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Full-Text Articles in Medical Specialties

Neuropsychological Research On The Neurosurgical Treatment Of Cerebrovascular Disease, James Ausman, Mark W. Shatz Sep 1983

Neuropsychological Research On The Neurosurgical Treatment Of Cerebrovascular Disease, James Ausman, Mark W. Shatz

Henry Ford Hospital Medical Journal

No abstract provided.


Methodological Issues In Studying Treatment Effects In Patients With Cerebrovascular Disease, Mark W. Shatz Sep 1983

Methodological Issues In Studying Treatment Effects In Patients With Cerebrovascular Disease, Mark W. Shatz

Henry Ford Hospital Medical Journal

Evaluation of the neuropsychological effects of surgical treatment on cerebrovascular disease is beset by numerous methodological difficulties. These include problems specific to this patient population as well as others inherent in all retrospective studies. Five such problems are described: 1) nonrandomized subject selection; 2) dropout from follow-up; 3) natural history of cerebrovascular disease; 4) effects of hospitalization; and 5) the role of practice effects. This paper examines these methodological problems for their impact on our knowledge and proposes alternative research directions to address their shortcomings.


Carotid Artery Disease, Carotid Endarterectomy, And Behavior: A Critical Appraisal, Mark P. Kelly Sep 1983

Carotid Artery Disease, Carotid Endarterectomy, And Behavior: A Critical Appraisal, Mark P. Kelly

Henry Ford Hospital Medical Journal

We reviewed the recent literature on the relationship between carotid artery disease, carotid endarterectomy, and behavior. The methodological adequacy of each study and the complexities involved in interpreting behavioral changes in patients with carotid disease are emphasized. Experimental design issues qualify conclusions in all studies. The weight of the evidence suggests that carotid artery disease may result in cognitive impairment, and that carotid endarterectomy is followed by psychometrically determined cognitive improvement in some patients. Although characteristics of the subgroup of patients most likely to improve have been identified in preliminary investigations, the clinical significance of such improvement has not been …


The Effects Of Cerebrovascular Surgery On Behavior: What Has Been Demonstrated?, Laurence M. Binder Sep 1983

The Effects Of Cerebrovascular Surgery On Behavior: What Has Been Demonstrated?, Laurence M. Binder

Henry Ford Hospital Medical Journal

We studied the effect of the superficial temporal artery to middle cerebral artery bypass (STA-MCA) procedure on neuropsychological function. Nineteen patients with cerebrovascular disease of the anterior carotid circulation (12 on surgical and seven on medical therapy) received an extensive battery of neuropsychological tests; the average test-retest interval was eight weeks. Both groups improved on some measures, and no patients deteriorated. There was no evidence of greater improvement by the surgical group. The results are compatible with a spontaneous remission/practice effect interpretation. A review of the carotid endarterectomy and STA-MCA bypass literature suggests that the null hypothesis of no effect …


Neuropsychological Evaluation Of The Results Of Surgical Treatment Of Cerebrovascular Disease, Melvin L. Schwartz Sep 1983

Neuropsychological Evaluation Of The Results Of Surgical Treatment Of Cerebrovascular Disease, Melvin L. Schwartz

Henry Ford Hospital Medical Journal

No abstract provided.


A Radiologic Method Of Assessment Of Bone And Joint Destruction In Rheumatoid Arthritis, Gilbert B. Bluhm, David W. Smith, Walter M. Mikulashek Sep 1983

A Radiologic Method Of Assessment Of Bone And Joint Destruction In Rheumatoid Arthritis, Gilbert B. Bluhm, David W. Smith, Walter M. Mikulashek

Henry Ford Hospital Medical Journal

We employed radiographic analysis and a numerical scoring system to evaluate bone and joint destruction in 39 patients who received aspirin and nonsteroidal, antiinflammatory drugs or benoxaprofen therapy over a continuous study period of 36 months (mean). Our purpose was to compare the radiological changes in these patients over two observation intervals and to test the reproducibility of the scoring system. Our modified rating system has sufficient intra-rater reliability to provide a statistically adequate, reproducible method for evaluating bone and joint destruction in rheumatoid arthritis.


