Public Health Commons^™

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

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

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

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

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

Henry Ford Hospital Medical Journal

No abstract provided.

Longitudinal Pantothenic Acid Status Of Pregnant And Lactating Women, Won Oack Song

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

Pantothenic acid nutritional status was evaluated in a cohort of twenty-nine Caucasian pregnant women, aged 20-35, during their third trimester of pregnancy, at two-weeks postpartum and at three months postpartum. Seventeen non-pregnant, non-lactating women who had similar demographic backgrounds as the pregnant women were selected as a control group and followed the same experimental schedule as the pregnant women. A fasting blood sample, two days 24-h urine specimens and diet record were obtained for each of two days from each subject at each period.

The mean dietary pantothenic acid intakes of the women during pregnancy (5.30±1.74 mg/day) and during lactation …

Editorials

Henry Ford Hospital Medical Journal

No abstract provided.

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

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

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

Henry Ford Hospital Medical Journal

No abstract provided.

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

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

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

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 …

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

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

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

Henry Ford Hospital Medical Journal

No abstract provided.

Back Matter

Henry Ford Hospital Medical Journal

No abstract provided.

Ua35/11 Student Honors Research Bulletin, Wku Honors Program

WKU Administration Documents

The WKU Student Honors Research Bulletin is dedicated to scholarly involvement and student research. These papers are representative of work done by students from throughout the university.

• Albin, Bettye. John Dryden's Criticism: The Neglected Link
• Allen, Christopher. Martial Reflections: Ancient Cultures and Their War-Gods
• Case, Laura. Climatic Preference
• Deller, Kathy. Regression Analysis: The Effects of Advertising, Price, Income and Import Sales on American-Made Auto Sales
• Downing, Elizabeth. Dorothy Leigh Sayers: Detective of Literary Theory in The Mind of the Maker
• Elder, Janice. A Retrospective Study on Discharge Planning and Primiparas at Breckinridge Memorial
• Flora, Joan. Narcissism and the Need for …

United States Naval Medical Research Unit Number Three, Cairo, Egypt, Medical Zoology Department Translation List, Harry Hoogstraal

United States Naval Medical Research Unit 3: Publications

List of translations of medical parasitology and medical entomology papers prepared by the United States Naval Medical Research Unit Number 3 in Cairo, Egypt. The papers were translated from numerous languages, such as Russian (most were translated from Russian), Bulgarian, Chinese, Czech, Finnish, French, German, and Japanese, into English. The publication dates of the original papers ranged from about 1915 to 1983. Harry Hoogstraal translated some or all of the papers.

Front Matter

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

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

Henry Ford Hospital Medical Journal

No abstract provided.

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

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

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 …

Back Matter

Henry Ford Hospital Medical Journal

No abstract provided.