Peribursal fat plane of the shoulder: anatomic study and clinical experience

A comprehensive anatomic and radiographic analysis of the peribursal fat plane in 12 cadavers confirmed that the fat plane seen on radiographs represents extrasynovial fat lining the subacromial bursa and documented the anatomic relations of the bursa. A three-part retrospective clinical evaluation of rotator cuff tears, calcific tendinitis, and rheumatoid arthritis was performed. Two osteoradiologists blindly graded the appearance of the peribursal fat plane with the shoulder in external versus internal rotation in 21 patients with arthrographically intact rotator cuffs and 21 patients with disrupted rotator cuffs. The peribursal fat plane was seen better with disrupted rotator cuffs. The peribursal fat plane was seen better with the shoulder in internal rotation and was seen in 60% of control subjects but only 21% of patients with rotator cuff tears. Partial or complete obliteration of this fat plane is a sensitive (79%) but less specific (60%) indicator of rotator cuff tears. Obliteration of the peribursal fat plane by inflammatory processes in adjacent tissues, including calcific tendinitis and rheumatoid arthritis, occurred with a high frequency.     

Computed tomography in obstetrics and gynecology.

Computed tomography (CT) has become essential in the diagnostic evaluation of the female pelvic. CT allows accurate delineation of neoplastic and inflammatory processes and provides an effective means of guiding percutaneous needle biopsy of masses and aspiration/drainage of fluid collections. In the pregnant woman, pelvimetry and excretory urography can be performed using the CT scout view with a radiation dose significantly lower than with conventional x-ray techniques. This paper covers the clinically relevant technical considerations involved in performing CT on women and follows with an overview of normal female pelvic anatomy and frequently encountered pathologic conditions.     

Craniofacial screening profile: quick screening for congenital malformations.

The correct identification of syndromes and other congenital malformations at an early age is critical for the child, family and care providers. Most specialists who conduct large screenings of young children are not adequately trained to recognize signs and symptoms that should lead to appropriate referral to the clinical geneticist and/or diagnostic team. A systematic approach for recognizing important signs is presented here; a Craniofacial Screening Profile. Following a brief training program, the Profile was validated by 39 speech-language pathologists in screening 3,539 kindergarten and first grade children. The results were excellent (specificity was 99.6%), demonstrating that with limited training, specialists can effectively screen for important signs and symptoms of a major group of syndromes and other congenital malformations.     

Early Teenage Substance Use as a Predictor of Educational-Vocational Failure

The authors report on the relationship of early adolescent substance use (up to the time of the 16th birthday) to educational-vocational performance in the early adulthood of 612 African-American urban subjects. Voluminous prospective data were available on the behavior, test performance, and families of 612 urban African-American subjects, from birth up to 7 years of age. Scarcer prospective data were available for school performance during later years of school. Control variables were derived from these data to determine the amount of variance in each dependent educational-vocational outcome variable that was accounted for, independently of the amount of variance accounted for by early substance use. (American Journal on Addictions 1994; 3:325–336)     

Helping families of homicide victims: A multidimensional approach

Homicide inflicts massive injury upon the intrapsychic and interpersonal realities of the surviving kin of murder victims. A New York City pilot program of outreach and counselling to 1182 families of Brooklyn homicide victims suggests that surviving kin undergo the symptoms of traumatic stress disorder. Recovery is prolonged by knowledge that the perpetrator is usually alive and in some cases unpunished, by repetitive confrontations with the criminal justice system and by the multiple losses endured: loss of a family member, loss of illusions of safety and invulnerability, loss of a sense of trust in the surrounding community, and loss of a belief system. Effective help to survivors requires interventions that respond to all aspects of the survivors' losses.     

Memory encoding and retrieval in the aging brain.

Decline in episodic memory, the encoding and retrieval of autobiographical events, is a hallmark of normal cognitive aging. Although the primary causes of this decline remain elusive, event-related brain potential (ERP) studies have contributed to an understanding of age-related episodic memory failure. These data reveal that, although the retrieval-based episodic memory (EM) effect does not differ dramatically between young and older adults, the acquisition-related data suggest a decline in episodic encoding (i.e., semantic elaboration) with increasing age. We conclude that, at the current state of knowledge, encoding deficiencies are more important than retrieval deficits in understanding the causes of episodic memory decline in the older adult.