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1979 Publications of the Staff of Henry Ford Hospital Henry Ford Hospital Medical Journal Volume 27 Number 4 Article 2 12-1979 1979 Publications of the Staff of Henry Ford Hospital Follow this and additional works at: https://scholarlycommons.henryford.com/hfhmedjournal Part of the Life Sciences Commons, Medical Specialties Commons, and the Public Health Commons Recommended Citation (1979) "1979 Publications of the Staff of Henry Ford Hospital," Henry Ford Hospital Medical Journal : Vol. 27 : No. 4 , 310-337. Available at: https://scholarlycommons.henryford.com/hfhmedjournal/vol27/iss4/2 This Article is brought to you for free and open access by Henry Ford Health System Scholarly Commons. It has been accepted for inclusion in Henry Ford Hospital Medical Journal by an authorized editor of Henry Ford Health System Scholarly Commons. Henry Ford Hosp Med Journal Vol 27, No 4, 1979 1979 Publications of the Staff of Henry Ford Hospital Selected Abstracts and Titles Edited by George C. Bower, MD Abstracts Alam M, Madrazo AC, Magilligan DJ, Goldstein S. Mmode and two dimensional echocardiographic features of porcine valve dysfunction. Am J Cardiol 1979;43:502-09. We present the echocardiographic featuresof degeneration of nine loss ofthe cusp detail. In five patients severe regurgitation due to a glutaraldehyde-fixed porcine xenograft valves implanted in eight tear in one or more cusps developed in the valve in the mitral patients. These features occurred 11 to 68 months after implanta­ position. M mode echocardiography in all five patients revealed on tion and were correlated with surgical and necropsy findings. the valve systolic or diastolic fluttering echoes, or both. The two Acute bacterial endocard itis in three other patients 47 to 52 months dimensional echocardiogram demonstrated thickened cusps with before valve degeneration was recognized. The valve was severely systolic protusion ofthe leaflets into the left atrium. Both modes of thickened in four patients, and in two ofthe fourthe thickening was echocardiography were ofvalue in identifying degeneration of the associated with a significant hemodynamic transvalve gradient. M porcine xenograft valve. mode echocardiography demonstrated increased thickness and Brown GG, Nixon R. Exposure to polybrominated biphenyls: Some effects on personality and cognitive functioning. JAMA 1979;242:523-27. Twenty-one persons exposed to polybrominated biphenyls (PBB) tory suggesting an adjustment reaction with depressive symptoms were compared with hospital volunteers on a battery of tests and somatizing defenses. Persons exposed to PBB were also measuring memory, motor strength and coordination, cortical- impaired relative to control subjects on tests of prose recall, short- sensory perception, personality, and higher cognitive functioning. term memory, concentration, and cognitive flexibility. However, Patients exposed to PBB were selected forthis study only ifthey had these differences vanished when group differences on education persistent medical complaints. The PBB adipose levels did not and personality were statistically held constant. The selective correlate with performance on any test in the battery. The two admission criteria forthis study limit the generalizability ofthese groups did differ on the Minnesota Multiphasic Personality Inven­ findings. Goldman J, Baldwin D, Rubenstein AH, et al. Characterization of circulating insulin and proinsulin-binding antibodies in autoimmune hypoglycemia. J Clin Invest 1979;63:1050-59. Five patients with fasting and/or postprandial hypoglycemia were tively, and, when present, provide incontrovertible evidence of found to have insulin antibodies in the absence of previously exogenous insulin administration. No such antibodies could be documented immunization. Stud ies on the equilibrium-binding of detected in the hypoglycemic patients with autoimmune insulin insulin to the autoantibodies revealed two classes of binding sites antibodies. with association constants and binding capacities analogous to those of insulin antibodies from insulin-treated diabetic patients. The kinetics of dissociation of the insulin-antibody complexes Similarly, no consistent differences in these parameters were found were consistent with the existence of two classes of antibody sites. in both groups of patients with insulins of bovine, porcine, and The corresponding dissociation rate constants were large enough human origin. Proinsulin (C-segment directed) antibodies capable to predict that significant amounts of free hormone may be of binding bovine or porcine proinsulin were present in 10 of 10 generated bythis mechanism and provldea plausible pathogenesis and 9 of 10 insulin-treated diabetics serving as controls, respec­ for the hypoglycemia in these patients. 