Lenox Hill Hospital Research Articles

Symptom improvement of spastic dysphonia in response to phonatory tasks.

It has been acknowledged that for many patients with spastic dysphonia, reflexive phonation remains essentially free of the spasticity that characterizes this disorder. The purpose of this paper is to document the extent to which various phonatory tasks change the patient's voice. We retrospectively reviewed 37 patients with spastic dysphonia evaluated at the Center for Communication Disorders of Lenox Hill Hospital, New York, between 1977 and 1981. The patients' responses to various phonatory tasks were observed. These tasks were grouped into the following ten categories: noncommunicative vocalization, primitive communication, speech superimposed on noncommunicative phonation, communicative phonation with varied mode of vocal fold vibration, normal communicative phonation with unusual pitch, normal communicative phonation with unusual emphasis, normal communicative phonation with normal laryngeal adjustments, use of the vocal folds in an artistic manner, speech in which normal auditory feedback was eliminated, and speaking with whisper which was not associated with vocal fold vibration. The results are summarized as follows: 1) whispered speech always resulted in an improvement of the symptom, in most cases markedly; 2) there was a tendency for a task that was more effective in reducing spasticity to be reduced in communicative function; 3) there was a tendency for a task that was more effective in reducing the spasticity to deviate more from the normal mode of phonation; and 4) there were some patients in whom an improvement occurred with elimination of auditory feedback.

Opportunistic infection complicating acquired immune deficiency syndrome. Clinical features of 25 cases.

Twenty-five cases of acquired immune deficiency syndrome (AIDS) complicated by opportunistic infections were diagnosed at Lenox Hill Hospital during an 18 month period and followed for at least 1 year or until the patients' deaths. Twenty-three patients were homosexual men, including 1 i.v. drug user, and 2 were heterosexual i.v. drug users, including the sole woman. Seventy infections were diagnosed. The commonest etiologic agents included Candida albicans, Pneumocystis carinii, cytomegalovirus, and Mycobacterium avium-intracellulare. Less frequent pathogens included Cryptococcus neoformans, Toxoplasma gondii, Cryptosporidium, JC virus, Mycobacterium xenopi, and Mycobacterium tuberculosis. Seven men also had Kaposi's sarcoma. Prodromal symptoms lasted up to 8 months before the diagnosis of AIDS. Immunologic and serologic evaluation demonstrated lymphopenia, polyclonal hypergammaglobulinemia, cutaneous anergy, reversal of the T-cell helper/suppressor ratio, and serologic evidence of previous exposure to CMV, EBV, and HBV. Pneumocystis pneumonia was diagnosed during life in 17 patients, by transbronchial biopsy and bronchoscopic washings, and all 17 cases were successfully treated. However, pneumocystis was more refractory to treatment than previously described and required an average of 29 days of antimicrobial therapy. Disseminated infections with atypical mycobacteria and cytomegalovirus were the leading causes of death. Bone marrow aspirates and biopsies often revealed a cellular abnormality (82%) but only occasionally yielded an infectious diagnosis (32%). However, bone marrow examinations were the major means of detecting atypical mycobacteriosis. Colonoscopic biopsies were most useful for establishing the presence of cytomegalovirus colitis. Transbronchial biopsies and bronchial washings gave a high yield of opportunistic pathogens including 34 infectious diagnoses confirmed by 31 procedures. Multiple site biopsies and close communication between the clinician and the pathologist were needed for early diagnosis of opportunistic infections. Twenty-two patients (88%) died, and the few survivors remain debilitated.

Surgical Pathology of Non-neoplastic Lung Disease

Director, Department of Pathology Lenox Hill Hospital Clinical Professor of Pathology College of Physicians and Surgeons of Columbia University New York, New York

Bracing the Anterior Cruciate Ligament Deficient Knee Using the Lenox Hill Derotation Brace

The Lenox Hill derotation brace fashioned by Castiglia and his staff at the Lenox Hill Hospital Brace Shop (New York, New York) under the direction of Nicholas during the 1960s has been worn successfully by thousands of patients with unstable knees, including elderly arthritic patients, adolescents with congenital instability, and professional athletes. Nearly 9000 braces were worn by patients in the United States during the period from 1976 to 1980. The brace, with its sliding axis of motion, corresponds to the axis of movement in the knee. The combination Lenox Hill brace includes not only the sliding axis of motion, but also a second below-knee leg pad, second derotation strap, and hyper-extension stop. It is designed to resist the combination anteromedial-rotatory, anterolateral-rotatory, and anteromediolateral-rotatory instabilities. More than 70% of the braces prescribed during the last five years have been the combination type. The derotation brace is a significant advance in brace designs for supporting chronic unstable and surgically reconstructed knees. It can function effectively even when the wearer is actively participating in sports.

Whatʼs Best for Willie?

