Performance-based evaluation of medical students' interviewing skills.
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Biomedical subjects
Publications and source records attributed to D Anderson.
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We report that interference with the cholesterol assay using the cholesterol oxidase: p-aminophenazone method which is observed during lipoprotein preparation, is caused by the anti-bacterial agent thimerosol used in the preparation. We suggest that an alternative anti-bacterial agent should be used in these circumstances.
The roles of B-mode real-time ultrasonic imaging (USI) and carotid angiography (CAG) in deciding on endarterectomy were analyzed. When greater than 50% stenosis and/or complicated ulceration were predicted by both techniques, endarterectomy was undertaken in 21/25; by only CAG in 5/8; and by only USI in 10/21. In vessels with adequate surgical data, stenosis was accurately predicted by CAG in 27/32, USI in 20/32, and ulceration by both CAG and USI in 21/29. USI results were sometimes used to justify endarterectomy despite unimpressive CAG. CAG is a better predictor of stenosis, whereas both are limited in predicting ulceration.
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From the annually examined sample of the Burlington Growth Centre, the 10% of the boys and girls with the largest, most open cranial base angles were contrasted with the 10% with the smallest, most closed cranial base angles at ages 4, 8, 12, and 16 years with respect to cranial length, width and height, cranial base length, mandibular condyle position, and Angle Class of occlusion. Both groups had crania of similar length, width, and cephalic index, and similar anterior cranial base length. The children with the flattest cranial bases had significantly larger upper cranial height, but much smaller lower cranial height, and as a result had smaller total cranial height than the children with the most closed cranial base angles. Children with the flattest cranial bases had a slightly shorter posterior cranial base region, and the mandibular condyles were located further backward and upward. These children showed a strong tendency to Class II molar relationships. The condyles of the closed cranial base angle groups were more forward and downward, but none of the children had Class III occlusions, and most were normal or Class I. These results do not support the views of Weidenreich (1943, 1945, 1946, 1947), Enlow with others (1973, 1975, 1980) and Lavelle with others (1977, 1979), but agree with the findings of Björk (1955) in 20-year-old males.
The authors examined 200 consecutive patients with pituitary adenomas admitted to the neuroendocrine service at the Montreal General Hospital between 1976 and 1981. The main presenting signs and symptoms were amenorrhea/impotence (70%), headache (46%), and typical acromegalic or cushingoid features (28%). Only 9% had visual field defects, 2% had optic atrophy, and 1% had ocular motility problems. A comparison of our findings with four previous studies has demonstrated an increasing incidence of reproductive system abnormalities and a decreasing incidence of visual abnormalities in patients with pituitary tumor. The reasons for this changing pattern are discussed and the role of the ophthalmologist in the care of these patients is redefined.
This article presents the rationale, selection, operation, and quality control of the Central Serum and Central Bile Laboratories utilized by the National Cooperative Gallstone Study. The external quality control protocols were designed to monitor long-term stability of the analytical procedures and to measure the precision of the measurements as affected by the collection, labelling, storage, shipping, and laboratory methods. For both laboratories, the assessment of long-term stability by pool standards failed to produce the data necessary to come to relevant conclusions. Several of the problems involved, however, did lead to protocol changes that increased the reliability of the laboratory data. The use of duplicate measurements to monitor precision was more successful and demonstrated acceptable performance of these systems. This article describes the external quality control surveillance procedures employed in the NCGS, their strengths and weaknesses, statistical methods for the analysis of such quality control programs, and the implications for the final statistical analyses of the clinical trial patient data.
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Thirteen of 14 tumor cells or tumor cell lines of guinea pig, mouse, and human origin spontaneously shed procoagulant activity in short-term (4 or 14 to 22 hr) tissue culture under conditions of high cell viability. This released procoagulant activity was pelletable in the ultracentrifuge and was associated with plasma membrane-derived vesicles as determined by transmission electron microscopy and marker enzyme analysis. The procoagulant activity shed corresponded to a substantial fraction of that expressed by intact or sonicated tumor cells and was composed of activities interacting at more than a single step in the clotting sequence. One procoagulant activity associated with shed human tumor vesicles behaved as tissue factor, requiring Factor VII for activity and being inhibited by a specific anti-bovine tissue factor antibody. Guinea pig tumor vesicles also exhibited tissue factor-like activity in a two-stage assay using homologous first-stage Factor VII/X concentrate. None of the human vesicles tested expressed a direct Factor X cleaving activity, independent of Factor VII. Shed tumor vesicles also acted at a second step late in the clotting cascade at the level of prothrombinase generation, presumably by providing a phospholipid surface. Taken together, these data indicate that a wide variety of tumor cells release plasma membrane vesicles with procoagulant activity. Such vesicles, as well as intact tumor cells themselves, may play an important role in the biology of tumor growth by inducing the local fibrin deposits found in association with many solid tumors.
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