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Pcom Digest Article (Winter 1988) Featuring Dr. Koch, Philadelphia College Of Osteopathic Medicine

Koch Collection, Papers of Richard S Koch, DO

PCOM Digest Article (Winter 1988) Featuring Dr. Koch, the 1988 PCOM Founder's day laureate.

Biography, Philadelphia College Of Osteopathic Medicine

Koch Collection, Papers of Richard S Koch, DO

A brief biography of Richard S. Koch, DO, FAAO, featured in PCOM's 1988 Founder's Day Program.

Richard S Koch, Do, Selected Curriculum Vitae, Philadelphia College Of Osteopathic Medicine

Koch Collection, Papers of Richard S Koch, DO

Dr. Koch's Selected Curriculum Vitae excerpted from the 1988 Founders Day Program.

Digest Of The Philadelphia College Of Osteopathic Medicine (Winter 1988), Philadelphia College Of Osteopathic Medicine

Digest

The Winter 1988 issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• 1988 O. J. Snyder Medalist
• DOs in the Arts
• Signing Up for More Visibility
• "PCOM Couldn't Have Done it Any Better"
• Alumni Notes
• On Campus
• Class Acts
• In Memoriam
• Calendar

Oral Assessment Guide, June Eilers, Ann Berger

Guides and Handouts: College of Nursing

The Oral Assessment Guide (OAG) can be used by the clinician to evaluate changes in the oral cavity. The OAG is comprised of eight categories of mucositis assessment of the mouth on a scale of 1 to 3, with “1” indicating normal and “3” indicating breakdown or loss of function. The OAG has been validated and is reliable in the current published format. Permission is granted for use in the current format. Any modifications will require new testing for validity and reliability. The OAG has been widely used in cancer and other populations and published in professional journals and books.

Nutritional Parameters Predicting Postoperative Infections, Jamsheer Talati, M. Shameem, Mohammad Khurshid

Department of Surgery Docs

Thirteen nutritional parameters viz body mass index (BMI), mid arm circumference (MAC), mid calf circumference (MCC), triceps skin fold thickness (TST), abdominal skin fold thickness (ASFT), abdominal girth at umbilicus (AG U), haemoglobin (Hb), total leucocytes count (WBC), absolute lymphocyte count (ALC), serum proteins (Prot.), serum albumin (AIb), serum total iron binding capacity (TIBC) and serum iron (Fe) were estimated in 52 (36 male and 16 female) consecutive patients admitted to a surgical service at the Abbasi Shaheed Hospital, Karachi. Nine males and one female developed surgical infections whilst the wounds of 27 males and 15 females healed by primary …

Sensitivity To Ingested Sulfites, Steve L. Taylor, Julie A. Nordlee

Department of Food Science and Technology: Faculty Publications

Sulfiting agents, including sodium and potassium bisulfite, sodium and potassium metabisulfite, sodium sulfite, and sulfur dioxide, have enjoyed widespread use as food and drug ingredients. The oral ingestion of these sulfiting agents is now known to trigger asthma in a small subset of the asthmatic population. The best evidence suggests that perhaps 150,000 to 200,000 individuals in the United States may be sulfite sensitive. Although the mechanism of sulfite-induced asthma remains unknown, several possibilities have been considered, including inhalation of sulfur dioxide (SO₂) while swallowing, an IgE-mediated reaction, and a deficiency of sulfite oxidase leading to impaired sulfite …

Clinical Use Of A Standard Kit-Preparation Of Radiolabeled Monoclonal Antibody 96.5 In The Diagnostic Imaging Of Metastatic Melanoma., Mansoor Saleh, D M. Miller, L Peterson, C D. Russell, M W. Unger

Haematology and Oncology, East Africa

We studied the efficiency of a standard-kit preparation using 1 mg 111In-labeled 96.5 monoclonal antibody in combination with 19 mg of unlabeled antibody in the diagnostic imaging of 27 patients with documented metastatic melanoma. Twenty-three of 26 patients (88%) demonstrated immunoscintigraphic localization of tumor. Of 104 metastatic sites previously documented by conventional studies, 62 (60%) were identified by immunoscintigraphy. A total of 77 sites demonstrated localization of radiolabeled antibody. Fifty-four (70%) corresponded to known sites of disease; eight sites (10%) were "discovered" by immunoscintigraphy and subsequently confirmed by conventional studies; 15 imaged sites (20%) could not be confirmed by conventional …

