects of screening for multiple endocrine neoplasia type 2A (MEN-2A) in 12 families. Genealogical studies going back to 1730 show a common ancestry for seven Swedish families and one American family. The total number of patients included 105 individuals, 68 of whom were diagnosed by our screening program. Our screening methods for medullary carcinoma of the thyroid (MTC) had an optimal sensitivity and specificity. The frequency of gene carriers detected in MEN-2A families was 55%. Screening will lead to early diagnosis and early therapy, which in turn, will significantly decrease morbidity, incidence of surgical complications, and mortality …