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Articles 661 - 690 of 2152
Full-Text Articles in Medical Specialties
The Other Breast: Indications For Biopsy And/Or Mastectomy, Charles S. Rogers
The Other Breast: Indications For Biopsy And/Or Mastectomy, Charles S. Rogers
Henry Ford Hospital Medical Journal
A search for malignant and premalignant lesions in 162 contralateral biopsy and/or mastectomy specimens yielded 45 (27.8%,) malignancies and 54 (33%) premalignant lesions (atypical epithelial hyperplasia, Wellings grades III and IV). In those with no palpable or mammographic suspicion of malignancy, the cancer incidence was 73.8%. Eight malignancies occurred one month to three years after antecedent biopsies which revealed premalignant lesions. No cancer has been detected after biopsies which revealed hyperplasia of grade II or less. Cancer size at time of discovery varied significantly with the method of detection: average 2.7 cm by palpation; 1.6 cm by mammography; 0.5 cm …
Current Concepts In Otitis Media, Michael M. Paparella
Current Concepts In Otitis Media, Michael M. Paparella
Henry Ford Hospital Medical Journal
Otitis media continues to be a common and disabling problem which has become, in recent years, a fertile area for research. Based on studies in animals and humans, otitis media is classified into four groups: acute purulent otitis media (POM), serous otitis media (SOM), and mucoid or secretory otitis media (MOM). Together, these are referred to as otitis media with effusion (OME). The types can overlap and evolve into another type to become chronic otitis media and mastoiditis, characterized by the presence of granulation tissue or cholesteatoma. The biochemistry, microbiology, and pathology as well as clinical features of the disease …
How Useful Is Peritoneal Lavage Amylase?, Eugene Meyer, James C. Gruenberg
How Useful Is Peritoneal Lavage Amylase?, Eugene Meyer, James C. Gruenberg
Henry Ford Hospital Medical Journal
Prospectively for 23 months, 289 patients with penetrating and 317 patients with blunt trauma to the lower chest and/or abdomen had amylase determinations in the peritoneal lavage as part of their initial evaluation. In nine (1.5%) of the 606 patients, the amylase in the lavage was higher than normal serum values and, when elevated, it identified intra-abdominal injury. Intra-abdominal injuries usually involved a hollow viscus injury—either isolated or combined with solid organ injuries—rather than pancreatic injury. Although elevation of the lavage amylase was a reliable indication of intra-abdominal injury in this series, we feel that routine use of this test …
Therapeutic Hemapheresis, Sheikh M. Saeed, B. K. S. Raman
Therapeutic Hemapheresis, Sheikh M. Saeed, B. K. S. Raman
Henry Ford Hospital Medical Journal
No abstract provided.
Hyperviscosity Syndrome Complicating Rheumatoid Arthritis: Report Of Two Additional Cases And Review Of The Literature, Michael R. Lovy, Mark C. Kranc, Gilbert B. Bluhm, Jeanne M. Riddle, Paul D. Stein
Hyperviscosity Syndrome Complicating Rheumatoid Arthritis: Report Of Two Additional Cases And Review Of The Literature, Michael R. Lovy, Mark C. Kranc, Gilbert B. Bluhm, Jeanne M. Riddle, Paul D. Stein
Henry Ford Hospital Medical Journal
A hyperviscosity syndrome developed in two patients with rheumatoid arthritis. Analytic ultracentrifugation of the sera from one patient demonstrated 22S complexes. Intermediate, 22S, and 31S complexes were found in the second case. Platelet aggregometry and electron microscopy surveys of the platelet reactivity in one patient demonstrated inhibition of platelet reactivity caused by the presence of the high molecular weight complexes. These abnormalities, as well as the clinical bleeding, whole blood, and plasma viscosity, became normal after treatment. In vivo leukocytic function was studied with the Rebuck skin window technique, and phagosomal inclusions were observed in both the polymorphonuclear neutrophils and …
Re: Abbs, Conrad R. Lam