Posttraumatic Hernia Of The Bladder, Joseph L. Ponka, Farouck N. Obeid Sep 1983

Posttraumatic Hernia Of The Bladder, Joseph L. Ponka, Farouck N. Obeid

Henry Ford Hospital Medical Journal

Fractures of the pelvis occur commonly in patients who are involved in high speed vehicle accidents or who fall from a substantial height. Fortunately, with improved surgical management, these patients usually recover not only from the pelvic fractures but from associated visceral injuries as well. Some survivors of pelvic fractures subsequently develop unusual hernias. We report the case of a man who developed hernia of the urinary bladder following pelvic fracture. Two previous operations had failed to eliminate his hernia. We describe the technique of repair used successfully in this case and review similar reported cases. Surgeons who care for …


Editorials Sep 1983

Editorials

Henry Ford Hospital Medical Journal

No abstract provided.


Back Matter Sep 1983

Back Matter

Henry Ford Hospital Medical Journal

No abstract provided.


Front Matter Jun 1983

Front Matter

Henry Ford Hospital Medical Journal

No abstract provided.


Issues In Diabetes: 1983, Fred W. Whitehouse Jun 1983

Issues In Diabetes: 1983, Fred W. Whitehouse

Henry Ford Hospital Medical Journal

No abstract provided.


Plasma Lipid Abnormalities In Diabetes Mellitus: Observations On Hdl Cholesterol And Recommendations For The Management Of Lipid Abnormalities, Dorothy Kahkonen Jun 1983

Plasma Lipid Abnormalities In Diabetes Mellitus: Observations On Hdl Cholesterol And Recommendations For The Management Of Lipid Abnormalities, Dorothy Kahkonen

Henry Ford Hospital Medical Journal

No abstract provided.


The Exclusion Of Restrictive Lung Disease By Spirometric Criteria In Patients With A Reduced Forced Vital Capacity, Michael S. Eichenhorn, John Popovich Jr., Richard K. Beauchamp, John Armstrong, Joseph C. Ward Jun 1983

The Exclusion Of Restrictive Lung Disease By Spirometric Criteria In Patients With A Reduced Forced Vital Capacity, Michael S. Eichenhorn, John Popovich Jr., Richard K. Beauchamp, John Armstrong, Joseph C. Ward

Henry Ford Hospital Medical Journal

Reductions in forced vital capacity (EVC) as determined by spirometry may result from restrictive or obstructive disease, either alone or in combination. Restrictive disease is implied when measures of forced expiratory flow are relatively maintained, and obstructive disease is present when flow measurements are disproportionately reduced. In the presence of air flow obstruction, the possibility of concomitant restrictive disease contributing to the reduction in FVC is difficult to assess from spirometry alone. Static lung volumes are usually necessary to establish this diagnosis. We evaluated the FEV1/EVC%o obtained at spirometry compared to its predicted normal value. We found it to be …


Back Matter Jun 1983

Back Matter

Henry Ford Hospital Medical Journal

No abstract provided.


Experience With Biosynthetic Human Insulin In Diabetes, Davida F. Kruger, Fred W. Whitehouse, Dorothy M. Kahkonen, Jean O. Partamian, J. David Fachnie, José Goldman, David Leach Jun 1983

Experience With Biosynthetic Human Insulin In Diabetes, Davida F. Kruger, Fred W. Whitehouse, Dorothy M. Kahkonen, Jean O. Partamian, J. David Fachnie, José Goldman, David Leach

Henry Ford Hospital Medical Journal

Thirty diabetic patients new to insulin were entered in an open label prospective study of biosynthetic human insulin (BHI). All patients experienced symptomatic control of diabetes attributable to dietary and BHI insulin therapy. Detailed six-month evaluation data were reviewed in 19 patients. A significant drop in fasting plasma glucose and glycosylated hemoglobin was noted at two months, and a further modest decrease occurred at six months. E. coli polypeptide antibodies were unchanged from baseline at six months, indicating that no bacterial protein contamination of BHI occurred. Percent binding of serum antibodies to human insulin measured in 19 patients at baseline …


The Artificial Pancreas Today, James F. Mcmurry Jr. Jun 1983

The Artificial Pancreas Today, James F. Mcmurry Jr.

Henry Ford Hospital Medical Journal

An artificial pancreas is now available in selected centers for clinical use in blood glucose control. With information derived from 24-30 hours of "closed-loop" insulin administration by means of the artificial pancreas, subcutaneous insulin doses may be determined for insulin-dependent diabetic patients. Eleven poorly controlled diabetic patients had their insulin doses reevaluated with the artificial pancreas. Ten of 11 patients showed improved glucose control when their insulin doses were modified by this method.


