An examination of role identification by students in health education and health services administration

This research was designed to test the extent to which health education and health services administration students' perceptions of their roles as professionals matched the expectations of professional faculty. These perceptions were found to match in general. However, doubt was cast on the extent to which internships or practicums contributed to this result, since there was no change in student responses between the beginning of the junior year and end of the senior year, a period which includes fieldwork and most of the professional coursework presumed to influence professional development. Additional research is required to test this result with other student populations in other health professions and identify the point at which professional role and task definitions are amenable to change.     

Rapid 31P spectroscopy on a 4-T whole-body system

Initial 31P spectroscopy results from a 4-T whole-body system are reported. Localized spectra from the human head, liver, and calf were obtained using DRESS, slice-interleaved DRESS, and volume 3DFT spectroscopic imaging techniques. Substantial reductions in data acquisition times to 10 s-4 min were achieved relative to previous similar experiments at 1.5 T. Some gain in spectral resolution (as measured in ppm) was also realized in the head.     

Shoulder instability: impact of glenohumeral arthrotomography on treatment

We used arthrotomography to study the glenoid labrum in 114 patients. Sixty-nine of the patients had anatomic instability of the shoulder (including recurrent dislocation and subluxation of the shoulder), and 45 patients had functional instability of the shoulder (denoted by chronic pain, clicking of the joint, and the sensation that an unstable condition exists without the objective signs of it). Labral tears were revealed arthrotomographically in 86% of the patients with anatomic instability, while only 40% of the patients with functional instability had labral abnormalities, and these were primarily of minor severity. Fifty-six patients (44 of whom had anatomic instability; 12, functional instability) required surgery. The surgical findings were correlated with the arthrotomographic findings, and no false-positive results were revealed. However, arthrotomography demonstrated only part of the pathologic condition of two patients. These results confirm that there is a strong correlation between labral pathologic conditions and anatomic instability of the shoulder. Arthrotomographic studies have a great impact on the selection of therapy in cases of both anatomic and functional instability of the shoulder.     

Linkage of the MHC to familial multiple sclerosis suggests genetic heterogeneity. The Multiple Sclerosis Genetics Group

Multiple sclerosis (MS) is a demyelinating autoimmune disease of the central nervous system. While its etiology is not well understood, genetic factors are clearly involved. Until recently, most genetic studies in MS have been association studies using the case-control design testing specific candidate genes and studying only sporadic cases. The only consistently replicated finding has been an association with the HLA-DR2 allele within the major histocompatibility complex (MHC) on chromosome 6. Using the genetic linkage design, however, evidence for and against linkage of the MHC to MS has been found, fostering suggestions that sporadic and familial MS have different etiologies. Most recently, two of four genomic screens demonstrated linkage to the MHC, although specific allelic associations were not tested. Here, a dataset of 98 multiplex families was studied to test for an association to the HLA-DR2 allele in familial MS and to determine if genetic linkage to the MHC was due solely to such an association. Three highly polymorphic markers (HLA-DR, D6S273 and TNFbeta) in the MHC demonstrated strong genetic linkage (parametric lod scores of 4.60, 2.20 and 1.24, respectively) and a specific association with the HLA-DR2 allele was confirmed (TDT; P < 0.001). Stratifying the results by HLA-DR2 status showed that the linkage results were limited to families segregating HLA-DR2 alleles. These results demonstrate that genetic linkage to the MHC can be explained by the HLA-DR2 allelic association. They also indicate that sporadic and familial MS share a common genetic susceptibility. In addition, preliminary calculations suggest that the MHC explains between 17 and 62% of the genetic etiology of MS. This heterogeneity is also supported by the minority of families showing no linkage or association with loci within the MHC.      

Invasive fungal sinusitis and meningitis due to Arthrographis kalrae in a patient with AIDS

We report the first described case of Arthrographis kalrae pansinusitis and meningitis in a patient with AIDS. The patient was initially diagnosed with Arthrographis kalrae pansinusitis by endoscopic biopsy and culture. The patient was treated with itraconazole for approximately 5 months and then died secondary to Pneumocytis carinii pneumonia. Postmortem examination revealed invasive fungal sinusitis that involved the sphenoid sinus and that extended through the cribiform plate into the inferior surfaces of the bilateral frontal lobes. There was also an associated fungal meningitis and vasculitis with fungal thrombosis and multiple recent infarcts that involved the frontal lobes, right caudate nucleus, and putamen. Post mortem cultures were positive for A. kalrae.     

Somatosensory Evoked Potential Changes With a Selective Attention Task

Somatosensory evoked potential (SEP) changes associated with selective attention were investigated. In 16 subjects, SEPs were recorded from five locations while they counted electrical stimuli to one of four randomly stimulated fingers. Sequential SEP events measured included peaks P30 (positivity at 30 msec). P45, N60, P100. N140. P190. N230, P400. Counting was associated with greater P45, P100. P190, N230, and P400 amplitudes; effects were not attributable to eye or tongue activity. Analyses designed to reveal changes associated with two conceptualized “channels” (finger class, hand) showed that the P45, P100, and P190 amplitude increases involved both channels. The P400 effect was limited to the target finger. Channel effects for N60 and N140 amplitudes resulted from decreases localized to the unattended element of one channel, suggesting “inhibition.” Latency effects involved mainly the hand channel; counted hand latencies were shorter for P30, P45, P100 and P190. The findings indicate modifications of both early and late electrocortical events with selective attention, and that changes can be of several kinds. They support the view that attention proceeds in more than one stage.     

The inferior alveolar artery in its bony course

Based on the dissection of 30 hemi-mandibles, the authors report a study of the inferior alveolar artery in its intraosseous course. On morphologic considerations they propose a classification of the collaterals into two groups: the principal collaterals destined for the teeth and the bony alveolar tissue and the secondary collaterals destined for the sheath and the nerve as well as the bony tissue around the canal. Loss of the teeth and absorption of the alveolar bone modify the caliber of the inferior alveolar arterial axis, the distribution of its collaterals and possibly its mode of termination. These facts suggest a consideration of the vascularization of the mandible in terms of four sectors. They arrive at practical conclusions that may be drawn from this study in stomatology.