The Measurement Of Human Chorionic Gonadotropin For Pregnancy Testing, Carolyn S. Feldkamp, William H. Pfeffer
The Measurement Of Human Chorionic Gonadotropin For Pregnancy Testing, Carolyn S. Feldkamp, William H. Pfeffer
Henry Ford Hospital Medical Journal
/Among many measurable hormones, human chorionic gonadotropin (FICG) is commonly used for pregnancy testing because it is very sensitive and relatively specific. Pregnancy can be identified shortly after implantation. Because some reagents cross-react with luteinizing hormone (LH), the sensitivity of urine tests has been adjusted to maintain specificity. Radioreceptor assay s on serum are more sensitive than urine tests but similarly lack specificity. The problems of LH cross-reactivity are eliminated by antisera specific for the beta subunit. Quantitation of HCG provides additional information useful in diagnosing ectopic pregnancy, providing a prognosis in threatened abortion, and following neoplasms. Considerations of cost, …
Primary Hyperparathyroidism: The Continuing Saga Of Surgical Problems, Melvin A. Block
Primary Hyperparathyroidism: The Continuing Saga Of Surgical Problems, Melvin A. Block
Henry Ford Hospital Medical Journal
Continuing problems in the management and surgical treatment of primary hyperparathyroidism include the localization of the elusive single tumor, the recognition and management of multiple gland involvement, prompt confirmation and operative treatment for hypercalcemic crisis, delineation of a liberal but selective policy relative to surgery for apparent uncomplicated hyperparathyroidism in the elderly, and recognition of the surgeon's responsibility to determine the extent of the operation on the basis of operative findings, realizing that histologic study may not confirm apparent gross abnormalities despite subsequent clinical recovery. When all four glands are involved in primary hyperparathyroidism, subtotal parathyroidectomy is recommended except for …
Echocardiographic Identification Of Left Ventricular Cavity Obliteration, Vidyadhar R. Gandra, Mohsin Alam, Fareed Khaja, Sidney Goldstein, Jeffrey B. Lakier
Echocardiographic Identification Of Left Ventricular Cavity Obliteration, Vidyadhar R. Gandra, Mohsin Alam, Fareed Khaja, Sidney Goldstein, Jeffrey B. Lakier
Henry Ford Hospital Medical Journal
We identified 22 patients with angiographic left ventricular cavity obliteration (LVCO), of whom 15 were available for M-mode and two-dimensional echocardiographic evaluation. All 15 patients had chest pain, and 13 had long-standing hypertension. Electrocardiographic evidence of left ventricular hypertrophy was present in ten patients. The echocardiographic criterion for LVCO was apposition of the left ventricular septum with the left ventricular posterior endocardium during systole as demonstrated by either M-mode or two-dimensional systems. LVCO was demonstrated during systole by M-mode echocardiography in seven of 15 patients and by two-dimensional echocardiography in 14 patients. LVCO could not be demonstrated in ten randomly …
Assessment Of The Orifice Area Of Bioprosthetic Valves By Orifice-View Roentgenography, Paul D. Stein, James F. Brymer, Daniel T. Anbe, Hani N. Sabbah, Gordon M. Folger Jr.
Assessment Of The Orifice Area Of Bioprosthetic Valves By Orifice-View Roentgenography, Paul D. Stein, James F. Brymer, Daniel T. Anbe, Hani N. Sabbah, Gordon M. Folger Jr.
Henry Ford Hospital Medical Journal
Orifice-view angiography permits us to visualize en face the orifice of the aortic or mitral valve. The radiopaque annulus of bioprosthetic valves assists in permitting the angiographer to position the patient exactly, so that the valve can be seen as if looking directly into the orifice. Orifice-view angiography of porcine bioprosthetic valves has been useful in assessing the size and configuration of the valve orifice. It can reveal a failure of leaflet opening that would indicate degeneration, even when hemodynamic measurements remain equivocal.