Current Management Of Pregnancy In The Diabetic: A Team Approach, Seth G. Kivnick, J. David Fachnie, Chang Y. Lee Jun 1983

Current Management Of Pregnancy In The Diabetic: A Team Approach, Seth G. Kivnick, J. David Fachnie, Chang Y. Lee

Henry Ford Hospital Medical Journal

We reviewed details of 89 pregnancies in diabetic women who were delivered from 1980 through 1982. Data are presented on the obstetrical outcome and the level of diabetic control in patients with White classifications of B through R. Although the mean blood glucose levels of all groups failed to meet the criteria for ideal metabolic control (fasting less than 105 mg/dl, postprandial less than 120 mg/dl), the perinatal mortality rate of 4% compared favorably with reports from other centers. Fifty-six percent of our patients were delivered at 37 weeks gestation or later. The primary Caesarean section rate was 37%, and …


Recommendations For Care Of The Asymptomatic Patient, James D. Bridges, Thomas Killip, N. Kevin Krane, David B. Macdougall, Carlos F. Petrozzi, Michael E. Somand, Susan Steigerwalt Jun 1983

Recommendations For Care Of The Asymptomatic Patient, James D. Bridges, Thomas Killip, N. Kevin Krane, David B. Macdougall, Carlos F. Petrozzi, Michael E. Somand, Susan Steigerwalt

Henry Ford Hospital Medical Journal

We present a set of reasonable guidelines for the care of healthy, asymptomatic individuals based upon recommendations prepared by an Internal Medicine review committee of Henry Ford Hospital. There recommendations have four goals: to prevent disease, to detect disease in an asymptomatic and potentially curable state, to enhance the patient's quality of life, and to help physicians teach patients good health habits. Recommendations are made for infectious diseases, cancer, metabolic diseases, neurosensory conditions like visual and hearing loss, and general health habits. Some recommendations are at variance with those of well recognized authorities and should be viewed only as a …


Hemolytic-Uremic Syndrome In A Patient Receiving Mitomycin C And 5-Fluorouracil, Glen R. Willie, Stanley M. Levy, Robert S. Michaels, Richard M. Zirkin Jun 1983

Hemolytic-Uremic Syndrome In A Patient Receiving Mitomycin C And 5-Fluorouracil, Glen R. Willie, Stanley M. Levy, Robert S. Michaels, Richard M. Zirkin

Henry Ford Hospital Medical Journal

Recently, an association was reported between a form of hemolytic-uremic syndrome and the use of adjuvant chemotherapy with mitomycin C and 5-fluorouracil. Our report presents the clinical course of a patient with this syndrome along with detailed renal pathological studies (including electron and immunofluorescence microscopy). This information is not available for most previous reports.


Drug-Induced Glomerulopathy: A Selective Review, Francis Dumler Jun 1983

Drug-Induced Glomerulopathy: A Selective Review, Francis Dumler

Henry Ford Hospital Medical Journal

Tbe pathogenesis of drug-induced glomerular disease is becoming better understood because of recent advances in the study of glomerular physiology and metabolism. Various classes of drugs may produce nephrotoxicity. This review is limited to types of drugs whose use may result in glomerular functional and metabolic abnormalities leading to proteinuria and/or renal insufficiency. Drugs which cause tubular necrosis are excluded. Nonsteroidal anti-inflammatory agents are examples of drugs that induce glomerular proteinuria and minimal change nephropathy. Gold, penicillamine, and captopril produce drug-induced glomerular proteinuria in association with membranous nephropathy. Finally, semustine and mitomycin are examples of drugs that induce glomerular sclerosis …


Editorials Jun 1983

Editorials

Henry Ford Hospital Medical Journal

No abstract provided.


Editorials Mar 1983

Editorials

Henry Ford Hospital Medical Journal

No abstract provided.


The Role Of Major Hepatic Resections For Liver Metastases From Colorectal Cancer, Angelos A. Kambouris Mar 1983

The Role Of Major Hepatic Resections For Liver Metastases From Colorectal Cancer, Angelos A. Kambouris

Henry Ford Hospital Medical Journal

Of the more than 120,000 new patients with colorectal cancer in 1982, at least 20% will develop liver metastases either at initial presentation or after treatment of the primary lesion. The median survival in such patients has been variously estimated at between five and nine months, and in spite of treatment by chemotherapeutic agents, only rarely do such patients survive five years. By contrast, patients who survive the longest after treatment of liver metastases from colorectal cancer have had major hepatic resections alone or combined with chemotherapy as part of their management. The present report describes five patients who were …


Clinical Note: Excision Of A Large Ovarian Leiomyoma In A Centenarian, James A. Sapala, M. Andrew Sapala Mar 1983

Clinical Note: Excision Of A Large Ovarian Leiomyoma In A Centenarian, James A. Sapala, M. Andrew Sapala

Henry Ford Hospital Medical Journal

Leiomyoma of the ovary is a rare neoplasm; only 28 cases in the literature are known to us. In 1979, we encountered a tumor of this type and are reporting it here because of its great size and its occurrence in a 103-year-old woman. The patient has been well for two years since the tumor was removed.