Anaemia In Pregnancy: Occurrence In Two Economically Different Clinic Populations Of Karachi, Saadiya Aziz Karim, Mohammad Khurshid, Javed H. Rizvi

Section of Haematology/Oncology

According to previous WHO standards, anaemia in pregnancy denoted a haemoglobin level of 11.0 gms/dl or less, but this is now considered to be variable¹ as it differs from country to country depending on local reference ranges and socio-economic conditions. Each country should “lay down minimal acceptable standards” below which an individual is considered to be anaemic, taking into account the available fmancial and manpower resources and other health needs of the country². There is a wide divergence in the quoted prevalence of anaemia in Pakistan and neigh­bouring countries.^3-6 This study was undertaken to determine a …

Efficacy Of Internal And External Quality Control In Chemical Pathology, Rukhsana Lalani, Mirza Naqi Zafar, Mohammad Khurshid

Department of Pathology and Laboratory Medicine

Quality control in chemical pathology is based on internal and external quality assessment. The internal quality control in clinical chemistry section of AKUH laboratory is based on the analysis of commercially available Beckman norma! and abnormal range control sera. These have known concentra­tions of blood chemistry constituents. After repeated estimations, mean values of all constituents were established for both normal and abnormal sera. Patients samples were analysed only when both controls were within ± 2SD from the mean or one control reads within ± 2SD and the other read between ± 2—3SD (once only) for each constituent. Samples were not …

The Effect Of A Self Directed Program On Locus Control And Control Of Diabetes, Mary Elizabeth Boyle

Theses & Dissertations

Does a self directed program have a significant impact on an individual's locus of control and the control of diabetes as measured by glycosolated hemoglobin?

Aspects Of Endocrinology, Michael Kleerekoper, Raymond C. Mellinger

Henry Ford Hospital Medical Journal

No abstract provided.

An Overview Of Magnetic Resonance Imaging Of The Appendicular Musculoskeletal System, Sharon C. Siegel, Allan M. Haggar, Jerry W. Froelich, Burton I. Ellis

Henry Ford Hospital Medical Journal

No abstract provided.

Pituitary Metastasis: Lung Cancer Presenting As Bitemporal Hemianopsia With Diabetes Insipidus And Anterior Pituitary Deficiency, A. Keith Cryar, Jay Morgan, Jack P. Rock, Max Wisgerhof

Henry Ford Hospital Medical Journal

Symptoms and signs of pituitary disease are rarely the first manifestations of malignancy originating in another organ. We present a case which exemplifies the key points that suggest a diagnosis of metastatic pituitary disease. Our patient's diagnosis was adenocarcinoma of the lung with a metastasis to the intrasellar and suprasellar regions, which caused diabetes insipidus, anterior pituitary deficiency, and visual field defects. The metastasis had a dumbbell appearance and extended from the sella turcica into the suprasellar region. Diabetes insipidus was the initial clinical manifestation of lung cancer in this patient. A metastasis to the pituitary should be suspected if …

Pregnancy Following Sequential Bromocriptine Therapy In A Hyperprolactinemic Subject, Malachi J. Mckenna, M. Saeed-Uz-Zafar, Raymond C. Mellinger

Henry Ford Hospital Medical Journal

Regular menses were maintained in a 26-year-old woman with a prolactinoma by sequential bromocriptine therapy given for either five or 14 days of the menstrual cycle. She conceived promptly when desired.

Comparison Of Four High-Sensitivity Immunoradiometric Assays For Thyrotropin And Results Of Preliminary Clinical Studies, Malachi J. Mckenna, Earl Goad, Mohini Pimputkar, Carolyn S. Feldkamp

Henry Ford Hospital Medical Journal

New immunoradiometric assays (IRMAs) that detect low concentrations of thyroid-stimulating hormone (TSH) have recently become available for routine diagnostic use. These new assays have the putative advantage over conventional radioimmunoassay in that they can distinguish hyperthyroidism from euthyroidism by the finding of a serum TSH below the normal limit. In the present study we sought to evaluate four of these kits according to analytical performance characteristics and clinical utility. All IRM As could detect TSH at a concentration substantially below the lower limit of normal and thus effectively identify hyperthyroid samples. Although differences in the performance characteristics were found, all …