SHIRLEY SHUFER, RN, PhD, is a mental health consultant in pediatrics at Lenox Hill Hospital in New York City and Vassar Brothers Hospital in Poughkeepsie, New York.

Tumors of the Ocular Adnexa and Orbit

This book presents the transactions of a symposium conducted in October 1977 at Lenox Hill Hospital in New York City. There are 30 contributors, with the majority of them being from the East Coast and many from New York City. The asset of this book is that a number of the contributors are not ophthalmologists, but are from other specialties such as radiology, radiotherapy, plastic surgery, otolaryngology, neurosurgery, dermatology, and anesthesiology. These participants add a great deal to the value of the book and especially to the discussions following each chapter. They bring a somewhat unorthodox and frequently controversial aspect to the diagnosis and management of orbital and lid tumors. While ophthalmologists frequently will disagree with their approach, nevertheless, it is interesting to hear another side. The ophthalmic contributions vary in quality. A number of the chapters are excellent summary statements, while others are too short to be of much

Comparison of pilcher bag technique with standard suprapubic prostatectomy

A total of 930 cases of open prostatectomies done at Lenox Hill Hospital from 1965 to 1974 are reviewed. The Pilcher bag technique utilized in 830 cases is compared with 100 cases of suprapubic prostatectomy with suturing of the bladder neck. Operating time, intra- and postoperative blood transfusions, hospital stay, and complications are compared. Operative time and intra- and postoperative blood loss are significantly less with the Pilcher bag technique.

High blood pressure control utilizing the traditional health care delivery system: Paul M. Zabetakis, Lenox Hill Hospital, 100 East 77 Street, New York, New York, 10021; Richard A. Matarese; Robert K. Novich; Michael F. Michelis

High blood pressure control utilizing the traditional health care delivery system: Paul M. Zabetakis, Lenox Hill Hospital, 100 East 77 Street, New York, New York, 10021; Richard A. Matarese; Robert K. Novich; Michael F. Michelis

Burrowing through blocked arteries with a balloon 'relocates' plaques

In the wake of the current controversy concerning the value of coronary bypass surgery, alternative methods for dealing with some forms of heart disease command special attention. So it is with the recently publicized use of a balloon catheter for "relocation" of plaque in the arteries to increase their patency. On June 15, 1978, the<i>New York Times, Time</i>magazine, CBS's Walter Cronkite, and the<i>International Herald Tribune</i>all reported on a "balloon which clears up heart arteries." A press conference on the subject had been held by Simon Stertzer, MD, head of the Hemodynamics Laboratory at New York's Lenox Hill Hospital. The four news articles tell the same story: A patient at Lenox Hill Hospital agreed to forego coronary artery bypass surgery to repair his clogged arteries and opted for percutaneous transluminal coronary angioplasty. In this procedure a small deflated balloon catheter is threaded through the narrowed artery and

TEACHING VIA THE PLAY-DISCUSSION-GROUP

SHIRLEY SHUFER, R.N., PH.D., is a psychiatric mental health nurse clinician at Lenox Hill Hospital, New York, New York.

Letter: Reset osmostat in hyponatremia.

Comments1 September 1976Reset Osmostat in HyponatremiaMICHAEL F. MICHELIS, M.D., F.A.C.P.MICHAEL F. MICHELIS, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-85-3-403_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The paper by DeFronzo, Goldberg, and Agus, "Normal Diluting Capacity in Hyponatremic Patients" (Ann Intern Med 84:538-542, 1976), proposes three criteria for the diagnosis of reset osmostat in patients with hyponatremia: a normal response to water loading, concentration of the urine when serum tonicity is raised above the reset level, and failure to correct the hyponatremia with salt loading.I wish to take issue with the last of these proposed criteria. One of the points emphasized in a recent report (1), cited by DeFronzo and associates, was that reset phenomena could be demonstrated in a patient with...Reference Reference1. MICHELISFUSCOBRADGON MRR: Reset of osmore-ceptors in association with normovolemic hyponatremia. Am J Med Sci 267:267-273, 1974 CrossrefMedlineGoogle Scholar1. DUNNBRENNANNELSON FTA: The role of blood osmolality and volume in regulating vasopressin secretion in the rat. J Clin Invest 52:3212-3219, 1973 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Nephrology Section Department of Medicine Lenox Hill Hospital New York, NY 10021 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 September 1976Volume 85, Issue 3Page: 403-404KeywordsAttentionHyponatremiaSaltsUrine Issue Published: 1 September 1976 PDF DownloadLoading ...

Critique.

