A computerized system for processing spin-echo magnetic resonance (MR) imaging data was implemented to estimate whole brain (gray and white matter) and cerebrospinal fluid volumes and to display three-dimensional surface reconstructions of specified tissue classes. The techniques were evaluated by assessing the radiometric variability of MR volume data and by comparing automated and manual procedures for measuring tissue volumes. Results showed (a) the homogeneity of the MR data and (b) that automated techniques were consistently superior to manual techniques. Both techniques, however, were affected by the complexity of the structure, with simpler structures (eg, the intracranial cavity) showing less variability and better spatial correlation of segmentation results between raters. Moreover, the automated techniques were completed for whole brain in a fraction of the time required to complete the equivalent segmentation manually. Additional evaluations included interrater reliability and an evaluation that included longitudinal measurement, in which one subject was imaged sequentially 24 times, with reliability computed from data collected by three raters over 1 year. Results showed good reliability for the automated segmentation procedures.

Body Fluid Compartments↗

PubMedDate not supplied

The 1990 census: how good is it?

"This article evaluates the 1990 [U.S.] census in light of its constitutional functions and the demographic history of the United States. It provides some principles which may be used to judge the quality and adequacy of the census." The focus is on the importance of the accuracy of census data for the reapportionment of Congress and of state and local legislative bodies, and for estimating the number of residents in poor inner-city neighborhoods.

Americas↗

PubMedDate not supplied

Enhancing the health of somatization disorder patients. Effectiveness of short-term group therapy.

To identify an effective method of treating patients with somatization disorder (SD), the authors conducted a randomized controlled clinical trial of group therapy with 70 SD patients. Primary care physicians treating all patients in the study received a consultation letter offering treatment recommendations for SD. The experimental patients were invited to attend eight group therapy sessions in addition to the consultation provided to their physicians; 45% attended one or more sessions. The experimental patients reported significantly better physical (P < 0.05) and mental (P < 0.01) health in a 1-year period during and after group therapy. The more group sessions SD patients attended, the greater the improvement in general and mental health. The 52% net savings in health care charges associated with group therapy plus the consultation indicate that it is economically feasible to improve outcomes without escalating the cost of care in this group of high users of medical resources.

Adaptation, Psychological↗

PubMedDate not supplied

Effect of mycophenolate mofetil on the Anti-CMV serologic response after renal transplantation.

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Adult↗

PubMedDate not supplied

A sympathetic ear.

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Aged↗

PubMedDate not supplied

And the band played on.

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Aged↗

PubMedDate not supplied

Social, ethical and practical aspects of perinatal substance use.

Substance use in pregnancy has garnered increasing attention over the last decade as a particularly concerning facet of the larger national drug problem. This concern stems from the unique circumstance presented by pregnancy, in which the fetus may suffer harm as a result of maternal behavior. Furthermore, organizing a response to this problem is complicated by the ethically and legally challenging nature of the maternal-fetal relationship. The medical implications of perinatal substance use are profound. A discussion of these associated medical and obstetrical complications lies outside the focus of this paper, and the reader is referred to other reviews (Andres & Jones, 1994; Robins & Mills, 1993). This article is intended to assist obstetricians and others in their approach to the substance using pregnant patient. We first review the scope of this problem in social and financial terms and then review the important ethical and legal issues involved in current policymaking. Lastly, we suggest a clinical intervention focusing on education and improvement in identification and management of this subset of patients.

Adolescent↗

PubMedDate not supplied

Plasma separation using a hollow fiber membrane device.

A disposable hollow fiber device was evaluated by collecting approximately 550 ml of normal donor plasma (n = 43) and by performing sham (n = 10) and therapeutic (n = 12) plasma exchanges. Blood was processed at 70 ml per min, and plasma flux averaged 23 (collection) and 25 (exchange) ml per min (mean separation efficiencies of 52 and 60%, respectively). The procedures were tolerated well by all donors and patients. The plasma hemoglobin concentration in separated plasma averaged 1 mg per dl, and cell contamination was negligible (mean of 1, 3, and 6 RBCs, platelets and WBCs/microliter, respectively). There was no evidence of in vivo classical or alternative pathway complement activation as assessed by total hemolytic complement generation (CH50), alternative pathway hemolytic activity (AP50), C3 conversion, or C5 activation, nor were unexpected changes seen in the results of laboratory tests performed after the procedure. Sieving coefficients during sham plasma exchange averaged as follows: albumin, 1.03; IgM, 1.0, IgG, 1.0; IgA, 0.98; factor V, 1.07; factor VII, 0.89; factor VIII, 1.05; and factor IX, 1.19. The device appears to be useful for separation of cell-free plasma from blood during therapeutic plasma exchange procedures.

Blood Component Removal↗

PubMedDate not supplied

Evidence of direction loss in elderly movement preparation is not due to spatial orienting effects.

Twenty elderly and young subjects performed matched movement plan restructuring and spatial orienting tasks. In the restructuring task, a precue stimulus was presented for 200 ms, followed by a preparation (PI; 250, 500, 1000, or 2000 ms), and the target stimulus. On 75% of the trials, the precue specified the aiming movement response enabling movement plan preparation concerning parameters of arm and direction. On 25% of the trials, the precue incorrectly specified the response requiring movement plan restructuring. The orienting task assessed shifts in perceptual localization of the precue and target stimuli for restructuring task conditions. At PIs of 1000 and 2000 ms, elderly, but not young, subjects restructured a movement plan for direction more quickly than for arm or both parameters. Spatial orienting shifts did not account for these effects.

Adolescent↗