Neurobehavioral Symptoms In Mild Primary Hyperparathyroidism: Related To Hypercalcemia But Not Improved By Parathyroidectomy, Gregory G. Brown, Richard C. Preisman, Michael Kleerekoper

Henry Ford Hospital Medical Journal

The neurobehavioral symptomatology of severe primary hyperparathyroidism (PHPT) has been thoroughly described. Less is known about more mild cases. We evaluated 34 patients with mild PHPT and followed 19 for an average of six months. Of those cases followed, ten had parathyroidectomy (PTX). Patients with no neurobehavioral abnormalities had the lowest serum calcium levels (10.9 ± 0.88 mg/dL), patients with signs of affective disorder had intermediate levels (11.25 ± 0.66 mg/dL), and patients with signs of cerebral dysfunction had the highest levels (12.17 ± 1.17 mg/dL). Serum calcium significantly correlated with motor speed, psychomotor speed, fluid intelligence, and short term …

Back Matter

Henry Ford Hospital Medical Journal

No abstract provided.

Prolonged Remission Of Cushing's Disease Following Bromocriptine Therapy, Malachi J. Mckenna, Marc Linares, Raymond C. Mellinger

Henry Ford Hospital Medical Journal

A 33-year-old woman developed hypercorticism of fulminant onset following delivery of a full-term, normal child. An ectopic hormone-producing neoplasm was excluded by extensive studies. Pituitary dependent hypercorticism of intermediate lobe origin was suggested on the basis of onset following pregnancy, failure of Cortisol suppression by high-dose dexamethasone, hyperresponsiveness of prolactin to thyrotropin-releasing hormone stimulation, and reduction in adrenocorticotropin titers following oral administration of bromocriptine. Initial remission of disease achieved with bromocriptine was followed by recurrence on discontinuation of the agent. However, complete remission which occurred following a prolonged course of bromocriptine has persisted for a total of 22 months.

Report Of The Commissioner's Task Force On Self-Destructive Behaviors And Teen Suicide, Department Of Mental Health And Mental Retardation

Maine Collection

Report of the Commissioner's Task Force on Self-Destructive Behaviors and Teen Suicide.

Susan B. Parker, Commissioner - Department of Mental Health and Mental Retardation, Augusta, Maine (December 1987).

Contents: Foreward / Task Force Members / Introduction / Characteristics of Self-Destructive Teens / Factors Contributing to Self-Destructive Behaviors / Findings and Recommendations / References

Front Matter

Henry Ford Hospital Medical Journal

No abstract provided.

Hypothalamic Hypogonadotropic Hypogonadism In An Adolescent Male: A Rare Manifestation Of Aqueductal Stenosis, Robert J. Wilson, Max Wisgerhof

Henry Ford Hospital Medical Journal

No abstract provided.

Naltrexone Does Not Affect Adrenal Steroidogenesis In Women With Hirsutism/Oligomenorrhea, Jeffrey A. Jackson, Thomas J. Wincek, Jose F. Pliego

Henry Ford Hospital Medical Journal

We studied the effects of the oral opiate receptor antagonist naltrexone on basal and ACTH-stimulated adrenal steroid levels in six women with hirsutism/oligomenorrhea and preexisting elevation of serum dehydroepiandrosterone sulfate. One of the six patients met the criteria for partial 3-β-hydroxysteroid dehydrogenase deficiency. No statistical differences were detected in steroid levels or ratios before and after 14 days of 50 mg/day of naltrexone. Thus, we find no support for the hypothesis that opioid peptides acting through opiate receptors (predominantly μ subtype) modulate the abnormal adrenal androgen secretion seen in these women with hirsutism/oligomenorrhea.

Hyperthyroidism Due To A Thyrotropin-Secreting Pituitary Microadenoma, Jeffrey A. Jackson, Mitchell Smigiel, John F. Green Jr.

Henry Ford Hospital Medical Journal

A 52-year-old man presented with elevated thyroid hormone levels and an inappropriately normal serum thyrotropin (TSH) (4.0 μU/mL: normal 0.5 to 6.0 μU/mL). Computed tomography suggested an intrasellar mass without radiographic sellar enlargement. Serum alpha-subunit was elevated with flat responses of both alpha-subunit and TSH to thyrotropin-releasing hormone. Transsphenoidal adenomectomy resulted in clinical and biochemical cure with subsequent development of hypothyroidism with otherwise preserved anterior pituitary function. Pathologic studies demonstrated an 8 mm typical thyrotroph cell adenoma. Early diagnosis of such tumors requires a high index of clinical suspicion and may be facilitated in the future by utilization of highly …

Primary Hyperparathyroidism And Associated Neoplasms, Angelos A. Kambouris, Mohammed R. Ansari, Gary B. Talpos

Henry Ford Hospital Medical Journal

No abstract provided.