Professor of Obstetrics and Gynecology, Cornell University Medical Center; Director, Obstetrics and Gynecology, Lenox Hill Hospital, New York, New York

News and Comment

<h3>Calendar of Events</h3> <h3>Oregon Academy of Ophthalmology and Otolaryngology.</h3> —The Academy will hold its 34th annual postgraduate convention at the Sheraton Motor Inn, Portland, March 14 and 15, 1975. Principal speakers for the ophthalmology section are F.C. Blodi, MD; K.D. Dolan, MD; J.R. Lynn, MD; and H. Schatz, MD. Their topics will deal with pathology of the orbit, abnormalities of the choroid and retina, glaucoma, and radiology of unilateral exophthalmos. This course has been approved for continuing medical education under the accreditation program of the American Medical Association. The fee for the course is $80 prior to March 7, $90 after that date. Residents are admitted without charge on presentation of a qualifying letter from their department heads. Further information may be obtained by writing to Miss Rebecca Tarshis, Executive Secretary, 918 NE 44 Ave, Portland, OR 97213. <h3>Uveitis Seminar.</h3> —The Department of Ophthalmology, Lenox Hill Hospital, will hold a

A mobile life support stretcher system

Despite the advantages of hospital Coronary Care Units, statistics indicated the number of fatalities from heart attacks were not reduced. Many victims of myocardial infarction and cardiac arrest died prior to arrival at the hospital. In order to provide mobile life support in cardiac emergencies a survival stretcher system was designed for use in a mobile Coronary Care Unit. The system was instituted and evaluated at Lenox Hill Hospital Emergency Department. After several months use, the stretcher was redesigned according to criticisms by Lenox Hill Staff and put into service for further evaluation. The stretcher provided the means for a minimum number of personnel to treat cardiac emergencies immediately and to monitor patients' conditions continually.

Carcinoma of the Parathyroid

Carcinoma of the parathyroid glands is a rare malignant neoplasm. The true incidence of this tumor cannot yet be determined due to the small recorded experience and the variable histologic criteria utilized in diagnosis. This report documents an example of parathyroid carcinoma followed for 14 years. It is the second longest recorded survival for a patient known to harbor this neoplasm. The tumor was initially considered to be a benign adenoma. The indolent course of the tumor over a period of 12 years is contrasted with a 2-year interval of extreme humoral activity culminating in death from uremia. The hormonal surfeit was of moderate severity as judged by the degree of hypercalcemia until shortly before the patient's death. Radioimmunoassay of plasma parathormone, however, indicated intense secretory activity. <h3>Patient Summary</h3> A 29-year-old white man was admitted to the Lenox Hill Hospital on Dec 21, 1953. The patient was in good health

Current Problems in Quality Control

Current Problems in Quality Control Get access Robert E. Wenk, M.D. Robert E. Wenk, M.D. Associate Pathologist, Lenox Hill Hospital, New York, N.Y., and Clinical Associate Pathologist, Columbia University College of Physicians and Surgeons. This paper was first presented to the New Jersey Society of Medical Technologists April 15, 7977, at Fairleigh Dickinson University. Search for other works by this author on: Oxford Academic PubMed Google Scholar Laboratory Medicine, Volume 2, Issue 12, 1 December 1971, Pages 28–30, https://doi.org/10.1093/labmed/2.12.28 Published: 01 December 1971

Primary Malignant and Benign Tumors of the Duodenum

Eighteen patients with primary tumors of the duodenum were seen at Lenox Hill Hospital from 1950 to 1968. Five tumors were benign and 13 were malignant. In our group of benign tumors, bleeding was common. Obstruction of the upper-intestinal tract also occurred but was less common. A palpable abdominal mass was rarely found. Other symptoms were usually secondary to associated diseases. Malignant tumors, on the other hand, almost invariably produced prominent findings. These included obstruction of the intestinal tract; persistent abdominal pain; bleeding; constitutional symptoms and signs of malignancy per se; a palpable abdominal mass; and, on occasion, jaundice. Properly executed roentgenographic study and techniques such as hypotonic duodenography and selected abdominal arteriography proved useful in diagnosis.

Staging, grading and histochemistry of ovarian epithelial tumors.

From the Department of Laboratories, Lenox Hill Hospital, and the Department of Pathology, College of Physicians and Surgeons of Columbia University, New York City

Spinal Cord Hypothermia Useful in Spasticity

A New York surgeon has found that spinal cord hypothermia appears to be a useful tool in the treatment of the spasticity and rigidity of cerebral palsy. Juan Negrin, Jr., MD, told the 32nd annual meeting of the American Academy of Orthopedic Surgeons that muscular spasticity and rigidity were relieved after lowering the temperature of intracranial structures or the spinal cord while the rest of the body remained normothermic. Negrin, of the Neurosurgical Service at Lenox Hill Hospital, New York, has applied local spinal cord hypothermia to only eight patients. All had had intensive physiotherapy and medication, but remained practically bedridden. Following therapy, all were significantly improved—some for as long as three and four years. The cerebral palsy patients ranged in age from 7 to 19 years. Five were mentally retarded while three were normal in this respect. The first patient was treated in early 1960 and remains improved. Several

The Angry Man

MISS ELLIOTT was a freshman student at the Lenox Hill Hospital School of Nursing, New York, N.Y., when she wrote this paper.