310 1979 HFH Staff Publications Gonen B, Goldman J, Baldwin D, et al. Metabolic control in diabetic patients: Effectof insulin-secretory reserve (measured by plasma C-peptide levels) and circulating insulin antibodies. Diabetes 1979;28:749-53. We measured circulating hemoglobin Ai (HbAi) and fasting plasma pmol / ml had significantly better metabolic control than did those C-peptide concentrations in 100 diabetic patients. Pancreatic with lower values. insulin reserve showed a negative correlation with HbAi con­ centrations in nonobese, insulin-treated patients but not in obese Anti-insulin antibodies were measured in 37 patients. There was no patients, whether they were treated with insulin, oral agent, or diet correlation between metabolic control andthe affinity constants or alone. Patients with fasting C-peptide concentrations above 0.1 binding capacities ofthese antibodies. Grant I, Adams K, Reed R. Normal neuropsychological abilities of alcoholic men in their late thirties. Am J Psychiatr 1979;136:1263-69. The neuropsychological performance of alcoholic men in their late alcoholism or estimated lifetime alcohol use, dietary adequacy, 30s (mean age, 37 years), some of whom had been abstinent for 3 and medical or blackout history did not relate to neuropsychologi­ weeks and others for 18 months, was com pared with that ofa group cal impairment. The authors suggest that a simple "dose-effect" of men who drank occasionally. There were no differences be­ relationship between alcohol use and cognitive decline cannot be tween the alcoholic groups and the comparison group that could assumed. not be attributed to normal aging. The number of years of Gruenberg JC, Grodsinsky C, Ponka JL. Pneumatosis Intestinalis: A clinical classification. Dis Colon Rectum 1979;22:5-9. Review of our experience with pneumatosis intestinalis has al­ contributingto the incidence of pneumatosis intestinalis. The ileus lowed usto identify three majorclinical groups of patients. In each, sometimes observed in these patients may accompany or precede the etiology of pneumatosis intestinalis usually can be identified, the development of intramural air, a condition identifiable on and it frequently has an ominous prognosis. Treatment should be roentgenograph ic examination. Awareness of the possible pres­ directed to the underlying condition when possible and hence ence of intramural air may help in identifying patients who may nol must be individualized. Those patients categorized as Croup I can need operation. But even when roentgenographic exam ination has simply be kept under observation. Patients in Croup II might obtain confirmed the presence of intramural air, abdominal exploration relief from breathing increased concentrations of oxygen. For still may be necessary to rule out a diagnosis of perforated viscus. patients in Croup III vigorous therapeutic measures generally are We hope that these concepts and our emphasis upon indi­ necessary to ensure survival. The increasing use of mechanically vidualized treatment may improve the prognosis for patients who controlled ventilation and positive end-expiratory pressure may be have pneumatosis intestinalis. HeinzerlingRH, Dziuba DS, Federyszyn HM, Burnham TK. Significance of levels of specific immunoglobulins to DNA in SLE patients' sera detected by solid phase radioimmunoassay. J Invest Dermatol 1979;72:55-8. A solid phase radioimmunoassay was developed for detecting the single-strand DNA. Renal involvement of some degree was found quantity of double-stranded and single-stranded DNA antibodies in all 11 with the high concentrations of IgC antibodies to DNA in patients with systemic lupus erythematosus (SLE) and other correlating with severe involvement. Patients with IgM antibodies connective tissue diseases. The assay system employs a solid to DNA alone had more benign types of SLE with little renal support 96-welI, flex-vinyl microliter plate to which bovine methyl involvement. albumin is layered, followed by denatured or native calf thymus DNA. A 1:80 dilution of patients' sera was added to respective No abnormal levels of IgA Ab to either single-strand DNA or wells followed by tritiated high affinity anti-lgA, -IgA, or IgM. double-strand DNA were found in SLE patients' sera. Corticoster­ oid and/or immunosuppressant treatment caused a marked drop Denatured DNA (single-stranded DNA) bound to methylated in the IgM Ab level to DNA within 10 days, while IgG Ab to DNA bovine serum albumin had less than 5% reannealment to the remained high for up to 30 days. double-stranded form and provided a better substrate for Ab binding than double-stranded DNA, producing a linear binding Quantitation of IgC and IgM Ab to single-strand DNA provides a curve. useful method for diagnosing severe SLE with possible renal involvement and monitoring the
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