The Role Of Splenectomy In Endocarditis, Donald J. Magilligan Jr., Edward L. Quinn Mar 1983

The Role Of Splenectomy In Endocarditis, Donald J. Magilligan Jr., Edward L. Quinn

Henry Ford Hospital Medical Journal

Five patients with endocarditis, persistent sepsis, and positive liver-spleen scans underwent splenectomy. Three had splenectomy performed concomitantly with cardiac valve replacement, one after valve replacement and one as an isolated procedure. Four of five spleens contained abscesses, and bacterial cultures of two were positive. Histologic study of one spleen revealed splenitis. All patients improved after splenectomy, and all are well two to twenty months postoperatively. An aggressive approach to splenic abscess in endocarditis may lead to reduced mortality from bacterial endocarditis and infected prosthetic valves.


Front Matter Mar 1983

Front Matter

Henry Ford Hospital Medical Journal

No abstract provided.


The Regional Acceleratory Phenomenon: A Review, Harold M. Frost Mar 1983

The Regional Acceleratory Phenomenon: A Review, Harold M. Frost

Henry Ford Hospital Medical Journal

The regional acceleratory phenomenon (RAP) is a complex reaction of mammalian tissues to diverse noxious stimuli. The phenomenon occurs regionally in the anatomical sense, involves both soft and hard tissues, and is characterized by an acceleration and domination of most ongoing normal vital tissue processes. It may represent an "SOS" mechanism which evolved to potentiate tissue healing and local tissue defensive reactions. When a RAP is obtunded, retarded healing and lowered resistance to infection and mechanical abuse may ensue. When ignored in experimental design, the phenomenon can seriously perturb studies of metabolic bone disease and of the effects of mechanical, …


The Acquired Double Pylorus, Klaus Anselm, Arthur H. Halprin Mar 1983

The Acquired Double Pylorus, Klaus Anselm, Arthur H. Halprin

Henry Ford Hospital Medical Journal

Four patients with the double pylorus are reported. In view of an earlier history of peptic ulcer disease, the double pylorus is considered to have been acquired in all four. The literature involving 54 reported cases is reviewed, and the natural history of the double pylorus is discussed.


Endoscopic Sclerotherapy In The Treatment Of Recurrent Bleeding From Esophageal Varices, Martin C. Zonca, Dominic K. H. Wong, Surinder K. Batra, Bernard M. Schuman Mar 1983

Endoscopic Sclerotherapy In The Treatment Of Recurrent Bleeding From Esophageal Varices, Martin C. Zonca, Dominic K. H. Wong, Surinder K. Batra, Bernard M. Schuman

Henry Ford Hospital Medical Journal

Endoscopic sclerotherapy as a method to treat bleeding esophageal varices was first performed by Crafoord and Erenckner in 1939 but was not widely accepted. Surgical therapy, using the portocaval shunt, became the preferred method of preventing hemorrhage from bleeding varices. Over the years, enthusiasm for the surgical approach has waned because the mortality rate with certain patients is prohibitively high. Conversely, interest in endoscopic sclerotherapy is growing as a result of several favorable reports. We present our initial experience with this procedure in the management of patients with bleeding esophageal varices.


Management Of Colonic Trauma: Six-Year Experience At Henry Ford Hospital, Farouck N. Obeid, Victor Sorensen, Gilford Vincent, Deepak Vij, H. Mathilda Horst, D. Paul Horan Mar 1983

Management Of Colonic Trauma: Six-Year Experience At Henry Ford Hospital, Farouck N. Obeid, Victor Sorensen, Gilford Vincent, Deepak Vij, H. Mathilda Horst, D. Paul Horan

Henry Ford Hospital Medical Journal

Surgical management of 114 patients with colonic injuries related to trauma who were treated over a six-year period is reviewed. Eighty-three (73%) injuries were secondary to gunshot wounds. Twenty-six patients (24%) had isolated colonic injuries. The majority of patients (60%)) were treated with colostomies: exteriorization of the injury, repair with proximal colostomy, or resection with colostomy and mucous fistula. Exteriorization of repaired colon, primary repair, and resection with primary anastomosis were performed in 40% of the patients. Six patients (5.3%) in our series died, and 24% had complications directly related to the colon injury. Based on this study, no standard …