Natural History Of The Porcine Bioprosthetic Heart Valve, Donald J. Magilligan Jr., Joseph W. Lewis Jr., J. Lancelot Lester Iii, Paul D. Stein, Mohsin Alam, Jeffrey B. Lakier, Julio C. Davilia, David W. Smith
Natural History Of The Porcine Bioprosthetic Heart Valve, Donald J. Magilligan Jr., Joseph W. Lewis Jr., J. Lancelot Lester Iii, Paul D. Stein, Mohsin Alam, Jeffrey B. Lakier, Julio C. Davilia, David W. Smith
Henry Ford Hospital Medical Journal
The porcine bioprosthesis has been the prosthetic valve of choice at Henry Ford Hospital since October 1971. By 1979, 23 cases of degeneration had been seen, and the rate seven years after implantation was 16%. Now, with a ten-year follow-up, there are 41 degenerated valves. After seven years, the percent free of degeneration is 88%, (SE of 2% [standard error]); at eight years, 82% (SE of 2.9%,); at nine years, 80% (SE of 3.4%); and at ten years, the percent free of degeneration is 69% (SE of 6.5%,). There was no difference in degeneration between men and women, between aortic …
Studies On Porcine Bioprosthetic Heart Valves At Henry Ford Hospital: An Overview, Paul D. Stein
Studies On Porcine Bioprosthetic Heart Valves At Henry Ford Hospital: An Overview, Paul D. Stein
Henry Ford Hospital Medical Journal
No abstract provided.
Frequency Content Of Heart Sounds And Systolic Murmurs In Patients With Porcine Bioprosthetic Valves: Diagnostic Value For The Early Detection Of Valvular Degeneration, Paul D. Stein, Hani N. Sabbah, Jeffrey B. Lakier, Stephen R. Kemp, Donald J. Magilligan Jr.
Frequency Content Of Heart Sounds And Systolic Murmurs In Patients With Porcine Bioprosthetic Valves: Diagnostic Value For The Early Detection Of Valvular Degeneration, Paul D. Stein, Hani N. Sabbah, Jeffrey B. Lakier, Stephen R. Kemp, Donald J. Magilligan Jr.
Henry Ford Hospital Medical Journal
The frequency content of heart sounds and murmurs in patients with implanted bioprosthetic valves may reveal evidence of degenerative changes before such changes are clinically apparent. An increased dominant frequency of the heart sound caused by a bioprosthetic valve in either the aortic or mitral positions suggests stiffening of the leaflets. While a musical systolic murmur of a bioprosthetic valve in the mitral position suggests flutter from a torn, insufficient leaflet, limited observations of musical systolic murmurs in the aortic position do not seem to indicate a degenerated valve.
Fluid Dynamic Stresses In The Region Of A Porcine Bioprosthetic Valve, Hani N. Sabbah, Paul D. Stein
Fluid Dynamic Stresses In The Region Of A Porcine Bioprosthetic Valve, Hani N. Sabbah, Paul D. Stein
Henry Ford Hospital Medical Journal
Mechanical forces caused by the dynamics of blood flow in the region of porcine bioprosthetic valves may directly injure the valve as well as formed elements of the blood. Previous in vitro studies in our laboratory evaluated quantitatively the fluid dynamic stresses in the region of such valves. In this paper we discuss our results in relation to fluid dynamic stresses found in patients with normal and diseased natural aortic valves. The levels of fluid dynamic stresses that may produce mechanical injury to erythrocytes and platelets are reviewed. These may indicate the extent to which fluid dynamic stresses may activate …
Immunological Involvement In Porcine Bioprosthetic Valve Degeneration: Preliminary Studies, Rollin H. Heinzerling, Paul D. Stein, Jeanne M. Riddle, Donald J. Magilligan Jr., John J. Jennings
Immunological Involvement In Porcine Bioprosthetic Valve Degeneration: Preliminary Studies, Rollin H. Heinzerling, Paul D. Stein, Jeanne M. Riddle, Donald J. Magilligan Jr., John J. Jennings
Henry Ford Hospital Medical Journal
Preliminary animal model studies have indicated that porcine bioprosthetic valves can be recognized by the immune system. This report presents the results of a preliminary investigation on the implanted valves of 27 patients. While none of the 27 demonstrated an immune response to porcine serum proteins, five patients developed antibodies against the implanted valve leaflets. Cells were enzymatically eluted from a degenerated bioprosthetic valve and were classified by means of monoclonal antibodies. Although these cells were not found to be of T-lymphocyte lineage, they did express la determinants and had the morphologic appearance of plasma cells. We therefore conclude that …
Clinical Note: Use Of Clonidine To Detoxify Opiate-Addicted Patients, Dennis L. Caffrey, Tai P. Yoo
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
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.
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
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
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
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
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.
Medullary Carcinoma Of The Thyroid With Bone Metastasis, Sheldon S. Stoffer, Sidney D. Kobernick, Richard M. Zirkin, Stuart W. Hamburger, Susan E. Harold
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
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
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 …