Effects Of Weight Reduction, Exercise, And Diet Modification On Lipids And Apolipoproteins A-L And B In Severely Obese Persons, J. David Fachnie, Craig C. Foreback

Henry Ford Hospital Medical Journal

We assessed the lipid and apolipoprotein effects of hypocaloric dieting, increased physical activity, and dietary modification in severely overweight adults (body mass index [BMI] 43.05 kg/m-). The 34 women and four men enrolled in the ambulatory weight control program donated blood before, during, and after hypocaloric dieting (420 kcal/day). Mean values before dieting included cholesterol of 223 mg/dL, high-density lipoprotein (HDL) cholesterol of 43 mg/dL, and cholesterol/HDL cholesterol of 5.90. This placed our subjects at high risk for coronary artery disease. Other values included triglycerides of 138 mg/dL, apolipoprotein A-l of 152 mg/dL. and apolipoprotein B/apolipoprotein A-l of 0.64. Significant …

Renal Involvement In Type 2 Diabetes Mellitus: A Clinicopathologic Study Of The Henry Ford Hospital Experience, Francis Dumler, Vijay Kumar, Raymond N. Romanski, Pedro Cortes, Nathan W. Levin

Henry Ford Hospital Medical Journal

To better understand renal dysfunction in type 2 diabetes mellitus, we studied the clinical and autopsy findings in comparable cohorts of 108 diabetic and 77 nondiabetic patients. In the diabetic group, no differences were noted between black and white patients in blood glucose concentrations, mean blood pressure, or the prevalence of diabetic glomerulosclerosis. However, the prevalence of renal insufficiency was significantly greater (P = 0.002) in black diabetics (58%) than in white diabetics (35%). black controls (28%), and white controls (20%). Logistic regression analysis demonstrated a significant association of renal insufficiency with diabetes (P = 0.006) and race (P = …

Primary Aldosteronism At Henry Ford Hospital In The 1980s, Max Wisgerhof

Henry Ford Hospital Medical Journal

This report describes the experience with the diagnosis and treatment of primary aldosteronism at Henry Ford Hospital since 1980. Of the 28 patients who received the diagnosis. 13 had unilateral primary aldosteronism and 15 had idiopathic hyperaldosteronism. Individual cases are used to demonstrate clinical points. The clue to the presence of primary aldosteronism in a hypertensive patient is hypokalemia. The diagnosis is established by showing 1) high plasma aldosterone after intravenous saline or high urinary aldosterone after treatment with sodium chloride orally, and 2) low stimulated plasma renin activity. Treatment with potassium supplement should be given during the testing. Unilateral …

Management Of Extramedullary Plasmacytomas, James A. Bonner, Jadranka Dragovic, Michael P. Abrash

Henry Ford Hospital Medical Journal

From 1965 through 1982. 12 patients with solitary, biopsy-proven extramedullary plasmacytomas (EMPs) were treated at our institution with surgery alone or biopsy followed by radiation therapy. The median age of the patients was 67 years, and the median-follow-up was 58 months. Of the seven patients who were treated by primary surgery, three developed recurrent or distant disease. Five patients underwent biopsy followed by radiation therapy, and none of their tumors progressed. Our series and a review of the literature show that occasionally EMPs will incompletely regress even after high doses of radiation (greater than 65 Gy); however, we recommend that …

Unusual Lymphomas Developing In Chronic Lymphocytic Leukemia, Sundara B. K. Raman, Sheikh M. Saeed, Joseph P. Abraham

Henry Ford Hospital Medical Journal

We report three patients with chronic lymphocytic leukemia (CLL) who developed malignant lymphomas of unusual character and modes of presentation. Two of the patients had received low doses of chlorambucil for several years before they developed malignant lymphoma, diffuse, large cell type (LCL). In one of these patients LCL manifested as a grossly evident osteolytic lesion. In the second patient LCL developed initially as a localized lesion in the iliac bone. Both patients died within a few weeks after LCL was diagnosed. The third patient, who was found to have CLL during a routine examination, did not receive any therapy …