Proximal femoral focal deficiency: radiologic analysis of 49 cases

Proximal femoral focal deficiency, an uncommon congenital anomaly, necessitates early radiologic classification for surgical planning and treatment. Objective radiographic criteria, including femoral length index, acetabular depth index, acetabular angle index, and shape of the proximal femur were determined in 49 patients before cartilaginous ossification of the femoral capital epiphysis; final classification was based on follow-up radiographs or findings at arthrography or surgery. These parameters were analyzed to determine the accuracy and contributions of each in classification. Correct classification into one of three groups was possible in 86% of cases with use of three of the parameters: femoral length index, acetabular depth index, and shape of the proximal femur. The acetabular angle was found to contribute insignificantly to classification. Magnetic resonance imaging, used in only one case, depicted the nonossified cartilaginous femoral capital epiphysis, thus obviating the need for invasive diagnostic procedures and facilitating early classification.     

Ejection fraction by combined inverse Fourier analysis and second-derivative technique: Correlation with isocontour method

Summary In order to measure ejection fractions (EFs) from nuclear ventriculograms, we devised a semi-automated edge-detection technique based on a combination of inverse Fourier analysis and second-derivative techniques. Initial clinical studies showed that, for the left ventricle, our method gives EF values statistically identical with those obtained using a conventional isocontour technique. For the right ventricle, however, the values obtained using the two methods were somewhat more at variance. Despite requiring a longer processing time, the results obtained with our method are reproducible because less operator intervention is necessary.     

Leadership in action: students learn with resource persons

The faculty maintain close contact with the resource persons and are aware of their interaction with students on a weekly basis. Faculty and resource persons exchange observations, assessments, suggestions and problems they have either anticipated or experienced. The resource persons report that as students gain from the experiences, so do they. In particular, resource persons state interactions with students have stimulated them to increase their own clinical inquiry. A head nurse, functioning as a resource person, recently told the members of the Nursing Curriculum Committee she wished she had had such a course seven years ago when she was a senior in the program (S. Collier, personal communication, October 1987). She further elaborated that the learning opportunities she sees students experiencing today would have been invaluable to her and her peers as they began their professional nursing careers. We, the authors, believe individual learning opportunities with nurse leaders as resource persons is a unique, invaluable experience for nursing leadership students. These interactions provide a variety of learning opportunities sufficient for undergraduate students to develop beginning leadership skills, while also narrowing the education-practice gap. These experiences enhance the students' orientation to "real-world" nursing leadership and management. Students recognize the uniqueness of this teaching-learning strategy and value the time spent with resource persons. They frequently report never dreaming "that such problems have to be dealt with." They agree that learning with resource persons provides an essential ingredient for reinforcing the theoretical concepts of nursing leadership and putting classroom lectures into action.     

A Comparison of DEF X-Ray Film and a Photodiode Array (Reticon) as Detectors for an X-Ray Crystal Spectrometer

A crystal spectrometer with a photodiode array (PDA) detector was tested for a range of x-ray energies between 1 and 2 keV. A laser-produced plasma has been used as an x-ray source and was generated by the high-power (Vulcan) glass laser system at the SERC Rutherford Appleton Laboratory, UK. The performance of the array was directly compared with the response of Kodak DEF x-ray film. In order to compare quantitatively the performances of the PDA and the film, detective quantum efficiency (DQE) considerations are presented for both devices. It is demonstrated that the PDA has a useful dynamic range which is approximately seven times greater than that of film, a peak DQE of approximately six times that of film, and a greatly superior low-signal performance. The operational characteristics of the PDA are discussed.     

Life expectancy in British Marfan syndrome populations

A total of 206 patients with Marfan syndrome were ascertained throughout genetic clinics in Wales and Scotland during the period 1970–1990. There were 45 deaths representing 22% of the cohort. Mean age at death was 45.3 ± 16.5 years. 50% median cumulative survival in the total cohort (n = 206) was 53 years for males and 72 years for females. Multivariate analysis confirmed severity as the best independent indicator of survival. These findings and survival curves will assist in the counselling of British families and individuals with Marfan syndrome.