Undergraduate ophthalmology education survey of New Zealand ophthalmologists, general practitioners and optometrists

Aim : To determine what New Zealand ophthalmologists, general practitioners and optometrists consider important ophthalmic topic areas requiring emphasis in the medical undergraduate curriculum. Method : A total of 793 questionnaires related to the content and teaching of undergraduate ophthalmology were sent to ophthalmologists, general practitioners and optometrists. Results were analysed separately for the three respondent groups and as a whole. Results : Four hundred and fourteen questionnaires were returned (52% return rate). Overall responses of the three participant groups were similar and agreed favourably with the current curriculum. The ability to measure visual acuity (97%) and pupillary reflexes (93%), perform ophthalmoscopy (92%), and assess visual fields (68%) were regarded as ‘important or essential’ by the majority of respondents. Only 53% of respondents consider the ability to diagnose chronic open angle glaucoma as important. The respondents stressed the importance of the diagnosis of predominantly anterior segment disease contrasting with the traditional bias towards the teaching of ophthalmoscopy and posterior segment disease. The majority of respondents stressed the importance of graduating medical students being able to treat bacterial and allergic conjunctivitis, styes, blepharitis, corneal abrasion, and corneal and conjunctival foreign bodies, areas present but not normally emphasized in current curricula. Conclusion : The findings of this study provided additional data to facilitate curriculum design and illustrated the value of an integrated problem‐based learning approach in ophthalmology undergraduate teaching.     

The Diurnal Variation of the Serum Iron Concentration

Observations made in an investigation of the diurnal variation of the serum iron concentration suggested that the diurnal variations of serum iron can be explained as a phenomenon secondary to the diurnal variation of the hemoglobin metabolism. This hypothesis is supported by parallel changes in the bilirubin and serum iron values.     

自身免疫甲状腺病循环和甲状腺内细胞毒性T细胞(T_8/S_6F_1)的实验研究

应用新型单克隆抗体T_8/S_6F_1和流体细胞测定仪双色荧光程序检测了15例Graves病和8例Hashimoto甲状腺炎患者循环和甲状腺内的细胞毒性T细胞(cytotoxic T ceils,Tc)的分布。传统的单克隆抗体CD_8(OKT_8或Leu_2)仅能检测含有两个次亚群——抑制性T细胞(Ts)和细胞毒性T细胞(Tc)的Ts/TcT细胞亚群,不能将它们区别开来。本文应用的单克隆抗体T_8/S-6F_1首次能够单独测定Tc亚群。Graves病和Hashimoto甲状腺炎患者的循环Tc亚群分别为27.6±11.2％和27.5％±12.2％,与正常对照组差异无显著性。两组患者甲状腺内的Tc亚群数目也未见增加。Graves病患者甲状腺内Te细胞为16.45±4.7％。本文结果提示:AITD患者循环内和甲状腺内的细胞毒性T细胞亚群的数目未见增加。     

Development of an Instrument to Assess Stress Levels and Quality of Life in Children with Asthma

The purpose of this study was to develop and evaluate a new instrument, About My Asthma (AMA), to assess stressors affecting quality of life in children with asthma. The AMA is a 55-item, 4-point Likert-type scale. Concurrent validity was established by comparing the AMA with the Pediatric Asthma Quality of Life Questionnaire (PAQLQ). Increased levels of stress measured by the AMA correlated with a decreased quality of life measured by the PAQLQ. We conclude that the AMA is a valid and reliable instrument to measure the quantity and type of stressors experienced by children who have asthma.     

Magnetic resonance imaging of prosthetic heart valves

To evaluate the safety of magnetic resonance (MR) imaging of prosthetic heart valves, nine different synthetic and tissue valves were studied ex vivo. Deflection was measured in 0.35-tesla (T) and 1.5-T superconducting magnets and at the edge of the bore of a 2.35-T electromagnet in field gradients of 5, 1.1, and 6.3 mT/cm, respectively. No valve deflected in the 0.35-T magnet; six synthetic valves deflected 0.25 degrees-3 degrees in the 1.5-T magnet; all valves deflected 1 degree-27 degrees at the edge of the 2.35-T magnet. Each valve was then submerged in a vial of water and the temperature was measured immediately before and after each of two spin-echo imaging sequences in the two superconducting magnets. No significant temperature rise followed exposure in either magnet. Image distortion varied from negligible to severe in both imagers; magnitude of distortion paralleled magnitude of deflection. These data suggest that patients with present-day prosthetic heart valves can be safely imaged in present-day MR imagers and that prosthesis-induced artifacts will not interfere with interpretation in most instances.     

ECG-synchronized cardiac MR imaging: method and evaluation

An electrocardiographic (ECG) sensing and gating device compatible with a 0.35-tesla (T) magnetic resonance (MR) imager has been developed and used to produce 802 MR images of the heart in 30 patients. The instrument consists of an isolated acquisition module, an electrically floating preamplifier, and a monitor gating module. Two spin-echo images were acquired for each of five, 0.7-cm thick, transaxial sections from the base to the apex of the heart during each ECG-synchronized imaging run. Image quality was assessed in a blind study by two investigators, on a scale from 0 to 3, as diagnostic [2-3] or nondiagnostic [0-1]. There was agreement in 91.4% of their assessments of diagnostic images (68.1% of the images studied). Resolution of heart anatomy on the MR images was adversely affected by prolonged spin-echo time delay, imaging in late diastole, image acquisition at the cardiac apex, irregular triggering, and artifacts. The synchronization of gradient pulses to the ECG at 0.35 T appears safe for patients, permits diagnostic resolution of images, allows image acquisition at distinct points during the cardiac cycle, and enables monitoring of patients during imaging.