The Educational Commission for Foreign Medical Graduates: global efforts in graduate medical education

In addition to its certification programme, which assesses the readiness of foreign medical graduates to enter graduate medical education programmes in the USA, the Educational Commission for Foreign Medical Graduates (ECFMG) is involved in a number of other programmes in international medical education. These include: (1) continuing to provide sponsorship for exchange visitors in graduate medical education programmes in the USA; (2) the development of a clinical skills assessment that is currently being introduced in pilot projects in the USA and abroad and will eventually become a component of the ecfmg certification process; (3) funding and administration of two fellowship programmes that provide foreign scholars (clinicians and basic scientists) with the opportunity to spend up to one year in a US medical school; (4) collaboration with the World Health Organization on the upcoming revised edition of the World Directory of Medical Schools ; and (5) co-sponsorship, with the World Health Organization, of a consultation on quality medical education oriented towards attaining a global consensus on the definition and the elements of quality in medical education and on the most appropriate ways to evaluate quality.     

Results of treating pseudarthrosis and leg bone defects caused by osteitis]

The results of treatment of 17 patients--8 cases of leg bones defect due to osteitis and 9 cases of leg pseudoarthrosis has been presented. The osteosynthesis of the fragments was done with the use of Zespol fixator. In 14 patients the lesion has healed and satisfactory function of the extremity was restored.     

Retinal detachment in pseudophakia

Retinal detachment in an aphakic eye is a grave therapeutical problem. There exists some fears that cataract extraction with implantation of an artificial lens may increase the number of these complications. Three hundred and seventy cases of cataract extraction with implantation of an artificial lens performed in our department were analysed from the point of view of the incidence of retinal detachment. The cataract was extracted extra- and intracapsularly and the artificial lens was implanted in the anterior as well as in the posterior chamber. During the period of observation--4 months to 3 years--it was established that the number of the retinal detachment in pseudophakia was not larger than in aphakic eyes without implant.     

Hip joint development after closed reduction, complicated by growth disturbance of the capital femoral epiphysis]

The purpose of the study was to assess hip joint development after the treatment of DDH with overhead traction and closed reduction complicated by growth disturbances of the proximal femoral epiphysis. Comparison was also made between joints affected by AVN and other treated joints. Antero-posterior radiographs of 107 hip joints (81 children) done during treatment and follow-up were retrospectively reviewed. The average age was 14.2 months (from 5 to 33 months) and age at the final follow up 20.7 years (minimum 14 years). AVN was detected in 31 (29%) of the hip joints. Type II necrosis according to Bucholz and Ogden classification system was the most common one. In the hips affected by growth disturbances of proximal femoral epiphysis there were worse final clinical and radiological results, osteoarthrosis and elongation of acetabulum were more often seen in comparison to other treated joints. There was no difference in terms of other parameters describing acetabulum. In 19 out of 31 cases deformity of femoral head was noted. AVN may present as a wide spectrum of pathology from mild, probably not significant growth disturbances of physis to severe deformity and lateralisation of femoral head. Statistically hips with AVN had worse final results and in cases with good congruity prognosis is often uncertain due to aspherical femoral head and secondary osteoarthrosis. Acetabular development is most often unaffected by AVN.     

Dialyzable factors from uremic serum increase 125I-fibrinogen binding by normal blood platelets

The influence of uremic serum on 125I-fibrinogen binding by normal blood platelets after induction with adenosine diphosphate was evaluated. The study was performed on 12 hemodialyzed uremic patients. The control group included 12 healthy subjects. It has been demonstrated that the uremic serum from the patients before hemodialysis significantly augmented fibrinogen binding by normal blood platelets (33.8 +/- 11.8%) in comparison with control subjects (14.4 +/- 8.9%). After hemodialysis, fibrinogen binding was comparable with the control group (14.9 +/- 10.1%). Uremic toxins removable during hemodialysis are probably responsible for the potentiation of 125I-fibrinogen binding by platelets.     

Synthesis and some biological properties of the hexapeptide analog of substance P with a C-terminal thioamide group.

A new hexapeptide analog of Substance P, containing a C-terminal thioamide group in the molecule [( Glp6, Mett11]SP6-11) was synthesized: Glp-Phe-Phe-Gly-Leu-Mett-NH2. Conversion to thioamide was accomplished from tert-butoxycarbonyl-L-methionine amide (Boc-Met-NH2) using Lawesson's Reagent. Its contracting activity on isolated guinea-pig ileum was considerably lower than that of [Glp6]SP6-11.     

Study of risk factors in invasive cancer of the corpus uteri

With the application of the case-control method, 173 patients suffering from invasive cancer of the corpus uteri (plus 346 women not suffering from this type of cancer and any type of neoplastic disease who formed control group) were analyzed. High incidence risk was ascertained for women who suffered previously from various diseases of reproductive organs, circulatory system, thyroid, diabetes, certain diseases of alimentary, urinary and also respiratory tract. Tobacco smoking together with the immediate exposure to dusts and gases in the microenvironment of work does not influence the increase of incidence risk of this organ, but certain type of diet which can be characterized by the high consumption of meat, animal fat and sugar with the lack of raw vegetables in diet influences the incidence risk of invasive cancer of the corpus uteri.     

Auranofin modulates gelatinase release from rat neutrophils

We have examined the effects of auranofin and some nonsteroidal anti-inflammatory drugs (NSAID) on the release of gelatinase from rat neutrophils. Two preparations of neutrophils were used, one derived from normal blood and the other from the inflamed pleural fluids of carrageenin-elicited pleurisy. Both neutrophil preparations released gelatinase in response to stimulation by serum-treated zymosan (STZ) or concanavalin A (Con A). Control, blood-derived neutrophils exposed to STZ produced more than a four-fold increase in the release of gelatinase, a response significantly inhibited by the presence of auranofin at 10(-5) and 10(-4) M. Inflamed, pleural neutrophils exposed to STZ produced a doubling in gelatinase release and this was also inhibited by auranofin at 10(-5) and 10(-4) M. The release of gelatinase by control neutrophils (no stimulation) or by neutrophils exposed to Con A was enhanced by 10(-6) M auranofin. In contrast, the NSAIDs aspirin, piroxicam, sulindac, indomethacin and naproxen had no inhibitory action on neutrophil gelatinase release. We conclude that auranofin is an effective inhibitor of gelatinase release from neutrophils and this property may represent a contributory factor assigned to the beneficial therapeutic action of gold salts.